Estrogen deficiency causes fatigue, weight gain, hair loss, depression, and insomnia. It also causes dry skin, recurrent bladder infections, and vaginal dryness.
Vaginal dryness is one of the most characteristic signs of estrogen deficiency and a good indicator that you do have deficiency.
What causes low estrogen?
There’s no one way to increase estrogen. It all depends on why it’s low. Let’s look at the three possible scenarios.
Scenario 1. You don’t ovulate but you’re not in menopause
Ovulation is how you make estradiol, your strongest and best estrogen. So the question is: “Can you still ovulate?”
You can ovulate if your blood test for FSH is less than 40 IU/L. That’s true even if you’ve had a partial hysterectomy (uterus removed). If you have ovaries, you can ovulate.
Treatment: Figure out why you don’t ovulate. Are you on the pill? Do you have one of 4 types of PCOS? Are you eating enough? (For a full discussion of obstacles to ovulation, read Chapter 7 of my book Period Repair Manual.)
Once you identify your obstacle to ovulation, simply correct that obstacle and your estradiol will rise dramatically. That’s all you need to do.
In the case of PCOS or hypothalamic amenorrhea, eating phytoestrogens like soy or flaxseed will not raise your estrogen because phytoestrogens are not estrogen.
👉 Hormonal birth control is not the solution. The pill stops ovulation and completely shuts down estradiol. It replaces it with a synthetic estrogen called ethinylestradiol, which is similar to estradiol, but not identical. That’s why being on the pill can cause vaginal dryness.
Scenario 2. You ovulate
If you ovulate, then, by definition, you have enough estrogen. Why? Because if you did not have enough estrogen, you would not be able to ovulate.
👉 Tip: It’s normal to have very low (menopausal levels) of estradiol on day 2 or 3 of your cycle.
If you have light scanty periods (but you ovulate), then you may have slightly lower than average estradiol. I call this relative estrogen deficiency.
Treatment: Relative estrogen deficiency can occur at any age, and is usually the result of smoking, undereating, stress, gluten sensitivity, a vegan diet, or eating too many phytoestrogens. Your best treatment is to correct that underlying problem.
Scenario 3. You’re in menopause
Your ovaries naturally make less estrogen after menopause and usually, your body can adjust to that. If your body cannot adjust and you’re having symptoms such as hot flashes, depression, or insomnia, you can think about taking hormone therapy or hormone replacement therapy (HRT).
The best type is body-identical or bioidentical estradiol in the form of a patch like Estradot combined with a natural progesterone capsule Prometrium or Utrogestan. That’s true even if you don’t have a uterus. Read 4 Things to Know About Bioidentical or Body-Identical HRT.
(I am currently working on a new book about perimenopause and menopause where I will discuss the benefits of body-identical estrogen therapy.)