If you’re a woman of reproductive age, making enough estrogen is important for mood, bones, muscles, and metabolism.
Signs that you are producing enough estrogen include the presence of cervical fluid and regular ovulation.
Signs that you’re not making enough estrogen include a lack of periods and genital dryness.
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Blood tests for estradiol
Your main estrogen is estradiol, and it changes throughout the cycle.
Early in the cycle (day 2 or 3), estradiol should be very low, usually less than 50 pg/mL (180 pmol/L).
A few days before ovulation (on day 10 of a 28-day ovulatory cycle), peak estradiol should be 200 to 400 pg/mL (700 to 1400 pmol/L).
The natural ovulatory cycle is how you produce estrogen
If your estradiol is low, your first question is, “Are you ovulating regularly?”. Because if you is ovulation, you know you’ve made enough estradiol — otherwise you wouldn’t have ovulated.
If you are no ovulating, your next question is, “Can you still ovulate, or are you in menopause?
Menopause (or, if you’re younger than 45, primary ovarian insufficiency) was diagnosed by two FSH readings (taken at least one month apart) higher than 40 IU/L. So, if both FSH readings are higher than 40 IU/L, you are in menopause; see below. If your FSH is below 40 IU/L, you are not in menopause and can still ovulate. That’s true even if you’ve had a partial hysterectomy (removal of the uterus). If you have ovaries, you can ovulate, at least until menopause.
Find out why you’re not ovulating.
For example, are you on the combined contraceptive pill? If so, you are not making estradiol, so your blood level will be very low. Instead, you have a synthetic estrogen (ethinylestradiol) in the pill, which is similar to estradiol but not identical. That’s why taking the pill can cause genital dryness.
Other possible reasons why you are not ovulating include:
For a full discussion of ovulation barriers, see Chapter 7 of my book Weather Adjustment Manual.
Once you identify your obstacle to ovulation, correct that obstacle and your estradiol will increase dramatically. That’s all you need to do.
What about menopause?
At menopause, your ovaries naturally produce less estradiol than before, so your estradiol will be low in a blood test. However, you will continue to make some estrogen within each cell, and since menopause is a natural stage of life, your body can adapt to lower (mostly intracellular) estrogen.
Check out my book Handbook of Hormone Regulation for a full discussion of perimenopause and menopause, including the option of taking body-identical estradiol.
What about phytoestrogens?
If you are of reproductive age (ie, not in menopause), phytoestrogens like soy or flaxseed usually have beneficial anti-estrogen effect. They will not increase estrogen.
After menopause, phytoestrogens can stimulate estrogen receptors and have a slight pro-estrogen effect.
