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Low Estrogen – Causes, Symptoms, and Treatment

Written by Elizabeth Buescher, Gynecologist

Estrogen is one of the core female sex hormones. It is responsible for the formation of primary and secondary sexual characteristics, as well as for the regulation of the menstrual cycle. At a younger age, low estrogen levels point to primary or secondary ovarian insufficiency. In women after 45 hypo estrogenism may be physiological, considering the fact of imminence of the menopause. In the first case, it is required to apply specific therapy while the second case is solely about correction of irritating symptoms.

Estrogen is a collective term that refers to a group of sex hormones in women. They are synthesized in ovaries and adrenal bodies (in small quantity). Besides, the process of certain type estrogen formation in fat cells has been studied.

Estrogen determines female characteristics:

  • It stimulates natural development of genitalia;
  • It is responsible for the development of secondary sexual characteristics;
  • In line with progesterone, estrogen regulates the menstrual cycle; specifically, it provokes the rejection of “futile” endometrium, prepared for pregnancy, which actually results in the occurrence of periods.

Apart from this, estrogens take part in carbohydrate and lipid metabolism, prevent bone tissue from resorption (dispersion), etc.

Congenial primary ovarian insufficiency is the main cause of low estrogen in young women

Primary insufficiency of sex glands (POI) may develop on the background of a genetic pathology (such as Turner syndrome or true hermaphroditism). Besides, it is possible to observe traumas of the receptor system of ovaries.

Such diseases most prominently show up in puberty (maturation), when retarded development of secondary sexual characteristics becomes obvious. These characteristics include:

  • Enlargement of breasts;
  • Female pattern of hair growth (with no hair distribution on the face, breasts, shoulders, );
  • Typical pattern of fat distribution – on buttocks and belly;
  • High-pitched voice, etc.

Treatment of primary ovarian insufficiency is usually based on etiology of the condition and the level of its advancement. So, girls, who lack or have underdeveloped external genitalia, need to undergo surgical reconstruction. In other cases, substitutive estrogen therapy may be used.

Secondary and congenial primary amenorrhea as the main cause of low estrogen levels at fertile age

In the case of absence of ovaries (for example, removal of ovaries due to an oncological disease) or their complete inaction, (due to radiation or chemical therapy) it is appropriate to speak about congenial POI.

Otherwise, if sexual glands are normally located and developed, but their performance does not provide for sufficient estrogen level in blood, this pathology is referred to as secondary amenorrhea. It can be provoked by the affection of hypothalamus and hypophysis, particularly swelling, tumors, nervous exhaustion, significant weight loss, excessive physical workouts.

Signs of low estrogen:

  • Irregular menstrual cycle;
  • Impossibility of conception;
  • Vaginal dryness and frequent inflammation;
  • Droopy breasts;
  • Skin changes (pimples, early wrinkling).

Solution can be found based on the cause of the problem. Neoplasm treatment is up to the oncologist, while other problems are to be solved by the gynecologist. In the majority of cases, the most optimal method of low estrogen correction is intake of oral contraceptives. However, in case of acquired POI it is appropriate to prescribe estrogen in make-up dosage.

Age-determined decline of reproductive function in women

The above discussed causes of low estrogen levels have pathological nature and are typical for younger age groups, since women after 45 experience physiological alteration of endocrine profile. Its ultimate point is the menopause – final termination of menstruation due to the absence of ovarian activity.

Natural menopause is defined as the absence of periods during one year (12 months), which is not associated with other causes. The average age of menopause is 50-51 years. The period of 4 years preceding it, is referred to as perimenopause, when the first signs of low estrogen are observed, and the year after it is called post menopause.

Decreased levels of all sex hormones are observed, however the main cause of obvious changes is not the actual decrease, but disturbed counterbalance of estrogens and androgens. These changes provoke basic low estrogen symptoms:

  1. On the part of the reproductive system:
    1. Irregularity of cycles eventually turns into amenorrhea;
    2. Signs of vaginal, urethral and cervical atrophy, accompanied by painful intercourse and frequent inflammation:
  2. On the part of central nervous system:
    1. Deterioration of hypothalamic centers’ thermoregulation results in the so-called hot flashes – sudden sensation of fever, mostly in breasts and on the face,
    2. Mood swings, insomnia, depressiveness;
  3. On the part of skin and adnexa: skin integument loses elasticity, breasts change shape, hirsuties (male pattern of hair distribution) and hair loss are observed;
  4. On the part of the cardiovascular system: disturbance of lipid metabolism and blood microcirculation is observed, which is associated with the risk of cardiovascular diseases;
  5. On the part of the locomotor system: bone tissue becomes less protective against age-determined elution of salts, which eventually leads to the risk of spontaneous fractures, particularly cervical hip fractures.

Menopause does not imply any treatment as it is a natural process. However, its negative presentations can be eliminated, which is about compensation of low estrogen. For example, smoking has a hypo estrogenic effect. Therefore, it is recommended to give up smoking in this period.

Non-smoking women, who do not suffer from hypertension or other vascular pathologies, can be recommended to take low-dose oral contraceptives. Substitutive estrogen therapy is an option for women, who for this or that reason wish to delay their menopause, but this is a rather radical measure. It is much safer to try receiving this hormone with the help of correction of one’s nutrition. This can be achieved through introduction of one’s diet products that contain estrogens, such as soy, yam, malt and others.

Regardless of age, observing the above-mentioned symptoms, one should not hesitate to consult a specialist, who will find out the cause of low estrogen and will help in correcting it. Or else the doctor may recommend methods for optimal leveling of irritating symptoms if it is the case with menopause.