Low Oestrogen: Period gone AWOL?
Have you lost your period? Or do you only get a period once in a blue moon? Perhaps your body is telling you, your oestrogen is low.
Oestrogen is the ultimate female hormone. It is what makes us female and with over 300 different roles within the body it’s important for more than just giving us a monthly bleed. Oestrogen stimulates the development and maintains the structure and function of not just the female reproductive tract but also breast tissue and the female urinary tract. It is involved in growing the endometrium (what you shed when you get your period), increases bone density, increases collagen production (keeping the skin healthy, hydrated and plump), improves insulin sensitivity, protects the heart, activates the immune system and also activates our longevity gene! Amongst all that it is beneficial for our mental health aiding in the synthesis of adrenaline, dopamine, acetylcholine and serotonin (our feel-good hormone). Essentially it keeps us happy, healthy and young!
Isn’t low oestrogen just a menopause thing?
Absolutely not! Yes, menopause is marked by low oestrogen but low oestrogen is common among women of reproductive age. If you tick the box for any of the signs/symptoms below than it is likely you are struggling with low oestrogen:
No period (amenorrohea)
Long cycles (longer than 34 days)
Late ovulation (ovulation after day 16)
Poor cervical mucous production
Dry vagina needing to use lubricates for sex
Light, scanty menstruation bleeds
Depression or moody
Lack of libido and/or trouble climaxing
Reduced bone density
Urinary incontinence or high frequency of urinary tract infections
Where has my oestrogen gone?
When we are talking low oestrogen during the reproductive age we are focusing on oestradiol. Did you know there are 3 types of oestrogen in the body? But let’s leave that for another blog post and get back to low oestradiol. Oestradiol is produced primarily but the ovaries in response to follicle stimulating hormone (FSH) and luteinizing hormone (LH) sent from the brain. Fat cells also make oestrogen and is why women with low body fat don’t get a period – their oestrogen is too low.
Below are the most common causes of low oestrogen for women of reproductive age:
Hypopituitarism/Hypothalamic issues – The pituitary and the hypothalamus, located in the brain, are the control centre for the ovaries. Issues here are usually detected by issues with FSH and/or LH. The oral contraceptive pill silences this part and is often the issue for women whose periods don’t return after stopping the pill.
Childbirth and Breastfeeding – Is naturally a state of very low oestrogen, which lasts until your period returns.
Anorexia, bulimia or eating disorder – results in low body weight.
Low body weight – As fat cells make oestrogen, low body weight often results in low oestrogen and a cessation of menstruation.
Over exercising – A combination of stress and low body weight.
Gluten intolerance – Has been linked to changes in oestrogen levels, amenorrhea, infertility or other menstrual disorders. In fact, 19% of women with gluten intolerance their main symptom was menstrual issues not gut issues. Click here and here for more.
Vitamin A deficiency – causes a decrease in an enzyme vital for the production of oestradiol in the ovaries. Common in women with untreated hypothyroidism.
Coming of birth control – Oestrogen levels can be quite low after stopping hormonal birth control and is why many women don’t get their period back straight away. If you have not had a period for 3 months after stopping hormonal birth control than it’s time to get help.
When to test
When testing hormones timing is everything! To identify if you have low oestrogen levels it is best to have a blood test for oestradiol, FSH and LH on day 3-5 of your cycle. For women who aren’t having a period then you can test any day of your cycle.
How to fix it
Avoid gluten – Knowing the link between gluten and low oestrogen, infertility and other menstrual disorders I highly recommend avoiding gluten. There are so many great alternatives to gluten these days that you won’t have to feel you are missing out. Enjoy grains such as rice, quinoa, buckwheat, teff and amaranth.
Eat more soy – soy contains phyto-oestrogens which are naturally occurring compounds that act like a weak oestrogen in the body. For women with low oestrogen consuming more soy can actually rise their oestrogen levels slightly. There is a lot of conflicting research when it comes to soy but at the end of the day consuming moderate amounts of soy can only be beneficial for women with low oestrogen. Consume about 2 serves per week and ensure that it is fermented and not genetically modified soy e.g. miso and tamari
Eat more flaxseed – flaxseeds also contain naturally containing compounds (lignans) that act like oestrogen within the body. A study found that eating 2 tablespoons of flaxseed twice per day for six weeks reduced hot flushes in premenopausal women, a key symptom of low oestrogen. Start boosting up your flaxseed intake. You can buy them whole and grind them before eating or you can buy flaxseed meal. Remember to always keep ground flaxseeds in the fridge to protect the good fats. Add them to your cereal or smoothies, for a nice nutty taste.
Don’t exercise too much – Not only is over exercising a stress on the body putting a holt on your menstrual cycle. Over exercising is linked to lower body fat and we know we need fat cells to make oestrogen (read about it below). By all means keep exercising but try lower intensity exercises like yoga, Pilates and keep it to 40min 3-4 times per week.
Boost your body fat – Women needs about 22% body fat for menstruation. Even a small loss of 10-15% can stop ovulation and result in no periods or long cycles. Besides the fact that fat cells make oestrogen a woman needs a certain amount of body fat so the body has enough stored energy for pregnancy and breastfeeding.
Maca (Lepidum meyenii) – is a herb that has shown to increase oestradiol in women and reduce symptoms of insomnia, depression and vaginal dryness while increasing mood and libido all symptoms of low oestrogen. Maca is readily available as a powder or capsule with a daily dose of 2,000mg/day.
Tribulus (Tribulus terrestris) – Tribulus is a herb with a long history of treating menstrual irregularities in women. It contains saponins and sterols that have an oestrogenic effect within the female body. It is used to stimulate ovulation, as an aphrodisiac and to enhance fertility. I recommend a daily dose of 7-14ml of a 2:1 liquid. It is also available in tablet form.