Estrogen builds bone, strengthens muscle, slows aging, raises libido, enhances insulin sensitivity, and boosts serotonin (which is why estrogen is so important for mood and sleep).
And those are just a few of the hormone’s many benefits. Estrogen regulates over a thousand genes, so it’s arguably one of our most influential and important hormones.
No wonder it feels so bad to have estrogen deficiency. (It also feels bad to have estrogen excess. Read Part 2: Estrogen Excess.)
Estrogen deficiency causes fatigue, weight gain, hair loss, depression, and terrible insomnia. It also causes dry skin, recurrent bladder infections, and the most characteristic of all estrogen deficiency symptoms: vaginal dryness. (If you were my patient, I would ask you about dryness to figure out how estrogen deficient you are.)
How to boost estrogen
There’s no one way to boost estrogen. It all depends on why it’s low. Let’s look at four common scenarios.
Scenario 1. You don’t ovulate but you’re not menopausal.
Ovulation is how you make estradiol, your strongest and best estrogen. So your big question is: “Can you still ovulate?”
You can ovulate if you are younger than 45 and your FSH is less than 25 IU/L. That’s true even if you’ve had a partial hysterectomy (uterus removed). If you have ovaries, you can ovulate.
Once you identify your obstacle to ovulation, then correct that obstacle your estradiol will rise dramatically. That’s all you need to do. (You do not need to “boost” estrogen–it will do its own boosting.)
👉Hormonal birth control is not a 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. Ethinylestradiol is not as beneficial as your own estradiol and it’s combined with progestin drug that can cause depression and hair loss.
Scenario 2. You do ovulate.
If you ovulate, then you have sufficient estradiol. Why? Because if you did not, then you would not be able to reach ovulation.
👉 Tip: It’s normal to have very low estradiol early in your follicular phase (even within “menopausal” reference range).
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 can be the result of smoking, undereating, stress, vegetarian diet, gluten sensitivity, or eating too much soy. Your best treatment is to correct that underlying problem.
Scenario 3. You’re having an easy menopause transition.
Your ovaries make less estrogen after menopause but the rest of your body can pick up the slack by converting an adrenal hormone called DHEA into estrogen. To be able to do that, you need a good supply of DHEA, which is why it’s so important to support your HPA (adrenal) axis function during the menopause transition. And over time, your body will adjust to your new normal lower level of estrogen.
Treatment: Read Rescue Prescription for Menopause and Perimenopause.
Scenario 4. You’re having a difficult menopause transition.
If you’re reading this section, then you know the hell that can come from a sudden and severe drop in estrogen. A difficult menopause transition can happen after a total hysterectomy (ovaries removed), or suddenly stopping hormonal birth control or hormone replacement.
Severe estrogen deficiency can cause hot flashes, depression, and terrible insomnia. I’ve witnessed these symptoms with many patients, and I really don’t think any woman should have to put up with them. That’s why I support the use of a body-identical estrogen such as an estradiol patch like Estradot. Estrogen works best when used together with a micronized or natural progesterone capsule such as Prometrium (even if you don’t have a uterus). Read Rescue Prescription for Menopause and Perimenopause.
In summary, estradiol is a luscious, life-giving, essential hormone. Before menopause, you make estrogen with your ovaries and you can only do that if you ovulate regularly. After menopause, you make estrogen from your adrenal hormone DHEA.