Oestrogen is a category of sex hormones that plays a key role in the development and regulation of the female reproductive system and secondary sex characteristics. While often associated with females, oestrogen is present in all individuals, though typically at significantly lower levels in males. It functions as a chemical messenger, signaling bodily processes.
The Role of Oestrogen in the Body
Oestrogen influences many organ systems beyond reproduction. It maintains bone density by regulating cells involved in bone formation and resorption, preventing conditions like osteoporosis. Declining oestrogen can lead to rapid bone density loss.
It also affects cardiovascular health by improving lipid profiles, increasing high-density lipoprotein (HDL) cholesterol and decreasing low-density lipoprotein (LDL) cholesterol. Oestrogen enhances vascular function by promoting nitric oxide production, widening blood vessels. Oestrogen receptors in the brain influence cognitive control, memory, and mood. It also impacts skin health by promoting collagen production and maintaining moisture.
Natural Fluctuations in Oestrogen Levels
Oestrogen levels naturally change throughout life and within regular cycles. During the menstrual cycle, estradiol, the most potent oestrogen, increases during the follicular phase, peaks before ovulation, and rises again during the luteal phase before decreasing at menstruation. These shifts prepare the body for potential pregnancy.
During pregnancy, oestrogen levels, particularly estriol (E3), rise significantly to support fetal development. As individuals approach menopause, perimenopause can last several years, often starting in the 40s. During this phase, oestrogen levels fluctuate dramatically and erratically, eventually declining as the ovaries produce less.
Menopause begins after 12 consecutive months without a menstrual period, typically around age 51, when oestrogen production significantly decreases and ovulation ceases. Male bodies also produce oestrogen, which plays roles in sperm maturation, libido, and bone health.
Signs and Causes of Oestrogen Imbalance
An oestrogen imbalance, whether too high or too low, can lead to various symptoms. High oestrogen, sometimes called oestrogen dominance, occurs when levels are elevated relative to other hormones like progesterone. Symptoms include weight gain, particularly around the hips and waist, irregular or heavy menstrual periods, and fibrocystic breast lumps. Individuals may also experience more severe premenstrual syndrome (PMS), mood swings, anxiety, depression, and fatigue.
Causes of high oestrogen include obesity, as fat tissue synthesizes oestrogen, and chronic stress, which can deplete progesterone. Certain medications, like some oral contraceptives, can elevate oestrogen. Environmental factors, such as xenoestrogens in plastics and pesticides, or health conditions like polycystic ovary syndrome (PCOS) and liver dysfunction, can also elevate oestrogen. In rare instances, tumors can secrete oestrogen.
Conversely, low oestrogen levels also have distinct symptoms. Common signs include hot flashes, night sweats, and vaginal dryness, which can lead to painful intercourse. Other symptoms may include fatigue, difficulty sleeping, mood changes, irritability, depression, and reduced interest in sex. Low oestrogen can also contribute to bone loss, increasing osteoporosis risk, and may cause headaches, trouble concentrating, and dry skin.
Causes of low oestrogen include menopause and perimenopause, where ovarian function naturally declines. Primary ovarian insufficiency, a condition where ovaries stop functioning prematurely before age 40, is another cause. Excessive exercise, eating disorders, and certain medical treatments can also decrease oestrogen production.
Addressing Oestrogen Imbalances
Diagnosing an oestrogen imbalance often begins with a review of symptoms and medical history. Blood tests measure specific oestrogen types (estrone E1, estradiol E2, estriol E3), though hormone levels can fluctuate significantly. These tests help identify consistently high or low levels, indicating a potential underlying condition. However, as hormone levels constantly change, a single blood test may not always provide a complete picture; symptom profiling offers additional insights.
Management strategies for oestrogen imbalances typically involve lifestyle adjustments and, if appropriate, medical interventions. Lifestyle changes include a balanced diet rich in fiber, healthy fats, and lean proteins, while reducing added sugars and processed foods. Regular physical activity helps regulate hormone levels and improves overall well-being, but over-exercising should be avoided.
Stress management techniques, like meditation and deep breathing, are beneficial as chronic stress can disrupt hormone balance by increasing cortisol. Prioritizing adequate sleep (7-9 hours per night) also supports natural hormone regulation.
Medical interventions for low oestrogen may include hormone replacement therapy (HRT), which replaces hormones to alleviate symptoms. HRT can be administered as tablets, patches, gels, or sprays, and may involve oestrogen alone or with progestogen, especially for individuals with an intact uterus to reduce uterine cancer risk. Medications or other therapies may be considered for high oestrogen, depending on the specific cause. Consulting a healthcare professional is important for accurate diagnosis and personalized treatment plans.