Raise your hand if, in the last few weeks, you’ve felt tired, bloated, or cranky. Sound familiar? Then you know the drill: Every month, your hormones—the body’s itty-bitty secret weapon—come out to play, wreaking havoc on your mood, skin, and mind. While levels generally stabilize after your period, various factors, like stress (yup, keep those hands raised) and anxiety can throw them off balance. So how can you tell if your symptoms require an office visit? Alyssa Dweck, MD, an OB-GYN at the Mount Kisco Medical Group in New York shares the five red flags that might merit a doctor’s note.

Fatigue

Exhaustion is one of the most, well, exhausting symptoms to a doc, since it has so many possible causes. “If you’re tired after a week of final exams or late nights at work, then you’re probably fine,” says Dr. Dweck. “But if you constantly feel worn out and notice weight gain, appetite fluctuations, and a change in bowel movements, it could be a sign of an underactive thyroid.” Yes, fatigue happens to everyone, but if yours doesn’t feel logical, then it’s worth getting it checked out.

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Skin changes

You’re breaking out—again. While those sudden zits could be caused by one too many nights of going to bed without washing your face, they may be indicative of something more. “Adult acne or cystic acne around the lower half of your face could suggest a high level of testosterone,” says Dr. Dweck. Although not a life-threatening problem, breakouts can take a toll on your psyche. Luckily, your doc can prescribe you medication to stabilize your hormone levels and clear up skin.

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Hair growth

We’re talking really fast hair growth. “If you all of a sudden grow a beard within a month or notice coarse, dark hair popping up on your chest, back or arms, that could be indicative of a testosterone-secreting tumor,” explains Dr. Dweck. But don’t freak out: Tumors are rare, she notes, and can often be treated with drugs or surgery.

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Weird periods

Just like fatigue, a messed-up menstrual cycle can be the result of many factors, like stress, thyroid issues, low estrogen, or polycystic ovary syndrome (PCOS). “The hallmark of PCOS is irregular or absent periods, but it could also present with difficulty losing weight or strange hair growth,” says Dr. Dweck. Generally, PCOS is managed through diet, exercise and birth control pills, but your doctor will work with you to develop a multi-faceted plan if she finds this to be the cause of your period problems.

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Night sweats

Unless it’s unusually warm in your bedroom, waking up feeling overheated and sweaty could be the result of lower estrogen levels and infrequent ovulation—AKA perimenopause. “Perimenopause can occur up to 10 years before you’re even near the age of menopause,” says Dr. Dweck, “so unless you’re having major menstrual issues before age 40, there’s a good chance your phantom sweating could actually be early menopause.” Either way, Dr. Dweck recommends making an appointment with your doc to make sure it’s nothing more serious.

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