Oestrogen is a key hormone that plays a vital role in reproductive health, sexual development, and many other bodily functions. While its levels naturally fluctuate throughout a woman’s life, a persistent decline can signal underlying changes in the body (1).
One of the most common causes of low oestrogen is menopause. As women approach this stage, oestrogen levels gradually drop, often leading to a wide range of symptoms that can feel anywhere from mildly uncomfortable to totally overwhelming.
In this article, we’ll explore the causes and signs of low oestrogen and treatment and management options. By understanding these changes, you can take control of your well-being and recognise when to seek medical support.
The role of oestrogen in the body
Oestrogen is produced in the ovaries, adrenal glands and fat tissues and plays a fundamental role in female sexual and reproductive health (2). It regulates the menstrual cycle, supports ovulation, and maintains the health of the uterus, making it essential for fertility and pregnancy.
Beyond reproduction, oestrogen also influences various systems and aspects of the body, including:
- Breast tissue: Oestrogen forms breast tissue and helps stop lactation after weaning.
- Bone health: Helps maintain bone density and strength, reducing the risk of osteoporosis.
- Brain and cognitive function: Plays a role in memory, mood regulation, and mental processing.
- Skin and hair health: Affects collagen production, skin elasticity, and hair growth.
- Genitourinary health: Maintains vaginal lubrication, elasticity, and urinary tract function.
- Metabolism and fat distribution: Affects body fat storage and metabolic rate.
- Immune system: Influences immune responses and helps with inflammation regulation
- Cardiovascular system: Supports healthy blood vessels and cholesterol levels, protecting against heart disease (2,3).
Learn more about the role of oestrogen in relation to menopause and heart issues.
How do oestrogen levels change over time?
Oestrogen levels do not stay consistent throughout your life and fluctuate during your reproductive years according to your menstrual cycle (3). Levels are lowest during your period and peak in the middle of a menstrual cycle before ovulation.
Females produce 3 different types of oestrogen, which vary according to your stage of life:
- Oestradiol: This is the main type of oestrogen produced before menopause and is predominantly made in the ovaries.
- Oestriol: This type is produced during pregnancy, mainly by the placenta and its levels peak just before giving birth.
- Oestrone: After menopause, oestradiol levels fall and oestrone becomes the main type of oestrogen in the body. It is a weaker form of oestrogen produced by your adrenal glands and fatty tissue (2,3).
Causes of low oestrogen
While menopause is the main cause of low oestrogen levels in midlife, they can be a sign of an underlying health condition or be the result of certain medical treatments:
- Autoimmune diseases: Some can attack your ovaries, preventing them from making enough oestrogen.
- An underactive pituitary gland: This limits a hormone that tells the ovaries to make oestrogen, resulting in low levels.
- Cancer treatment: Chemotherapy and radiation therapy can damage the ovaries, leading to reduced or halted oestrogen production.
- Diabetes: Uncontrolled diabetes can disrupt hormone regulation, potentially leading to lower oestrogen levels.
- Eating disorders: Such as anorexia and bulimia can result in nutritional deficiencies that lead to hormonal imbalances.
- Excessive exercise: Intense physical training, can lead to hypothalamic amenorrhea, disrupting hormonal balance and suppressing oestrogen production.
- Genetic conditions: Like Turner syndrome and Fragile X cause low oestrogen.
- High blood pressure: Chronic hypertension may contribute to vascular and hormonal imbalances that affect oestrogen levels.
- Medications: Certain drugs, such as those used in cancer treatment, can inhibit oestrogen production.
- Polycystic ovary syndrome (PCOS): PCOS can cause hormonal imbalances, including lower levels of oestrogen relative to other hormones.
- Premature ovarian insufficiency: In some women, the ovaries stop functioning properly before the age of 40, leading to significantly reduced oestrogen levels.
- Tumours of the ovaries or adrenal glands: Certain tumours can interfere with normal hormone production, either by suppressing oestrogen or producing excess androgens that disrupt balance (1,2).
Low oestrogen symptoms
As oestrogen influences so many functions in the body, low levels can produce many different physical and emotional symptoms. These will be different for everyone but may include:
- Irregular or missed periods in perimenopause
- Hot flushes
- Night sweats
- Tender breasts
- Dry skin
- Mood swings
- Irritability
- Depression
- Anxiety
- Trouble concentrating
- Vaginal dryness and vaginal atrophy
- Fatigue
- Insomnia
- Weight gain, particularly around the abdomen
- Headaches
- Worsening of existing migraine
- Loss of libido
- Painful intercourse
- An increase in urinary tract infections (1,2,4)
Discover other symptoms of menopause.
Long-term health risks of low oestrogen levels
As with any deficiency, chronically low oestrogen levels after menopause are associated with several health risks:
Osteoporosis
Oestrogen helps to maintain bone health and strength. A drop in oestrogen after menopause increases the risk of osteoporosis, a condition where bones begin to break down more quickly than they can be restored. This leads to weakness and an increased chance of bone breaks and fractures. Women can lose up to 10% of their bone strength in the 5 years after menopause (5).
Diabetes
Blood sugar levels are influenced by oestrogen, so when levels are low, it can lead to metabolic changes in the body. This results in an increased risk of postmenopausal women developing type 2 diabetes (5).
Cardiovascular disease
Oestrogen has a key role in maintaining your blood vessels and managing cholesterol levels. This is why after menopause, the risk of coronary heart disease, stroke and vascular dementia increases (5).
Dementia and clinical depression
The cells in your brain require oestrogen as well as testosterone to function properly. When the levels of these hormones decline in menopause, it makes women more likely to develop dementia and clinical depression (5).
Learn more about testosterone levels in menopause.
How to test oestrogen levels
Most women do not need to have their hormone levels checked to confirm menopause – a review of the symptoms you’re experiencing is usually enough.
However, if it’s suspected that you have low oestrogen for another reason, or you’re experiencing menopause symptoms and are under 45, you may be offered blood tests.
Low oestrogen treatment options
Fortunately, there are ways to increase oestrogen levels, promote hormone balance and manage the effects of low oestrogen to improve your symptoms and quality of life.
Hormone replacement therapy
Hormone replacement therapy (HRT) is a common treatment for low oestrogen in menopause. Body-identical HRT provides the body with hormones that are the same as those produced by the body, but they are typically derived from plant sources.
HRT comes in several formats including tablets, patches, gel and spray. Oestrogen will typically be prescribed alongside progesterone in a combined HRT regimen (unless you’ve had a hysterectomy) to prevent health risks such as endometrial hyperplasia and uterine cancer.
If low oestrogen is predominantly causing vaginal and urinary symptoms, local vaginal oestrogen treatments are also an option and can be used with other forms of HRT. These types do not enter the bloodstream. Instead, they only work on the part of the body they are applied to alleviate dryness, itching and pain (6).
Learn more about oestrogen therapy for menopause.
Natural remedies for low oestrogen levels
Natural remedies won’t increase your body’s oestrogen levels but they can mimic the effects of oestrogen, help your body use the oestrogen it has more effectively and reduce symptoms (7).
Phytoestrogens
Phytoestrogens are plant compounds that work as antioxidants and prevent DNA damage. They also mimic oestrogen, so when ingested, your body recognises them as such. The most common phytoestrogens are:
- Coumestan
- Isoflavones
- Lignans
- Stilbene (7)
These can be found in:
- Fruits: Peaches, pears, plums, apples, berries, grapes
- Vegetables: Broccoli, Brussels sprouts, onions, spinach, kale
- Grains: Barley, wheat germ, oats
- Nuts and seeds: Peanuts, sesame seeds, almonds, sunflower seeds, flaxseeds
- Soy and soy products: Soybeans, miso, tofu
- Plant liquids: Coffee, tea, beer, olive oil, red wine (1,2,7)
Vitamins and minerals
Some vitamins and minerals help your body to produce oestrogen and use what it has more effectively. These include:
- Boron
- Vitamin B
- Vitamin D
- Vitamin E (7)
Supplements
Research is limited but there is some evidence to suggest that certain supplements can help reduce the symptoms of low oestrogen. These include:
- Black cohosh
- Red clover
- Dehydroepiandrosterone (DHEA)
- Soy isoflavones (1,2,7)
Learn more about herbal remedies and supplements for menopause.
Lifestyle changes
While there are no behaviours that can fully restore your natural oestrogen levels after menopause, there are lifestyle changes and healthy habits that can contribute to better overall hormone balance and well-being and alleviate symptoms. These include:
- Maintaining a healthy body weight
- Regular moderate exercise
- Reducing stress
- Getting enough sleep and optimising your sleep environment
- Wearing cool, loose clothing
- Reducing caffeine, alcohol and spicy food
- Giving up smoking (1,8)
If you suspect you are menopausal and are experiencing unpleasant symptoms associated with low oestrogen, don’t continue to navigate these alone. Reach out for professional support. The doctors at Menopause Care are experienced in creating personalised treatment plans based on your symptoms, medical history and well-being goals. To see each doctor's area of expertise and find the right practitioner for you, browse our menopause doctor profiles or take our symptoms quiz.
¹Low Estrogen: Causes, Symptoms, Diagnosis & Treatment (February 2022)
²Estrogen: Functions, uses, and imbalances (November 2023)
³Oestrogen | healthdirect (June 2024)
⁶Menopause - Treatment - NHS (May 2022)
⁷⁸Treating menopause symptoms (February 2025)
