Hormonal Issues and Imbalance

Medically reviewed by David Shusterman, MD · Updated September 28, 2026

Hormones are chemical messengers made by glands such as the thyroid, the pituitary, the adrenal glands, the pancreas, the ovaries and the testes. They travel through the bloodstream and tell tissues and organs what to do, regulating energy, weight, mood, sleep, sex drive, fertility, bone strength and blood sugar. When a hormone runs too high or too low, the effects can spread across the whole body, which is why hormone problems are so often mistaken for stress, aging or simply being tired.

NYMD Center is a multi-specialty group, and hormone care is one of the places that pays off. Our internal medicine physicians manage thyroid disease and diabetes, our urologists treat low testosterone in men, and our gynecologists care for women through perimenopause, menopause and polycystic ovary syndrome. When a problem crosses those lines, and hormone problems often do, your physicians can coordinate in one practice.

Our approach is the same across all of them: evaluate before treating. Hormone levels vary through the day and from week to week, and many symptoms have other causes. We confirm the diagnosis with the right tests at the right time, look for what is driving the problem, and only then decide on treatment.

Symptoms that can point to a hormone problem

Hormonal symptoms are often vague and build slowly. Common ones include unexpected weight gain or loss, fatigue, feeling unusually cold or hot, thinning hair, dry skin, nervousness, anxiety, irritability or depression, muscle weakness, frequent urination and excessive thirst, blurred vision, low sex drive or erectile dysfunction, irregular or absent periods, hot flashes and night sweats, acne or excess facial hair, and trouble getting pregnant. None of these proves a hormone disorder on its own, but a combination of them deserves an evaluation.

The hormone conditions we treat most often

Thyroid disease

An underactive thyroid slows the body down, causing fatigue, weight gain, cold intolerance, dry skin, thinning hair and irregular periods, while an overactive thyroid does the opposite, with weight loss, a racing heart, anxiety and heat intolerance. The NIDDK notes that women are much more likely than men to develop hypothyroidism and that it cannot be diagnosed on symptoms alone. Blood tests confirm it, and ultrasound evaluates nodules. Learn more on our thyroid disease page.

Low testosterone in men

Low testosterone can cause low libido, erectile problems, fatigue, loss of muscle, weight gain and low mood. Because levels are highest in the morning and fall with illness, diagnosis requires early-morning blood tests repeated on separate days, as the Cleveland Clinic and Mayo Clinic both describe. We also look for the causes behind it: obesity, sleep apnea, type 2 diabetes, medications such as opioids, and pituitary problems. One point matters before any treatment starts. Testosterone therapy suppresses the body's own production and can lower sperm count and shrink the testicles, as the Cleveland Clinic explains, so we talk about fertility first with every man who may want children. Our urologists manage this through our low testosterone program and AndroMD.

Perimenopause and menopause

Menopause is the point when periods stop permanently, and the National Institute on Aging notes that most women begin the transition between 45 and 55. The years leading up to it, called perimenopause, bring irregular periods, hot flashes, night sweats, poor sleep, mood changes, vaginal dryness and urinary symptoms. Our gynecologists offer both hormonal and non-hormonal treatment; see our perimenopause treatment and menopause pages.

PCOS and insulin resistance

Polycystic ovary syndrome is a hormonal disorder that causes irregular periods, excess facial and body hair, acne, weight gain and difficulty getting pregnant, and it raises the risk of prediabetes and type 2 diabetes through insulin resistance. Insulin resistance itself, in men and women, is a hormone problem that drives weight gain and can lower testosterone. We treat PCOS through our PCOS care and manage blood sugar in internal medicine.

Adrenal and pituitary disorders

Less often, symptoms come from the adrenal glands, which make cortisol and related hormones, or from the pituitary gland, which directs many of the others. A pituitary problem can show up as low testosterone, missed periods, breast discharge or headaches. When our testing points to these glands, we arrange imaging such as MRI and refer you to endocrinology.

How we evaluate hormone problems at NYMD Center

Evaluation starts with a careful history of your symptoms, sleep, weight, medications, supplements and family history, followed by a physical examination and, for women, a pelvic exam when relevant. Blood tests are timed to the hormone being measured; testosterone, for example, is drawn in the morning and repeated before any diagnosis is made. Depending on what we find, we may add an ultrasound of the thyroid, pelvis or testes, and arrange further imaging such as thyroid scans, MRI or x-rays, or a biopsy when a nodule or mass needs it. We also look for common causes that masquerade as hormone disorders, including sleep apnea, anemia, depression and medication side effects.

Treatment, least invasive first

Many hormone problems improve when the underlying cause is treated. Weight loss, better sleep, treating sleep apnea, more activity and changing a problem medication can raise testosterone, improve insulin sensitivity and ease PCOS symptoms without any hormone prescription. When medication is needed, options include thyroid hormone replacement, medications that improve insulin sensitivity, hormonal and non-hormonal treatments for menopause, and testosterone or fertility-sparing alternatives for men, described on our hormone replacement page. Hormone therapy is monitored with follow-up labs to keep levels in a safe range and watch for side effects. In uncommon cases, such as certain thyroid nodules or pituitary and adrenal tumors, surgery is the right treatment, and we refer you to the appropriate surgeon.

What to expect at your visit

Bring a list of your symptoms and when they began, your medications and supplements, including any hormones you have used, and any previous lab results. Your first visit usually includes a history, an exam and blood work, with an early-morning draw scheduled if testosterone or other time-sensitive hormones need checking. We review results with you, explain what is and is not a hormone problem, and build a plan with the right specialist in our group.