As we age, our estrogen levels decrease. It’s a normal part of the ageing process. However, if you’re younger and suffering from low estrogen levels, you may notice symptoms such as hot flashes, depression, and irregular (or non-existent) periods.
Although men produce estrogen (at low levels), this hormone is commonly associated with women, and it plays some significant roles in the body. An adequate amount of estrogen is essential for your overall health and well-being, but unfortunately, low estrogen is a common problem.
Here’s a closer look at the causes, symptoms and treatments of low estrogen, and how you can help balance out your hormones naturally.
What Does Estrogen Do?
Estrogen is one of the most important hormones, and it plays a significant role in the reproductive and sexual development of women. It’s also responsible for a variety of bodily functions, including glucose metabolism, body weight, insulin sensitivity, and metabolic regulation.
In women or assigned female at birth (AFAB) people, estrogen can impact the reproductive and urinary tracts, bones, breasts, the heart and blood vessels, skin, pelvic muscles, brain, and more.
In other words, estrogen wears many hats. Although it helps regulate the menstrual cycle and plays an important role in the development of secondary sex characteristics (such as pubic hair and breasts), we shouldn’t forget the role it also plays in regulating our moods, protecting our health and skin, and even regulating cholesterol levels.
AFAB people produce three main types of estrogen:
Estrone (E1)
Estrone supports sexual development and function, and it’s the only type of estrogen that the body continues to make naturally after the menopause. If you’re postmenopausal, you may actually have higher levels of estrone than premenopausal people.
Estradiol (E2)
Estradiol is produced by the placenta during pregnancy, and also the ovaries and adrenal gland. It helps regulate many processes in the body, and it’s the most abundant form of estrogen. Estradiol also plays a big role in regulating the menstrual cycle.
Estriol (E3)
This weaker form of estrogen is produced in the placenta during pregnancy. These estrogen levels rise during pregnancy to help keep your body (and your uterus) healthy.
The Symptoms Of Low Estrogen
If you have low estrogen levels, you may experience a variety of symptoms, including:
Pain during sex due to a lack of vaginal lubrication
Chronic or persistent urinary tract infections (UTIs), due to thinning of the urethra
Irregular periods
Extreme changes in mood
Hot flashes
Depression
Fatigue
Difficulty concentrating
Tender breasts
Headaches or migraines
Decreased bone density and increased susceptibility to bone fractures
It’s normal for your estrogen levels to fluctuate throughout the menstrual cycle. However, if your estrogen levels are chronically or unusually low, they may lead to irregular periods or issues with your fertility.
What Causes Low Estrogen?
Low estrogen has a number of causes, such as:
Menopause
The menopause is the most common cause of low estrogen. The menopause causes drastic hormonal changes in AFAB people, and low levels are associated with the most common symptoms of the menopause, such as hot flashes and night sweats.
Being Underweight
If you’re underweight, it can have serious consequences for your health. Being underweight can also lead to low estrogen levels, and may contribute to irregular or missed periods. You may also develop a low bone mass density which can increase your risk of bone fractures and osteoporosis.
Turner Syndrome
Turner syndrome is a genetic disorder that affects AFAB people, and it can present with a variety of symptoms such as:
Shorter height
Broad chest
Low hairline
Teeth issues
Spoon-shaped nails
Teeth issues
Unfortunately, Turner Syndrome can also affect the ovaries, which produce sex hormones and trigger periods. Most girls do not have enough estrogen to trigger their periods and may require HRT to induce them. Unfortunately, some can even be infertile.
Excessive Exercise
Exercise may be good for our health, but too much can lead to low estrogen levels. If you’re working out excessively, it may be the cause of your hormonal imbalance – especially if you’ve become underweight and have a poor diet.
The Contraceptive Pill
The contraceptive pill is a synthetic form of estrogen and progesterone, and it’s used to stop ovulation and keep your hormones consistent. The contraceptive pill also suppresses the body’s production of estrogen to prevent ovulation, which may lead to symptoms of low estrogen.
Can You Test Your Estrogen Levels?
Yes. If you think your estrogen levels are low, you can ask for your levels to be tested with a blood test. If you’re struggling to make it to a doctor or you’d prefer to test your levels yourself, you may be able to request a home testing kit.
This usually requires a small sample of blood via a finger prick, and your sample can be sent away for analysis.
However, many symptoms of low estrogen can also be caused by other conditions. If your estrogen levels are normal, you may be experiencing symptoms of another condition such as:
Overactive Thyroid: Hyperthyroidism can cause fatigue, low libido, palpitations, mood swings, and more.
Underactive Thyroid: On the other hand, an underactive thyroid can also cause similar symptoms. If your glands don’t produce enough thyroid hormones, you may experience weakness, weight gain, low libido, irregular periods, and more.
How To Treat Low Estrogen
Thankfully, if you’re suffering from low estrogen, there are many treatments available to help manage your symptoms. However, the treatment you’re recommended may depend on what’s causing your symptoms.
Hormone Replacement Therapy
HRT Is a popular treatment for people with low estrogen. HRT can help restore estrogen levels, but your doctor may recommend a combination therapy that includes progesterone if you’re going through the menopause.
You’ll usually be recommended the lowest dose of HRT, and you can take it orally, topically, vaginally, or as an injective. If you have a history of heart attacks, high blood pressure or strokes, you may not be able to take HRT.
Estrogen Therapy
Estrogen therapy is a type of HRT that doesn’t use progesterone, only estrogen. Estrogen therapy may be recommended as a more appropriate way to manage your symptoms, especially if you’re going through the menopause.
Talk to your doctor to learn more about the differences between HRT and estrogen therapy, and see which one is right for you.
Natural Remedies
There are also a variety of natural remedies that you can use to manage your low estrogen levels. Your doctor may recommend trying some of these alongside your HRT, if applicable.
Natural remedies can include moderate exercise (especially strength training) and maintaining a healthy weight. If your weight is the result of an eating disorder or another underlying health condition, you may be offered more support to reach your goals.
Final Thoughts
Low estrogen is a common problem, especially for AFAB people going through the menopause. However, low estrogen can occur at all stages of life, for all sorts of reasons.
If you think you may be experiencing symptoms of low estrogen, arrange to test your levels with your doctor and discuss the most appropriate treatment plan.
You can also try adding a few lifestyle changes into the mix to improve your symptoms, however, you may still require a treatment like HRT to manage your symptoms.
I'm Clare, the owner and operator of Off The Couch, where I serve as a qualified Nutrition & Health Coach.
Based in Dublin, Ireland, I offer coaching services both locally and globally, providing personalized strategies in nutrition, stress management, sleep quality, and fitness.
My journey into this field began as I navigated my own chronic illnesses, including early menopause, Interstitial Cystitis, Lyme Disease, and hydrocephalus.
