Estrogen is a class of steroid hormones which regulates the growth, development and physiology of the human reproductive system. It plays an important role in the development and regulation of primary sexual characteristics of women (such as menarche) and secondary sexual characteristics (such as breast development and pubic hair).
Estrogen is essential for every woman, and neither primary nor secondary sexual characteristics will fully develop in its absence, according to Dr Ananatharaman R, consultant endocrinologist at Magna Centres for Obesity, Diabetes and Endocrinology, Bengaluru.
Causes of low estrogen in women
Low levels of estrogen in women may result from premature ovarian failure, certain congenital conditions like Turner syndrome, hypopituitarism (where the pituitary glands do not produce a normal amount of hormones), hypogonadism (when the ovaries or the body’s sex glands produce little or no hormone), thyroid disorders, chemotherapy, extreme exercise and being severely underweight, according to Dr Louis Cojandaraj A, associate professor and research coordinator at Lovely Professional University, Phagwara, Punjab.
Dr Deepti Asthana, senior consultant, obstetrics and gynecology, Fortis Memorial Research Institute, Gurugram, Haryana, tells Happiest Health that menopausal women and girls who have not attained puberty have low levels of estrogen. “Once you attain puberty, there are various causes of low estrogen,” says Dr Asthana. “It could be due to the removal of ovaries, premature menopause, chronic kidney disease and many auto-immune and genetic disorders. Estrogen is also low in conditions such as anorexia nervosa.”
Symptoms of low estrogen in women
Dr Asthana says the symptoms of low estrogen are hot flashes, sweating, weight gain, hair thinning, dry skin, vaginal dryness, irregular menstrual cycle, infertility, mood changes, trouble sleeping, low sex drive and osteoporosis. These symptoms are usually seen in women who have attained menopause.
If low estrogen in reproductive women persists for long, it can lead to bone fragility or fracture; the bone mineral density goes down, making the bones weaker, says Dr Ananatharaman.
Dr Cojandaraj says amenorrhea, headaches and depression are also symptoms of low estrogen.
Causes of high estrogen in women
Dr Cojandaraj says that health conditions such as polycystic ovarian syndrome, endometriosis, uterine fibroids, certain types of cancers and insulin resistance can lead to high estrogen. Other factors include obesity, stress, alcohol consumption and certain medications.
Dr Asthana says these factors, in turn, increase cortisol levels. “Increase in cortisol level depletes the levels of progesterone which balances estrogen,” she says.
Symptoms of high estrogen
Experts say high levels of estrogen in females can cause symptoms such as irregular periods (light or heavy periods), weight gain, fatigue, uterine fibroids, fibrocystic breast lumps, anxiety, bloating, hair loss, disrupted sleep, bloating and premenstrual syndrome.
In males, symptoms include gynecomastia (enlarged breasts), erectile dysfunction and infertility.
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Lifestyle changes
Doctors say that to keep estrogen levels in a healthy range and prevent hormone imbalances, certain lifestyle changes should be adopted:
- Getting an adequate amount of sleep
- Managing stress levels
- Getting the right amount of exercise
- A healthy diet and practising good eating habits
- Limiting alcohol intake
Dr Ananathraman says hormone therapy is given to those with severe symptoms.
Diagnosis
“To check the level of estrogen, we monitor the menstrual cycle of a female,” says Dr Anantharaman. “A normal menstrual cycle is an indication that the estrogen levels are in control. Estrogen levels are also measured when girls attain late puberty, to check the growth of the uterus (uterine development).”
Estrogen levels differ every day in every woman. The ideal range includes:
- 30 to 400 pg/mL (picograms per millilitre) for premenopausal women
- 0 to 30 pg/mL for postmenopausal women
The link between estrogen, progesterone
Progesterone and estrogen are both ovarian hormones. Estrogen helps in the regulation of the menstrual cycle and progesterone prepares the uterus during pregnancy. Estrogen and progesterone play a vital role in the maturation of female secondary sex organs, implantation of ovum and maintenance of pregnancy. Estrogen levels naturally fluctuate during the menstrual cycle along with progesterone.
Estrogen increases the growth of breast cells. Progesterone decreases the rate of multiplication of the breast cells, which helps in the prevention of many breast cancers.
Types of estrogen
- Estrone – Plays an important role in the reproductive system of females. It is considered the storehouse of estrogen.
- Estradiol – Controls how the female reproductive cycles of ovulation and menstruation are regulated. Female secondary sexual traits like the growth of the breasts, broadening of the hips and a pattern of fat distribution specific to women are all driven by estradiol. During puberty, maturity and pregnancy, it plays a crucial role in the growth and maintenance of female reproductive structures like the uterus, vagina and mammary glands. Numerous other tissues — such as bone, fat, skin, liver and the brain — are also significantly impacted.
- Estriol (E3) — Generally undetectable when not pregnant. But a high level of E3 is secreted in the placenta during pregnancy.
- Estetrol – Produced exclusively in the fetal liver and found only during pregnancy. It is called the native estrogen of fetal life.
