Her Sex Hormones | Why do I feel so hormonal?

 Your hormones are not random. They follow rhythms, respond to what is happening around you, and shift as your body moves through different seasons of life.

That conversation begins in puberty and continues through the reproductive years, pregnancy, postpartum, perimenopause, and menopause. The hormones involved may change, but they never stop communicating.

The problem is that most women were never taught how to understand what they are saying.

Instead, we were taught that periods are inconvenient, PMS is simply part of being a woman, and perimenopause is something to grit our teeth and get through. We are often told that mood changes, disrupted sleep, low libido, and feeling unlike ourselves are just normal consequences of getting older or having too much on our plates.

But symptoms are not character flaws, and they are not always something you should have to push through. Sometimes they are useful information about what is happening beneath the surface.

Sex hormones are powerful messengers, but none of them works alone. Estrogen, progesterone, testosterone, DHEA, follicle-stimulating hormone, luteinizing hormone, and cortisol all influence one another. Together, they affect far more than your menstrual cycle. They can shape your mood, sleep, skin, energy, fertility, metabolism, bone health, brain function, cardiovascular health, and even your sense of who you are.

We often talk about estrogen as though it is a single hormone, but it is actually a family of hormones. The three main forms are estrone, estradiol, and estriol.

Estrone, also called E1, becomes more prominent after menopause. It is considered less potent than estradiol, but it can still affect estrogen-sensitive tissue and be converted into other forms of estrogen.

Estradiol, or E2, is the dominant estrogen during the reproductive years. It plays an important role in ovulation and fertility, but its influence reaches much further. Estradiol also supports bone density, skin, mood, brain function, and cardiovascular health.

Estriol, or E3, rises significantly during pregnancy. It is generally considered a gentler form of estrogen and is often associated with vaginal, urinary, and mucosal tissue support.

This is why it can be misleading to talk about being “high estrogen” or “low estrogen” without looking at the broader picture. Which form of estrogen are we talking about? What stage of life are you in? Where are you in your cycle? Are you ovulating? Are you taking hormonal medication?

The context matters just as much as the number.

Progesterone is often associated with calm, sleep, emotional steadiness, and the ability to maintain a pregnancy. In a typical menstrual cycle, progesterone rises after ovulation.

That last part matters because progesterone testing has to be timed appropriately. Testing it on a random day may produce a perfectly accurate result that is not particularly useful.

Many women have been told that progesterone should always be tested on day 21 of the menstrual cycle. That timing only makes sense for someone with a roughly 28-day cycle who ovulates around day 14. A more useful approach is usually to test about seven days after ovulation, when progesterone is expected to be near its peak.

For women who are still menstruating, FSH, LH, and estradiol may be tested early in the cycle, often around days three through five. Other forms of hormone testing have their own timing recommendations. DUTCH testing, for example, is commonly timed during the second half of the cycle, depending on the woman’s cycle length and the purpose of the test.

After menopause, testing is usually less dependent on a particular cycle day. Even then, results still need to be interpreted alongside symptoms, medications, and the woman’s overall health history.

This is one of the reasons a result marked “normal” may not answer the questions you actually have.

Normal for which point in the cycle? Normal for someone who ovulated or someone who did not? Normal during the reproductive years, postpartum, perimenopause, or menopause? Normal for a woman using hormonal birth control or hormone therapy?

A hormone result without context is simply a number on a page. It becomes more useful when it is interpreted alongside cycle timing, symptoms, life stage, medications, and what is happening in the rest of the body.

Hormones are often discussed as though each one exists in its own separate compartment. In reality, your hormonal health is connected to nearly every other system in your body.

Chronic stress can influence ovulation and progesterone production. Blood sugar instability may affect mood, energy, cravings, and androgen levels. Thyroid dysfunction can change menstrual patterns and mimic symptoms commonly blamed on sex hormones. Sleep, inflammation, nutrition, illness, and major life transitions can all shift the hormonal conversation.

This is also why one hormone panel cannot always explain everything. Testing may be useful, but the goal is not to collect as many numbers as possible. The goal is to ask the right questions and interpret the results within the full context of your life.

You do not need to obsessively document every sensation in your body, but noticing patterns can be incredibly helpful.

You may start to recognize that your sleep changes at a particular point in your cycle, or that headaches, breast tenderness, anxiety, cravings, or irritability regularly appear during the same few days each month. Perhaps your energy improves around ovulation and drops sharply before your period. Maybe your cycles are becoming shorter, longer, heavier, or less predictable as you move into perimenopause.

Those patterns are often more informative than a vague sense that something feels off.

Tracking does not need to become another task you have to do perfectly. A simple note in your phone or calendar may be enough. Over time, you begin to see your body’s rhythm instead of experiencing each symptom as an isolated event.

That information can also make conversations with your provider more productive. Rather than saying, “I feel terrible all the time,” you may be able to explain that your insomnia, anxiety, and heart palpitations consistently worsen during the week before your period, or that your cycles have changed significantly over the past six months.

That is useful clinical information.

When your results fall within the lab reference range but you still do not feel well, it is reasonable to ask how those results were interpreted.

You may want to know which hormones were tested, why they were chosen, and whether the timing made sense for your cycle. Ask whether ovulation was taken into account and whether thyroid function, blood sugar, iron status, medications, stress, and sleep could also be contributing to your symptoms.

The goal is not to demand every possible test. It is to understand whether the testing that was done actually answers the question you are trying to solve.

Your hormonal life is not something you are meant to white-knuckle your way through. Changes are inevitable, but suffering without explanation should not be treated as a requirement of womanhood.

When you begin to understand your own patterns, something important shifts. You stop seeing your body as unpredictable and start recognizing the rhythm underneath what you are feeling.

That understanding can help you rebuild trust in a body you may have spent years questioning.

- Dr. Liane

Learn the Conversation Already Happening Inside Your Body

If no one ever taught you how estrogen, progesterone, testosterone, and the rest of your hormones work together, Her Hormones: Sex Hormones is a place to begin.

Inside the course, Dr. Liane walks you through the physiology of your sex hormones, how they change across different stages of life, and why the timing and context of hormone testing matter. You will learn how to look beyond isolated numbers and begin making sense of the patterns your body has been showing you.

Because your hormones are already part of the conversation. Understanding them helps you become a more informed participant in it.

- Lena

Explore Her Hormones: Sex Hormones and start making your body make sense.