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What happens when estrogen levels are low?

Estrogen is a hormone that is most often associated with females, although men do produce small amounts. Declining estrogen can lead to a variety of health concerns and symptoms.

Although estrogen is primarily associated with female development during puberty and the reproductive cycle, it affects everything from bone health to emotional well-being.

Low estrogen levels can develop in women of all ages for several reasons.

Fast facts on low estrogen:

  • Estrogen is largely produced by the ovaries.
  • When estrogen levels are low, it can have several effects on the body.
  • Women who have eating disorders, such as anorexia, are at a higher risk of having low estrogen levels.

Causes of low estrogen

Woman with low estrogen levels running on machine in gym.
Excessive exercise may cause low estrogen levels.

Levels of estrogen vary for many reasons. Any condition that affects or damages the ovaries can cause a decrease in estrogen levels in the body.

The most significant risk factor for having low estrogen is age. As women age and approach menopause, it is normal for estrogen levels to drop.

In fact, estrogen levels start to lower several years before menopause occurs a phase called perimenopause.

Estrogen levels can also decline for several other reasons including:

  • premature ovarian failure
  • congenital conditions, such as Turner syndrome
  • thyroid disorders
  • excessive exercise
  • being severely underweight
  • chemotherapy
  • low-functioning pituitary gland

Having a family history of hormonal problems can also increase a woman s risk of developing low estrogen.

Effects of low estrogen

Depressed woman sitting on bed.
Potential symptoms of low estrogen include irregular periods, infertility, and depression.

Estrogen is an essential hormone so the effects can be quite wide-ranging.

Symptoms of low estrogen may include the following:

  • Irregular periods: Estrogen is one of the main hormones driving the menstrual cycle. Low estrogen may lead to missed or irregular periods.
  • Infertility: Low estrogen levels can prevent ovulation and make getting pregnant difficult, leading to infertility.
  • Weak bones: Estrogen helps keep the bones healthful and strong. As estrogen levels decrease, bone loss may occur. For example, women who are post-menopausal are at an increased risk of developing osteoporosis and bone fractures.
  • Painful intercourse: Estrogen can affect vaginal lubrication. If levels become too low, vaginal dryness can occur, which often leads to painful sex.
  • Hot flashes: Hot flashes often happen during menopause due to low estrogen levels.
  • Depression: Estrogen is thought to increase serotonin, which is a chemical in the brain that boosts mood. Estrogen deficiency may cause a decline in serotonin that contributes to mood swings or depression.
  • Increase in urinary tract infections: Increased urinary tract infections may occur due to the thinning of the tissue in the urethra, which can develop with decreased estrogen.

Effect on weight

Hormones including estrogen can play a role in weight management and how much fat the body stores. Low estrogen levels, such as during perimenopause and menopause, may contribute to weight gain.

The areas where women store fat may also change during menopause. Typically, women store fat in their hips and thighs. But that changes as estrogen levels drop. According to the Journal of Climacteric, the decrease in estrogen at midlife is associated with an increase in abdominal fat.

Although weight gain due to low estrogen levels is typical, it does not have to be inevitable. Eating a healthful diet and getting regular exercise can help women reduce their chances of weight gain.

Diagnosis

A diagnosis of low estrogen often starts with a physical exam, medical history, and a review of symptoms. Telltale indicators of low estrogen include hot flashes and missed periods. But some of these symptoms can also occur as a result of other conditions, including thyroid problems.

To determine the cause of low estrogen, a doctor may do a blood test to check hormone levels. The doctor may also recommend additional tests to rule out other conditions that might be causing symptoms similar to low estrogen.

Treatment options

Not all women require treatment for low estrogen. But if low estrogen symptoms are bothersome, treatment may be recommended. Treatment is individualized based on the cause of low estrogen and the symptoms present.

Hormone replacement therapy

Pills in blister packet
Hormone replacement therapy may be used to treat low estrogen.

Typically, doctors prescribe hormone replacement therapy HRT for low estrogen levels.

Different types of HRT are available. Sometimes, doctors suggest a combination hormone therapy that contains estrogen and progesterone.

The combination of hormones may be effective in balancing estrogen levels in some women experiencing symptoms.

Doctors tend to prescribe combination HRT for women who are approaching menopause or are experiencing post-menopausal symptoms. Side effects from HRT may include bloating, headaches, and vaginal bleeding.

Women can take HRT orally, topically, vaginally, or have pellets inserted under the skin. In some instances, women may have an injection. The dose given varies according to the individual. Usually, doctors prescribe the lowest dose that relieves symptoms.

Not all women can use HRT. For example, HRT may not be suitable for women who have had a history of a stroke, heart attack, or high blood pressure. It is essential that any woman who is considering HRT speaks to her doctor about the risks versus the benefits.

Estrogen therapy

Sometimes, doctors prescribe just estrogen to treat some women with estrogen deficiency for example, women who have had their ovaries removed. Sometimes, a doctor will prescribe estrogen therapy to treat bothersome symptoms at menopause.

Natural remedies

There does not appear to be many scientifically proven methods for increasing estrogen levels using natural remedies. However, a few lifestyle and diet changes may help.

Maintaining a healthy weight

Because being extremely underweight can cause reduced estrogen levels, maintaining a healthy weight may help.

Exercise reduction

Extreme amounts of exercise can also cause a decline in estrogen production so cutting back on exercise may help increase estrogen levels.

Soy

Some studies have been conducted on the benefits of soy for treating low estrogen symptoms. There is conflicting research on the benefits of soy for increasing estrogen levels. However, this small study indicated that soy isoflavones might reduce menopausal symptoms caused by declining estrogen levels.

Increasing soy may not be appropriate for all women. Before adding more soy or taking a soy supplement, a woman should talk with her doctor.

Takeaway

Low estrogen levels can cause a variety of health issues and affect a woman s overall well-being. Any woman who experiences symptoms of low estrogen should talk with her doctor.

In many instances, treatments for low estrogen symptoms work well. Although outlooks vary depending on the cause, HRT is often helpful.

It is also important to remember that the length of time a woman needs to take HRT will vary according to her situation.