Table of Contents
Introduction
It has become more and more common for women to look for natural therapies to “cure what ails them”. As women age or experience changes in their bodies, many look for supplements to balance hormones. Hormone imbalance is often the root cause for many of the symptoms that are experienced.
There are a variety of reasons that women refuse hormone replacement therapy (HRT). We will discuss why an estimated 70% of women refuse HRT and explore natural ways to balance your hormones.
Hormone Production
The endocrine system is responsible for the production of all hormones in the body. The thyroid, adrenal, pituitary glands, and pancreas produce specific hormones that are released into the bloodstream. They act as chemical messengers to other organs and tissues.
Also known as the hormone system, the endocrine system regulates all biological processes from conception through advanced age (10). The largest endocrine organ in the body is the gut (1).
Hormone Imbalance
Hormone imbalances can occur for a variety of reasons. Premenstrual syndrome (pms), menopause, and thyroid disorders are some of the most common reasons.
It can be quite frustrating, because these imbalances may take a while to diagnose and treat. The root cause of the hormone imbalance may determine the symptoms that you experience.
Symptoms of hormone imbalance
This next part may come as no surprise. Unfortunately, during PMS women may experience an array of symptoms. These may include angry outbursts, anxiety, depression, irritability, abdominal bloating, breast tenderness, weight gain or headaches (8).
Additionally, women with hormone imbalance may experience polycystic ovary syndrome (pcos), infertility, and endometriosis (6). During menopause, the most common symptoms include hot flashes, osteoporosis, mood disorders, and weight gain (3,5).
Finally, individuals with thyroid disorders may experience inflammation, insomnia, mental, physical, and emotional fatigue, mood disorders, and autoimmune conditions (4).
Hormones and the Gut
You are going to want to pay attention to this next part. The gut produces and secretes over 20 different hormones. These hormones play an important role in metabolism, glucose response, appetite control and fat storage. They carry out their metabolic functions by interacting with various organs and tissues that are necessary for metabolism, such as the liver, pancreas, fat tissue and the brain (1).
Blood Sugar Balance
Gut hormones are required to maintain a balance in blood sugar by activating other organs that are involved in this process. Without this balancing act of glucose input and output, the risk of developing metabolic diseases such as type 2 diabetes and cardiovascular disease are increased (1).
Energy Balance
Energy intake is determined by the drive to eat and the rate at which nutrients are absorbed, while energy expenditure is determined mostly by how much energy is needed to maintain basic metabolic processes, such as maintaining body temperature, and voluntary activities, such as exercise.
This delicate balance between energy intake and output ultimately determines our body weight. When we have a surplus of energy, our body stores it as fat, and this is one key driver of obesity. Some gut hormones target this fat tissue for metabolism, helping our body utilize it for energy (1).
Satiety and Hunger
The gut brain axis sends signals between the gut and the brain to inform the brain of energy status, which creates either a feeling of hunger or fullness. This demonstrates the importance of how hormones and neurotransmitters that are found in the gut help control appetite and food intake.
For this reason, gut hormones offer a desired target in the treatment of overweight and obesity. Ghrelin, for example, is an appetite stimulating gut hormone that increases following weight loss, which explains why some individuals tend to regain weight after a period of dieting (2).
Nutrient Absorption
Nutrient absorption relies heavily on efficient digestion of food, which is regulated by gut hormones and optimized by the gut brain axis (1,2). Gut hormones send signals that start a cascade of events, one of which is the activation of digestive enzymes, that are critical in breaking down macronutrients so that they can be utilized by your body. Macronutrients are categorized as carbohydrate, protein and fat (1).
Conventional Treatments
Hormone Replacement Therapy (HRT)
More than 70 million women in the United States experience menopausal symptoms. In women with moderate or severe symptoms, HRT is generally the first line of treatment.
HRT is often considered the best option for therapeutic relief of menopausal symptoms, however many women refuse HRT for a variety of reasons, including but not limited to concern for cancer or other adverse effects, drug costs, dissatisfaction with conventional healthcare, a desire for more personalized medical care and the perception that “natural is good”.
Adverse effects of inappropriately dosed HRT include fluid retention, nausea, headaches, breast tenderness, bloating, leg cramps and vaginal bleeding, which may be why it has been reported that less than 30% of menopausal women take HRT and only 15% continue the therapy for a prolonged period of time (5).
Pharmacologic Treatments
Women experiencing premenstrual syndrome (PMS) suffer from symptoms similar to menopausal women, such as abdominal bloating, breast tenderness, and weight gain.
About 80% of women report at least one physical or psychiatric symptom during PMS. Psychiatric symptoms may include angry outbursts, anxiety, depression, and irritability. The primary treatment for women in the United States suffering from PMS is selective serotonin reuptake inhibitors (SSRIs) and other psychiatric medications such as Zoloft, Paxil, Prozac, Celexa, Lexapro, and Seroquel.
Some studies suggest that oral contraceptives also provide benefit when looking to treat psychiatric and physical symptoms of pms (8).
Alternative Treatments
While HRT is generally the first therapeutic option for menopausal symptoms, a majority of women choose not to use HRT and opt for a more natural approach, often seeking supplements to balance hormones.
On the other hand, nutraceuticals often lack clinical trials that demonstrate evidence-based results and are not regulated by the Food and Drug Administration (FDA).
Therefore, when choosing products, it’s important to pay close attention to good manufacturing practices, a guarantee for consistent, standardized composition and clinical studies to support effectiveness and safety (5).
Supplements to Balance Hormones
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There are a considerable number of vitamins, minerals, herbal derivatives, adaptogens and other natural therapies used to improve symptoms of hormone imbalance. For example, Ashwagandha, Magnesium and Vitamin C may reduce stress and anxiety, which are common symptoms when hormones are out of balance.
You may find it fascinating that Vitamin E may play a role in the prevention of hot flashes and sleep quality (5).
As we discuss five common supplements to balance hormones, please note that supplements alone will not be helpful if dietary and lifestyle are not also into considered.
Probiotics
Probiotics provide a host of benefits, including but not limited to gut health, mental wellness, immunity, and hormone balance. Some individuals may lean toward quick fixes because they aren’t sure how long it takes for probiotics to work.
Interestingly, probiotics may help with several symptoms of hormone imbalance. This includes weight stability, energy balance, fat deposition, inflammation, and protecting against autoimmune diseases (11).
Vitamin D3
Vitamin D is a hormone and a vitamin that is relatively inexpensive, yet gives a lot of bang for the buck. It may reduce metabolic syndrome risk, hypertriglyceridemia and hyperglycemia in vitamin D deficient women.
Interestingly, calcium and phosphate absorption requires Vitamin D, which is necessary for bone mineralization and helps with appetite control, insulin sensitivity, metabolism and keeping the stress hormone, cortisol, from becoming elevated (5).
Currently, a large amount of research is being done on the effects of Vitamin D3 and its protective effects from the COVID-19 virus. Most multivitamins do not offer adequate amounts of Vitamin D to experience beneficial effects (12).
Omega 3
Omega 3 fatty acids are precursors to eicosanoids, locally produced hormones, that are important in the prevention and treatment of various diseases, particularly in women. Some studies report that omega 3 may help prevent preeclampsia, postpartum depression, menopausal problems and post-menopausal osteoporosis (14).
Omega 3 may also be a recommendation for the treatment of PCOS with insulin resistance. Unfortunately, this is one of the most common endocrine disorders in women (13). Additionally, omega 3 has powerful anti-inflammatory properties.
Selenium
Supplementation of the micronutrient, selenium, has an association with improvement of thyroid antibodies and improved quality of life in patients with autoimmune thyroiditis. The thyroid requires selenium for antioxidant function and metabolism of thyroid hormones.
Selenium supplementation may improve immune function, even in individuals that are not deficient in the micronutrient. Interestingly, consuming too little or too much selenium may result in adverse outcomes. Therefore, supplementation is generally only for patients with a true selenium deficiency (17).
Vitamin B12
A deficiency in B12 may present itself as impaired memory, dementia, depression or anemia. Therefore, vitamin B12 is essential for every aspect of brain function. Early supplementation may prevent long term consequences of B12 deficiency, such as cognitive impairment.
Deficiencies in B12 may also result in a folate deficiency, as these two vitamins are linked to each other. Vitamin B12 also plays a key role in generating energy within the cells (15, 16).

Conclusion
When it comes to our bodies, our individual health needs and varying lifestyle factors. There is no one-size-fits-all when it comes to supplements to balance hormones. Many women are moving away from conventional methods of treating hormone imbalance and seeking a more natural approach.
Natural remedies, such as vitamin, mineral and naturopathic supplementation may effectively balance hormones. At the very least they may improve some symptoms that accompany hormone imbalance.
Information in this article does not replace medical advice given by your medical provider. It is a vehicle to provide knowledge and an understanding of hormone imbalance, symptoms and natural solutions that may provide relief to women.
Angela Lago is a Registered Dietitian Nutritionist and holds a Master’s of Science in Nutrition. She is passionate about researching the connection between gut health and mental wellness. Learn more about Angela’s journey from being depressed, anxious, and sleep deprived to being happy, healthy, and thriving!