14 Low Estrogen Symptoms (Plus Causes, Testing, and Treatment)

Estrogen is one of the key female sex hormones and plays a crucial role in reproductive development, along with many other areas of health and fertility. From driving sexual development to regulating the menstrual cycle – not to mention bone health, mood, and metabolism – estrogen is a major player. When estrogen levels dip below where they should be, your health can suffer. That’s why in this article we’ll cover everything you need to know about estrogen, including what it does, why it can fall below optimal levels, and most importantly, what you can do about it! Read on to learn the symptoms, causes, and treatments for low estrogen, including natural remedies, at-home hormone tracking, and even when to see a doctor. Let’s go!

What Is Estrogen and Why Is It Important?

Estrogen actually refers to a group of hormones that are responsible for the sexual and reproductive development of women. Different types are produced at different life stages, mainly reproductive age, pregnancy, and menopause. Estradiol is the most common type in women of reproductive age, estriol and estetrol are the dominant estrogen hormones produced during pregnancy, and estrone is produced after menopause. 

Before the onset of menstruation, estrogen plays an important role in puberty and female sexual development. During the reproductive years, it helps regulate the menstrual cycle and facilitate pregnancy. While during menopause estrogen levels drop and low estrogen symptoms like night sweats and hot flashes may become more prominent. 

Although estrogen levels vary, it’s an important hormone for your health and you need just the right amount to maintain optimal health. Estrogen is needed for many functions and systems in your body, so symptoms of low estrogen can affect everything from organ systems to the heart and blood vessels and the brain. 

The Four Types of Estrogen

Although we often refer to it in the singular, there are four types of estrogen. Each plays a different role in the body and occurs in different levels at different life stages. 

Estradiol (E2)

E2 is the major female sex hormone and is responsible for sexual development and menstrual cycles. It is the predominant type of estrogen during the reproductive years and is mainly produced in the ovaries. It is key for menstruation and fertility.

Estrone (E1)

E1 is a weaker estrogen and less potent than estradiol. It is most dominant during menopause and in postmenopausal women, it is the dominant form of estrogen in the body.

Estetrol (E4)

This form of estrogen is only produced during pregnancy. It is essential for fetal life and is produced by the fetal liver. Its physiological function is not well known, but it has been used in some medications like combined oral contraceptives. 

Estriol (E3) 

Levels of estriol (E3) are almost undetectable in non pregnant women, but during pregnancy it is synthesized by the placenta and is the predominant estrogen found in serum levels. Relative to other estrogens, it is a weaker version of the steroid hormone and therefore less potent, but it plays a role in fetal development during pregnancy. 

Estrogen’s Role in the Body

Estrogen is the driving force behind female sexual development. It triggers the development of the body’s reproductive organs, which eventually leads to the beginning of menstruation. It’s also responsible for physical changes in the body’s shape and appearance during puberty, like breast development, widening of the hips, and female fat distribution. 

Estradiol levels change throughout your cycle and normal estradiol levels by age also change. Levels rise approaching ovulation and peak just before ovulation. After ovulation levels begin to fall again and the cycle starts over if you’re not pregnant. Tracking when estradiol levels rise can be helpful for estimating your fertile window and predicting ovulation. This can be done with the Mira Monitor and Wands, which can measure E3G (the urinary metabolite of estradiol).

Aside from regulating your menstrual cycle, estrogen plays a crucial role in numerous other bodily functions. Estrogen is important for the skin, including the vaginal lining. By maintaining thickness, elasticity, and moisture, estrogen supports your natural lubrication and blood flow to the area. Estrogen also thins your cervical mucus to make it easier for sperm to swim through it and fertilize an egg during intercourse.

When it comes to bone health, estrogen is a vital component in not only maintaining strong bones but preventing osteoporosis. Bones break down and rebuild over time to maintain their strength and structure. Old bone tissue is reabsorbed while new bone tissue forms. Low estrogen can throw off this balance, while adequate estrogen levels keep these two processes in check so that bone resorption doesn’t outpace bone formation. 

Estrogen influences multiple organ systems of the body, including the cardiovascular system and central nervous system. It helps regulate your mood and emotions by acting on the parts of the brain that control emotion, including regulating serotonin receptors affecting your mood. Estrogen is a complex hormone that does many jobs, including supporting overall health by helping the body regulate weight, bone and cholesterol metabolism, and glucose metabolism.

Causes of Low Estrogen

Natural Causes

Estrogen levels can vary widely, but certain groups are more at risk of experiencing a drop in estrogen levels. As your body transitions to menopause, estradiol levels naturally decline and this is the most common cause of low estrogen. During perimenopause, your ovaries begin making less estrogen and eventually stop producing it altogether. Similarly, if your ovaries were removed or injured, your body will produce less estrogen since they are the primary production site. 

Another common natural time of low estrogen is during the postpartum period and breastfeeding. During pregnancy, the placenta produces estrogen, so after birth, estrogen levels naturally drop. Breastfeeding can inhibit estrogen production due to higher levels of prolactin, a hormone involved in breast milk production. During this period, low estrogen symptoms like hot flashes and vaginal dryness may appear. 

Medical & Lifestyle Causes

When low estrogen is not related to age or menopause, it may be a sign of something else. Common causes of low estrogen include:

• eating disorders that deprive the body of nutrients to keep hormone levels balanced

• genetic disorders like Turner Syndrome or Fragile X 

• autoimmune conditions like Addison’s disease

• premature ovarian insufficiency

• pituitary gland conditions that interfere with normal hormone production

• chronic stress that alters hormone production via the hypothalamus

• hypothalamic amenorrhea (excessive exercise, causing periods to stop)

Signs of low estrogen in women can be diagnosed and treated by talking to your doctor. They will take a comprehensive health history and discuss your symptoms and concerns. If you suspect you have low estrogen, lab tests like Mira’s Panorama Lab Test can provide insights into your hormone levels and overall reproductive health. This minimally invasive blood test measures 5 key hormones with a quick and easy finger prick. You’ll get five individual and personalized hormone reports with actionable steps to understand what your numbers mean for your hormonal balance and fertility health. 

Symptoms of Low Estrogen

Reproductive & Sexual Symptoms

Not only does estrogen help keep the vagina lubricated, but it also regulates the menstrual cycle. Low estrogen levels may lead to the following reproductive and sexual symptoms:

• Vaginal dryness & painful sex

• Irritation around the genital area

• Increased risk of developing urinary tract infections (UTIs)

• Irregular or missed periods

• Low libido

Physical & Metabolic Symptoms

Since estrogen has such far reaching effects, low estrogen symptoms include physical and metabolic consequences as well. Estrogen plays a big role in regulating physical processes, so when levels are off, you can see the effects in a variety of ways, including:

• Hot flashes and night sweats

• Unexplained weight gain (even though your lifestyle has remained the same)

• Weakened and brittle bones (increased risk of fractures)

Mood & Cognitive Symptoms

Estrogen is a crucial hormone for brain health and cognitive function, particularly in regulating mood. Low estrogen symptoms can lead to cognitive changes such as the following:

• Mood swings, low mood, depression, and anxiety

• Brain fog and trouble concentrating

• Difficulty falling and staying asleep

14 Symptoms of Low Estrogen

1. Weight Gain

One common symptom of low estrogen is weight gain. This is because estrogen helps to regulate processes that influence weight – such as glucose and lipid metabolism. So when estrogen levels are lower than normal, it’s easy to gain weight even if your lifestyle has remained the same.  

2. Breast Tenderness

According to Harvard Health, estrogen is known to have a “stimulating effect” on the breasts, which is why fluctuating or low estrogen levels may cause the breasts to feel tender. In addition to breast tenderness, low estrogen may also cause the breasts to retain more water than normal and have a “full” feeling.

3. Painful Sex

Estrogen plays a key role in maintaining vaginal wall thickness. So when estrogen levels drop, this causes the tissue in the vagina to become thin, which can understandably make sex unpleasant and painful. Alongside the thinning of the vaginal walls, lower estrogen levels may also lead to vaginal dryness which can also contribute to painful sex. 

4. Dry, Itchy Skin

Collagen and natural oils maintain the strength and elasticity of your skin.  Estrogen stimulates the formation of collagen and oils in the skin, so lower levels of estrogen means the skin can become drier and less elastic leading to itchy skin.  With less estrogen, oil production for the skin is lower which also reduces your skin’s ability to retain moisture.  

5. Hot Flashes and Night Sweats

Hot flashes and night sweats are other common symptoms of low estrogen levels. Even though there is limited research into why exactly this is, researchers tend to agree that lower estrogen levels can make your body’s internal thermostat (i.e. the hypothalamus) more sensitive and responsive to changes in body temperature. The result? Hot flashes!

6. Sleeping Problems (Insomnia)

Research shows that estrogen has a profound influence on the body’s ability to sleep. This is because estrogen not only helps to regulate body temperature, but it also affects certain neurotransmitters, such as serotonin and norepinephrine, which influence mood and sleeping patterns. When estrogen levels are low, it makes it difficult to fall asleep and stay asleep. 

7. Vaginal Dryness

Estrogen helps keep the vagina lubricated, which means that lower estrogen levels may lead to the uncomfortable sensation of vaginal dryness. This can cause a number of painful symptoms including painful sex, irritation around the genital area, and increased risk of developing urinary tract infections (UTIs). 

8. Mood Swings or Depression

Research shows that estrogen is critical for mood regulation, with low estrogen levels associated with an increased risk of mood swings, low mood, and depression. While there are many factors at play, one of the key factors is estrogen’s influence on the production of serotonin and endorphins. 

9. Brittle Bones

Another common symptom of low estrogen is brittle bones. This is because estrogen stimulates the cells in the body that form bone. As estrogen levels decrease, these cells do not function properly leading to weakened and more brittle bones.

10. Headaches Before or During Your Period

Low estrogen levels are also known to cause headaches. This is why it’s normal to experience a headache before and/or during your period, as estrogen dips in the days leading up to your period. Among individuals prone to migraines, approximately two-thirds will experience a migraine around the time of their period. 

11. Irregular Periods

Estrogen is among several hormones that regulate the menstrual cycle. More specifically, the drop in estrogen towards the end of the cycle is what triggers the period to begin. When estrogen is too low, this process doesn’t always work the way that it should which can lead to irregular or missed periods. 

12. Brain Fog

Struggling to concentrate, words on the tip of your tongue, and forgetting things are unfortunate symptoms of low estrogen.  There are estrogen receptors in every area of your body, including the brain and estrogen plays an important role in cognition and memory by stimulating the brain, helping neurons fire, and supporting new cells.  Less estrogen means the brain simply isn’t firing the way it was before and you may experience “brain fatigue” or “brain fog”.  The good news is that brain fog tends to get better over time and likely won’t last.      

13. Brittle Hair

Similarly to dry skin, your hair can become brittle and dry when your estrogen levels are low.  Since estrogen supports and promotes the production of oils (sebum) that naturally lubricate the scalp, a decline in estrogen may lead to less oil production on the scalp and dry flaky skin.  Estrogen also supports the hair follicle and promotes healthy hair too so you may also notice thinner hair that is less full and falls out easier.  

14. Back Pain

Estrogen is essential for strong bones and ligaments.  A decline in estrogen can lead to back pain by weakening bones and the tissues and ligaments supporting your spine.  When ligaments loosen and bones deteriorate, you may experience back pain and soreness you didn’t before.  

Diagnosis: How to Test for Low Estrogen

If you are concerned about symptoms of low estrogen or have been experiencing low estrogen symptoms, it’s a good idea to talk to your doctor. Based on your symptoms and history, they can determine which blood or hormone tests are needed.  They can also help you determine normal estradiol levels by age and know where you should be at.   

Blood Tests for Estrogen

Blood testing is the standard for measuring hormones. Blood tests usually measure only the levels of estradiol, estriol, and estrone in the blood. Depending on why an estrogen test is being ordered in the first place will determine which type of test your doctor orders. 

Since estradiol is the main estrogen in reproductive age women, the most common low estrogen test for this group is the estradiol (E2) blood test. Your doctor may also want to test follicle–stimulating hormone (FSH) levels, especially if you are approaching menopause. Research has found that if FSH rises and estrogen declines, it may indicate a transition to menopause.

Regular FSH tracking is especially helpful for individuals who want to know how far away menopause may be for them or to monitor any perimenopausal symptoms during their transition to menopause. Monitoring FSH patterns at home is possible with the Mira Monitor and Mira Wands, which measure FSH levels in urine and can provide insight into ovarian functioning, ovarian reserve, and reproductive aging. 

At–Home Hormone Testing Options

An estrogen blood test is performed by a healthcare professional and has long been accepted as the standard for measuring hormones. There are now at–home hormone testing options available as well. For instance, Mira’s Panorama Fertility Lab test is a finger prick test that allows you to screen for prolactin, AMH, free testosterone, TSH, and fT4 for a clear picture of your hormonal balance. 

While blood tests are a common method to measure estrogen, you can also track estrogen metabolites (E3G) in urine at home using the Mira Hormone Monitor, Mira App and Wands. Mira’s hormone monitor offers an all-in-one at-home hormone testing and fertility tracking solution that uses AI-powered technology to generate a 99%, lab-grade accurate result for your key reproductive hormones. It can detect the smallest hormone fluctuations and learn your unique patterns to provide real-time insights into your hormonal health. If you suspect your estrogen levels are off or you may have low estrogen, an at–home hormone test can provide a solution for you to monitor your hormones on your own. 

How to Increase Estrogen Levels Naturally

Balanced hormones are essential for maintaining a healthy lifestyle. Signs of low estrogen in women can be improved naturally with just a few adjustments. 

Dietary Adjustments 

Dietary adjustments can significantly impact estrogen levels. Incorporating certain foods into your everyday diet may help you raise estrogen levels. These foods function as phytoestrogens, mimicking the role of estrogen in your body and helping your body get rid of bad estrogen (so you can raise levels of good estrogen). 

Foods that increase estrogen include flaxseeds, soy foods, dried fruits, broccoli, and alfalfa sprouts, to name a few. These foods are high in phytoestrogens to give your body an estrogen boost. Consuming nutrient–rich estrogen foods such as nuts, seeds, and whole grains means you are getting essential nutrients for reproductive health and supporting your hormonal balance. And since fats are the building blocks for hormone production, healthy fats, especially saturated fats, are essential for any diet. Excellent sources of healthy fats include avocados, olive oil, nuts, chia seeds, eggs, and oily fish, but there are many more. 

In addition to a balanced diet with all the right nutrients to support hormone production, you may want to introduce supplements into the equation. Several vitamins and minerals help regulate hormonal imbalances and can be an excellent addition to help manage issues caused by low estrogen. Depending on your goals, Mira offers both prenatal supplements and PCOS supplements to support your hormonal health. Mira’s PCOS supplements support hormone balance by addressing insulin resistance, while our prenatal supplements offer all the right nutrients that are crucial for setting a pregnancy up for success. 

Lifestyle Changes

The truth is, our lifestyle has a significant impact on the way our hormones function. By addressing lifestyle factors such as exercise, stress management, and getting sufficient sleep, you can significantly contribute to balancing your hormones and mitigating symptoms of low estrogen. 

In terms of exercise, that means focusing on moderate activities, since intense exercise can actually lower estrogen levels in women. The American Heart Association recommends getting at least 150 minutes of “moderate–intensity” aerobic activity per week. Regular exercise is also one of the best ways to release tension and reduce stress. Other research–backed stress management techniques include practicing yoga, meditation, or even deep breathing techniques. And since our hormones play a major part in controlling our sleep cycles, it’s essential to make sure you’re getting quality uninterrupted sleep each night for optimal health (and fertility). The CDC recommends that all adults should get at least 7–9 hours each night. 

Medical Treatments for Low Estrogen

There are a number of different medical treatments for low estrogen and symptoms, but they are not right for everyone. Some women with low estrogen may benefit from taking hormone therapy, while others may not have that option due to risk factors. 

Hormone Replacement Therapy (HRT)

Hormone therapy is a type of hormone replacement to replenish low hormone levels and is either estrogen–only or a combination of estrogen and progesterone. Estrogen–only therapy is an estrogen supplement specifically for women who have symptoms of low estrogen due to menopause, especially for those without a uterus. For women with an intact uterus, estrogen pills alone can increase the risk of endometrial cancer by causing the lining of the uterus to become too thick. These women use a combination hormone therapy with both estrogen and progesterone known as estrogen progesterone therapy (EPT). The added progesterone helps limit the risk of developing uterine cancer by preventing the uterine lining from becoming too thick. 

Hormone therapy doesn’t come without risks, though. The risk of breast cancer depends both on the type of HRT and your personal history of breast cancer, but hormone replacement therapy does come with a slightly increased risk of breast cancer, blood clots, and stroke. The risks vary based on the type of HRT you are taking, the dose, when you start taking it, and how long you take it. 

If you have specific symptoms that may be helped by hormone therapy and have a suitable health history, HRT may be a viable solution for you. For many people, the benefits of HRT far outweigh any possible side effects or risks. But if you have a history of certain cancers, blood clots, heart disease or stroke, or blood pressure issues, then HRT may not be an option for you. Your doctor will consider your medical history, risk factors, and the severity of your symptoms before making any decisions to start hormone replacement therapy. The official recommendation for HRT is to use it for the shortest period possible, taking the lowest dose necessary. 

Vaginal Estrogen (Localized Treatment) 

Another type of hormone replacement therapy is using a low dose of estrogen that stays localized in your vagina. It’s effective for relieving vaginal dryness and irritation and comes in the form of creams, tablets, or rings applied or inserted into the vaginal area. Rather than be absorbed into your bloodstream, the medicine stays mostly in local tissue. It does not treat other symptoms of low estrogen like hot flashes or mood swings but rather localized symptoms like vaginal atrophy and painful intercourse. It can take up to 3 months to fully work and does not have the same risks as other types of HRT because of the low dose and localized delivery. 

When to See a Doctor

It can be difficult not to feel your best, and if your symptoms are interfering with your quality of life, it’s definitely time to see a doctor. 

If you are experiencing any of the following symptoms, it’s important to get them checked out since they might be from low estrogen:

• irregular periods

• missed period for 3+ months

• severe hot flashes

• sleep disruptions

• mood swings 

• difficulty getting pregnant despite regular cycles

It can be beneficial to be armed with information or questions to ask your doctor or healthcare provider. Mira’s Hormone Health Clinic can get you started on your journey with an in–depth exploration of your hormone health. Our trained fertility coaches can offer practical, holistic guidance on all aspects of lifestyle, nutrition, and general wellness related to fertility. Not to mention that all of our fertility coaches have first–hand experience with the Mira App and Monitor and can help you understand and interpret your data. They’re not doctors themselves, but they can provide invaluable support in the practicalities of implementing any medical plan and help you navigate your reproductive health challenges. 

Conclusion & Key Takeaways

Estrogen is an important hormone for many aspects of your health. Low levels of estrogen can impact your mood, fertility, and overall health and wellness. Different stages of life call for different estrogen levels, but if symptoms are interfering with your quality of life, it’s important to take notice. Low estrogen can be addressed in a variety of ways, from lifestyle factors like exercise and sleep to foods that increase estrogen and phytoestrogens, as well as hormone replacement therapy. 

Low levels of estrogen can impact many systems in your body, not just your reproductive health. If you’re looking to tap into valuable information about your health, tracking hormone levels at home can help you and your doctor uncover valuable information about your cycles and hormones. A personalized lab–quality and data–driven solution, such as Mira Fertility can allow you to identify your unique patterns and offer personalized fertility insights on your estrogen levels and more. Mira takes the guesswork out of tracking and can help you make informed decisions about your reproductive cycle. 

Frequently Asked Questions

When should I see a doctor for low estrogen?

If you are struggling to conceive due to low estrogen levels, it’s often recommended to try to get pregnant for at least a year (if under 35) or at least six months (if over 35) before seeing a doctor.

Alternatively, if you find yourself struggling to cope with the physical symptoms of low estrogen due to menopause, don’t be afraid to bring it up with your doctor at your next checkup and they can help you find some relief.

How can I increase my estrogen naturally?

The best way to boost estrogen naturally is by maintaining a well–balanced lifestyle that incorporates plenty of exercise, healthy foods, and low–stress activities. Certain foods may also help to increase estrogen naturally. This includes soy, nuts, flax seeds, berries, and garlic.

Can low estrogen be a sign of other conditions?

Yes, low estrogen may be an indicator of other underlying conditions such as Turner Syndrome, Fragile X Syndrome, thyroid disorder, or pituitary gland disorder. It may also be an indicator of an eating disorder.