Estrogen is a hormone that’s naturally produced by your body. It’s found in both people assigned male at birth and people assigned female at birth. Estrogen plays an important role in managing your reproductive system, but it also protects your bones and helps your skin heal from bruises and injury.

Sometimes, your body doesn’t make enough estrogen. This can happen for various reasons. For example, in people assigned female at birth, estrogen production slows down as they get older. Some conditions can also affect your estrogen levels.

If your estrogen levels are low, a doctor or healthcare professional may prescribe hormone therapy to help replace your estrogen levels and ease symptoms.

According to a 2015 American Cancer Society article, some research suggests that long-term hormone therapy may increase your risk of developing other conditions, including severe conditions such as cancer. Talk with a doctor about this before you begin using hormone therapy.

Learn more about the symptoms of low estrogen.

Keep reading to learn more about the benefits and risks of estrogen and which conditions may be treated with hormone therapy.

Your natural estrogen production changes over time. As you begin puberty, you’ll create more estrogen. If you are a person with ovaries, you’ll continue to have higher levels throughout the period between puberty and menopause. As menopause approaches, your estrogen levels will begin falling.

As your estrogen levels fall, you’ll start having symptoms of menopause. Most commonly, these symptoms include:

  • hot flashes
  • vaginal dryness
  • chills
  • difficulty sleeping
  • excessive sweating

For menopause symptoms, many doctors will prescribe an estrogen-containing medication. Replacing the declining estrogen with hormone therapy may help ease menopause symptoms.

Estrogen can help support your vaginal health. When estrogen levels decline, you may experience changes to the tissue, lining, and pH balance of your vagina. These changes can cause several vaginal health conditions, including:

  • vaginal dryness
  • vulvar atrophy, a condition that causes dryness, soreness, and urinary incontinence
  • atrophic vaginitis, or inflammation of vaginal tissues that’s frequently caused by dryness and irritation

Estrogen may be able to help treat these conditions.

Your ovaries are responsible for producing estrogen. If they fail to produce the hormone or if they’re affected by any other condition, hormone therapy may be necessary.

These conditions may require supplemental estrogen:

  • female hypogonadism, or decreased function of your ovaries
  • failure of both of your ovaries
  • an oophorectomy, or the removal of both of your ovaries

If you’ve had your ovaries removed, hormone therapy may be used to help ease symptoms of premature menopause. Sometimes, both your uterus and ovaries are removed. This is called a total hysterectomy.

Estrogen may help decrease bone loss after menopause. However, new medications are better able to stop and reverse bone loss, so most doctors rely on those now.

Those medications aren’t always effective, and their side effects may be too severe. In those cases, a doctor may recommend using estrogen to treat osteoporosis, or bone loss.

Learn more about osteoporosis treatments.

Hormone therapy isn’t without its risks. In fact, hormone therapy isn’t used as widely as it once was because research began revealing risks with long-term use, such as cancer and heart risks.

However, thanks to these studies, doctors and medical researchers have a better understanding of who will benefit most from estrogen therapy and who should try other treatments.

The risk factors and side effects associated with estrogen use include:

  • Blood clots. Estrogen increases your risk of blood clots, which can cause a stroke, a heart attack, and even death.
  • Cancer. Estrogen may increase your risk of certain cancers, specifically breast cancer. Talk with a doctor about your personal health history, your family history, and your risk of breast cancer.
  • Birth irregularities. If you’re using estrogen or hormone therapy and become pregnant, your pregnancy may end prematurely. If you’re able to carry a pregnancy to full term, birth irregularities are common for babies born to people using estrogen.
  • Dense breast tissue. People who take estrogen may develop dense breast tissue. Dense tissue makes reading mammograms harder, so identifying breast cancer in its early stages may be difficult.

Doctors typically prescribe estrogen-only medication if you’ve had a hysterectomy but still have your ovaries.

If you haven’t had a hysterectomy, you’ll usually receive a combination estrogen-progesterone medication. That’s because estrogen-only treatments increase your risk of endometrial cancer.

The endometrium is the lining of the uterus. Removing the uterus during a hysterectomy removes the risk of endometrial cancer.

What’s been approved by the Food and Drug Administration (FDA)?

The FDA approves all estrogen therapy medications. Some hormones are sold as “bio-identical hormones” and aren’t FDA approved.

They’re available without a prescription, and they’re not held to the same safety standards as prescription medications. Despite marketing claims, these hormones are also not more natural than the FDA-approved treatments.

The short-term benefits of estrogen therapy can help ease symptoms of several conditions and lower your risk of developing other conditions. However, there are health concerns related to hormone therapy.

Before you begin using estrogen, weigh the pros and cons of the treatment with a doctor. Use estrogen at the lowest dose you can and use it for as short a time as possible to reduce risks.

Pros

  • may improve your vaginal health
  • can help reduce your symptoms of menopause
  • may promote your bone and heart health

Cons

  • may increase your risk of certain cancers
  • may increase your risk of blood clots, which can lead to heart disease or a stroke
  • if taken while you’re pregnant, it may lead to a miscarriage or cause birth irregularities

While you can’t prevent your body’s natural hormone fluctuations, you can help ease the symptoms of estrogen loss. You can also take measures to prevent some of the complications of estrogen loss.

These strategies for managing estrogen loss include:

  • Eating a balanced diet. Foods rich in calcium and vitamin D can boost bone health and help prevent osteoporosis.
  • Considering a calcium supplement. Estrogen and calcium need each other to help build bone strength. Eat plenty of calcium-rich foods to give your body natural building blocks for your bones.
  • Lifting weights. Strength training is a highly effective way to build bone strength and lower your risk of osteoporosis. If you’ve never done strength training, work with a certified physical trainer to create a routine.