At Flow Wellness, we believe that optimizing your hormone levels is one of the most powerful ways to restore energy, improve wellness, and support long-term health—especially as you age. This guide explains the four key sex hormones we evaluate in bioidentical hormone replacement therapy (BHRT): estradiol, progesterone, testosterone, and DHEA.

Each plays a vital role in your health and well-being. When levels are too low or too high, you may experience a wide range of symptoms. The good news? With the right testing and personalized treatment plan, we can restore balance and help you feel your best again.

🌸 Estradiol

The dominant estrogen during reproductive years

Estradiol is the primary estrogen used in BHRT for women. It’s essential for:

• Regulating menstrual cycles and reproductive health
• Maintaining vaginal moisture and elasticity
• Strengthening bones and preventing osteoporosis
• Supporting skin elasticity and collagen
• Aiding heart health (especially when started around menopause)
• Enhancing brain function and possibly lowering Alzheimer’s risk
• Regulating body temperature and reducing hot flashes
• Supporting mood, libido, metabolism, and deep sleep (especially REM sleep)

How it’s prescribed: Typically via transdermal creams or hormone pellets

Symptoms of Low Estradiol:

• Hot flashes, night sweats
• Vaginal dryness, painful intercourse
• Recurrent urinary tract infections
• Depression, irritability
• Poor memory or concentration
• Insomnia or light sleep
• Fatigue
• Joint pain, stiffness
• Weight gain, bone loss
• Dry or thinning skin, dry eyes/hair

Symptoms of High Estradiol:

• Heavy or irregular menstrual bleeding
• Breast tenderness or fibrocystic breasts
• Mood swings, irritability
• Bloating, water retention
• Worsening of fibroids
• Weight gain in hips/thighs
• Headaches, fatigue

🌙 Progesterone

The calming hormone

Progesterone is often the first hormone to decline in perimenopause. It helps:

• Balance the effects of estrogen
• Regulate menstrual cycles
• Promote restful sleep
• Reduce anxiety and inflammation
• Support bone density and early pregnancy
• Aid thyroid function and blood pressure
• Prevent estrogen dominance, which is linked to higher breast/uterine cancer risk

How it’s prescribed: Commonly orally or sublingually

Symptoms of Low Progesterone:

• Irregular or heavy cycles
• PMS: mood swings, breast tenderness
• Infertility or early pregnancy loss
• Anxiety, depression, insomnia
• Hot flashes, bloating
• Weight gain around the waist
• Low libido, fatigue
• Difficulty concentrating, bone loss
• Fibrocystic breasts or fibroids

Symptoms of High Progesterone:

• Drowsiness (especially with oral forms)
• Bloating or “full” feeling
• Nausea
• Lightheadedness, dizziness
• Weepiness or mild depression
• Acne or oily skin
• Symptoms of estrogen deficiency if overly dominant

💪 Testosterone

The vitality and strength hormone

Though commonly associated with men, testosterone is essential for women, too. It supports:

• Lean muscle mass and bone strength
• Cognitive function, memory, and mood
• Energy, motivation, and overall well-being
• Libido and sexual satisfaction
• Insulin sensitivity and fat metabolism
• Vaginal tissue and collagen for youthful skin

How it’s prescribed: Most often transdermally

Symptoms of Low Testosterone:

• Low sex drive, difficulty with orgasm
• Fatigue, poor muscle tone
• Mood changes, depression, irritability
• Brain fog, memory issues
• Weight gain, decreased strength
• Thinning skin and hair
• Sleep disturbances, incontinence

Symptoms of High Testosterone:

• Acne or oily skin
• Unwanted facial or body hair (hirsutism)
• Scalp hair thinning
• Aggression or mood swings
• Irregular cycles
• Deepening of the voice
• Enlarged clitoris (rare with proper dosing)
• Symptoms resembling PCOS (in some women)

🔄 DHEA

The adrenal reserve hormone

Dehydroepiandrosterone (DHEA) is produced by your adrenal glands and acts as a precursor to testosterone and estrogen. It supports:

• Energy and mood stability
• Libido and stress resilience
• Bone density and muscle strength
• Immune function and healthy aging
• Skin vitality and blood sugar regulation

Think of DHEA as a backup generator—it kicks in when other hormones decline, especially under stress.

How it’s prescribed: Orally, sublingually, or via cream

Symptoms of Low DHEA:

• Fatigue, low mood, brain fog
• Decreased muscle tone
• Reduced libido and stress tolerance
• Bone thinning
• Dry skin and eyes
• Increased abdominal fat
• Poor memory or insulin resistance

Symptoms of High DHEA:

• Acne, oily skin
• Hirsutism (unwanted hair growth)
• Hair loss (androgenic pattern)
• Sleep disturbances or feeling “wired”
• Menstrual irregularities
• Voice deepening (rare)

💡 Final Thoughts

Sex hormone imbalances can affect nearly every part of your body—from your mood and metabolism to your skin and sleep. That’s why at Flow Wellness, we take a personalized, data-driven approach to hormone replacement therapy, beginning with comprehensive lab testing and one-on-one care to help you feel balanced and energized again.

If you’re experiencing symptoms of hormonal imbalance, schedule a consultation with one of our experienced providers. Whether you’re in perimenopause, menopause, or simply feeling off, we’re here to help you feel your best.

Interested in starting BHRT therapy? Book a consultation today!