What Are the Symptoms of Low Estrogen?

Some of the common symptoms of low estrogen levels include:

• Painful sex

• Mood swings

• Hot flashes

• Headaches

• Breast tenderness

• Depression

• Irregular periods/no periods

• Increased occurrence of urinary tract infections

Symptoms of menopause - this can cause low estrogen levels:

• Hot flushes

• Night sweats

• Palpitations

• Difficulty sleeping

• Headaches

• Mood swings

• Low libido (sex drive)

• Vaginal dryness

What Can Cause Low Estrogen Levels?

Menopause – the menopause and the period before it, known as the perimenopause, brings about hormonal changes in females. Decreasing levels of oestrogen during the menopause is associated with the development of hot flushes. However, hot flushes are also likely to occur in women who have a high body mass index (BMI). 

Too much exercise – increased exercise can cause low estrogen levels. There is some evidence which suggests that increased physical activity in premenopausal women can result in a reduced risk of breast cancer due to the decreased level of oestrogen.

Being underweight – being underweight or having anorexia nervosa can have serious implications for your health. Anorexia in females can cause low estrogen levels and may result in a later onset of menstruation or the absence of periods. These factors are also determinants of low bone mass density which can put you at an increased risk of fractures and osteoporosis.

Premature ovarian failure – this is also known as premature menopause and usually occurs before the age of 40. Early menopause occurs at or before the age of 45, but both can occur naturally or be induced through factors such as medical treatment. 

When premature or early menopause occurs, the ovaries stop making specific hormones particularly estrogen. Premature ovarian failure often runs in families although this is not always the case.

Turner Syndrome – this is a genetic disorder which affects females, around 1 in 2000 baby girls. There is a wide range of symptoms associated with Turner Syndrome, including:

• Shorter height

• Underdeveloped ovaries

• May not have periods

• May become infertile

Turner Syndrome can affect the ovaries. They are female reproductive organs which produce sex hormones and trigger the start of a girl’s periods. However, 9/10 of girls with Turner Syndrome do not produce enough of these sex hormones including estrogen. This means:

• They may need hormone replacement therapy (HRT) as they may not develop sexually without it

• They may not start their periods naturally

• They are likely to be infertile

Most girls with Turner Syndrome will begin HRT between the ages of 10 and 12 and then progesterone therapy around 3 years later to induce their periods.

Cancer treatment – hormonal therapy with or without chemotherapy is often used as a treatment for breast cancer. However, it can suppress the release of estrogen and in turn, bring on the menopause.

The Menstrual Cycle – during the menstrual cycle, estrogen levels naturally fluctuate. On day one both estrogen and progesterone levels are low which tells the pituitary gland to produce follicle stimulating hormone (FSH). FSH starts the production of a follicle – a fluid-filled sac which contains an egg in the ovary. 

The follicle produces estrogen and levels rise which prepares the uterus for pregnancy. Between days 12 and 14, ovulation usually occurs and the high estrogen levels cause a sharp rise in Luteinizing Hormone (LH) which causes the egg to be released from the follicle.

The ruptured follicle also called the corpus luteum secretes both progesterone and estrogen to continue the preparation of the uterus for pregnancy. If the egg is not fertilised then the levels of estrogen and progesterone drop. On day 28, a bleed will take place.

The Pill – a contraceptive pill is a synthetic form of progesterone and estrogen, the female sex hormones. The pill stops ovulation from occurring by keeping the hormone levels consistent. If there isn’t a peak in estrogen then the ovary doesn’t release an egg, which prevents pregnancy. 

How Can You Test Your Estrogen Levels?

Yes you can – your doctor will test your estrogen levels through a blood test. A blood sample will be taken from a vein in your arm. Your doctor may test your oestrogen levels if you are experiencing symptoms such as:

• Hot flushes

• Night Sweats

• Abnormal vaginal bleeding

• Irregular periods

• Pelvic heaviness

Testing at home – there are home test kits available to measure your estrogen levels. These normally require you to carry out a finger prick, collect a drop of blood and send it away for analysis.

Getting an assessment for oestrogen treatment – if you think you require HRT, you can get an assessment for it and order treatment online using our online doctor service. You can also make an appointment to get assessed by your GP.

What Else Can Cause Similar Symptoms?

Although you may have symptoms of low estrogen, you could, in fact, have a different condition.

Overactive thyroid – an overactive thyroid or 'hyperthyroidism' is a thyroid condition where too much thyroid hormone is produced. The symptoms it can cause may be similar to having low estrogen, such as:

• Increased heart rate

• Palpitations

• Difficulty sleeping

• Weakness

• Mood swings

• Low sex drive

• Feeling tired

Underactive thyroid – an underactive thyroid or 'hypothyroidism' is where the thyroid gland doesn’t produce enough thyroid hormones. Again, the symptoms can be similar to that of low estrogen, for example:

• Tiredness

• Weight gain

• Muscle aches

• Weakness

• Low sex drive

• Irregular periods

• Dry skin

The best thing to do is to consult your doctor if you are experiencing any of these symptoms. They will be able to send you for a blood test to determine exactly what is wrong. Once you are given a diagnosis, you will be able to begin receiving the right treatment to make you feel well again.

What Can You Do About Low Estrogen Symptoms?

Getting medical help – if you have symptoms of low estrogen you will need to visit your doctor to confirm a diagnosis. Your estrogen levels will be tested through a simple blood test and if your estrogen levels are low, you may be given a prescription for HRT. If you are using HRT for the menopause, you can order repeat prescription through our online service. You will need to complete a short online questionnaire, where one of our doctors will be able to check you are still suitable for the medication. If you are, your treatment can be delivered to your for free, alternatively, you can collect in-store.

Tips for symptoms – you can also manage some of your symptoms with some handy techniques. For example, if you are experiencing hot flushes you could carry around a hand-held fan to help keep you cool. If you suffer from night sweats, wear light pajamas to bed and use a low tog duvet.

Keeping active – exercise is an important menopause management tool and this is good for women who have low estrogen levels. Low estrogen levels can result in a low bone mineral density. Therefore, exercise can help to keep your bones strong and at less risk of fracture. Exercise also helps to reduce the risk of heart attacks and death from cardiovascular disease.

Diet – eating a healthy, balanced diet is also important. Low estrogen levels can put women at a greater risk of cardiovascular complications. Therefore, eating a diet which is low in saturated fat and high in fibre and whole grains can be beneficial.

Sources

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Kemmler, W., Kohl, M. and von Stengel, S. (2016). Long-term effects of Exercise in postmenopausal women: 16-year results of the erlangen fitness and osteoporosis prevention study (EFOPS). Menopause: The Journal of the North American Menopause Society: 24(1).

Kossman, D. A. et al (1985). Exercise lowers estrogen and progesterone levels in premenopausal women at high risk of breast cancer. Journal of Applied Physiology; 111(6): 1687-1693.

Misra, M. and Klibanski, A. (2017). Anorexia nervosa and its associated endocrinopathy in young people. Horm Res Paediatr; 85(3):147-157.

Reed, B. G. and Carr, B. R. (2015). The normal menstrual cycle and the control of ovulation. Endotext.

Saenger, P. et al (2001). Recommendations for the Diagnosis and Management of Turner Syndrome. The Journal of Clinical Endocrinology and Metabolism: 86(7).

Shuster, L. T. et al (2010). Premature menopause or early menopause: long-term health consequences. Maturitas: 65(2). 

Singer, P. A. et al (1995). Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA.