Ask a doc: Could my husband be suffering from hormonal mood swings?

Dr Anjum Omar, an endocrinologist at Kenyatta National Hospital and lecturer at the School of Medicine, University of Nairobi, spoke to Hillary Orinde on some of the common hormone-related conditions.

I was told by a doctor to get on hormone pills to balance out my hormones. Are there safer and effective ways I can do that without popping pills?

Listen to your doctor. Hormonal imbalance could be a deficiency or overproduction of a particular hormone. The kind of hormone that is imbalanced will play a major role in determining how the sign and symptoms will manifest and risks involved. You need to replace the hormone absent in your body and depending on which hormone replacement you are taking it could be pills or injectable.

I have been reading up on hormone replacement therapy. Is it offered in Kenya?  

Hormone replacement therapy replaces the hormones deficient in your body and it can take you up to one month to see a change. Depending on what hormone you have been prescribed for, most are available in Kenya. Costs of hormones may vary and can cost from as low as Sh500 to as high as Sh30,000.

How do hormonal changes affect the way our skin ages?

With aging, there is a decrease in the level of hormones, such as oestrogen, progesterone and testosterone. These hormones can have a noticeable impact on your skin with imbalances often leading to flare-ups, outbreaks and bouts of dry or oily skin

My husband turned 45. And I think he has mood swings. Could they be hormonal mood swings?

Men can get hormonal mood swings and this is known as irritable male syndrome. This is    often the result of high cortisol (stress hormone) and low testosterone (male sex hormone) levels and occasionally high oestrogen (female sex hormone) levels.

My weight has gone up since I got on hormonal contraceptives. How long will the effect wear off after stopping use?

Common side effects of birth control pill are breakthrough bleeding, weight gain, breast swelling or tenderness, stomach upset, headaches and mood changes. Breakthrough bleeding, headache, nausea and mood changes usually go away after 2-3 months while it may take up to 6 months for your weight to be normal.

Are there a group of women who should keep away from hormonal contraceptives?

Those who must absolutely not be on hormonal contraceptives are women who have conditions associated with blood clots, cerebro-vascular or coronary artery disease, breast cancer or colorectal cancer, abnormal genital bleeding, known or suspected pregnancy and benign or malignant liver tumor.

What are some of the lifestyle choices that contribute to hormone-related problems?

Factors such as exposure to hormone disrupting toxins in our environment and foods, long term use of hormone replacement therapies like the oral contraceptive pill, caffeine, testosterone boosters (supplements commonly used in sport and body building), sleep deprivation, work environment such as shift workers, genetic predisposition, stress, too much or not enough exercise, poor dietary choices, food sensitivities, nutrient deficiencies and gut dysbiosis (un balanced gut microbiome) are just some of the triggers of hormonal dysfunction.

I am in mid 30s and is often fatigued, often even before half the day elapses, how can I rule out hypothyroidism? Is there a treatment for the condition?

Some of the symptoms of hypothyroidism includes being easily fatigued, weight gain, lethargy, cold intolerance and insomnia. You can do a thyroid function test to rule out hypothyroidism. Once the diagnosis of hypothyroidism is confirmed you will be put on thyroxine tablets.

Lately, my bones have felt frail and I am increasingly worried about osteoporosis, especially having read its common in women. Does everyone get it as they get older?

As you grow older and go through menopause, oestrogen in your body starts to decline. oestrogen deficiency causes both the early and late forms of osteoporosis in postmenopausal women and contributes to the development of osteoporosis in elderly men. There are now many drugs and medications for osteoporosis, but oestrogen remains a fairly common treatment to conserve bone mass and prevent osteoporosis-related fractures in post-menopausal women.

We have been trying to conceive a baby for years to no success. What could we be doing wrong? Is there a right time to have to have sex to conceive?

The cause of your infertility may be difficult to determine without tests but may include inadequate levels of certain hormones in both men and women, and trouble with ovulation in women. You need to be evaluated for infertility with your spouse. Many treatments significantly improve the chances of getting pregnant. They include hormone treatments, fertility drugs and IVF.

My baby is nearing teen years but is way shorter than the peers. Is there hormonal treatment to correct the stature?

There are many causes of short stature. Your teenage child needs to be evaluated for short stature by a paediatric endocrinologist. Once the diagnosis is confirmed then the child is put on treatment for short stature.

I am female but I have facial hair. How can I stop them from growing?

Hair on the face in a female is a sign of overproduction of androgens. Androgens are a group of hormones that play a role in male traits and reproductive activity. Facial hair can also occur in women with polycystic ovary syndrome. You need to be evaluated by an endocrinologist to check if your hormones are balanced. If there is no issue with the hormones, then you can go for laser treatment for removal of the facial hair.