How to balance hormones naturally: what the evidence says

Hormones are the body’s chemical messengers. MedlinePlus explains that they travel through the bloodstream to tissues and organs and affect growth, metabolism, sexual function, reproduction and mood. Because they are so potent, too much or too little of one hormone can be serious.

But “hormonal imbalance” is not a medical diagnosis. It is a catch-all phrase that covers very different conditions, and also changes that are completely normal. Your hormones are not supposed to sit at one fixed level:

• Across the day. Cortisol, for example, is highest in the morning and much lower by late afternoon, according to MedlinePlus.
• Across the month. Estrogen and progesterone rise and fall with each menstrual cycle.
• Across life. The Endocrine Society lists puberty, pregnancy and aging among the factors that change the endocrine system.

That is why there is no single “hormone panel” that shows whether you are “in balance”. A number outside the range can be normal for the time of day, the day of your cycle or your age, and a normal number does not rule out a problem. Good care works the other way round: your symptoms and history first, then the test that answers a specific question.

None of these signs proves a hormone problem on its own. Nearly all of them also have causes that are not hormonal, such as short sleep, anemia, medicines or stress. They are reasons to get checked, not a way to diagnose yourself.

No habit has been shown to “balance” the hormones of a healthy person, and no habit replaces treatment for a hormone condition. What does have good evidence is that the habits below protect your overall health, and some of them are part of managing conditions such as PCOS or type 2 diabetes.

“Adrenal fatigue.” The tiredness is real, but the label is not a recognised diagnosis. The Endocrine Society says no scientific proof exists to support adrenal fatigue as a true medical condition, and that no test can detect it. It also warns that many supplements sold for it have not been tested for safety, and that taking adrenal hormone supplements you don’t need may make your adrenal glands stop working. Lasting tiredness deserves a real evaluation.

Compounded hormones and saliva panels sold online. We do not recommend compounded bioidentical hormone products sold online, or the saliva hormone panels marketed to “customise” them. The FDA has not approved compounded “bioidentical” hormone products and says it has no evidence that they are safer or more effective than FDA-approved hormone therapy. The American College of Obstetricians and Gynecologists (ACOG) states that salivary testing to tailor hormone therapy does not offer an accurate or precise assessment of hormone levels. A specific test your doctor orders to answer a specific question, such as a cortisol test, is a different thing.

Hormone-balancing supplements. There is no good evidence that any supplement balances your hormones. MedlinePlus points out that supplements do not go through the testing that drugs do, and the NIH Office of Dietary Supplements warns that some interact with medicines. Tell your doctor about everything you take.

“Detox” diets and cleanses. According to the NIH’s NCCIH, there is no good evidence that “detox” diets or cleanses eliminate toxins or help with weight management.

Hormone testing without a clinical question. Measuring many hormones “just in case” tends to produce numbers that are hard to interpret, because levels shift with the time of day and the cycle. The Endocrine Society notes that little or no scientific evidence supports the claims made for unapproved, custom-compounded hormone therapy.

If you are in midlife and want support with sleep, movement and stress habits, you can read about the midlife wellness retreat. It is a few days of habits, not a hormone treatment.