You’re gaining weight, feeling “off,” and are frequently tired, irritable, and moody. During the week before your period, you may be subject to cravings, bloating, mood swings, weepiness, or anger. The week of your period, you get cramps and perhaps heavy bleeding. If you’re in your 40s, you may be noticing more frequent problems with memory, focus, and mood, not to mention weight gain, sex drive, and what feels like the loss of your sensuality.

Your health-care practitioner may tell you that hormones fluctuate so frequently that it isn’t worth testing them. If you are tested, you might be told that your estrogen and progesterone levels are in the normal range so there’s nothing to worry about. Or your practitioner offers to prescribe the birth-control pill or some antidepressants.

You leave the office feeling frustrated and confused. You want to feel vital, focused, energetic, at home in your own body. You want to feel sexy and sensual. And you don’t understand why the person you trust to help you with your medical problems has just let you down.

So what’s going on?

Unfortunately, all too often, the approach most conventional practitioners take misses the mark. Here are some reasons why.

1. Many practitioners look at too few hormones. When women struggle with PMS, painful periods, perimenopause, endometriosis, fibroids, or PCOS, most health-care practitioners look at the female sex hormones most immediately responsible for a woman’s cycle: estrogen and progesterone. But these tell only part of the story—and often not even the most important part. If you are having problems with any of the conditions I just mentioned, three other hormones are almost certainly involved:

•    Cortisol and adrenaline: stress hormones produced by the adrenal glands, which get involved every time you face a physical or emotional challenge

•    Insulin: the hormone produced by the pancreas to help move blood sugar into your cells, which gets involved every time you eat a carbohydrate.
Without addressing these three hormones, your practitioner probably can’t offer you an effective long-term solution. Yet most conventional practitioners don’t even consider these hormones when treating “female complaints.”

2. Many practitioners ignore the hormonal cascade. Your body contains more than 100 hormones and they all communicate with each other. If one hormone is off, it throws off another, and then another, creating a hormonal cascade of interrelated problems and symptoms.

A key hormonal cascade begins with cortisol, the stress hormone. When your adrenals produce either too much or too little cortisol, your other hormones feel it right away, including thyroid (which regulates metabolism), leptin (which regulates fullness), ghrelin (which regulates hunger), insulin (which regulates blood sugar), serotonin (a natural antidepressant that helps you feel calm and self-confident), dopamine (a “feel-good” hormone that helps you feel excited and energized), and many, many others. All of these hormones must work together to produce health, well-being, and vitality, so if your health-care practitioner isn’t looking at the hormonal cascade, he or she isn’t seeing the whole picture.

3. Many practitioners look at individual hormones rather than overall hormonal balance. Suppose you have “high-normal” estrogen and “low-normal” progesterone. Your practitioner is likely to tell you that you’re in the normal range and that you have nothing to worry about. You don’t understand how that can be because you are still struggling with PMS, painful periods, or the symptoms of perimenopause (memory problems, lack of focus, weight gain, loss of sex drive). What your practitioner has failed to look at is the balance between estrogen and progesterone. Perhaps your “high-normal” estrogen is too high for your “low-normal” progesterone. This lack of balance is known as estrogen dominance and it may be responsible for a lot of what you’ve been feeling.

4. Many practitioners look at symptoms rather than root causes. As a result, they might prescribe either the birth-control pill or an antidepressant, either of which might have some limited effectiveness in relieving your symptoms. Unfortunately, neither of these medications gets at the root of the problem. Your estrogen and progesterone likely went out of whack because of an imbalance in your cortisol, adrenaline, and insulin levels, which reflect diet, lifestyle, and the stresses in your life. Inflammation and toxicity might also be contributing factors. The Pill and antidepressants are just Band-Aids that don’t address the problem at the deepest, most helpful level.

When addressing symptoms and disorders, it’s important to look at what’s going on upstream, at the whole matrix of conditions that gives rise to hormonal imbalance and other health issues. This integrated approach allows us to look at antecedents and triggers as well as results.

5. Many practitioners underestimate the crucial impact of diet, lifestyle, and psychology on hormonal balance. After more than two and a half decades of practice, I’m still amazed at the near-miraculous impact of changing your diet. When a woman cuts out sugar, eats more protein and healthy fat, and takes the herbs and supplements her body needs, a myriad of health problems clear up almost immediately. Getting the right kind of exercise can also make a world of difference, as can seven to nine hours of restful, refreshing sleep per day.

Another key issue is life stress—the challenges of family, relationships, work, and personal life. As a great deal of scientific research has shown, stress has a powerful effect on your body. Finding effective ways to modify stress is crucial to achieving hormonal balance and freeing yourself from many symptoms once and for all.