I have had a myriad of hormone issues over the last 10 years. I can say this; it is mainly mental and stress. Your mind takes you down these strange path's of paranoia and doubt and wanting to say the hormones and medications make you gain weight. But it really does not. There might be a slight variation in metabolism, but it's slight.
So if you live an active lifestyle yet still have a problem with the body fat level creeping up, it's the food baby. No other way around it.
The real issue is the amount of food. Too much makes us gain fat over time, and it accumulates quickly. It seems like it accumulates more quickly then it take to lose it. It never seems fair. It always makes us think there is something wrong causing it.
I do believe that it's because eating is like spending with a credit card, you don't always see it until the bill arrives. But a calorie deficit is like spending cash, it hurts, and we remember every penny. My husband talks about this all the time because he loves numbers and finances; in the financial world they call it mental accounting. He's watched me on this journey for over 25 years and he's seen the same pattern in me with my eating and my fluctuations.
I was in tears once a few years ago about this, in the midst of really icky hormone problems where I didn't get good sleep and felt like I was run over by a truck every single morning. The stress makes you hungry. The stress makes you not see what you are eating, the little bites here and there and the inaccuracies. You meant to count it, but you ate it earlier and you forgot to count it (the ease of the credit card spending and you really didn't get a bill until the fat started to accumulate on your body and you wondered where the heck it came from).
So, my advice is that it's TIME to focus on the diet. Never let that out of your sight. It IS the issue. Nothing else is the issue. It is the food intake, end of story. You can't change the laws of thermodynamics, even with your health issues. It really is only slight. If you sequestered yourself in a house where they brought you the right amount of food and you simply did not have access to the extra, you would achieve your goal. The key is that you don't get to be sequestered like that, so you must set up your environment to avoid those extra temptations. We can't rely on willpower, because when you are under so much stress, and the food is right there -- you will eat it and willpower is not enough. I probably have more willpower than anyone I know, and I know it's not enough. Randy and I were just laughing about that the other night.
Also because of of the amount of stress you are under, you might have to adjust the calorie plan you have. Every day does not have to be the same eating pattern. Learn to go with your own ebbs and flows and stress. Eating at maintenance is ALWAYS A WIN because you are not going backwards (not gaining). All you need is more deficit days your maintenance days. Use a free caloire counting tool to find your maintenance and deficit, or if you have the Venus Factor nutritional calculator use that.
Accurate accounting and consistency is the KEY. Get a monthly calendar and put a sticker or symbol for every day you eat under maintenance. Know that if there are more days every week with those, you are WINNING the game.
I hope this helps!