Chapter 5- Hormonal Imbalances

Hormonal issues and imbalances are common and come and go throughout our lives.   Like everything in medicine, health issues have varying degrees of severity and no two people respond to an issue or illness in the same way exact way.  If you believe that you have a women’s health or hormonal imbalance issue you should find a provider to work with you.  Below are some of the more common issues:

Common Hormonal Issues:

• PCOS: Polycystic ovary syndrome is a hormonal imbalance where an abnormally high level of androgenic hormones prevents the ovaries from producing hormones and functioning normally. It often causes missed or irregular periods, benign ovarian cysts, infertility, acne, excessive hair growth, and weight gain. Hormonal contraceptives are often prescribed to assist in treating the symptoms. Diet and exercise are key for those with this hormone imbalance.
• PMS: Premenstrual syndrome is described as the emotional and physical symptoms that appear a few days before and during menstruation. This includes depression, fatigue, bloating, trouble sleeping and irritability. It is extremely common and can come and go as hormones and life stages change.
• PMDD: Premenstrual dysphoric disorder is a severe and sometimes debilitating form of premenstrual syndrome (PMS). It is known to cause depression and anxiety especially during the luteal phase which typically lasts for half of the menstrual cycle. Hormonal contraceptives are often prescribed to assist in treating the symptoms. Depending on the situation and severity, additional medications such and SSRIs may be prescribed by a physician.

Sexually Transmitted Disease of Infections:

• Chlamydia: A very common bacterial infection which is usually easily treated with antibiotics. If left untreated, chlamydia can cause severe pelvic infections, infertility, and arthritis.
• Gonorrhea: A bacterial infection that is usually easily treated with antibiotics. If left untreated it can lead to severe pelvic infections, infertility, arthritis, and heart problems.
• Herpes: A common STD that is caused by a virus. Herpes simplex virus type one (HSV-1) presents on the mouth or genitals, while herpes simplex virus type two (HSV-2) presents on the genitals. There is currently no cure for either virus, but treatment options are available to control outbreaks. Genital herpes in the United States is common with over one out of every six people between the ages of 14-49 years having genital herpes. The virus can still be spread even if no skin lesions are visible and it is suggested to use male or female condoms consistently to decrease the risk of spreading the virus to sexual partners.
• HIV/AIDs: Human immunodeficiency virus is a chronic virus that breaks down the immune system leaving the person more vulnerable to other infections and diseases. If left untreated it can cause acquired immunodeficiency syndrome or AIDS for short. It is suggested to use male or female condoms to assist in not spreading the virus to sexual partners as well as having your partner talk to their provider about pre-exposure prophylaxis (PrEP) medications.
• HPV: Human papilloma virus is the most common STD in the world. HPV has several viral strains, and while most go away on their own, others can cause genital warts or cancer of the anus, cervix, penis, throat, or vulva. The HPV vaccination is available and recommended for those over 11 years of age.
• Syphilis: A bacterial infection that is easily cured with antibiotics. If left untreated it can cause permanent damage including vision problems or blindness, permanent neurological damage, and even psychiatric illness.

Women’s Health Issues:

• Ectopic pregnancy: This is a pregnancy that develops outside the uterus, often in a fallopian tube and can be life threatening. It should be noted that no treatment is available to save the embryo, and treatment is necessary to save the patient.
• Endometriosis: A condition in which endometrial tissue (the tissue that lines the uterus) grows outside the uterus. This can lead to abdominal and pelvic pain, especially before and during menstruation, as well as infertility, and many additional rare complications. The only way to confirm and treat endometriosis is through laparoscopic surgery.
• Fibroids: A fibroid is a benign tumor that grows on the walls of the uterus. Although generally harmless, surgical removal is sometimes necessary. Fibroids can lead to excessive vaginal bleeding, infertility issues, as well as other rare complications.
• Ovarian Cysts: Are fluid-filled growths on an ovary that are usually benign (not cancerous). Ovarian cysts can cause lower abdominal pain as well as vaginal bleeding. They can rupture or lead to the twisting of the ovary (ovarian torsion) which can require medical treatment, but the cysts typically go away on their own without any complications or treatment necessary.
• Pelvic Inflammatory Disease (PID): PID is an infection in the uterus, fallopian tubes, and/or the ovaries. It is often caused by untreated STDs such as gonorrhea and chlamydia. PID can lead to infertility, ectopic pregnancy, chronic pain, and even life-threatening infections.
• Polyps: are small growths that are usually harmless. They are common in many parts of the body, including our sex organs, particularly the uterus and cervix. Sometimes they can cause problems, in which case they can often be removed. They may also be removed or biopsied to make sure they do not have pre-cancerous or cancerous cells.