Balancing your hormones

By Dr Sandra Cabot

When your hormones are out of balance you can have a wide range of symptoms and it can be hard to work out what is going on. To pinpoint the problem, you can have blood tests to measure the levels of the hormones FSH, TSH, Oestradiol, Progesterone, Testosterone (free and total) and DHEA-S. These blood tests are very accurate. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.

The levels of the other hormones fluctuate (go up and down) a lot during a typical monthly menstrual cycle which makes it harder to interpret results. This is why our handy table on Symptoms of Hormonal Imbalances can enable you to diagnose what your hormonal imbalance is.




Hot flushes Tender and/or lumpy breasts
Insomnia Headaches, including migraines
Poor libido Depression
Dryness of vagina Worsening of varicose veins
Bladder irritability Fluid retention



Heavy periods Sleepiness
Painful periods Constipation
Fibroids Breakthrough bleeding
Endometriosis/ adenomyosis
Unexplained infertility
Polycystic ovarian syndrome
Premenstrual syndrome
Postnatal depression
Moodiness or PMT
Chronic iron deficiency
Infrequent / irregular periods
Hair loss
Worsening of autoimmune disorders
Breast pain and lumpiness
Premenstrual epilepsy



Poor libido Facial hair
Aches and pains Hair loss
Depression Excess libido
Fatigue Weight gain
Osteoporosis Acne and greasy skin
Muscle loss Deepening of the voice



Fatigue Acne and greasy skin
Aches and pains Weight gain

Natural Progesterone

Natural progesterone is bioidentical to your body’s own progesterone. Progesterone is the hormone of fertility and is beneficial for a healthy immune system and thyroid function. Progesterone is made by the ovary after ovulation occurs and can be deficient in women with Polycystic Ovarian Syndrome (PCOS), older women in the perimenopausal age group, and women with thyroid problems. Progesterone can reduce premenstrual tension and has a relaxing effect. See the symptoms of progesterone deficiency in our table.

How to use Progesterone Cream

The progesterone cream is rubbed into the inner upper thighs or into the opening of the vagina. Rub well into these areas, until all cream has gone.

Use as follows –

Rub one gram once daily, into the skin. Apply cream after a shower or you will wash the cream off your skin.

Use the cream every day until your menstrual bleeding starts; then stop using the cream on day one of bleeding. Ten days later (10 days after the first day of your menstrual bleeding) begin to use the cream again every day, until your next bleeding begins.

Natural bioidentical progesterone is not effective if you are taking the contraceptive pill. Natural progesterone can increase your fertility.

How to use Hormone Replacement Cream

If you are menopausal and no longer have menstrual periods, then you can use the HRT cream everyday. Ideally creams used for hormone replacement for menopause will not cause any bleeding and/or menstrual periods because the doses of hormones used in the creams are so low that they should not cause the lining of the uterus (endometrium) to grow. If you do get a period, stop using the cream and wait until the bleeding is finished. Once the bleeding is completely gone, start using the cream again, but in half the dose, as it is best to avoid bleeding on HRT. If bleeding persists, consult your doctor for an examination and pelvic ultrasound scan or see a specialist gynecologist for tests to exclude things like endometrial hyperplasia, polyps, fibroids or cancer. One can never be too careful!

HRT cream contains a combination of hormones – such as some type of oestrogen (eg. oestriol, oestradiol or oestrone) plus natural progesterone and sometimes testosterone, and sometimes DHEA. The doses of each hormone vary according to your symptoms and age and requirements and are easily adjusted

The hormones in creams can relieve symptoms after one to two weeks in most women. Some women choose to use bioidentical hormones for many years after menopause and this is fine to do if you have regular checkups and mammograms.

Women who have had breast cancer are told to avoid any form of hormone treatment which is the safer way to go.

Some women prefer to use plant derived hormones and products such as FemmePhase, Promensil and Remifemin can help to relieve menopausal symptoms.

If you have any problems or questions, I recommend my books 

You may also email my naturopaths or myself from our websites


For more information call the Women’s Health Advisory Service on 02 4655 4666.

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