Types of Hormone Imbalance
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
Hormonal imbalance is one of the most frequent presenting complaints in my clinic. It underpins a wide range of conditions — from irregular periods and PCOS to anxiety, fatigue, poor sleep, and difficulty conceiving. Understanding which hormones are out of balance, and why, is the first step towards effective treatment. Traditional Chinese medicine offers a detailed diagnostic framework that complements modern hormone testing and allows treatment to be precisely targeted.
Oestrogen Dominance
Oestrogen dominance occurs when oestrogen is disproportionately high relative to progesterone, either because oestrogen is genuinely elevated or because progesterone is too low to balance it. It is the most common hormonal pattern I see in women of reproductive age. Symptoms include heavy or prolonged periods, premenstrual breast tenderness, bloating, mood swings, weight gain around the hips and thighs, and fibroids or endometriosis. In TCM, oestrogen dominance typically maps to a pattern of liver qi stagnation with blood stasis — the liver is failing to metabolise and clear oestrogen efficiently.
Low Progesterone
Progesterone is produced primarily after ovulation and is essential for maintaining the uterine lining in early pregnancy. Low progesterone leads to a shortened luteal phase, spotting before the period, recurrent early miscarriage, PMS, and difficulty sustaining a pregnancy after IVF. In TCM terms, low progesterone is most often associated with kidney yang deficiency — insufficient warming energy to support the second half of the cycle. Treatment focuses on tonifying kidney yang from ovulation through to menstruation.
Elevated Androgens (Including Testosterone)
Excess androgens in women most commonly occur in the context of PCOS, though they can also arise from adrenal dysfunction or insulin resistance. Symptoms include acne, excess facial or body hair (hirsutism), irregular or absent periods, and difficulty ovulating. In TCM, this pattern is usually one of kidney yang deficiency with phlegm-dampness obstructing the ovaries — the same underlying pattern that produces the cystic ovarian morphology seen on ultrasound.
High FSH and Low AMH
Follicle-stimulating hormone (FSH) rises as the ovarian reserve declines, and anti-Müllerian hormone (AMH) falls in parallel. Together these markers reflect diminished ovarian reserve — a common concern for women over 35 or those who have experienced premature ovarian insufficiency. In TCM, low AMH and high FSH are a clear expression of kidney jing and yin deficiency — the fundamental reproductive essence that governs egg quality and quantity. Treatment with acupuncture and kidney-tonifying herbs can help to regulate FSH levels and optimise the quality of the remaining follicles.
Thyroid Hormone Imbalance
Thyroid hormones regulate metabolism, temperature, and energy — and have a direct effect on the menstrual cycle and fertility. Hypothyroidism (low thyroid function) is associated with heavy periods, fatigue, weight gain, cold intolerance, and difficulty conceiving. Even subclinical hypothyroidism — where TSH is only mildly elevated — can impair implantation. In TCM, hypothyroidism frequently reflects a pattern of kidney and spleen yang deficiency. Acupuncture and herbal medicine can support thyroid function alongside any conventional treatment your doctor prescribes.
Elevated Cortisol (Stress Hormones)
Chronic stress raises cortisol levels, which in turn suppresses the hypothalamic-pituitary-ovarian axis — effectively putting the reproductive system on hold. The result can be delayed ovulation, cycle irregularity, reduced libido, and disrupted sleep. In TCM, this pattern is understood as liver qi stagnation affecting the thoroughfare and conception vessels. Acupuncture is particularly effective at regulating the stress response and restoring hypothalamic-pituitary function.
Elevated Prolactin
High prolactin (hyperprolactinaemia) can suppress ovulation and cause irregular or absent periods. It is worth checking if you have irregular cycles, galactorrhoea (spontaneous milk production outside of breastfeeding), or persistent difficulty conceiving. In TCM, excess prolactin is typically associated with liver qi stagnation — the same pattern that underlies oestrogen dominance and PMS — and responds well to liver-regulating acupuncture and herbal treatment.
How TCM Treats Hormonal Imbalance
One of the strengths of TCM is that it does not treat individual hormone levels in isolation. Instead, I assess the whole person — your menstrual cycle patterns, temperature regulation, energy levels, emotional state, tongue and pulse — and identify the underlying pattern of imbalance. This allows me to address the root cause rather than manage symptoms in isolation. Treatment typically combines weekly acupuncture with a bespoke Chinese herbal formula, adjusted at each follow-up as your pattern shifts.
Most women notice meaningful improvement within two to three menstrual cycles. Hormone testing before and after a course of treatment can provide useful objective confirmation of progress.
To discuss your hormone health, contact me or book a consultation at my Wokingham clinic.
