Estrogen deficiency occurs when women have low levels of the important “female” hormone, estrogen. Sometimes this condition occurs before menopause and is considered abnormal because it disrupts menstrual cycles and creates many unpleasant symptoms. An estrogen deficiency is expected during menopause, but when the body stops making estrogen pre-menopause, doctors may choose to treat with estrogen substitutes.
Causes of estrogen deficiency are varied in women not entering menopause. Some benign causes include extreme exercise, and champion athletes or women with very little body fat can have unusually low levels of estrogen and progesterone, which is most noted because periods cease or are irregular. Some women enter menopause very early, generally before they reach their 40s. The average age of menopause is about 51, so low estrogen before the 40s is considered unusual. Thyroid disorders, genetic diseases like Turner syndrome, or some cancers of the adrenal glands or ovaries may additionally reduce estrogen.
With normal menopause or surgical removal of the ovaries, estrogen deficiency is expected. In younger women, treatment may include supplementation with estrogen, and this used to be common treatment for women in normal or induced menopause. Today, if estrogen replacement therapy is used in menopausal women, it’s usually short-term because estrogen increases the risk of certain cancers and heart disease. Many of the symptoms of estrogen deficiency in menopause are reduced as women become post-menopausal, and doctors and their patients determine if adding estrogen to the body is worth the risks.
There are many common symptoms associated with estrogen deficiency, and women may experience all or some of these to greater or lesser degree. The first symptom is usually irregularity or full cessation of menstrual periods. Headaches and migraines become more common, women may experience hot flashes and night sweats, vaginal dryness and vaginal or urinary tract infections occur more regularly. Sleep can be disrupted, fatigue may result and these two symptoms may be tied to reduced ability to concentrate and forgetfulness.
Libido may be diminished and this symptom is often related to discomfort that sex may cause due to vaginal dryness. Some women also have trouble with urinary incontinence. More serious symptoms include changes in heart rhythm. Emotionally, low estrogen is linked to strong mood changes, from depression to anxiety to anger or despair. Many women describe temper as having a short fuse and report episodes of extreme emotional responses like a lot of crying.
These initial symptoms may be paired with long term causes of estrogen deficiency. Lack of estrogen can be linked to obesity. It also affects bone stability and can over time create osteoporosis.
In the younger woman, usually it’s important to treat diminished estrogen with supplemental estrogen. In older women who are expected to be estrogen deficient, this treatment course is not always endorsed, though short-term treatment for exaggerated symptoms may be advised. Should these symptoms arise, it’s suggested women seek medical advice on best treatment course.