Don't ignore the signs: Malaysian doctor explains hormonal imbalance in women

Around 80 per cent of women worldwide are estimated to experience hormonal imbalances, often a gradual condition that may go unnoticed until symptoms manifest significantly. Common hormonal-related ailments among females encompass conditions such as polycystic ovary syndrome (PCOS), endometriosis, diabetes, and adrenal insufficiency.

Dr Sharan Kaur, who runs a women’s health clinic in Subang Jaya, has been treating patients with hormonal imbalance for more than 12 years. She tells Yahoo Southeast Asia that the potential long term consequences of untreated hormonal imbalance in women affects many parts of the body starting from the brain.

“Memory can be impaired, focus, concentration and motivation can be affected and there are higher risks for Alzheimer’s and Parkinson’s. For the heart, it can raise the LDL, the bad cholesterol and increase the risk of heart diseases and strokes and potentially raise the blood pressure.

As for the female reproductive system, it can increase the chances of cysts and fibroadenomas in breasts, fibroids and polyps in the uterus and cysts in the ovaries, to name a few. Insulin resistance is another contributing factor together with bone loss and muscle loss that increases the risks of osteoporosis,” she said.

She said common hormone imbalance symptoms can be as simple as dry skin, dry brittle nails, dry hair or hair loss, acne breakouts, bloating, mood swings, gut issues, and fatigue among others.

“The impact can vary from mild, moderate to severe affecting most parts of a patient's life. They have difficulties in their day to day activities such as remembering simple tasks, work performances are affected as there might be deterioration in normal work duties to the point of quitting their jobs as they are unable to cope with their symptoms, social issues such as being withdrawn from friends and crowds and even maintaining physical relationships especially intimacy,” she said.

She further explained that there are two types of hormones, one that can cause side effects such as increased risks of cancer, heart attack, stroke, weight gain, acne, abnormal uterine bleeding etc commonly known as synthetic hormones and the other is bio-identical hormones which mimics the hormone structure of the body and prevents such side effects, improves longevity, prevents chronic diseases, alleviate symptoms and it is safe as a long term treatment.

For Natasha Gideon, 34, she has had to endure birth-like contractions during her menstrual cycle for the past 17 years.

“I was told period pains are normal and I need to give birth to cure it. The plot twist I guess is a lot of people have fertility issues as a result,” she told Yahoo Southeast Asia.

“I had been to 5 gynaecologists in 16 years when I got tired of it and posted about my condition on my instagram. A few people suggested their own gynae and I found one in Avisena. He immediately diagnosed me with adenomyosis. I also had a fibroid and a Mullerian cyst so I had surgery to take those out and during surgery my doctor found that I had endometriosis and confirmed adenomyosis only when I was undergoing my laparoscopy,” she said.

Adenomyosis is a gynecologic condition that causes endometrial tissue in the lining of the uterus to grow into the muscular wall of the uterus. It enlarges the uterus, and may lead to very heavy menstrual bleeding. Meanwhile, endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It can cause severe pain in the pelvis and make it harder to get pregnant.

‘Unable to live normally a few days a month’

Hormonal imbalances, like many other medical conditions, can significantly impact a woman's life across various aspects, despite their appearing to function normally

“I can't live my life normally for 2-3 days a month. I am disabled during my period. I have to use a wheelchair if I absolutely need to go somewhere. I arrange my appointments around my period. On days I don't get my period I sometimes get flare ups. It’s exhausting and has taken a huge chunk of my life. It holds me hostage no matter how positive I try to be,” Natasha said.

“Honestly, before I had money for therapy it was worse. I would get suicidal tendencies because the contractions wouldn’t stop and the painkillers worked less and less. People say giving birth is the worst pain they’ve experienced. Some endo and adeno patients say it’s nothing compared to what we go through. I bawl my eyes out due to pain, and loss of freedom, every month. I get anxious a few days before my period. It’s mental and physical torture,” she added.

Natasha revealed that she has undergone numerous tests, including a hormone profile, to determine the optimal diet and supplements tailored to her specific needs amidst lifestyle changes.

“It's very trial and error when it comes to food. It's complex because you have no guideline and everyone is different. I have since done a DNA test, a hormone profile, annual blood tests to see how I can eat better. I exercise daily according to the cycle syncing method. I'm taking a bunch of supplements regardless of what people say,” she said.

“I am on painkillers now and every few years I become resistant to the last one. I am on hormone therapy as I have found my progesterone is low. Nothing else works / has worked.

Also a bunch of supplements catered to my body,” she added.

Learning from her own experience, Natasha also advises women to get their hormones checked, if they can afford it.

“Thanks to medical gaslighting and unsolicited advice, we are taught that our problems are "normal ". If you think something is wrong and you have the privilege of getting checked, please do. Whether you are not in pain, or not planning on having kids. Just get checked. You cannot function with imbalanced hormones. It's not a great quality of life,” she said.

Impact on weight gain and mental health

Meanwhile, makeup artist Nabilah Mohamed revealed that she discovered she had PCOS in 2017, prompted by a family friend who is a doctor urging her to undergo a medical health check-up after she gained thirty kilograms within two years.

“Since I got my menses, I’ve never had a regular menstrual cycle. On top of that, since I was a teenager, I was always prone to feeling depressed. At 20, I was diagnosed with it and throughout my 20’s, I had severe chronic depression. It was only after I found out about my PCOS, that I knew these things were all connected,” she said.

“When I gained all that weight, I tried working out, I tried eating right but none of it helped. I felt like I had no control over my body and that really drove my depression because I felt defeated,” she said, adding that it had also messed with her ability to concentrate which impacted her ability to study.

After finding out about her condition and doing multiple blood tests in 2019, Nabilah, now 34, said she has altered her lifestyle.

“I schedule in a lot of rest and keep stress at a minimum. I don’t overwork myself because that tends to flare up my PCOS. I regularly exercise and I try to eat well.

“I also care more about my sleep health and make sure I get eight hours of sleep. I take several kinds of supplements including magnesium, melatonin and others, as prescribed by my doctor,” she said.

Preventing and managing hormonal imbalance

Dr Sharan recommends for women to have their hormones checked in their early 20’s for prevention purposes and as soon as they experience changes in their bodies, moods, energy levels, irregularities in their period and any other changes.

She said diagnostic tests would typically involve a comprehensive hormone blood profile assessing various factors such as thyroid levels, dhea, cortisol, estradiol, progesterone, testosterone, follicle stimulating hormone, luteinising hormone, insulin, as well as vitamins and minerals. Additionally, she said a basic blood test would be conducted to evaluate cholesterol, kidney and liver function.

As for women who have been diagnosed with hormonal imbalances, Dr Sharan strongly advocates a healthy lifestyle by incorporating proper nutrition and exercising regularly.

“I strongly advocate healthy lifestyle by incorporating proper nutrition, consuming the '5 colours on your plate concept' - red, green, yellow, orange and purple, removing all whites- salt / sugar/ refined carbohydrates, consuming NON-GMO organic chicken, grass fed meats and wildly caught seafood, eliminating junk/ processed foods/ carbonated drinks, staying active,” she said.

"My motto is 'the day you eat, you exercise.' I recommend strength training 2-3 times a week and incorporate cardio for heart health, stress relief, and detoxification. I also recommend taking appropriate supplements and ensuring uninterrupted, restful sleep for 7-8 hours," she explained.

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