Low estrogen: what a low estradiol result can mean

Low estrogen is a result, not a diagnosis. Estradiol is meant to be low at certain points in the menstrual cycle and after menopause. What a low number means depends on your age, your cycle and why you were tested.

Estradiol

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When low is expected

The Office on Women’s Health says that after menopause your ovaries make very little estrogen and progesterone. Menopause is reached after 12 months in a row with no period (Menopause basics).

Estradiol is also lower early in the cycle. In one published study of healthy volunteers, the upper limit was below 97.1 pg/mL on days 3 to 5 after a period began, and below 31.1 pg/mL after menopause (Schüring et al., 2016). See estradiol levels for the full table. A low value drawn early in a cycle may be normal for that day.

What a low result can mean

MedlinePlus says estrogen levels that stay too high or too low may be a sign of a health problem. Conditions it links to estrogen levels that are too high or too low include early or late puberty, polycystic ovary syndrome (PCOS), thyroid or pituitary gland disorders, and infertility (Estrogen Levels Test).

The Office on Women’s Health describes one way low estrogen can show up (Period problems):

• Missing periods before menopause, called amenorrhea, that are not caused by pregnancy or breastfeeding could mean the ovaries stopped making normal amounts of estrogen.
• Amenorrhea can happen if body fat drops so low that ovulation stops, as with eating disorders such as anorexia nervosa. It also says gaining too much or losing too much weight can cause missed periods.

Genetic conditions such as Turner syndrome are covered below under early or premature menopause.

Early or premature menopause

The Office on Women’s Health calls menopause between ages 40 and 44 early menopause. Menopause before 40 is premature menopause, also called primary ovarian insufficiency. Known causes include a family history of early menopause, smoking, chemotherapy or pelvic radiation, surgery that removed both ovaries, autoimmune conditions such as thyroid disease, and genetic conditions such as Turner syndrome. Sometimes there is no clear cause (Early or premature menopause).

It also says that years without estrogen raise the risk of bone loss, heart disease and diabetes.

When to see a clinician

• Your periods stop or become irregular before age 45. The Office on Women’s Health says to tell your provider. It says blood tests may be ordered and that testing is most useful before age 40.
• You have vaginal bleeding after menopause. The Office on Women’s Health says this is not normal and to see your provider right away.
• You have missed periods, or have been unable to get pregnant after a year of trying. MedlinePlus lists both among reasons for estrogen testing.
• You have hot flashes or night sweats and want to understand them. MedlinePlus lists these as menopause symptoms that can lead to an estrogen test. The Office on Women’s Health says blood hormone tests are not usually needed to tell whether you are in perimenopause, because a provider can usually tell from your age, symptoms and period changes.

If you are pregnant or might be, talk to a clinician. This page does not cover pregnancy.

Decisions about treatment belong with a clinician, and this page does not cover them. For the test itself, see the estradiol blood test.