The safest form of estrogen to use is estriol. While it is weak, it does have a protective effect against breast cancer development. The most effective estrogen is estradiol, but it does carry some risk. Synthetic estrogens, such as Premarin are not advised.
Often a combination of 2 or 3 different bioidentical estrogens are used by Holistic doctors in formulas with names such as BiEst and TriEst, prepared by a compounding pharmacy.
Signs, symptoms & indicators of Low Estrogen Levels
Rapid pulse rate
Reduction in breast fullness
Low levels of estrogen, typically experienced at menopause, can cause sagging breasts. Sagging that occurs prior to menopause is not reversible by hormone replacement therapy.
Health declining with age
Meal-related bloating
Fatigue that worsens during the day
Constant fatigue
Fatigue on light exertion
Lethargy and lack of vitality are early signs that your anti-aging hormones (such as estrogen and progesterone) are diminishing.
(Occasional) daytime sweating
A 'foggy' mind
Short-term memory failure
Facial burning/tingling
Lowered estrogen levels can cause all sorts of unusual symptoms. The body’s thermostat fluctuates, causing flushing and circulation changes which sometimes result in tingling of the face.
Hot flashes
Hot flashes between period or constant hot flashes
Mood swings during menstrual cycle
Poor concentration during cycle
No difficulty achieving orgasm
Joint pain/swelling/stiffness
Excess perspiration
Thin skin
Thinning skin is sometimes an indication of lowered estrogen levels. This can be seen, along with other symptoms, most easily at menopause.
Conditions that suggest Low Estrogen Levels
Atherosclerosis
Low estrogen levels raise LDL-C (bad) cholesterol, while lowering HDL (good) cholesterol, both of which contribute to atherosclerosis. Supplemental estrogen reduces this risk, at least partially by increasing the HDL particle size which confers some protection against heart disease.
Counter Indicators
Depression
Low estrogen levels trigger the brain to release MAO, an enzyme in the brain which breaks down and destroys the neurotransmitter, serotonin. Estrogen increases the destruction of this enzyme. The lower your MAO enzyme levels the better you probably feel, since MAO breakdowns serotonin. Low serotonin levels are associated with depression.
Panic Attacks
There has been research showing an association of panic attacks with decreased levels of estrogen in women.
Headaches
The problem of menopausal headache is substantial; it is probably under-estimated, under-treated and poorly understood. It certainly deserves further attention. [J Br Meno Soc 1998; 4: pp.56-61]
Headaches, Migraine/Tension
Women must first be exposed to elevated estrogen levels before low estrogen levels will trigger headache activity. Constant low levels of estrogen, as in menopause, are less likely to be associated with increased headache pattern.
Osteoarthritis
In studies of older women, a lower risk of osteoarthritis was found in women who had used oral estrogens for hormone replacement therapy. The researchers suspect that low estrogen levels could increase risk for the disease, but further studies are needed.
Night Sweats
Night sweats or their daytime version, hot flashes, may be the first symptom of low estrogen. In both cases, the profuse sweating follows a brief but intense wave of heat, usually in the face and chest.
Vaginal Dryness
The most common cause of vaginal dryness is lack of estrogen.
Vaginitis/Vaginal Infection
A decrease in estrogen results in several vaginal changes. The vaginal lining becomes thinner and more fragile resulting in an increased risk of bacterial infection.
Urinary Stress/Overactive Bladder
The cause of urinary stress incontinence in women is usually pelvic relaxation resulting from childbirth and the aging process. These changes become more pronounced following menopause as estrogen deficiency allows atrophy of the genitourinary tissues.
Risk factors for Low Estrogen Levels
Hyperprolactinemia
Prolactinoma is a condition in which a noncancerous tumor (adenoma) of the pituitary gland in your brain overproduces the hormone prolactin. The major effect of increased prolactin is a decrease in normal levels of sex hormones — estrogen in women and testosterone in men.
Having very/having low estrogen levels
Marginal/poor ovarian reserve
Counter Indicators
Having elevated estrogen levels
Non-human estrogen use
(Past) natural estrogen use
(High) green tea consumption
High intake of green tea has been associated with higher levels of sex hormone binding globulin (SHBG) and lowered levels of serum estradiol (estrogen) concentration in women.
Recent unexplained weight gain
Counter Indicators
Recent unexplained weight loss
Absence of short-term memory loss
Frequent orgasm
Low Estrogen Levels suggests the following may be present
Increased Risk of Alzheimer's / Dementia
Women who use hormone therapy before the age of 65 could cut their risk of developing Alzheimer’s disease or dementia. This possibility is raised by research that will be presented at the American Academy of Neurology’s 59th Annual Meeting in Boston, April 28 May 5, 2007.
The study found women who used any form of estrogen hormone therapy before the age of 65 were nearly 50 percent less likely to develop Alzheimer’s disease or dementia than women who did not use hormone therapy before age 65.
The study was part of the Women’s Health Initiative Memory Study, which is a sub-study of the Women’s Health Initiative (WHI), one of the largest U.S. prevention studies of postmenopausal women. The study looked at prior hormone use in 7,153 healthy women ages 65-79 before they enrolled in the WHI Memory Study. Researchers followed the women’s cognitive health over an average of five years.
In that time, 106 of the women developed Alzheimer’s disease or dementia. Dementia is a general term referring to the progressive decline in a person’s cognitive function. Dementia can affect memory, attention, language and problem solving abilities. Alzheimer’s is the most common type of dementia.
Prior studies have shown that hormone therapy started during the WHI Memory Study increased a woman’s chance of dementia. The reduced risk of dementia was seen only with prior hormone therapy, used before study enrollment. Reduced risk was not affected by other examined factors. “We found that it didn’t matter how old the woman was when she started hormone therapy, how long or recently she took it or what kind of prior therapy she used,” said study author Victor W. Henderson, MD, of Stanford University in Palo Alto, CA, and Fellow of the American Academy of Neurology.
Women who began estrogen-only therapy after the age of 65 had roughly a 50-percent increased risk of developing dementia. The risk jumped to nearly double for women using estrogen-plus-progestin hormone therapy.
Low Estrogen Levels can lead to
Atherosclerosis
Low estrogen levels raise LDL-C (bad) cholesterol, while lowering HDL (good) cholesterol, both of which contribute to atherosclerosis. Supplemental estrogen reduces this risk, at least partially by increasing the HDL particle size which confers some protection against heart disease.
Recommendations for Low Estrogen Levels
Black Cohosh (Cimicifuga racimosa)
Black Cohosh is well known for reducing hot flashes associated with low estrogen levels, especially during menopause.
There is a natural product which has been helpful for some women, which contains Black cohosh. It is called Estroven. Each caplet or gelcap contains: Vitamin E 30IU; Thiamin 2mg; Riboflavin 2mg; Niacin 20mg; Vitamin B-6 10mg; Folate 400mcg; Vitamin B-12 6mcg; Calcium 150mg; Selenium 70mcg; Boron 1.5mg; Purified isoflavones (from GMO-free soybeans and other plants) 55mg; Estroven Calming Herbal Blend (proprietary blend of Date seed extract [ Zizyphus spinosa ] and Magnolia bark extract) 150mg; Black cohosh root standardized extract 40mg.
Reading List
Actress and author Suzanne Somers has written a book, The Sexy Years: Discover the Hormone Connection, on how to not only survive but also prosper from the changes of middle age that affect both women and men. It provides many details on how to recognize the source of the problem and what you can do about it.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Weakly counter-indicative |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Menopause
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Estrogen
One of the female sex hormones produced by the ovaries.
Premenopause
The period when women of childbearing age experience relatively normal reproductive function (including regular periods).
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
High-Density Lipoprotein
(HDL): Also known as "good" cholesterol, HDLs are large, dense, protein-fat particles that circulate in the blood picking up already used and unused cholesterol and taking them back to the liver as part of a recycling process. Higher levels of HDLs are associated with a lower risk of cardiovascular disease because the cholesterol is cleared more readily from the blood.
Atherosclerosis
Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.
MAO
Abbreviation for a breakdown enzyme monoamine oxidase. A MAO inhibitor blocks the action of monoamine oxidase, thus raising the levels of the monoamine neurotransmitters such as norepinephrine, epinephrine, dopamine, and serotonin - which have significant effects on mood and behavior. Epinephrine, norepinephrine and serotonin are normally deactivated by MAO-A while dopamine and phenylethylamine are normally metabolized by MAO-B.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Neurotransmitters
Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.
Serotonin
A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.
Panic Attack
A brief, irrational episode of fear that is perceived as so real that an individual may be driven to escape from the place or situation where it occurs. The attack is sudden and increases in severity until it leaves, usually within ten minutes. Panic attack symptoms are numerous and involve both mental and physical signs and symptoms. A panic attack can occur in other anxiety states such as agoraphobia and with certain activities and places. It may occur spontaneously without an apparent cause.
Adenoma
An ordinarily benign growth of epithelial tissue in which the tumor cells form glands or gland-like structures that tend to exhibit glandular function.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Prolactin
An anterior pituitary peptide hormone that initiates and maintains lactation.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Alzheimer's Disease
A progressive disease of the middle-aged and elderly, characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia.
Dementia
An acquired progressive impairment of intellectual function. Marked compromise exists in at least three of the following mental activity spheres: memory, language, personality, visuospatial skills, and cognition (i.e., abstraction and calculation).
Postmenopause
The postmenopausal phase of a woman's life begins when 12 full months have passed since the last menstrual period and any menopausal symptoms have become milder and/or less frequent.