Estrogen is a hormone that is most often associated with females, although men do produce small amounts too. Decreasing estrogen can lead to many health concerns and symptoms.
Declining estrogen levels can occur in women of all ages for a lot of reasons. Estrogen is associated with female development during puberty and the reproductive cycle. It also affects everything from bone health to emotional comfort.
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Estrogen is mainly 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.
Low estrogen levels can develop in women of all ages for several reasons.
Causes of low estrogen
Any condition that affects or damages the ovaries can cause a decline in estrogen levels in the body. The most important risk factor for having low estrogen is age. As women become older and approach menopause, it is normal for estrogen levels to drop. Estrogen levels begins to decline during perimenopause.
Estrogen levels can also decline for several other reasons including:
- premature ovarian failure
- thyroid problems
- congenital conditions
- excessive exercise
- being severely underweight
- low-functioning pituitary gland
Having a family history of hormonal problems can also increase a woman’s risk of developing low estrogen.
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Effects of low estrogen
Symptoms of low estrogen may include the following:
- Irregular periods: Estrogen is one of the vital hormones driving the menstrual cycle. Low estrogen may lead to irregular or missed periods.
- Infertility: Low estrogen levels can prevent ovulation leading to infertility.
- Weak bones: Estrogen helps keep the bones healthful and strong. As estrogen levels decrease, bone loss may occur. Example is osteoporosis.
- Painful intercourse: Estrogen can affect vaginal lubrication. If levels become too low, vaginal dryness can occur, which often leads to pain during sex.
- Hot flashes: Hot flashes often happen during menopause due to low estrogen levels.
- Depression: Estrogen is thought to increase a chemical in the brain that boosts mood called serotonin. Estrogen deficiency may lead to a decline in serotonin that contributes to depression or mood swings.
- Increase in urinary tract infections: Increased urinary tract infections (UTIs), may occur due to the thinning of the tissue in the urethra, which can develop with decreased estrogen.
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A diagnosis of low estrogen often starts with a physical exam, medical history, and an evaluation of symptoms. Revealing signs 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.
Not all women require treatment for low estrogen. But if low estrogen symptoms are bothersome, treatment may be recommended. Treatment is based on the cause of low estrogen and the symptoms present.
Hormone replacement therapy
Most 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 active 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 headaches, bloating, and vaginal bleeding.
Women can take HRT orally, topically, vaginally, or have pellets inserted under the skin. Some women may have an injection. The dose administered depends on individual conditions. Some 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 high blood pressure, heart attack, or stroke. It is essential that any woman who is considering HRT speaks to her doctor about the dangers against the benefits.
Doctors may prescribe just estrogen to treat some women who have estrogen deficiency. For instance, women who have had their ovaries removed. Sometimes, a doctor will prescribe estrogen therapy to treat niggling symptoms at menopause.