Hormones are chemical messengers that travel through the bloodstream, helping to regulate nearly every function in the body. They influence how we feel, think, sleep, digest, and move, guiding systems like metabolism, memory, energy, and mood. Produced by glands in the endocrine system, hormones constantly signal tissues and organs to act in rhythm with what the body needs. While often linked to reproduction, hormones do far more. Oestrogen, progesterone, and testosterone are key sex hormones for women, but hormonal balance as a whole is essential for lifelong wellbeing. When things shift, even slightly, we often feel the effects in subtle or noticeable ways.
Women produce dozens of hormones, not just the “classic” sex hormones. Each plays a unique role in keeping the body balanced, supporting mood, energy, metabolism, sleep, reproduction, and stress response.
Hormones are made in several key hubs; the brain, ovaries, adrenal glands, thyroid, and pancreas, and work together in a complex network. Even small imbalances can affect wellbeing, from fatigue and low mood to digestive issues or disrupted sleep.
Understanding hormones as a whole system helps us see why changes in one area can ripple across the body. It’s not just about oestrogen and progesterone; it’s about total body harmony.
Synthetic hormones are commonly used in hormonal contraception. This includes the combined oral contraceptive pill, the mini pill, hormone-releasing IUDs like the Mirena, the contraceptive patch, injection and implant. These products typically contain synthetic forms of oestrogen and progesterone, known as ethinylestradiol and progestins.
While effective at preventing pregnancy, these synthetic hormones do not exactly match the hormones naturally produced in our bodies. As a result, they may cause side effects such as mood changes, low libido, headaches, or changes in bleeding patterns.
Some women also report symptoms that mimic hormonal imbalance, especially with long-term use. These risks vary depending on the product and individual health. It’s important to be aware that synthetic hormones are primarily used to stop ovulation and control the menstrual cycle, not to support or restore natural hormone balance. They can be helpful tools, but they may not suit everyone.
Body-identical hormones are structurally identical to those naturally produced in our bodies. In hormone replacement therapy (HRT), they are used to gently restore balance during perimenopause and postmenopause. Oestrogen is typically given through patches or gels, while progesterone is taken as micronised capsules. This form of HRT is well-tolerated and carries fewer risks than older synthetic versions.
Beyond symptom relief, such as; better sleep, mood, skin, and energy, these hormones can also offer long-term health protection. They help maintain bone density, reducing the risk of osteoporosis and fractures, and may support cardiovascular health, with transdermal oestrogen shown to have a protective effect on blood vessels. There is also evidence that they may help preserve brain function and reduce the risk of dementia when started near the onset of menopause.
Body-identical HRT is not used as contraception but is an effective way to support long-term wellbeing in midlife and beyond.
This is a general overview, not everyone will follow the same pattern. Hormone levels can be affected by many factors, including stress, medical conditions & treatments, hysterectomy, or induced menopause. Each journey is unique.
Hormones are meant to work together in balance. But sometimes, one becomes too dominant and disrupts the rhythm. This is called hormonal dominance. Oestrogen dominance is the most common form, especially in the years leading up to menopause, when progesterone begins to decline. This doesn’t always mean oestrogen levels are high, only that there’s not enough progesterone to keep it in check.
Hormonal dominance can also involve other key hormones, like cortisol or insulin. Long-term stress, poor diet, sleep issues or inflammation can all tip the scales. Even small imbalances in this system can lead to noticeable symptoms.
Dominance doesn’t always show up clearly on blood tests. Often, levels fall within the normal range, but the relationship between hormones is off. That’s why looking at symptoms is just as important as lab results. Hormonal dominance can affect the menstrual cycle, mood, weight, sleep and skin.
Bringing things back into balance often starts with gentle changes. Nutritional support, stress reduction, better sleep and targeted supplements or hormone therapy can all help. Awareness is the first step when we understand the signs of imbalance, we can take action that supports our long-term wellbeing.
In puberty, rising oestrogen, progesterone and testosterone shape mood and sensitivity as the brain adapts. During the menstrual years, monthly hormonal shifts can naturally affect emotional rhythm.
After childbirth, hormone levels change quickly. Oestrogen and progesterone drop sharply in the first days after birth, while prolactin rises for breastfeeding and cortisol may increase due to stress and lack of sleep. This mix can affect mood, emotional stability and energy, contributing to postpartum anxiety or depression. These shifts are biological, not personal, and understanding them helps reduce self-blame.
In perimenopause, progesterone is often the first hormone to decline. Because it supports calmness and sleep, early signs can include night anxiety or disrupted rest, which naturally affects mood. As perimenopause progresses, oestrogen becomes more erratic, influencing serotonin and contributing to irritability, low mood or emotional sensitivity. In postmenopause, hormones settle at lower levels and many emotional symptoms ease.
Knowing how hormones shape mental wellbeing across each stage helps us recognise patterns and seek support that aligns with what our bodies need.
Our hormone levels naturally rise and fall across different life stages; puberty, pregnancy, postpartum and menopause. But sometimes, the internal systems that regulate hormones become disrupted. Ongoing stress, poor sleep, unstable blood sugar or chronic conditions like PCOS or thyroid disorders can all impact how hormones are made and used. When this balance is off, we may notice fatigue, mood changes, brain fog, skin issues, low libido or weight gain. These symptoms are not just a normal part of ageing. They are signs that the body is asking for support, and often responds well to gentle, targeted changes in lifestyle and care.
Hormone health can also be influenced by what we’re exposed to day to day. Endocrine-disrupting chemicals, found in some plastics, perfumes, makeup, cleaning products and pesticides, can interfere with how hormones work in the body. They may block hormone receptors, mimic hormones or disrupt how they are processed. Diet, alcohol, synthetic hormonal contraception and long-term medication use can also affect balance. While we cannot eliminate every exposure, we can make informed choices that help reduce this burden. Choosing natural skincare, limiting processed foods, and using safer cleaning products are small steps that can make a meaningful difference.
Hormone Replacement Therapy (HRT), also called Menopausal Hormone Therapy (MHT), comes in several forms. Below are some of the options available in the UK & USA.
Usually applied daily to the skin, this clear gel delivers oestrogen through the bloodstream. It’s body-identical and easy to adjust based on symptoms.
Worn on the skin and changed once or twice a week, patches release oestrogen steadily. A good option for those who prefer not to use gels or pills.
Taken orally or vaginally, this is body-identical progesterone used alongside oestrogen for those with a womb to protect the uterine lining.
Contain both oestrogen and progestogen. These options may suit women who want a single product for convenience, though not all are body-identical.
A newer option, this spray is applied to the inner forearm. It absorbs quickly and suits those who want an alternative to gel.
Used for local symptoms only, like dryness, burning or pain during sex. Available as a cream, tablet or soft capsule inserted into the vagina. It is not systemic HRT, it does not act as full body hormone replacement. See GSM (Genitourinary Syndrome of Menopause) for more details.
Testosterone is often labelled a male hormone, yet it has always been an essential part of women’s health. From the teenage years through early adulthood, women naturally produce significant amounts of testosterone. In fact, by daily production, women make more testosterone than oestrogen, highlighting how central it is to female physiology. This is not a minor or optional hormone, but one the body relies on throughout life.
Testosterone supports energy, muscle and bone strength, motivation, mental clarity, confidence and mood stability. It also plays a role in libido, joint health and physical resilience, while helping to reduce inflammation and support healthy mitochondrial function, which allows cells to produce energy efficiently.
As women move through their 30s, 40s and beyond, testosterone levels gradually decline. This drop often accelerates during perimenopause and menopause, or following medical treatments that affect hormone balance. When levels fall, symptoms may include fatigue, low mood, anxiety, reduced motivation, muscle loss, joint pain, hair thinning, weight gain or a general sense of feeling flat or disconnected from the body.
These symptoms are frequently treated with antidepressants, mood stabilisers or pain medications, yet testosterone levels are not always tested. If there is little improvement with treatment, it may be worth discussing testosterone testing with a doctor. A simple blood test can assess levels, and treatment is usually an easy, once daily gel applied to the skin. For many women, restoring testosterone can lead to meaningful improvements in mood, strength, energy and overall wellbeing.
It’s not in our head. We’re not imagining it. But it is happening in our head, because the female brain responds to hormones differently. Pioneering research from Dr Lisa Mosconi shows that oestrogen is a key protective hormone for the brain. It supports blood flow, helps regulate glucose (the brain’s main fuel) and supports the repair of neural connections.
This matters because women are at greater risk of Alzheimer’s and dementia, and hormonal changes across midlife are part of the reason. In perimenopause, fluctuating oestrogen can affect memory, focus and mental clarity, which is why brain fog is so common. After menopause, hormone levels settle at lower levels, and while symptoms often ease, long-term low oestrogen may influence, even accelerate brain ageing.
Understanding this connection helps us act early. Supportive habits, stress care, good sleep, targeted nutrition and HRT can all contribute to long-term cognitive resilience. To expand your knowledge further we recommend reading The Menopause Brain.
Medical suppression uses medication to temporarily reduce or switch off ovarian hormone production. It is commonly used for endometriosis, fibroids, adenomyosis, severe PMDD, or during IVF when doctors need to control the cycle. Treatments such as GnRH analogues or progestin-based therapies create a reversible, low-oestrogen state similar to temporary menopause. Symptoms can include hot flushes, low mood, poor sleep, brain fog and vaginal dryness because the hormonal change is sudden. Women should be fully prepared by their medical team, with a hormone support plan discussed and agreed before treatment begins to help protect mood, bone health and overall wellbeing.
Temporary
Uses medication (GnRH analogues or progestin therapies)
Often for endometriosis, fibroids, adenomyosis, PMDD or IVF cycles
Creates a reversible low-oestrogen state
Symptoms may include hot flushes, low mood, brain fog and vaginal dryness
Needs a hormone support plan agreed before starting treatment
Permanent
Caused by removal of both ovaries or loss of ovarian function after surgery or cancer treatment
Sudden and steep drop in oestrogen, progesterone and testosterone
Symptoms may be stronger than natural menopause
Long-term considerations for heart, bone and brain health
Needs a hormone support plan agreed before surgery
Surgical menopause occurs when both ovaries are removed (bilateral oophorectomy) or stop functioning after certain operations or cancer treatments. This causes an immediate and permanent menopause with a much sharper drop in oestrogen, progesterone and testosterone than natural menopause.
Symptoms can be intense at first, and long-term risks relating to the heart, bones and brain may increase. Women should have a clear hormone management plan in place before surgery, tailored to their medical history and future health needs, so they feel supported and understand what to expect afterward.
