Demystifying Low Estrogen in Women: Causes, Symptoms, and Treatment

Estrogen, commonly referred to as female sex hormone, significantly impacts a woman throughout her life.

It regulates various bodily functions, including the menstrual cycle, bone density, mood, and sexual health.

While Estrogen levels naturally fluctuate throughout the different stages of a woman’s life, it becomes concerning when they fall below certain levels.

The menopausal transition is the obvious causative factor associated with declining Estrogen levels in women.

However, there are other factors that can contribute to a fall in Estrogen levels, resulting in various symptoms and potential health issues.

Read on to discover the causes, symptoms, and available treatment options for low Estrogen in women.

Signs of low Estrogen in women 

Estrogen significantly influences different body areas, such as the breasts, ovaries, brain, musculoskeletal, and cardiovascular systems.

Consequently, low Estrogen in women can result in various health issues.

Vulvovaginal Atrophy.

Decreased Estrogenization is associated with Vulvovaginal Atrophy(VVA), i.e., complications related to the vulva and vagina.

The vaginal and vulvar mucosal epithelium(inner lining) becomes thin and presents a range of symptoms, including

• Vaginal dryness, irritation, and soreness,
• Genital pain before, during, or after sex
• Abnormal urinary frequency and urgency
• Postcoital bleeding

Decreased sex drive

Low Estrogen in women is also linked to reduced sex drive, particularly during postmenopausal years.

Hypoestrogenism can lead to changes in the vaginal wall layers, resulting in a decline in the quality of the genital arousal response, further impacting the sex drive.

Vasomotor symptoms

Low Estrogen in women can lead to the occurrence of vasomotor symptoms (VS).

These include hot flashes, sudden and intense feelings of heat, primarily affecting the upper body and causing the skin to redden, resembling a blush.

When these hot flashes occur at night, they are called night sweats.

Obesity

Low levels of Estrogen have been found to be associated with impaired metabolic function.

Individuals may experience obesity if their Estrogen levels go down.

Increased sensitivity to pain and anxiety

Studies have shown that women experience increased sensitivity to pain and anxiety when their Estrogen levels are low.

Meaning, the intensity levels of pain and anxiety tend to rise during phases with low Estrogen in women.

Joint pain

The deficiency of Estrogen has been linked to impaired bone mineral density which can lead to osteopenia and osteoporosis(bone deterioration).

In some cases, the decrease in bone mineral density can contribute to joint pain.

Irregular or absent menstrual cycles

Women with low Estrogen may experience irregular periods or even missed periods.

Mood disorders

The decline in ovarian Estrogen production among women can contribute to depressive disorders characterized by a range of mood disorders.

These changes may present as sudden mood swings, fatigue, nervousness, impaired memory function, and challenges managing stressful situations.

Sleep Disturbances

Studies indicate that Estrogen has been proven to minimize the time taken to fall asleep and the frequency of awakenings during sleep.

Estrogen has been shown to increase the overall duration of sleep.

In addition to its impact on sleep patterns, Estrogen also helps regulate body temperature, further enhancing sleep quality.

Hence, low Estrogen in women may disrupt their soundness of sleep.

Depression and Anxiety

Insufficient levels of Estrogen in women, particularly during menopause, can hurt their overall mental well-being.

Low Estrogen levels are linked to higher rates of depression and anxiety.

What causes low Estrogen in women

The natural aging process is linked to a decline in sex hormones in both males and females.

Several factors can contribute to low Estrogen in women. 

These include:

Menopause

The most common cause of low Estrogen is menopause.

As women age, their ovaries produce less Estrogen, leading to hormonal changes and a decline in Estrogen levels.

Although Estrogen decline starts with the onset of menopausal transition, the decline increases significantly when menopause occurs.

In the initial year of menopause, women typically experience an average annual reduction of 80% in their Estrogen levels.

Premature Ovarian Insufficiency (POI)

POI, also known as premature menopause, is a condition where a woman’s ovaries stop functioning prematurely.

As a result, Estrogen is not produced sufficiently.

Hypogonadism 

Hypogonadism is characterized by reduced functioning of the gonads, specifically the ovaries, in females.

It also leads to a decrease in the production of sex hormones.

Hypogonadism at a younger age may result in poor development of female features.

This is related to the low levels of Estrogen hormones in women.

Polycystic Ovary Syndrome(PCOS)

PCOS is a disease that creates a problem in the ovaries.

Impaired ovarian function results in the underproduction of Estrogen hormone by the ovaries.

Ovariectomy

Some women opt for surgical removal of ovaries called Ovariectomy.

This procedure leads to low Estrogen levels since the ovaries are the primary Estrogen producer.

Intense physical activity

Studies have suggested a correlation between physical activity and decreased Estrogen levels.

Engaging in fitness training or aerobic exercise has the potential to lower Estrogen levels in women.

Genetic defects

Some genetic disorders can also contribute to low Estrogen in women.

Turner Syndrome (TS) is one such condition.

Females with TS experience impaired gonadal function, resulting in decreased levels of androgens and Estrogens starting at a young age.

Eating disorders

Certain eating disorders may also hurt Estrogen concentration among females.

Psychological conditions like Anorexia Nervosa or Bulimia involve patterns of undereating or overeating and over-exercising.

These disorders can contribute to low Estrogen levels across different age groups in women.

Smoking

Studies have indicated a link between smoking activity and reduced production of Estrogen.

Strategies to address low Estrogen in women

If there is a suspicion of low Estrogen in women, it is crucial to seek guidance from a specialist to identify the cause and appropriate treatment.

Here are some measures that can assist in addressing low Estrogen levels.

Hormone Therapy

Hormone Therapy is the supplementation of hormones by external means to compensate for the Estrogen concentration deficit.

Estradiol is commonly considered Estrogen hormone for Hormone Therapy in the treatment of low Estrogen and menopausal complications.

Estradiol dosage can also be taken in the form of oral pills, skin patches, solution or lotion, injections, sprays, and vaginal creams.

Managing the symptoms 

Measures can be taken to manage the complications that arise due to low Estrogen in women.

Vaginal lubrication can be considered to minimize the vaginal and sexual discomfort.

A study discovered that the application of locally administered Vitamin E and phytoestrogen gel improved the symptoms of Vulvovaginal Atrophy.

However, at present, there is a lack of well-established and effective complementary and alternative medicine treatments for VVA.

Identifying and treating underlying conditions

As discussed earlier, certain medical conditions such as PCOS, genetic disorders, and hypogonadism can result in low Estrogen in women.

Therefore, individuals with these conditions must receive appropriate treatment to regulate estrogen levels and alleviate associated symptoms.

Alternate solutions

There are some non-medical approaches to help lower Estrogen in women.

Some of them may include:

Environmental Estrogens

Estrogenic compounds can also be present in certain environmental substances and food items.

Animal-derived products like meat, eggs, and dairy from animals treated with external hormones tend to have higher levels of Estrogen.

Phytoestrogens is a form of Estrogen found in food items that contain the compounds Polyphenols, Flavonoids, and Isoflavonoids.

• Polyphenols can be found in red wine and the skin of grapes.
• Flavonoids are present in citrus fruits, juices, parsley, celery, kale, broccoli, chocolate, green tea, lettuce, apples, beans, apricots, cherries, and berries.
• Isoflavones are found in soybeans, legumes, clover, alfalfa, and spinach.

However, it is important to acknowledge that their effectiveness is a subject of debate, and their long-term safety remains uncertain.

Quit smoking

As we established earlier, smoking is associated with low levels of Estrogen.

It can be beneficial to do away with it.

Avoid extreme physical activity

Intense physical activity has been found to have an inverse relationship with Estrogen levels.

As a result, it may be prudent to limit participation in high-intensity physical activities.

However, it is important to note that complete inactivity can also negatively affect Estrogen concentration.

Therefore, engaging in moderate exercise is a recommended approach.

Foods to avoid

Certain food items are associated with Estrogen-reduction activity.

Compounds found in oyster mushrooms have the potential to inhibit aromatase, an enzyme who converts Testosterone to Estrogen, leading to a reduction in Estrogen.

Curcumin, a yellow polyphenolic pigment, is found in turmeric and has the ability to reduce Estrogen levels.

Additionally, I3C(Indole-3-carbinol) compound derived from the breakdown of glucobrassicin is associated with anti-Estrogen activity.

This compound is present in cruciferous vegetables such as broccoli, cabbage, and cauliflower.

Individuals can consider avoiding such items to their diet.

Summary

A number of symptoms present themselves as signs of low Estrogen in women.

These may include hot flashes, irregular menstrual cycles, difficulty conceiving, vaginal discomfort, and diminished sexual pleasure and satisfaction.

The causes of low estrogen can include medical conditions like PCOS, primary ovarian insufficiency, Hypogonadism, or eating disorders such as Anorexia Nervosa.

Certain lifestyle habits, including excessive exercise, obesity, and smoking, can also adversely influence Estrogen levels.

The medicinal approach to address estrogen deficiency and its associated symptoms is hormone therapy, which involves the external administration of Estrogen.

In addition to hormone therapy, alternative options can be considered, such as quitting smoking, managing weight, and incorporating estrogen-rich foods into the diet.

However, Hormonal balance is a complex activity, and it is essential to discuss your symptoms with your doctor to find the right cause and treatment for you.

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