All humans produce estrogen, but females have higher levels than males. Low estrogen can lead to irregular periods in females and a low sex drive, reduced bone density, and other issues in all people.

Estrogen plays an essential role in sexual development and fertility. In females, the ovaries produce estrogen. Estrogen levels naturally drop during and after menopause, which can lead to various symptoms.

In males, estrogen supports overall health, sexual development, and reproductive functions.

Read on to learn more about low estrogen and how it affects the body.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

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People with low estrogen do not always have symptoms. If symptoms do occur, they may resemble those of other conditions. As a result, a doctor may find it challenging to determine whether someone has low estrogen based on symptoms alone.

As a person gets close to menopause, they may notice symptoms such as irregular periods, hot flashes, and vaginal dryness. Other symptoms of low estrogen, which may happen during or outside of menopause, include:

  • absent or irregular periods
  • bone fractures due to osteoporosis
  • infertility
  • decreased libido
  • high cholesterol or high triglycerides

A 2020 case study also reported that low estrogen in males had associations with low libido and delayed ejaculation, while a 2019 study links low estrogen and testosterone in males to coronary heart disease.

Estrogen levels vary for many reasons. One of the most significant factors is a person’s age.

In males and females, estrogen levels increase during puberty. For females of reproductive age, hormonal fluctuations during the menstrual cycle also mean that estrogen levels are constantly rising and falling. In perimenopause, the first stage of menopause, estrogen levels begin to decline.

Some health conditions can also decrease estrogen. In females, any condition that affects the ovaries may lead to reduced estrogen levels. In males, conditions that cause low testosterone may also cause low estrogen.

Health conditions or circumstances that may lead to low estrogen include:

Estrogen is essential to many bodily functions in all people. Effects of low estrogen include:

  • Irregular periods: Estrogen helps regulate the menstrual cycle. Estrogen levels rise right before ovulation and again halfway through the luteal phase, which is the second half of the cycle after ovulation. If this does not happen, a person may experience late, skipped, or absent periods.
  • Infertility: Because estrogen has a significant impact on the menstrual cycle, low estrogen may result in some females having difficulty getting pregnant. Low estrogen in males, may affect fertility or libido, potentially impacting reproductive function.
  • Osteoporosis: Estrogen helps protect the bones. When estrogen levels drop, a person may develop osteoporosis and have a higher risk of bone fractures.
  • Pain during intercourse: Estrogen helps the vagina lubricate itself. If a person develops vaginal dryness, they may find sexual intercourse painful.
  • Urinary tract infections (UTIs): Decreased estrogen can thin the vaginal tissues, increasing the risk of UTIs.
  • Mood changes: According to a 2018 review article, females are more susceptible to depression during certain stages of life in which hormonal fluctuations are frequent.

Effect on weight

The effect of estrogen on body weight is complex, and researchers do not yet fully understand it.

A 2020 study in males observed that lower activity of an estrogen-influencing gene is associated with more fat tissue. This suggests that low estrogen levels may affect metabolism and weight gain.

A 2022 review of previous research in females theorizes that low estrogen may affect food intake and may play a role in weight gain after menopause. However, scientists are still investigating this.

A doctor may suspect low estrogen based on a person’s symptoms or age and may recommend a blood test to determine a person’s estrogen levels.

Estrogen levels fluctuate during menstruation according to the stage of a person’s cycle. A doctor may ask to carry out the test at a specific point in the cycle to ensure the most accurate result.

While a blood test can identify low estrogen, it does not indicate the cause. Sometimes, a person’s life stage or recent experiences play a role. For example, a person who is nursing may have low estrogen as a result.

When the cause is unclear, a doctor may recommend additional tests such as:

  • a physical exam
  • further blood tests, such as thyroid function tests
  • scans of the ovaries

If a person’s low estrogen levels are the result of a typical physiological process, such as menopause, and a person has few symptoms, doctors may recommend taking no action.

However, a person may need medical care if the symptoms are significant. The treatment depends on the symptoms, the root cause, and a person’s treatment goals.

Hormone replacement therapy (HRT)

Hormone therapy or menopausal hormone therapy (MHT) can restore levels of estrogen and other hormones. Sometimes, doctors recommend combination therapy that provides both estrogen and progesterone to people in menopause.

Many types of MHT are available, including tablets, gels and creams, patches, and vaginal rings. Doctors usually recommend using the lowest effective dose.

However, hormone therapy is not safe for all people, including those with a history of stroke, high blood pressure, or heart attack.

Estrogen therapy

Estrogen therapy is a type of hormone therapy that uses only estrogen. For example, a doctor may prescribe vaginal estrogen cream to reduce vaginal dryness and address thinning of the vaginal skin.

Symptom management

Doctors may recommend additional treatments to manage symptoms, including:

Treatment for underlying conditions

If a person has an ongoing health condition or is undergoing medical treatment that affects their estrogen levels, doctors may suggest other treatments. For example, a person with a thyroid condition may benefit from taking thyroid hormone medication.

A doctor may recommend additional treatments depending on the person’s unique circumstances. If a person does not know the cause of their symptoms, it is important to consult a healthcare professional.

No natural remedies can reliably raise estrogen levels, but some may help reduce the symptoms of low estrogen levels.

Maintaining a moderate weight

Reaching or maintaining a moderate weight can improve overall health and reduce some potential risks associated with low estrogen, such as cardiovascular disease.

People with low estrogen due to low body weight may need support to reach an appropriate weight, particularly if their low weight is the result of another health condition or, potentially, an eating disorder.

Moderate exercise

Alongside a balanced, nutritious diet, moderate exercise can help people reach or maintain a moderate weight. Strength training, in particular, can also help increase bone strength, which can benefit people at risk osteoporosis.

According to the United Kingdom’s National Health Service (NHS), exercise may also help to reduce hot flashes and improve sleep.

However, people who have low body weight or engage in intense exercise may need to change their routine, as this combination can cause low estrogen levels rather than increase them.

Soy

Research on the role of soy in improving estrogen levels is ongoing. A 2021 review suggests that soy may modestly improve estrogen levels, but not all studies support this conclusion.

Vitamin D

There is no compelling evidence that vitamin D increases estrogen levels. However, vitamin D may counteract some of the effects of low estrogen.

Vitamin D is important for preventing osteoporosis because it helps the bones use calcium, which makes them stronger. Vitamin D levels may also play a role in the risk of cancer, heart disease, and depression.

Below are some answers to common questions about low estrogen.

What happens when estrogen is extremely low?

Estrogen that is very low for a person’s age and sex may result in more pronounced symptoms, such as infertility, mood changes, low libido, or a decline in bone density.

Can you replace estrogen naturally?

There are no foods or herbal supplements that can replace estrogen directly. Some contain phytoestrogens, which mimic estrogen, but there is mixed evidence on whether these work.

However, standard hormone therapy often comes from natural sources, according to the NHS. This can reliably increase estrogen levels and is a well-studied approach.

If people prefer other methods, regulated bioidentical estrogen is also available. This is chemically identical to the estrogen inside the body.

People should seek guidance from a doctor about the options and their pros and cons.

Estrogen affects not only the sexual organs and fertility but also brain and heart health, mood, and more. Therefore, low estrogen levels can affect many aspects of a person’s health.

If a person suspects they have low estrogen, they can consult a healthcare professional for a diagnosis. A healthcare professional will be able to identify an underlying cause and suggest the best ways to improve or manage it.

Treatment varies depending on the cause of a person’s low estrogen levels, so it is important to seek medical advice whenever possible.