Estrogen is a hormone. Although present in the body in small amounts, hormones have big roles in maintaining your health.

Estrogen is commonly associated with the female body. Men also produce estrogen, but women produce it in higher levels.

The hormone estrogen:

  • is responsible for the sexual development of girls when they reach puberty
  • controls the growth of the uterine lining during the menstrual cycle and at the beginning of a pregnancy
  • causes breast changes in teenagers and women who are pregnant
  • is involved in bone and cholesterol metabolism
  • regulates food intake, body weight, glucose metabolism, and insulin sensitivity

Girls who haven’t reached puberty and women approaching menopause are most likely to experience low estrogen. Still, women of all ages can develop low estrogen.

Common symptoms of low estrogen include:

You may also find that your bones fracture or break more easily. This may be due to a decrease in bone density. Estrogen works in conjunction with calcium, vitamin D, and other minerals to keep bones strong. If your estrogen levels are low, you may experience decreased bone density.

If left untreated, low estrogen can lead to infertility in women.

Estrogen is primarily produced in the ovaries. Anything that affects the ovaries will end up affecting estrogen production.

Young women may experience low levels of estrogen due to:

In women over 40 years old, low estrogen can be a sign of approaching menopause. This time of transition is called perimenopause.

During perimenopause your ovaries will still produce estrogen. Production will continue to slow until you reach menopause.

Learn more: What can cause bleeding after sex?

The most common risk factors for low estrogen levels include:

  • age, since your ovaries produce less estrogen over time
  • family history of hormonal issues, such as ovarian cysts
  • eating disorders
  • extreme dieting
  • excessive exercising
  • issues with your pituitary gland
  • chemotherapy and radiation therapy
  • substance use disorder

Diagnosis and treatment of low estrogen can help prevent many health issues.

If you’re experiencing symptoms of low estrogen, talk with your doctor. They can assess your symptoms and make a diagnosis if needed. Early diagnosis may help prevent further complications.

During your appointment, your doctor will discuss your family health history and assess your symptoms. They’ll also perform a physical exam. Blood tests will likely be needed to measure your hormone levels.

Your follicle stimulating hormone (FSH) levels may also be tested to determine whether your estrogen is low if you’re experiencing:

In some cases, your doctor may order a pituitary hormone test to check for any medical conditions that may be affecting the endocrine system. If your pituitary hormones are abnormal without clear explanation, your doctor may follow up with a brain scan.

Women who have low levels of estrogen may benefit from hormonal treatment. Hormonal treatment is the standard for low estrogen. There are non-hormonal options to help relieve symptoms. Non-hormonal options are preferred for women at high risk for breast cancer, blood clots, stroke, or liver disease.

Estrogen therapy

Women between ages 25 to 50 years old who are estrogen deficient are generally prescribed estrogen, which can reduce the risk of:

  • bone loss
  • cardiovascular disease
  • other hormonal imbalances

In 2002, the Food and Drug Administration (FDA) urged women to take the lowest possible dose for the shortest amount of time. Since then, high doses are not generally prescribed anymore.

The actual dose will depend on the severity of the condition and the method of application. Estrogen can be administered:

  • orally
  • topically
  • vaginally
  • via injection

In some cases, long-term treatment may be needed even after your estrogen levels return to normal. This may require lower doses of administered estrogen over time to sustain your current level.

Estrogen therapy may also ease the severity of menopausal symptoms and reduce your risk for fractures.

Estrogen therapy is only recommended for 1 to 2 years. This is because estrogen therapy may increase your risk for cancer.

Hormone replacement therapy (HRT)

HRT is used to increase your body’s natural hormone levels. Your doctor may recommend HRT if you’re approaching menopause. Menopause causes your estrogen and progesterone levels to significantly decrease. HRT can help return these levels to normal.

In this therapy, hormones can be administered:

  • topically
  • orally
  • vaginally
  • via injection

HRT treatments can be adjusted in dosage, length, and the combination of hormones. For example, depending on the diagnosis, progesterone is required if a woman still has her uterus, but it’s not required if she’s had a hysterectomy.

The Women’s Health Initiative, a 2002 women’s health prevention study that the National Institutes of Health (NIH) conducted, concluded that women taking combination (estrogen + progesterone) hormone therapy for menopause had an increased risk for breast cancer, heart disease, stroke, blood clots, and urinary incontinence.

Check out: Dealing with early menopause.

Sex hormones, such as estrogen, influence the amount of fat in the body. Estrogen regulates glucose and lipid metabolism. If your estrogen levels are low, it can result in weight gain.

Research suggests that this may be why women approaching menopause are likely to become overweight. Being overweight can increase your risk for obesity, diabetes, and cardiovascular disease.

If your estrogen levels are low and it’s affecting your weight, speak with your doctor. They can assess your symptoms and advise you on next steps. It’s always a good idea to try to eat a balanced diet and exercise as often as possible. Talk with your doctor about developing a diet and exercise plan that’s right for you.

Hormones, such as estrogen, play a key role in your overall health. Age, certain diseases, or inherited disorders can cause your estrogen levels to drop.

Low estrogen levels can interfere with sexual development and sexual functions. They can also increase your risk for obesity, osteoporosis, and cardiovascular disease.

Treatments have evolved over the years and become more effective. Your individual reason for low estrogen will determine your treatment as well as the dosage and duration.

Keep reading: What you need to know about vaginal health at every age.