Low Estrogen Treatment: How to Naturally Enhance Estrogen During Your Reproductive Years

Low estrogen symptoms are often thought of as only affecting women who are postmenopausal. However, women of all ages can experience low estrogen levels. Let’s get a better understanding of the root causes of low estrogen levels as well as treatment strategies to boost your estrogen levels naturally.

Why is Estrogen So Important?

Estrogens are a class of hormones that encompasses three primary types of estrogens: estrone (E1), estradiol (E2), and estriol (E3). Estradiol (E2) is the most potent form of estrogen and the primary form in the body during reproductive years.

Estradiol is a hormone, or chemical messenger, that is crucially important for hormone cycles. An increase in estradiol during the follicular phase of the menstrual cycle is key as we prepare for ovulation. Increased estrogen during this time stimulates a spike in luteinizing hormone (LH). This is called the LH surge, and is required for ovulation to occur and for progesterone to be made.

Estradiol is also responsible for thickening the lining of the uterus, which allows implantation of a fertilized egg to occur, which is the first stage of pregnancy. If implantation and pregnancy does not occur, estradiol then blunts progesterone levels during the luteal phase. This effectively triggers the start of menstruation and the next menstrual cycle.

In addition to regulating hormone cycles and supporting reproduction, estrogen also plays key roles in water retention and electrolyte balance, bone health, brain function, immune system responses, heart health, and blood sugar metabolism.

Symptoms of low estrogen include period irregularity or amenorrhea, hot flashes and night sweats, mood changes, irritability, depression, brain fog, low bone density and frequent bone stress injuries, headaches, fatigue, breast tenderness, and more! Interestingly, many of these symptoms are also characteristic of high estrogen levels as well. 

Understanding Causes of Low Estrogen…

In Women of Reproductive Age

For cycling women, in many cases we see two common nutrition shortcomings contributing to low estrogen levels – inadequate cholesterol consumption, and underfueling.

Cholesterol is a precursor to estrogen and other reproductive hormones, as well as cortisol, our main stress hormone. While the majority of the cholesterol in our body is made by our liver, dietary cholesterol still plays a very important role, providing the body with resources to produce hormones like estrogen. 

We can get cholesterol in our diet from animal-based foods, such as meat and poultry, shellfish, and dairy products. Some of these foods are not only good sources of cholesterol, but also of saturated fats. While saturated fats are often demonized, research has shown that women who consumed 12-14% of their calories from saturated fat had the lowest rates of ovulatory infertility compared to those who consumed less saturated fat. This means that this group had the best ovulatory function with higher saturated fat intake.

Underfueling, or not consuming enough energy (calories and macronutrients) is another very common cause of low estrogen levels. Progesterone production, another critical reproductive hormone, and thyroid function will also be downregulated if there is a chronic energy (calorie intake) deficiency. This happens because in a low-energy state, our bodies divert nutrition and resources toward more essential body functions and away from reproduction.

Negative energy balance (i.e. underfueling or intentional caloric restriction) significantly suppresses the brain protein kisspeptin. Kisspeptin is responsible for stimulating the release of gonadotropin-releasing hormone (GnRH) by the hypothalamus, and the production of estrogen and progesterone in the ovaries. A decrease in GnRH results in the suppression of LH, which is critical for ovulation and fertility.

Other considerations and causes of low estrogen include conditions such as PCOS and premature ovarian failure, as well as environmental exposure to mold mycotoxins and endocrine disrupting chemicals (EDCs). Both of these environmental factors can impact hormone receptor binding sites, where hormones like estrogen need to enter for proper communication and signaling. 

In Perimenopausal Women

During the reproductive years, both the ovaries and the adrenal glands are responsible for estrogen production. During perimenopause, ovarian estrogen production (estradiol) begins to fluctuate, and ultimately stops completely. As the adrenal glands eventually become the only producer of estrogen, we can expect a significant decline in estrogen levels. 

The goal during perimenopause and even postmenopause as it relates to hormone support is not to recover estrogen levels, but rather to manage symptoms of this estrogen decline. One major symptom being changes in metabolism and insulin sensitivity, or blood sugar regulation. Other hallmark signs of low estrogen levels during perimenopause include hot flashes, night sweats, vaginal dryness and atrophy, thinning skin, bone loss or osteopenia, mood changes, and irregular cycles.

Top 3 Natural Ways to Boost Estrogen Levels

1. The Power of Food as Medicine

Recall that one of the primary root causes of low estrogen levels in women of reproductive age is underfueling. The importance of providing our bodies with enough energy goes beyond ensuring we have a regular period. Adequate fueling is crucial for proper thyroid function, maintaining metabolism, growth and healing, and so much more. 

In addition to getting enough macronutrients – protein, fat, and carbohydrates – we also want to pack our diet with phytonutrients. Phytonutrients are natural compounds in plant foods that provide tremendous benefits to different body systems and functions. To name a few, examples of phytonutrients include polyphenols, carotenoids, flavonoids, phenols, ellagic acid, and lignans. 

Many of these phytonutrients have antioxidant properties, protecting our cells against free radicals and oxidative stress. This is especially important for mitochondrial and ovarian health, which influences hormone health and egg quality! 

Phytoestrogens are another class of phytonutrients that are so powerful and often misunderstood. Phytoestrogens are similar in structure to the estrogen that we make in our bodies, and therefore act similar to estrogen, although to a lesser effect. 

Flax seeds, tempeh, edamame, chickpeas, and sesame seeds are all great sources of phytoestrogens. Consistent phytoestrogen consumption can help modulate estrogen levels, helping boost estrogen when low and lowering when elevated, and the symptoms associated with each. 

2. The Power of Lifestyle Modifications

Resistance training, or strength training, has been shown to increase estradiol levels more than aerobic, or cardio, exercise. Building lean muscle mass is incredibly important as we age for metabolic health, heart health, bone health, and ensuring we can live a vibrant life for as long as possible! 

If you’re not sure how to start building resistance training into your workout plan, or if you want to optimize your strength and fitness, check out our Strength in Hormones program.

Stress management is another key area to address if experiencing low estrogen symptoms. Practices such as meditation, deep breathing, journaling, and spending time in nature, can all help lower cortisol levels. Chronic stress hormone output, both in the case of low and high cortisol, can have significant effects on estrogen production due to its influence on the hypothalamic-pituitary-adrenal (HPA) axis.

Implementing stress relief strategies daily helps alleviate the mental and emotional symptoms of low estrogen levels. It also helps reduce chronically elevated cortisol levels to boost estrogen levels naturally. 

3. The Power of Herbal Supplements and Natural Remedies

Certain herbs are well known for their estrogen-supportive effects. This includes black cohosh and red clover. Utilizing supplementation can be helpful for some individuals, but should be considered after addressing nutrition and lifestyle strategies to boost estrogen production. 

We also want to bolster up our liver function, which is responsible for detoxifying or eliminating unwanted estrogens and other hormones. Liver detoxification is a critical process for maintaining health and hormone balance, even if estrogen levels are low to begin with. Herbs such as milk thistle, nettle leaf, and dandelion root are especially great for liver function.

For women of reproductive age, it’s also critically important that we are also mindful of progesterone levels. Progesterone is estrogen’s counterpart, and we want to ensure a proper balance between the two. Some herbal blends support both estrogen and progesterone levels simultaneously. It’s important to have an understanding of your hormone status before utilizing herbs that can affect your hormone levels.

For perimenopausal women, we know that both estrogen and progesterone levels are decreasing or have already dropped. During this time, testing and supplement recommendations will look different. Remember that the focus at this time is more so symptom relief as opposed to boosting estrogen levels back to where they were during reproductive years.  

Before Getting Started

Remember that many low estrogen symptoms are also symptoms of high estrogen levels as well. Before jumping into any treatment strategies, it’s important to understand your hormone levels. 

Comprehensive hormone testing, like our Dried Urine Hormone Testing Package, gives key insight into your specific hormone profile, and helps to inform your personalized treatment plan! 

Written by Romana Brennan, MS, RD