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How Hormonal Axis Imbalance Triggers PMS Symptoms

By Michael Lam, MD, MPH, Carrie Lam, MD, Jeremy Lam, MD

In This Article

Many women have PMS. It is the natural result of the whole menstrual cycle and the accompanying changes in hormone balances. However, symptoms can get a lot worse when the hormonal axis is disrupted, especially when Adrenal Fatigue is present.

This hormonal axis imbalance, if left unchecked, can result in a wide range of systemic symptoms. Identifying and addressing the root causes is very important for effective management.

What Is the Hormonal Axis and Why It Matters

An image of a person with hormonal axis imbalanceThe hormonal axis is made up of various glands that form a part of the endocrine system. Two major hormonal axes include the Hypothalamic-Pituitary-Adrenal (HPA) axis, which regulates stress, and the Ovarian-Adrenal-Thyroid (OAT) axis, which controls mood, metabolism, reproduction, and more.

Hormones are transported via our blood and attach to receptors in the target tissue where they stimulate the targeted destination to perform various functions.

When the hormonal axis becomes disrupted, hormone production declines or becomes irregular. Over time, this may lead to Adrenal Fatigue—a condition where the body is unable to keep up with long-term stress, resulting in various nonspecific symptoms such as tiredness, sleep disturbances, anxiousness, and weight gain— and hormonal imbalances throughout the body.

Key Glands of the Hormonal Axis

The glands primarily involved in the hormonal axis and the endocrine system include, amongst others, the hypothalamus, the pineal gland, the pituitary gland, the thyroid, the adrenal glands, the pancreas, and the ovaries (in women).

Each gland makes a different hormone that affects everything from sleep and emotion to metabolism and reproduction.

  • Hypothalamus (and Pineal Gland): Produces dopamine and melatonin. Regulates mood, sleep, temperature, hunger, thirst, and sex drive.
  • Pituitary Gland: Known as the “master gland” for its role in sending out messages to the other glands, stimulating them to produce the hormones needed.
  • Adrenal Glands: Releases cortisol (the stress hormone) and androgens that affect sex drive.
  • Thyroid: Regulates metabolism, heart rate, and calorie-burning efficiency.
  • Pancreas: Produces insulin to control blood sugar levels.
  • Ovaries: Produce estrogen, progesterone, and testosterone in women.

When stressed, the body prioritizes cortisol production, which can suppress the production of other hormones. Hormone levels may go back to normal after balance is restored, unless stress becomes a long-term problem.

How Chronic Stress Disrupts Your Hormones

There are more than fifty hormones produced by the adrenal glands. When you are under stress, they release cortisol and adrenaline. The brain sends a message to the pituitary gland when it senses stress.

The pituitary gland then tells the adrenal glands to make more hormones. This prepares the body to either fight or flee. The adrenal glands usually go back to normal hormone levels after the stressful situation is over.

When stressors persist, the adrenal glands make more and more cortisol over time. This leads to hormonal axis imbalances and a condition known as Adrenal Fatigue.

Eventually, the glands cannot sustain this cortisol production, resulting in low cortisol levels, which can be harmful to the body.

How Hormonal Axis Imbalance Contributes to PMS

Women have higher levels of cortisol right before their period, and stress can make these levels even higher, putting the body in a heightened state of alertness.

Progesterone, produced by the adrenal glands, is a precursor to cortisol. When you are under a lot of stress all the time, your body makes less progesterone due to the shunting effect to make more cortisol. This can cause an imbalance between estrogen and progesterone, even if estrogen levels are normal.

Estrogen is key for female characteristics and affects reproductive organs. When the progesterone-estrogen balance is disrupted, estrogen dominance takes place negatively impacting the thyroid and potentially causing thyroid resistance. Elevated cortisol levels can disrupt hormonal balance as the body tries to compensate by producing more hormones.

Stress, for a long period of time, lowers levels of dopamine and serotonin, which makes the body produce more cortisol as an energy reserve. When these hormones are low, they can lead to addictive habits like emotional eating, which creates a cycle of weight gain.

An imbalanced hormonal axis may lead to PMS symptoms, such as:

  • An image of a person having anxiety and depressionMood swings, anxiety, and depression
  • Weight gain
  • Fatigue
  • Brain fog and memory loss
  • Constant hunger
  • Digestive disorders
  • Sleep issues
  • Loss of libido
  • Night sweats and hot flashes
  • Migraines and headaches
  • Skin problems like acne
  • Breast changes and tenderness
  • Vaginal dryness

Conditions like endometriosis, uterine fibroids, and infertility are also signs of hormonal axis imbalance. Since each person experiences symptoms differently, it is recommended that you consult a healthcare professional if you encounter any of these issues.

Understanding and Addressing Hormonal Axis Imbalance: Natural vs. Conventional Medical Approaches

Conventional medicine usually manages symptoms one at a time and often recommends birth control pills for hormonal imbalances.

For PMS, conventional medicine tends to prescribe birth control to shut down the brain signals to the reproductive system.  This stops the body from ovulating, which can help with symptoms.  But it doesn’t go to the root of the problem, which is often a deeper hormonal imbalance that causes PMS symptoms.

Birth control pills can help with the symptoms, but they don’t get rid of the problem.  They might help with mood swings, cramping, or irregular cycles, but relief usually doesn’t last long.  Birth control doesn’t fix your hormones; it just stops your body from doing what it normally does.  When you stop taking it, the symptoms usually come back.

Correcting a hormonal axis imbalance is more complex than just taking a pill. Medication may help for a short time, but it doesn’t fix the underlying problem, including Adrenal Fatigue and imbalanced cortisol levels.

Adrenal Fatigue is primarily caused by ongoing stress, whether physical, psychological, or environmental. There’s no quick fix, as this condition develops over time, leading to a lengthy recovery process.

Before considering any course of medication, make sure you have a baseline saliva test done in order to test your cortisol levels.

How to Help Yourself on the Journey of Recovery

Recovery from hormonal axis imbalance takes time, not a quick fix. Once you figure out what’s causing your hormone problems, making simple, regular changes to your daily routine can make a big difference. Just as your condition didn’t develop overnight, healing will also take time and your participation is key.

Adjust Your Lifestyle

Overeating and poor eating habits have become common in modern society, primarily due to fast food. Following a low-fat, plant-based diet can help with digestion and weight loss, while following a low-GI diet can help keep cortisol levels in check.

Physical inactivity is another challenge in the modern age. Moderate, regular movement like daily walks can support heart health and manage weight. For those experiencing Adrenal Fatigue, intense workouts are not recommended. A slow, steady approach works best with your energy levels.

Additionally, regular exercise boosts dopamine levels, a hormone that improves mood that can help with emotional recovery.

Cut Down on Caffeine

Many people see caffeine as a great pick-me-up to boost them throughout the day. And yes, caffeine does provide that boost, but too much caffeine increases estrogen levels, thereby contributing towards a hormonal imbalance.

Detoxify Gently

Your liver plays a central role in eliminating toxins from the body. To support this detox function, hydration is key. Certain foods and drinks also aid the liver’s detoxification process, including:

  • Green leafy vegetables
  • Grapefruit
  • Beets and carrots
  • Lemons
  • Garlic
  • Green tea

If you’re already feeling depleted, avoid intense detox programs. Go slow, and always listen to your body.

Clean Up Hidden Hormone Disruptors at Home

An image of household cleaning productsMany everyday products contain disrupting chemicals known as xenoestrogens. These synthetic chemicals can throw off the body’s hormonal balance because they act like estrogen. You may usually find them in:

  • Household cleaners
  • Packaging materials made of plastic
  • Cosmetics, lotions, soaps, and other personal care goods
  • Artificial fragrances and air fresheners

Tips to reduce xenoestrogen exposure:

  • Switch to natural cleaning products
  • Use glass or stainless steel instead of plastic
  • Choose fragrance-free or essential oil-based products
  • Read ingredient labels and avoid parabens, phthalates, and BPA

What you eat and drink isn’t the only thing that detoxifies you; what you breathe in and skin also plays a role.

Consider Nutritional Supplements

Targeted supplements can enhance adrenal function and ease symptoms of hormonal axis imbalance. But you should choose supplements that are right for your body, especially if you are in the later stages of Adrenal Fatigue.

Some helpful options include:

  • Natural sea salt – Helps reduce cortisol levels.
  • Vitamin C – Balances stress, blood pressure, and cortisol (avoid excessive doses). You can try LipoNano C, an advanced liposomal supplement that provides fat-soluble Vitamin C for superior intestinal absorption. It boosts the immune system, helps the body make collagen, and promotes better skin, hair, and nails.
  • Magnesium – Supports mineral balance; best absorbed via Epsom salt baths (though not tolerated by all).
  • Ashwagandha – Aids weight management, mood, and thyroid health. Consider Adrenal Rescue, a scientifically formulated adaptogenic blend that includes Ashwagandha, Rhodiola, Eleuthero, and Asian Ginseng. It helps regulate cortisol, boost energy, sharpen mental focus, and support adrenal and liver function.
  • Fish oil (Omega-3) – Reduces inflammation. Experience the benefits of OmegaMax, a pharmaceutical-grade fish oil delivering 1,500 mg EPA and DHA per lemon-flavored teaspoon. It promotes heart, brain, and metabolic health.
  • Liquid Vitex – Naturally helps hormone cycles by making the pituitary gland make more luteinizing hormone (LH), which increases progesterone levels. Most women who have too much estrogen don’t have enough progesterone. Liquid Vitex helps restore the balance between estrogen and progesterone.

Before you start taking any supplements, go to a qualified healthcare provider to find out what doses are right for you and make sure your choices are compatible with your hormone profile.

If you take the wrong supplements or too many of the right ones, they can make your condition worse.

In Closing

If you’re struggling with PMS symptoms that feel overwhelming, the root issue may lie in a disrupted hormonal axis. This complicated network of glands and hormones is very important for controlling mood, energy, sleep, and reproductive health.

It takes time to heal the hormonal axis, but it can be done with the correct help. You can help restore balance naturally by reducing stress, changing your diet, and taking care of your adrenal health. The Adrenal Fatigue Recovery Program can give you useful resources and guidance to help you get your hormones back in balance and feel better.

Listen to your body. Supporting your hormonal axis is one of the most powerful steps you can take toward long term relief and good health.

Dr. Lam’s Key Questions

The hormonal axis in women refers to the network of glands like the hypothalamus, pituitary, and ovaries that control hormones related to stress, mood, and reproduction. When disrupted, this axis can lead to hormonal imbalances and worsen PMS symptoms.

Chronic stress overactivates the hormonal axis, especially the adrenal glands, which increases cortisol levels. Over time, this leads to hormonal imbalances, including low progesterone, contributing to PMS, fatigue, and mood swings. Addressing stress is key to rebalancing the hormonal axis.

Yes, a hormonal axis imbalance can cause or worsen PMS symptoms. It affects hormone levels like estrogen and progesterone, leading to mood swings, fatigue, and bloating. Understanding this connection helps target the root cause of PMS rather than just managing symptoms.

© Copyright 2017-2025 Michael Lam, M.D. All Rights Reserved.