What Does a Hormonal Imbalance Actually Mean?

If you’ve been told your blood tests are “normal” — but you’re still struggling with acne, fatigue, painful periods or mood changes — you’re not alone.

In clinic, I often see women who’ve been told everything looks “fine” on paper, even though their symptoms are saying otherwise.
No further testing, no clear answers — just a vague reassurance that it’s all okay.

But what your GP is missing is this: hormonal imbalances don’t always show up as red flags in standard reference ranges.
And unless your results are way outside the reference ranges, most GPs won’t dig deeper.

So what does it actually mean when your hormones are “out of balance”?
Let’s talk about it and explore the tests, timings, and patterns I look for in clinic to uncover what’s really going on.

What Are Hormonal Imbalances?

Hormones are your body’s chemical messengers. They influence your mood, energy, skin, menstrual cycle, digestion, metabolism — nearly everything.

A hormonal imbalance isn’t just one hormone being too high or too low.
It often means the relationship between hormones is disrupted — like oestrogen and progesterone being out of sync, or insulin interfering with androgens.

These shifts can cause a cascade of symptoms, even if your levels still fall within “normal” on a pathology report.

Common Hormonal Patterns I See in Clinic

Here are the most common hormone patterns I assess in women experiencing skin, cycle, or energy concerns:

1. Oestrogen Dominance
This means oestrogen is too high relative to progesterone — not necessarily that oestrogen is elevated on its own.
Symptoms may include:

• Hormonal acne (especially before your period)

• Heavy, painful periods

• Breast tenderness

• Mood swings or irritability

• Bloating or fluid retention

2. Low Progesterone
Often caused by stress, over-exercising, or post-pill recovery.
Without enough progesterone to balance oestrogen, inflammation and anxiety can rise.
Signs include:

• PMS, anxiety or low mood

• Spotting before your period

• Difficulty falling or staying asleep

• Short luteal phase (less than 10 days post-ovulation)

3. Androgen Excess (High Testosterone or DHEA-S)
These hormones stimulate oil production and are commonly elevated in conditions like PCOS.
Symptoms may include:

• Acne on the jawline, chin or back

• Oily skin

• Hair thinning or loss

• Increased body or facial hair

4. Insulin Resistance
Insulin plays a key role in hormone regulation. When elevated, it can worsen androgen excess and create systemic inflammation.
Look for:

• Mid-cycle breakouts

• Energy dips after meals

• Intense sugar or carb cravings

• Weight gain around the middle

5. Low Thyroid Function (Hypothyroidism)
Often missed in standard testing, thyroid dysfunction can affect nearly every system in the body.
Symptoms may include:

• Dry, dull skin

• Fatigue and brain fog

• Irregular or heavy periods

• Cold sensitivity

• Hair loss or brittle nails

Why Blood Test Timing Matters

One of the most important (and overlooked) parts of hormone testing is timing.

Hormones fluctuate throughout your cycle, so when you test determines what your results actually mean.

Here's what I recommend:

Day 2–3 of your cycle
(Counted from the first full day of bleeding)
This is the best time to assess baseline hormones:

• Oestrogen

• Testosterone

• SHBG

• FSH & LH

Day 21 of a 28-day cycle
(This is roughly 7 days post-ovulation)
This is when progesterone should be peaking — helping us assess whether you’re ovulating and whether progesterone is sufficient.

If your cycle is irregular or longer than 28 days, we’ll adjust these timings based on ovulation (which we can track through temperature, symptoms or ovulation kits).

GPs rarely advise on cycle day timing — but it makes a huge difference in the accuracy of your results.

What I Look for in Blood Test Results

You don’t always need expensive functional testing to assess hormones.
Standard bloods — when done properly and assessed functionally — can give us a clear picture.

Here's what I usually request and assess:

Sex Hormones

• Oestradiol (E2)

• Progesterone

• Testosterone & Free Testosterone

• SHBG

• DHEA-S

• FSH & LH

Blood Sugar & Insulin

• Fasting Glucose

• Fasting Insulin

• HbA1c

Thyroid Markers

• TSH

• Free T3 and Free T4

• Thyroid antibodies (TPO, TGAb) if autoimmune conditions are suspected

Then I interpret these against optimal ranges — not just “normal” ones.

For example, a ferritin (iron storage) level of 30 may be considered “fine” by your GP, but for optimal energy, mood, and skin health, I prefer to see it around 50–80.
The same goes for progesterone, thyroid markers, insulin, and oestrogen balance.

(psst… you can actually get our hands on all of my optimal ranges I use for my 1:1 clients with my Blood Test Chest Sheet!)

What Happens After Testing?

Once we’ve collected and reviewed your results, we create a plan that actually supports what your body needs right now.

Depending on what we find, that might include:

• Adjusting nutrition to support blood sugar and detox pathways

• Targeted supplements (herbs, minerals, vitamins)

• Stress and nervous system support

• Cycle education and tracking tools

• Phased treatment (we don’t do everything at once — it’s layered and strategic)

My goal is always to help you feel empowered and educated — not overwhelmed.

Final Thoughts

“Hormonal imbalance” isn’t just a buzzword. It’s often your body’s way of asking for support.
And the answers you’re looking for might already be in your blood work — they’ve just been overlooked.

With the right timing, interpretation, and support, you can move from guessing to clarity — and start healing from the inside out.