What are the symptoms of low estrogen in women, and what can you do?
Irregular periods, hot flashes, difficulty sleeping, mood swings, and headaches can all be signs of low levels of the hormone estrogen in women.
The most common cause of low estrogen is perimenopause, your body’s transition into menopause, but other factors can be involved.
Your doctor may prescribe hormone replacement therapy for low estrogen. The latest research shows that it is safe for most women, but check with your doctor to see if it's right for you.
There are studies to suggest that eating more plants containing substances called phytoestrogens could reduce the symptoms of low estrogen. Some studies also suggest that herbal remedies and certain vitamins involved in estrogen production may help. But the evidence for these is not very strong.
If you’re on medication, you should talk to your doctor before trying these.
There may also be a link between your gut microbiome and the levels of estrogen in your body. Your gut microbiome is the collection of trillions of bacteria and other microbes that inhabit your gut and play an important role in your health.
At ZOE, we run the largest nutrition, gut microbiome, and menopause research program in the world. With the ZOE program, you can find the best foods for your body and the life stage you are in right now.
Take our free quiz to find out more about what ZOE can do for you. And read on to learn more about causes and symptoms of low estrogen levels in women, including how to increase them.
Causes of low estrogen in women
There are several potential causes of low estrogen in women, but the most common is menopause, which means you've stopped having your period.
Perimenopause, the body's natural transition to menopause, usually begins in your 40s, but it can start earlier or later for some women. During this time, your estrogen levels fluctuate and can be high and low. The average length of perimenopause is 4 years, but it can last longer.
Other causes of low estrogen can include:
surgical removal of the ovaries
problems with ovary function
exercising too much
a history of eating disorders
Symptoms of low estrogen in women
The hormone estrogen has many roles in a woman’s body, including reproductive functions such as regulating your menstrual cycle. It also influences cholesterol levels, bone health, heart health, and mood.
Signs and symptoms of low estrogen can include:
reduced sex drive
pain during sex
A woman’s estrogen levels rise and fall throughout her menstrual cycle. But unusually low levels may lead to irregular or missed periods and problems with fertility.
Some women with low estrogen levels may also experience a lower sex drive. And low levels of this hormone may also affect vaginal pH levels, leading to dryness, pain during sex, and potential urinary problems.
How to increase your estrogen levels
If you’re experiencing symptoms of low estrogen, you may be looking for ways to increase the levels in your body.
Your doctor may prescribe hormone replacement therapy (HRT). If you take HRT that includes estrogen, it will increase the levels of the hormone in your body.
Researchers have found that HRT can be used in a safe way by most women.
There are studies looking into the possibility of changing what you eat, adding more of certain plant foods and vitamins to your diet, and trying herbal remedies to increase your estrogen levels. We discuss how strong this evidence is below.
Phytoestrogens are plant compounds that can replicate some of the functions of the estrogen produced by your body.
But findings are not consistent, and further studies are needed to confirm whether the use of phytoestrogens is safe and effective.
There are different types of phytoestrogens, but as a group, they can be found in certain fruits, vegetables, legumes, nuts, and seeds.
Foods that contain phytoestrogens include:
soybeans and soy products, like miso, tempeh, and natto
other legumes, like chickpeas and peanuts
certain fruits, including apples and pomegranates
Vitamin D plays an important role in the regulation of estrogen production. Combined low levels of vitamin D and estrogen have been linked to a greater risk of symptoms of metabolic syndrome — such as raised cholesterol and blood pressure — in women who have gone through menopause.
Your body produces vitamin D when you expose your skin to sunlight. But many people’s vitamin D levels aren’t high enough.
Some foods contain vitamin D, but it can be difficult to get enough of the vitamin from food alone. Foods that contain higher levels of vitamin D are meat, fish, and some mushrooms.
You can also get vitamin D from supplements, but it’s worth being aware that there are health risks associated with taking too much.
There is some evidence that certain herbs and medicinal plants may help with symptoms of low estrogen, but overall, this evidence is not very strong.
Examples of these, and their possible benefits, include:
fennel: may help with vaginal atrophy, which is the drying and thinning of the vaginal walls
More research is needed to study how safe these supplements are and how well they work.
Estrogen and gut health in women
There are trillions of bacteria and other organisms living in your gut, and together they make up your gut microbiome.
Having a healthy gut microbiome with a variety of beneficial bacteria is important for overall health and has been associated with lower risk of heart disease, inflammatory bowel disease, cancer, overweight, and type 2 diabetes.
Studies suggest the changes that happen through menopause, including decreased levels of estrogen, may be linked to changes in the makeup of your microbiome.
Unpublished research by ZOE scientists also found that women’s post-meal blood fat and blood sugar responses change significantly during menopause.
ZOE’s PREDICT program, the world’s largest in-depth study of nutrition and menopause, looks at the relationship between your gut microbiome, your health, and how your body responds to food. And it’s shown us that everyone is different.
Our at-home test analyzes the makeup of your unique gut microbiome, together with your blood fat and blood sugar. Based on your results, you receive personalized nutrition advice to help you find the best foods for your body.
Take our free quiz to find out how ZOE can help you.
Low estrogen levels in women can cause symptoms including irregular periods, hot flashes, painful sex, headaches, mood swings, and more.
The most common cause of low estrogen is menopause. But too much exercise, disordered eating, or complications with your ovaries could also lead to lower levels.
HRT may be an option for reducing symptoms, but you should talk to your doctor about the risks and benefits.
Foods high in phytoestrogens may help with symptoms of low estrogen. This includes soybeans and other legumes, flax seeds, garlic, and apples. Some herbal remedies may help, too. But the evidence for these approaches is not strong.
To process estrogen properly, your body needs the right amount of vitamin D. Talk to a healthcare professional before you take any supplements to make sure you are getting the right dose for your personal circumstances.
Changes to estrogen levels through menopause may also be related to your gut health. ZOE research has found that the way a woman’s body responds to food changes with menopause.
Take our free quiz to learn more about your gut microbiome and the best foods for you.
Anaerobic bacteria need their vitamin B12 to digest estrogen. Proceedings of the National Academy of Sciences of the United States of America. (2020). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995009/
A review of effective herbal medicines in controlling menopausal symptoms. Electronic Physician. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783135/
Black cohosh. (n.d.). https://www.nccih.nih.gov/health/black-cohosh
Effect of CIMicifuga racemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC). Archives of Gynecology and Obstetrics. (2019). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033259/
Effect of fennel on the health status of menopausal women: A systematic and meta-analysis. Journal of Menopausal Medicine. (2018). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949311/
Effect of vitamin D3 on biosynthesis of estrogen in porcine granulosa cells via modulation of steroidogenic enzymes. Toxicological Research. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266376/
Effects of phytoestrogen supplementation on intermediate cardiovascular disease risk factors among postmenopausal women: a meta-analysis of randomized controlled trials. Menopause. (2020). https://journals.lww.com/menopausejournal/Abstract/2020/09000/Effects_of_phytoestrogen_supplementation_on.19.aspx
Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. (2015). https://www.tandfonline.com/doi/full/10.3109/13697137.2014.966241
Estrogen’s effects on the female body. (n.d.) https://www.hopkinsmedicine.org/health/conditions-and-diseases/estrogens-effects-on-the-female-body
First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Advances in Therapy. (2011). https://link.springer.com/article/10.1007%2Fs12325-011-0027-z
Hormone replacement therapy. (2019). https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/
Hypothalamic amenorrhea and the long-term health consequences. Seminars in Reproductive Medicine. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374026/
Management of the perimenopause. Clinical Obstetrics and Gynecology. (2018). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400/
Menopause basics. (n.d.). https://www.womenshealth.gov/menopause/menopause-basics
Menopause, the gut microbiome, and weight gain: correlation or causation? Menopause. (2020). https://pubmed.ncbi.nlm.nih.gov/33235036/
Primary ovarian insufficiency. The Lancet. (2010). https://pubmed.ncbi.nlm.nih.gov/20708256/
Reproductive hormones. (2022). https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones
Reviewing the options for local estrogen treatment of vaginal atrophy. International Journal of Women’s Health. (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958523/
Sage. (n.d.). https://www.nccih.nih.gov/health/sage
Straight talk about soy. (n.d.). https://www.hsph.harvard.edu/nutritionsource/soy/
Taking too much vitamin D can cloud its benefits and create health risks. (2019). https://www.health.harvard.edu/staying-healthy/taking-too-much-vitamin-d-can-cloud-its-benefits-and-create-health-risks
The effects of phytoestrogens on postmenopausal health. Climacteric. (2021). https://www.tandfonline.com/doi/abs/10.1080/13697137.2020.1863356?journalCode=icmt20
The normal menstrual cycle and the control of ovulation. (2018). https://www.ncbi.nlm.nih.gov/books/NBK279054/
The role of reproductive hormones in the development and maintenance of eating disorders. Expert Review of Obstetrics & Gynecology. (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622542/
The synergistic effects of vitamin D and estradiol deficiency on metabolic syndrome in Chinese postmenopausal women. Menopause. (2019). https://journals.lww.com/menopausejournal/Abstract/2019/10000/The_synergistic_effects_of_vitamin_D_and_estradiol.15.aspx
Use of plant-based therapies and menopausal symptoms. JAMA. (2016). https://jamanetwork.com/journals/jama/fullarticle/2529629
Vitamin B12. (2021). https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/