All women have experienced — and learned to live with — the ups and downs of hormone fluctuations. Throughout your reproductive years, you get to know these changes, when to expect them and how to manage (or at least tolerate) them.
You may not have given much thought to what causes the cycle of ups and downs. The main culprit is estrogen, a hormone vital for becoming a woman and having children, and even for protecting your brain, bones and heart, but one that can be frustrating every month and especially during menopause.
What Does Estrogen Do?
A woman’s main sex hormone, estrogen is primarily responsible for maintaining a woman’s sexual and reproductive health. Both women and men have estrogen, but women have much higher levels.
During puberty, estrogen causes girls to develop breasts, grow pubic hair and start their menstrual cycles.
“After puberty, estrogen plays other important roles in the body,” says Dr. Eve Ashby, a board-certified gynecologist at Beaufort Memorial Lowcountry Medical Group. “Estrogen affects your cognitive health, bone health and heart health, as well as your weight and how efficiently your body uses blood sugar.”
What Happens When You Have a Lack of Estrogen?
Levels of estrogen fluctuate during perimenopause — the months and years leading up to menopause — and during other phases of life, such as during pregnancy or as part of the menstrual cycle. These are natural fluctuations. Experiencing a headache just before your period starts is a sign of low estrogen in your body.
Menopause and ovary removal surgery are the two most common reasons estrogen levels drop. During perimenopause, a woman may experience many different symptoms, varying in intensity. Symptoms related to a drop in estrogen include:
- Hot flashes
- Low sex drive
- Irregular periods, including irregular bleeding or spotting
- Poor sleep, including difficulty falling or staying asleep
- Vaginal dryness
Read More: Managing Menopause
How Do You Know If Your Estrogen Level Is Low?
If you’re experiencing symptoms of low estrogen, talk with a women’s health provider, who can test your estrogen levels and determine what’s happening. You may be entering perimenopause, which can start in your 40s, or have another issue related to low levels of estrogen, such as:
- An eating disorder
- Family history of hormone-related conditions, such as ovarian cysts
- Overexercising
- Pituitary gland problems
Addressing those issues may help regulate your estrogen levels. However, if you’re in the menopausal transition and experiencing uncomfortable symptoms, ask your provider about treatments and lifestyle changes that can help.
Depending on your specific symptoms and other factors, your OBGYN may recommend that you take what’s known as hormone replacement therapy. With hormone replacement therapy, also called HRT, you take small doses of replacement hormone to help balance your hormones and alleviate symptoms.
There are two primary types of HRT: estrogen therapy, which contains estrogen alone, and estrogen plus progestin. HRTs are offered as oral medications and in topical skin creams. Your provider can recommend the right HRT to meet your needs.
Read More: The Truth About Female Longevity
“Because estrogen plays a role in bone and heart health, we’re also concerned about osteoporosis and cardiovascular disease in women who have reached menopause,” Ashby says. “HRT can help prevent osteoporosis, but it’s less clear whether HRT has any heart-health benefits. In both cases, however, it’s important for women to visit their providers regularly so we can make sure that health problems related to a drop in estrogen don’t have a serious impact later in life.”
Wondering whether your estrogen levels could use a boost? Request an appointment with a women’s health provider.
