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Low Estrogen: What it Means and Why it Matters

Are your hormones out of whack? Estrogen plays an important part in your health, and having too little can lead to some unpleasant symptoms. But how can you know if your symptoms are from low estrogen? Let’s talk about Low Estrogen: What it Means and Why it Matters. 

Estrogen is often called a “sex” hormone because it’s important for forming body parts like breasts and ovaries. But estrogen doesn’t just support sexual characteristics, and it’s not just found in women. It’s also important for bone, heart, and immune health. That’s why having too little estrogen can lead to some weird symptoms. 

We’re still learning about how estrogen impacts different body processes. To understand the effects of low estrogen, let’s first talk about where we get estrogen in the body. 

Where does estrogen come from?

If you’re in your reproductive years, most of your body’s estrogen is being made by your ovaries. It’s also made in smaller amounts by fat cells. 

After menopause, women are reliant on their fatty tissue to make estrogen. Levels of estrogen are much lower in postmenopausal women because their ovaries shrink and don’t produce it anymore.  

The pituitary and hypothalamus glands in the brain affect the amount of estrogen made by the ovaries and fat cells. These glands are responsible when estrogen levels rise and fall throughout your fertility cycle. 

What does estrogen do?

Here are the major areas in the body that are affected by estrogen:

  • The Breasts: Estrogen helps to create and develop breast tissue in girls. Estrogen helps with developing milk ducts during pregnancy and puberty. 
  • The Uterus: Estrogen tells the uterus to thicken its lining in the follicular phase to get ready for a potential pregnancy.
  • The Vagina: Epithelial cells in the vagina depend on estrogen for development. Without estrogen these cells thin, and vaginal dryness can occur. 
  • Bones: Estrogen helps long bones grow and fuse during puberty. It also stops bones from being broken down. 
  • Heart Health: Estrogen helps control cholesterol levels, increasing “good” cholesterol and decreasing “bad” cholesterol. This reduces the risk of heart disease. 
  • The Brain: Estrogen assists with cognitive processing, and it also keeps synapses healthy so that signals travel quickly. 

Normal estrogen levels in women 

Normal estrogen levels change throughout the lifetime. Some women may have more circulating estrogen than others. These individual variations are generally normal. 

A little estrogen goes a long way in the body. Estrogen circulates in such small amounts, it’s measured in picograms (pg), or one trillionth of a gram, per milliliter. 

Here are a few reference levels of estrogen for different populations:

  • Adolescent girls: 20-300 pg/mL
  • Childbearing age women: 30-800 pg/mL
  • Pregnant women: up to 20,000 pg/mL
  • Postmenopausal women: <20

Estrogen levels fluctuate during the menstrual cycle. Notice that the range of “normal” estrogen levels in women of childbearing age is quite wide. You’ll notice also that there is a steep decline in estrogen levels after menopause because the ovaries aren’t creating it anymore. 

This drop in estrogen is one of the main reasons why we see symptoms of menopause, like hot flashes and weight gain. Low estrogen causes changes across the body. Let’s talk about what low estrogen means for women. 

Symptoms of low estrogen

Because estrogen is so important across the body, not having enough estrogen can cause a range of symptoms. Take a look at these symptoms of low estrogen:

  • Fatigue
  • Low sex drive
  • Headaches 
  • Issues with concentration
  • Moodiness and irritability
  • Irregular period, or amenorrhea (no periods)
  • Weight gain
  • Vaginal dryness
  • Bone breakage
  • Breast tenderness
  • Dry skin
  • Hot flashes and night sweats

What causes low estrogen?

Estrogen levels naturally fall with age. The menopausal transition is the most common reason why women experience a drop in estrogen. 

But menopause is not the only cause of low estrogen levels. If you’re in your childbearing years, estrogen levels can be low for several reasons, such as:

  • Eating disorders, like bulimia and anorexia. These starve the body of nutrients so that the ovaries can’t make estrogen.
  • Hypothalamic amenorrhea, where the hypothalamus isn’t telling the ovaries to release estrogen. This typically happens as a result of physical or emotional stress. Female athletes may have very low estrogen for this reason. 
  • Polycystic Ovary Syndrome (PCOS) typically affects other hormones, but can lead to low estrogen levels.
  • Premature menopause, sometimes called Primary Ovarian Insuffiency (POI). This is when the ovaries stop producing eggs and estrogen drops before menopausal age. 
  • Pituitary gland problems, where the pituitary is no longer telling the ovaries to release estrogen. 
  • Radiation or chemotherapy for female cancers.
  • After an oophorectomy operation, when the ovaries are surgically removed. This is a treatment for ovarian cancer, and it results in a steep drop in estrogen. 
  • Autoimmune disorders that attack the ovaries and prevent them from making estrogen.
  • Genetic conditions like Turner Syndrome and Fragile X. 

As you can see, there are quite a few reasons why your estrogen may be low. If you’re worried about your estrogen levels, consult your primary care doctor or gynecologist.  

Low estrogen and ovulation

Without enough estrogen, the ovaries won’t release an egg for fertilization. If you’re trying to conceive, not having enough estrogen is a problem. 

Estrogen levels need to rise in the follicular phase to help with egg maturation. Then they normally drop after the egg is released in ovulation. Estrogen rises again during the luteal phase, as the uterus is preparing for pregnancy. 

Without enough estrogen, the egg can’t mature and the uterus can’t prepare for implantation.  

Can low estrogen affect pregnancy?

Yes. 
Some women with low estrogen levels may still be able to conceive, but it’s difficult to sustain a pregnancy without enough estrogen. Pregnancy requires high amounts of estrogen. Not having enough estrogen can lead to premature pregnancy loss and miscarriage

Treating low estrogen

If you’re experiencing the symptoms of low estrogen, there are ways to feel better. Here are a few things you can try to boost your estrogen levels at home. 

Diet and exercise to boost estrogen levels

Maintaining a healthy weight through diet and exercise has shown to help with estrogen production. You may be reading this and thinking that’s easier said than done. This can be tough advice for women who find themselves gaining weight due to falling estrogen levels. In fact, estrogen levels are thought to play a large role in female obesity

The meditarranean dietmay help menopausal women to limit weight gain. This includes a diet high in lean protein, healthy fats, and fiber. Foods that fall within the mediterranean diet include fish, nuts, olive oil, whole grain cereals, and fruits. Speak with your doctor about how the mediterranean diet could help to limit the symptoms of menopause.  

Exercise could also help increase estrogen in women. One study has shown that after just 12 weeks of exercise, women could boost their estrogen levels after menopause. Exercise can also help to strengthen bones and muscles, which tend to decrease from low estrogen. 

You just need to remember one thing. Never overdo any exercise and never exercise in excess. This can cause a drop in estrogen levels in your body.

Reducing stress to increase estrogen

Stress increases the levels of another hormone: cortisol. Cortisol has a negative effect on estrogen levels, so having a lot of stress can make low estrogen worse. 

Using good stress-reduction practices can help bring down your cortisol. Exercise helps to release cortisol from the body, and can even make us more resilient to stressful life events. 

Low estrogen can cause problems with sleep, which can increase cortisol even more. Trying to get more sleep is another way to help bring down cortisol and increase estrogen.  

Replacing estrogen with supplementation 

If estrogen levels are low, can’t women just take synthetic estrogen? The answer is a little complicated. 

Estrogen replacement is still a controversial topic among experts. In early research, it seemed like estrogen could help postmenopausal women stay healthy. It had positive effects on bone health, heart disease risk, and even mortality.  

But more research has revealed risks associated with estrogen replacement therapy. One study was even stopped early because of risks for breast cancer and coronary artery disease. Yet other research has shown that estrogen supplementation could improve quality of life for women. It’s shown to reduce risk for heart disease and other problems in postmenopausal women. 

The Food and Drug Administration has approved the use of estrogen supplementation for symptoms of menopause. Birth control pills also contain estrogen in smaller amounts. 

Talk to your primary care physician or gynecologist if you’re having symptoms of low estrogen. 

Testing for low estrogen

If you’re being evaluated for low estrogen, your doctor may use tests that measure your saliva, blood, or urine. You won’t need to do anything to prepare for these tests. 

Keep in mind that low estrogen is expected after menopause, and it’s totally normal to have a drop in estrogen after the age of 55 years. Even though this decline in estrogen causes unpleasant symptoms, there’s nothing going wrong when this happens. Still, if you’re noticing a decrease in the quality of your life because of menopausal changes, speak with your doctor about possible solutions.

Summing up low estrogen

  • Estrogen isn’t just a sex hormone. It influences bone and heart health, brain processing, vaginal lubrication, and more.
  • For women in their childbearing years, estrogen mostly comes from the ovaries. Postmenopausal women rely on estrogen from fat cells. 
  • The most common reason for low estrogen levels is age. Low estrogen causes a lot of the symptoms we associate with menopause, like hot flashes and weight gain. 
  • There are other reasons why women may have low estrogen. These include pituitary problems, physical stress, and genetic disorders. 
  • Low estrogen affects ovulation and pregnancy because without estrogen, neither can happen successfully. 
  • It’s possible to increase estrogen levels with lifestyle changes and with estrogen replacement therapy. 
 

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