Estrogen deficiency

An estrogen deficiency can have far-reaching consequences in affected women. This is because estrogens are the most important female sex hormones. They play a central role in the development of the female reproductive organs, in the menstrual cycle, in fertilization and in pregnancy.

Overview: What is estrogen deficiency?

As women get older, estrogen levels drop. The ovaries gradually stop functioning during menopause. Reduced estrogen levels often lead to menstrual irregularities, hot flashes and vaginal dryness. However, estrogen deficiency does not necessarily first occur during menopause. Young women can also suffer from low estrogen levels. Not infrequently, estrogen deficiency is to blame for an unfulfilled desire to have children.

What is the function of estrogens?

Child, teenager, adult, older woman: every woman goes through different stages in her life. These are also influenced by the sex hormones – above all the estrogens and progestins. A permanently disturbed hormone concentration can have various consequences – from slight cycle disturbances and a late onset of the first period to severe physical changes and infertility.

In a woman’s life, estrogens have several roles:

  • Maturation of the sexual organs
  • Maturation of the oocytes (menstrual cycle)
  • Influences the maturation of sperm in the female reproductive organs (capacitation) and is thus important for fertilization
  • Maintenance of pregnancy
  • Maintaining the moisture of the mucous membranes

Fluctuations in estrogen levels are normal

Short-term fluctuations in estrogen levels are quite normal. Without the fluctuations, neither the menstrual cycle would function nor pregnancy would persist. During monthly bleeding, the estrogen concentration in the female body is at its lowest. It is highest during pregnancy.

During puberty, the monthly ups and downs of estrogen levels have to properly adjust first. Within certain limits, deviating concentrations are completely harmless. During menopause, the ovaries then gradually stop functioning. As a result, estrogen levels continue to decrease. After menopause, estrogen levels settle at a relatively constant but low level.

Estrogen deficiency: causes and risk factors

Estrogen deficiency can occur when the ovaries function in a limited way and produce too little or no estrogen at all. The most common cause is the natural aging process. During menopause, the ovaries gradually stop functioning. Other causes of reduced function or complete loss of function of the ovaries include:

  • a maldevelopment of the ovaries as well as
  • surgical removal of the ovaries (for example, due to benign or malignant tumors or ovarian cysts).

Other organs besides the ovaries may be responsible for estrogen deficiency. Estrogen deficiency is confirmed by blood tests.

Other causes of estrogen deficiency

  • Adrenal insufficiency: In adrenal insufficiency, the adrenal glands produce too little dehydroepiandrosterone (DHEA). DHEA is a precursor of estrogen. The consequence: estrogen deficiency.
  • Luteal Insufficiency: Luteal Insufficiency also leads to an estrogen deficiency.
  • Taking the contraceptive pill: Hormonal contraceptives can also cause an estrogen deficiency in young years, since the synthetic estrogens in the contraceptive pill suppress the body’s own estrogen. If the synthetic estrogen is not sufficient to replace the body’s own estrogen, this can lead to an estrogen deficiency.

Estrogen deficiency and pubertas tarda

The so-called pubertas tarda is a particular consequence of estrogen deficiency. In pubertas tarda (late puberty), the lack of estrogen delays sexual maturation. Girls with pubertas tarda often do not get their first period until they are 18 and older. The external sexual characteristics also mature much later than in other female adolescents. Possible causes of estrogen deficiency and associated pubertas tarda are:

  • High performance sports,
  • Malnutrition, undernourishment (anorexia),
  • Malfunction of endocrine glands (for example, adrenal insufficiency).

Symptoms: Detect estrogen deficiency

Estrogen deficiency can lead to various symptoms. The symptoms should always be clarified by a doctor. Acute signs of estrogen deficiency include:

  • Hot flashes
  • dry mucous membranes
  • Sweating
  • Sleep disturbances
  • Cycle disorders

  • Elevated blood lipid levels
  • Depression
  • Problems with skin and hair
  • Hair loss
  • Cardiac arrhythmias
  • dry eyes and hair
  • Wrinkles
  • Concentration disorders
  • Menstrual disorders
    (spotting, interstitial bleeding)
  • Muscle and joint pain
  • Nervousness
  • Osteoporosis
  • Irritability
  • Sleep problems,
  • hormone deficiency-related changes in the
    Genital organs and urinary tract (urogenital atrophy):

    • Urinary urgency and frequent urination
    • Infections of vagina
      and urinary tract
    • Incontinence
    • Itching
    • Vaginal dryness
      (vaginal atrophy)
    • Pain during sexual intercourse
    • increased discharge from the vagina

In addition, a lack of estrogen changes the structure of the mucus in the cervix (cervical mucus). It becomes more viscous and is difficult for sperm to penetrate. This can make fertilization difficult or prevent it completely.