8 Natural Treatments for Low Estrogen
Hypoestrogenism refers to lower than normal levels of estrogen in our body. This is a normal physiologic response in postmenopausal women, but is a concerning find in women trying to conceive. Although less common than low progesterone, hypoestrogenism requires proper diagnosis and treatment to prevent long-term health consequences.
What are the symptoms of low estrogen?
Common symptoms of low estrogen include:1
- Low sex drive
- Decreased bone mineral density (BMD)
- Increased bone fractures
- Abnormal lipid profiles
- Amenorrhea (no menses) or irregular menses
Without enough estrogen, premenopausal women are at an increased risk of fractures and cardiovascular disease because of the protective effects of estrogen on bone and vascular health1. It is also important for optimal brain function, especially memory.
What is considered too low?
Hypoestrogenism is diagnosed when serum estradiol levels are lower than 30-40pg/ml.1
If you have been diagnosed with hypoestrogenism, this does not mean you necessarily require hormonal treatment. A functional medicine practitioner understands the relationship between diet and hormones, and can help correct this imbalance. Here are eight natural therapies that use herbal remedies and diet for helping estrogen levels. Please note no herb has been shown to actually increase serum estrogen significantly. Taking bio-identical estrogen is sometimes needed but for the purpose of this article, here are some alternatives.
Tribulus terrestris is a herbal remedy historically used in naturopathic medicine for its aphrodisiac properties. Emerging evidence has shown that Tribulus has the ability to increase follicle stimulating hormone (FSH) and estrogen levels in women.2 Studies have also shown an increase in the amount and size of follicles in mice injected with Tribulus.3 This natural tonic may be beneficial when used during the follicular phase of your cycle. Tribulus is not safe during pregnancy.
Soy has had a bad reputation over the past few years, but is not something you should necessarily avoid. Soy contains phytoestrogens, which are naturally occurring estrogen-like compounds found in plants and seeds.4 Phytoestrogens bind to estrogen receptors in our body, and can help raise or lower estrogen as needed. Think of a dimmer switch for your lights; phytoestrogens can help rebalance estrogen to an optimal level. Several rigorous studies have shown that soy consumption has a protective effect on breast cancer recurrence and mortality.4 There are however, serious and valid concerns regarding the use of GMO soy and its effects on reproductive organs.5 Soy should be avoided in anyone with a thyroid condition as it can adversely affect thyroid functioning. I recommend consuming organic soy in traditional fermented forms, such as miso and tempeh. How much soy do you need? One cup of soy milk or ½ cup of tempeh contains approximately 25 mg of soy isoflavones. Consume this amount 2-3 times a week for health benefits. Or if my patient is sensitive, I will prescribe the active isoflavone component.
Flaxseeds contain a high amount of lignans, which are a great source of phytoestrogens. Consumption of 10 grams (2 tbsp) daily has been shown to increase levels of 2-hydroxyestrogen, the ‘good’ estrogen in our body.6 Add organic ground flax into your diet daily to boost healthy levels of estrogen. This superfood tastes great in smoothies, oatmeal and baked goods, or sprinkled on top of salads and roasted veggies.
4. Black Cohosh
Black cohosh (Cimicifuga Racemosa) is one of the best herbs for relieving menopausal symptoms, especially hot flashes. It contain naturally occurring estrogenic compounds that decrease both the severity and frequency of hot flashes.7 For women who have been diagnosed with PCOS, black cohosh increases midcycle estrogen and clinical pregnancy rates when combined with the fertility drug Clomid.8 MenoVantage PETM by Bioclinic is a professional product containing standardized herbal extracts designed to help women transition through menopause. You can find more information about MenoVantage PETM on their website.
5. Rhodiola Rosea
Rhodiola Rosea is often cited as an adaptogen, a type of herb that helps our body adapt to stresses in our life. Emerging research is finding that Rhodiola may also act as a Selective Estrogen Receptor Modulator (SERM).9 As a SERM, rhodiola can help balance estrogen levels in our body, and may even relieve symptoms of menopause. Rhodiola is also beneficial in the treatment of amenorrhea as it helps decrease the levels of cortisol, our stress hormone in the body.
The female flowers of hops (Humulus Lupulus) give beer its zesty flavor, but this herb is also a potent phytoestrogen. Hops contains a compound called 8-prenylnaringenin. Several studies has shown that 8-prenylnaringenin has equal or greater estrogen activity as genistein, the active ingredient in soy.10 EstromendTM by Douglas Labs contains a proprietary blend of hops and other herbs that promote healthy metabolism of estrogens and functioning of estrogen receptors. Full ingredients and supporting research can be found on their website here.
Maca root (Lepidium meyenii ) is a safe and effective alternative to hormone replacement therapy (HRT) during menopause. Maca GO® by Femmenessence is a certified organic, pre-gelatinized form of maca that naturally raises estrogen, providing relief of menopausal-related symptoms without the need for HRT.11 Maca can be purchased in both pill and powder form. As a powder, add maca into your morning smoothie or oatmeal, or stir into a hot drink for rich and earthy taste. I prefer the Femmenessence brand because their products are backed by strong, evidence-based research and high quality standards. You can learn more about their products here.
8. Cod Liver Oil
Cod liver oil contains high amounts of Vitamin A, Vitamin D and Omega-3 fatty acids, which are important nutrients for sex hormone production. Cod Liver Oil does not contain any estrogenic compounds, but simply provides the building blocks for making new hormones. It has a positive effect on bone mineral density, increasing calcium levels in the bone and preventing bone loss due to hypoestrogenism.11 It is important to choose a brand of cod liver oil that has been third party tested for purity, freshness and potency to avoid exposure to harmful toxins and contaminants.
What about too much estrogen? I hear the term ‘Estrogen Dominance’ a lot on various blogs and health articles. I like to think of this as a ‘Relative Estrogen Dominance’ as it is often due high estrogen levels relative to low levels of progesterone. Read my blog post HERE where I discuss Relative Estrogen Dominance.
- Meczekalski, B & Podfigurna-Stopa, A & Czyzyk, A & Katulski, K & Maciejewska-Jeske, M. Why hypoestrogenism in young women is so important?. Archives of Perinatal Medicine. 2014, 20:78-80.
- Akhtari E, Raisi F, Keshavarz M, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo – controlled study. DARU Journal of Pharmaceutical Sciences. 2014;22(1):40
- Esfandiari, Arash & Dehghan, Asghar & Sharifi, Siavash & Najafi, Bardia & Vesali, Esmaeil. Effect of Tribulus terrestris Extract on Ovarian Activity in Immature Wistar Rat: A Histological Evaluation. Journal of Animal and Veterinary Advances. 2001, 10(7):883-886.
- Wu A. H., Lee E, Vigen C. “Soy isoflavones and breast cancer.” American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Meeting. 2013.
- Carman J.A, Vlieger HR, Ver Steegd, L.J., Sneller, V.E., Robinson G.W., Clinch-Jones C.A, Haynes J, Edwards J. (2013). A long-term toxicology study on pigs fed a combined genetically modified (GM) soy and GM maize diet. Journal of organic systems. 2013, 8:38-54.
- Haggans C.J., Hutchins A.M., Olson B.A., Thomas W., Martini M.C., Slavin, J.L. Effect of flaxseed consumption on urinary estrogen metabolites in postmenopausal women. Nutrition and cancer. 1999 33(2):188-195.
- Osmers R, Friede M, Liske E, Schnitker J, Freudenstein J, Henneicke-von Zepelin HH. Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms. Obstet Gynecol. 2005;105(5 Pt 1):1074-83.
- Shahin AY, Mohammed SA. Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates–a randomized trial. Gynecological Endocrinology. 2014, 30(7):505-10.
- Gerbarg PL, Brown RP. Pause menopause with Rhodiola rosea, a natural selective estrogen receptor modulator. 2016, 23(7):763-9.
- Nikolic D, Li Y, Chadwick LR, Grubjesic S, Schwab P, Metz P, Van Breemen RB. Metabolism of 8-prenylnaringenin, a potent phytoestrogen from hops (Humulus lupulus), by human liver microsomes. Drug metabolism and disposition. 2004, 32(2):272-9.
- Carter R. Clinical Effects of a Proprietary, Standardized, Concentrated, Organic Lepidium Peruvianum Formulation (Maca-GO®) as an Alternative to HRT. White Paper. 2009.
- Moselhy SS, Al-Malki AL, Kumosani TA, Jalal JA. Modulatory effect of cod liver oil on bone mineralization in overiectomized female Sprague Dawley rats. Toxicology and industrial health. 2012 Jun;28(5):387-92.