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Hormones are biochemical messengers that are involved in numerous body processes. They influence, for example, the metabolism, cellular differentiation, behaviour and reproduction. The interactions between hormones are extremely complex and sensitive to disturbances. If there is too much or too little of a particular hormone, this upsets the hormonal balance and affects the whole system. Hormonal imbalance describes a condition in which the concentration of an individual hormone is either too low or too high or the function of the hormones at the corresponding receptors of the target cells is insufficient. In most cases, such an imbalance leads to further hormonal disorders as the different hormones influence each other.
Hormonal imbalance may cause diverse symptoms. These encompass, among others, fatigue, mood swings, sleep disorders, concentration issues and loss of libido. The causes of hormonal imbalance are just as manifold. Chronic stress, functional disorders of endocrine organs, environmental influences, medication and ageing processes of the body are just a few of the causes that should be considered.
In the case of symptoms that could be caused by hormonal imbalance, the determination of the levels of involved hormones and an overall assessment of the different results support the corresponding diagnosis. Here are a few examples:
Hormonal disorders in men are often associated with reduced androgen synthesis. The determination of testosterone in men is recommended in suspected cases of hypogonadism. In men with total testosterone levels near the lower reference range or in suspected cases of changed levels of sexual hormone-binding globulin (SHBG), the concentration of free testosterone should be taken into account.
In women, testosterone levels should be determined in the case of virilisation. An increased androgen concentration can be caused by tumours of the ovaries or the adrenal cortex, called congenital adrenal hyperplasia (CAS) or polycystic ovary syndrome (PCOS). Other signs of PCOS, in addition to virilisation, are an increased number of follicles in the ovaries and lack of ovulation. A lack of ovulation leads to a significant increase in the concentration of anti-Müllerian hormone (AMH).
Various other hormonal imbalances in women are the result of a reduced production of oestrogen, which leads to reduced sexual desire.
Chronic fatigue, on the other hand, can be caused by a decreased production of cortisol or an imbalance of the thyroid hormones.
International scientific associations such as the Endocrine Society provide guidelines for the diagnostics of many diseases associated with hormonal imbalance.
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