Hormones rule our lives. No, really. From puberty and reproduction to growth and weight management, they have a gigantic influence on so many aspects of our health and well-being. So when things are off with your hormones, it can have a very real effect — especially on your reproductive system.

There are two main types of sex hormonal imbalances in women of childbearing age: polycystic ovarian syndrome (which many people know as PCOS) and low progesterone. Your thyroid is also responsible for much of your hormone regulation, but most of what we’ll share here is focused specifically on sex hormones. We spoke with certified nurse midwife Hilary Schlinger about how to identify these two conditions and what you can do to make sure your hormones are healthy.

PCOS
Polycystic ovarian syndrome is a condition in which the ovaries grow small cysts, hence the name. The cysts are the result of an imbalance in hormones; they are the evidence of follicles forming, but ovulation not occurring. People with PCOs often have more androgens, which can inhibit ovulation and impact fertility. Many people who have PCOS do not ovulate, or ovulate erratically. This can cause irregular or absent periods.

PCOS is linked to insulin resistance, so people afflicted with this condition often gain weight as a side effect. It’s also associated with acne and excessive hair growth on the body. PCOS can lead to infertility, pelvic pain, and more. People who have it are also more likely to have high blood pressure and diabetes, mostly linked to the weight factor. It’s important to remember, says Schlinger, that PCOS can happen on a spectrum: “For some, it’s more mild and some simple diet changes get them ovulating again. Others need medical help. You don’t have to think, ‘Oh no, I have this and I’m doomed.’ There is a range of how severely it manifests for you.”

Low progesterone
Progesterone is a hormone secreted by the corpus luteum, a small temporary gland that’s made each month after your body ovulates. It prepares the uterine lining to accept a fertilized egg and is needed to sustain a healthy pregnancy. If you don’t have enough progesterone in your body, the lining will start to release, giving you your period before the length of time needed for an egg to implant.

If you have low progesterone, the main symptom is having a short luteal phase, or the time between ovulation and menstruation. Ideally, this time period should be about 12-14 days, although ten or eleven days can be normal, as well. A single digit period of time — meaning nine days or less — can indicate low progesterone, as can spotting before your period or recurrent miscarriages. Some people with low progesterone have issues with sleeping, anxiety, or PMS.

The treatment for low progesterone is often progesterone supplementation, either through a cream or a vaginal suppository. Other ways to encourage your body to produce more progesterone include an herb called chaste berry (sometimes called Vitex), a Chinese herb called dong quai, evening primrose oil, or other supplements. Acupuncture is another option.

How do you know if you have an hormonal imbalance?
One good way to figure out if your menstrual cycle is normal is through charting your fertile signs, using basal body temperature, cervical fluid, and even ovulation strips. These days, apps like Kindara, Clue, and Glow make it really easy to use your phone to track and chart. Remember, says Schlinger, “It’s not abnormal for your cycle to change or even skip a period in times of stress or travel. Also, not everyone has a 28 day cycle.”

If you do determine things are off after tracking your cycle, you can ask your doctor for additional blood tests to look at your hormone levels, including a full thyroid panel. Schlinger suggests that you ask for a copy of your lab results, so you can always get a second opinion or do your own research.

General ways to support your hormones
Keep in mind that if you are on hormonal birth control, the synthetic hormones will mask any imbalance you might have. This is why providers often recommend going on birth control to “regulate” hormones. While that treatment might work for some, you may find you suffer from the same issue if and when you decide to stop taking hormonal birth control.

Schlinger suggests a whole-foods diet high in healthy fats for anyone experiencing a hormonal imbalance, as well as minimizing exposure to hormones in your environment — do this by consuming organic meat and milk, plus using glass food containers. For PCOS, a low carb or limited sugar diet might help. There are also holistic women’s health professionals, like Alisa Vitti and Nicole Jardim, who have nutritional protocols you can follow to tweak your hormones. Check with your gynecological health provider if you’re interested in trying them out. Naturopathic doctor Lara Briden’s blog and book are also worth a look, if you’re interested in learning more about how to optimize your hormones through supplements and diet.

If you’re worried about your hormones, the most important thing you can do is pay attention to your body — because it’s telling you things about your health. Find out what’s normal for you and be prepared to advocate for yourself if things don’t seem right. “We’re not robots,” reminds Schlinger, “what’s normal should be looked at in the context of what has been normal for you previously. Our bodies are variable and human.”

Carrie Murphy is a freelance writer and doula in Albuquerque, NM. Read more on her website, carrie-murphy.com.