9 Signs of Hormonal Imbalance in Midlife

Hormonal shifts in your 40s and 50s can feel like a mystery. One moment you’re powering through your day, the next you’re foggy, fatigued and wondering where the old “you” went. You're not imagining it, these changes are real and they’re often signs of hormonal imbalance.

Here’s how to recognise what your body might be trying to tell you, so you can take action, feel more in control and start feeling like yourself again.

1. Energy Dips You Can’t Shake

If you’re waking up tired, dragging yourself through the day, or crashing hard mid-afternoon even with good sleep and solid nutrition, shifting hormone levels could be the reason. Oestrogen, progesterone and cortisol all affect how your body creates and uses energy.

2. Brain Fog and Memory Blips

Can’t find your words? Walked into a room and forgot why? Hormonal changes affect neurotransmitters and blood flow in the brain. You’re not losing your edge, your brain just needs different support during this phase.

3. Weight Gain, Especially Around the Middle

If your usual habits no longer “work” and your waistline is shifting despite no major changes, fluctuating oestrogen and insulin sensitivity could be at play. It’s not about eating less, it’s about working with your hormones, not against them.

4. Mood Swings and Increased Irritability

Feel more anxious or quick to snap? This isn’t just stress, it can be the result of imbalanced oestrogen, progesterone and cortisol levels, all of which influence mood regulation.

5. Disrupted Sleep

Whether it’s trouble falling asleep, staying asleep, or waking up too early, your hormones have a major say in your sleep cycle. Low progesterone and erratic cortisol levels are common culprits.

6. Hot Flushes and Night Sweats

These are the classic signs but not every woman experiences them and they can vary wildly. They’re your body’s response to changing thermoregulation, driven by falling oestrogen.

7. Low Libido or Vaginal Dryness

Your sexual health matters and it’s not “just ageing.” Lower oestrogen can reduce natural lubrication, sensitivity and interest in sex. But with the right support, intimacy can feel enjoyable again.

8. Muscle Loss and Strength Decline

Feeling physically weaker or noticing a loss of muscle tone? Hormonal decline affects your muscle-building ability, recovery and overall strength but strength training and nutrition can make a huge difference.

9. Leaking When You Laugh, Sneeze or Run

A little leak here and there isn’t just “one of those things”, it can be a sign of weakened pelvic floor muscles, often caused by dropping oestrogen levels. The good news? With targeted strength work and pelvic health support, things can improve. You don’t have to just live with it.

What You Can Do Next

You’re not broken and you’re not alone. Hormonal imbalance isn’t the end of the story, it’s a signal that your body needs a new kind of support.

As a certified Health & Nutrition Coach specialising in menopause and women 40+, I help you fuel your body, rebuild strength and regain clarity with practical, personalised strategies.

✨ Book a free discovery call to explore how we can work together.

Research & Clinical Insights

1. Verywell Health – 7 Signs and Symptoms of Early Menopause
   This article outlines key signs and symptoms of early menopause, including irregular periods, hot flashes, disrupted sleep, and mood changes.

2. Cleveland Clinic – Hormonal Imbalance: Causes, Symptoms & Treatment
   Provides an overview of hormonal imbalances, including symptoms such as weight gain, fatigue, and skin changes, and discusses potential causes and treatment options.

3. UCLA Health – 7 Signs of a Hormonal Imbalance
   Highlights common signs of hormonal imbalance, such as menstrual changes, hair issues, skin problems, and mood swings, and offers guidance on what to do about them.

4. Healthline – Hormonal Imbalance: Symptoms, Causes, Diagnosis, Treatment
   Discusses a wide range of symptoms associated with hormonal imbalances, including weight gain, fatigue, and mood changes, and explores potential causes and treatment options.

5. WebMD – Do You Have a Hormone Imbalance?
   Offers a slideshow of common signs of hormonal imbalance, such as fatigue, weight changes, and skin issues, and provides information on potential causes and treatments.

Expert Guidance & Lifestyle Strategies

1. SF Chronicle – The 'Single Most Important Behavior' for Women in Perimenopause and Menopause
   Emphasises the importance of diet and strength training for managing weight and health during perimenopause and menopause, highlighting the role of hormonal changes in metabolism and muscle mass.

2. The Guardian – Hot Flashes and Mood Swings: Why Perimenopausal Symptoms Get Misdiagnosed
   Discusses how perimenopausal symptoms like hot flashes, mood swings and irregular menstrual cycles are often misdiagnosed and emphasises the need for proper hormonal treatment.

3. Atlantic Health – Recognising Hormonal Imbalances After Menopause
   Outlines common symptoms of hormonal imbalances after menopause, including hot flashes, brain fog, vaginal dryness, weight gain, insomnia, and mood changes and provides information on management strategies.