I learned early on that endometriosis tends to be an estrogen dominant condition. Your body either has too much estrogen or not enough progesterone to balance things out.
Estrogen has always been the “bad” hormone in my mind. It feeds endo right? Because of this much of the treatment options offered for endometriosis (like Lupron or birth control pills) limit your body’s natural estrogen production.
But hold on…. we do still need some estrogen. Especially if you are trying to conceive.
On my journey of struggling to conceive, much of my attention has been on my progesterone levels: the primary player in my luteal phase where the magic happens and pregnancy takes place.
After charting my cycle for years now I am aware of the my history of short luteal phases and spotting prior to flow, both strong indicators of progesterone issues. And when I miscarried about a year and a half ago I was sure it was because of low progesterone.
With this in mind, I had not considered estrogen being a factor in my infertility journey.
Turns out I was wrong.
Estrogen’s Role in Your Menstrual Cycle
First and foremost, estrogen is what triggers your body to ovulate. If there is not enough estrogen then this doesn’t happen and pregnancy is not possible.
Estrogen also plays a role in the production of cervical fluid, which should increase prior to ovulation. Lubricative cervical fluid is meant to carry sperm to your eggs for fertilization.
With low estrogen, however, you may experience little to no cervical fluid.
Estrogen, specifically estradiol, is necessary for the thickening of your endometrium in your follicular phase. This endometrial lining contains a number of glands that are meant for implantation of a fertilized egg in your uterine wall.
If your body does not produce enough estrogen then the lining of your uterus becomes thin and it becomes impossible for the egg to implant. Another infertility factor.
With a thin uterine wall then your periods could be lighter, shorter or completely absent.
How Could I Have Low Estrogen?
Like I said, estrogen wasn’t on my radar in my infertility journey, but I’ve given it more attention of late because, well, I’m not getting any younger and… have yet to conceive.
My cervical fluid each month hasn’t been as lubricative as it has been in the distant past and this doesn’t seem to be improving.
As we age estrogen levels drop off, which is why it becomes harder to conceive past 35.
(I’m knocking on that door).
In addition to my age, I cannot deny the fact that I spent most of my fertile years on birth control pills.
Birth control pills essentially turns off your body’s natural hormone production and pumps it instead with artificial ones. The overuse of them throws your body’s hormones out of order.
For ten years my body was not naturally producing progesterone or estrogen.
If you take birth control pills for a long period of time there is a greater chance for thinning of your endometrial lining. Eventually it actually causes shrinkage of your lining.
While this may help with endometriosis it’s a bad situation for pregnancy.
Factors That Can Lead to Low Estrogen
In addition to age, and long term use of oral contraceptives, there are other factors that can lower your estrogen levels. These include:
- Decreased functioning of your ovaries
- Cysts on and/or in your ovaries
- Pregnancy problems that lead to miscarriage
- Childbirth and breast feeding
- Decreased functioning of your pituitary gland
- Eating disorders or excessive exercise, resulting in very low body fat
- Any estrogen prohibiting drugs like Lupron
Another factor to consider are the health of your adrenal glands. If your adrenal glands are fatigued then hormone production is affected.
DHEA (dehydroepiandrosterone) is a hormone produced by your adrenal glands and is a precursor to estrogens, progesterone and testosterone.
If your adrenals are fatigued then DHEA production drops and so does the production of your other sex hormones.
If Estrogen Is Low What Do You Do?
I’m not one for adding in more artificial hormones to the mix, so I wouldn’t jump to adding in artificial estrogen, which in most cases is made from synthetic horse urine!
My thoughts on hormonal imbalance line with the idea of balancing different factors in your system as a whole so that the body is able to reset.
An important factor in it all is your uterus. Increasing blood flow to your uterus is the first step to improving natural rhythms and stagnation that can contribute to infertility.
Here are some ideas…
Acupuncture has been show to improve the supply of blood to the uterus and in turn this can help improve the thickening of a thin endometrial lining. Acupuncture can also stimulate the master pituitary gland, which can help bring hormones back into balance.
Maca root is another option. This superfood is supposed to help bring your hormones back to natural balance. I’ve taken this in the past with great results, but I know other ladies with endo have had mixed results. If you decide to go this route start slow.
Royal jelly is said to have an estrogen effect on the body and can be helpful if you have inadequate levels of estrogen. It’s been shown to increase the thickness of your endometrial lining.
Nettle is said to increase blood flow to your uterus and keep the endometrium healthy and fertile.
Raspberry leaf supports overall health of your uterus.
Castor oil packs are helpful in stimulating your circulation to your uterus and improving lymphatic supply and liver function. These also promote the breakdown and removal of scar tissue. They promote blood flow and hormonal balance.
Address adrenal fatigue. Check out my course Eat for Energy with Endo on how to support and heal your adrenals here.
On the Positive Side?
In retrospect it’s funny how one sided my focus has been:
progesterone = good
estrogen = bad
When I looked back at the hormonal saliva sample I did a short time ago I saw that my estradiol levels were right above what was considered “low”.
The first go around I didn’t even notice this number. All I saw was that my progesterone was “low”.
Turns out estrogen isn’t that bad after all 🙂
Do you know that you have endometriosis and low estrogen? Experienced any of the symptoms of low estrogen? Struggling to conceive?
I’d love to hear from you….
You sure could! This whole “estrogen drives Endo” thing is rubbish.
I’m a fellow endo sufferer – my estrogen is low. Always has been. I think it’s because my Endo has stuffed proper ovarian function. My AMH is low and according to my gyno i will have early menopause. I’m 33 and also suffer from fibromyalgia (linked by some doctors to low estrogen too).
My belief is that they’ll discover Endo is caused my immune malfunction…I think this is why colostrum supplements help me. Estrogen is a great hormone – I agree with you that it’s got a bad reputation unfairly. Estrogen nurtures bone, skin, brain, youth, fertility, beauty and low levels can lead to osteo & cognitive problems. Great blog by the way!
Sorry to hear of your struggles too. I agree that endo is very much tied to the immune system.
Thanks for the blog love 🙂
I too have low progesterone and estrogen with endometriosis! Only 25 too, I always thought I was infertile until a month after they cream I became pregnant. I think it might have something to do with ovary function and adrenal too because before the cream I had an ovarian cyst. I currently still have pain near that ovary though, but my ultrasound says the cyst is gone now an Dr keeps disregarding my pain there :/ .
Isn’t increasing estrogen suppose to make endometriosis worse though? I have had crazy painful heavy periods since the cream but before the cream too. I was told the cream would help endometriosis symptoms but hasn’t yet
Congrats on your pregnancy Amy 🙂
I get pain near my ovaries too. I think even if there is no cyst that it’s a sensitive spot in terms of your nervous system.
I don’t think it’s as simple as add progesterone or add estrogen. It’s about a full balance (or re-balance) of your body and so many factors come into play. I know some ladies who’ve had success with the progesterone cream and it is great for maintaining pregnancy, but others who have not had success with it.
I tried an over the counter natural progesterone with wild yam and stopped taking it. It caused all kinds of negative reactions in my body. Many ladies with endometriosis can have progesterone resistance, adding even more to the mix: http://peacewithendo.com/2015/11/progesterone-resistance-and-endometriosis.html
I am starting to think I have low estrogen and progesterone but the dr tested and it came back in the normal range. I have a very light period and I usually get a migraine a week before my period. Since the dr has put me on Femara to help me get pregnant, my period has gotten heavier and I didn’t have a migraine.
I am tempted to try essential oils just not sure how that will work with the Femara. I have always had painful ovulation and period which I know is from endometrosis. I told bc for 12 years so I agree that it has something to do with having trouble conceive.
Hi Megan – I’m assuming the doctors tested your hormones via blood? Blood tests are not the best measures of hormones in your body. It only shows what’s in your blood, not what’s in your cells.
A better way to test is via saliva. Most conventional doctors don’t do saliva testing, but you could go see a naturopath or functional doctor or order online via John Lee’s site (http://www.johnleemd.com/saliva-hormone-testing.html)
I’m not familiar with Femara but it looks like it suppresses estrogen and impacts your pituitary gland?
Yes my dr did it by blood. I am going to order a saliva test.
Femara does suppress estrogen, it is used for breasy cancer that is caused by estrogen. It is now also used as a fertility treatment. This is my second month on it 2.5mg the first month and 5mg the second month.
I have low estrogen, but very low progesterone – hence still estrogen dominance, and endometriosis. 38, clock’s ticking! Dr is putting me on Lupron for a few months to force temporary menopause. Really nervous about the side effects. Anyone with experience with this drug?
Hi Marceline – I’d really research the impacts of Lupron before you take it. I’ve heard many horror stories about it. Lupron impacts your brain to shut off estrogen production, except your body still needs estrogen for lots of things. I would think that it’d make things worse, rather than better when your estrogen levels are already low. There are ways to feel better without it. Please let me know if I can support you on a more holistic path. Much Love.
I have been thinking about this too recently. I was on the pill from age 13 until just over a year ago when I was 32. I decided that I wanted to get off the pill. That’s when many of my period problems started and continued to get worse until I finally ended up in emergency and eventually seeing a gyneaocologist. I then found out I had endometriosis and had lap surgery and a mirena inserted. It has been three months now and I have had heavy periods and pain, low mood, and have developed three ovarian cysts since.
I am now on day 1 of my cycle and have decided to start the pill today – LevlenED.
I feel that since being off the pill, a number of things have happened. This includes bouts of acne around the time of my period which completely clears up once it’s over; severe anxiety, massive mood swings and depression; my hair being dull and flat (it used to be very healthy looking and shiny); worsening eyesight, particularly in the dark; tinnitus; and minor signs of peripheral neuropathy i.e. Tingling in hands and feet.
At the same time as coming off the pill I came off anti-depressants (tapered and not the exact same time, I spaced it out), and I always thought the tinnitus was due to that. Now I’m starting to think it’s all hormonal.
This is all aside from the ridiculous amount of pain I’m having which could be due to the cysts or could be the mirena (which showed in ultra sound as being in the correct position).
But again I feel that this is all due to my hormones being completely out of balance and that it is the loss of estrogen in my body that the pill was providing that is the issue.
I’m very hopeful that going on the pill again in addition to having the mirena will be the right combination for me to stop my period altogether.
I also wonder if I had never gone off the pill, if any of this would’ve happened (i.e. Worsening of endo growth), or if it was all happening in the background and the pill was masking my symptoms. I’m starting to think that based on the fact my endo symptoms got worse over a period of about 10 months, that it was the former and the pill was effectively suppressing my symptoms.
What a fucked up journey all of this is.
I will try to remember to come back and report whether the pill does in fact address all or some of these issues.
Good luck to you all.
Hi Sally. I took the pill for a long time without understanding how it all works. I wrote a later post that explains how: http://peacewithendo.com/2016/07/birth-control-work.html
Also curious if you’ve ever had mono? Tinnitus could be a link to the Epstein Barr Virus. I’ve found this to be a primary culprit behind many of my issues and connecting factor. Learn more here: http://peacewithendo.com/2016/11/epstein-barr-virus-ebv-blame.html
Great great blog . I have endo and I am trying to conceive , hasn’t happened yet. I also suffer from the worst constipation ever , so I am trying Fennel seeds which are good for fertility but bad for endo because of estrogen. I am 32 and longing to be a mom.
Fennel’s great for digestion. I hope your dream comes true, love.
Hi Aubree. I am 24 years old. I have had trouble conceiving since my first intercourse (16). I have been havings excruciating pains in my pelvic and vagina for about 5 years. For the last 3 years I have been getting blood work done that always comes back as abnormally low LH and estradiol. I have been to about 5 doctors since pain began and this last one has told me to research endo after seeing my ultrasound which shows large cystic activity on my left ovary. Most things I read are about women with too much estrogen which isnt my case so I am so happy to have found this blog. With my low estrogen I have low libido, and abnormally low vitamin D which goes hand in hand with estrogen,little breast development and abnormal periods and spotting. My last menstual was 2 weeks apart. It is so scary and confusing. My vitamin D last checked was at 19 and LH 0.3. I am now sleeping almost 11-12 hours a night because of my low Vitamin D. I feel fatigue and sluggish ALL THE TIME. At about age 4 or 5 I had trauma to my head which has left a dent in my skull. Which could very well have damaged my pituitary gland. I have to figure out whats wrong myself because the doctors are little help alot of the time. I really want to become pregnant I dont want to be barren it is a scary thought. The surgical doctor has recommended a laparoscopy but with my low Vitamin D I am afraid to go into surgery. It poses a hugher risk of death. (Scary). I have started taking organic Pueraria Mirifica (a strong plant phytoestrosgen) to naturally boost estrogen and hopefully Vitamin D.I have read amazing reviews about women with low estrogen who have taken this. Especially concerning breast development. The name is SIAM NATURALS they are in Thailand. This may help some ladies out. Have you ever heard this? Please reply, Shayla
Hi Shayla. I have not heard of that. Hope it helps you. Sending Love.
Also Aubree I have much trouble keeping on weight. I can gain weight pretty quickly when I try. But it just melts off. One doctor told me estrogen is created from our body fat. But my theory is that even when I do gain more body fat my estrogen is still not kicking in which is why I cant maintain my weight. Hopefully this pueraria mirifica will help. I am 24 y.o and about 115lbs my highest weight was 139 in highscool and it fluctuates so easily. I believe I should see and endocrinologist to have a look at my pituitary gland. Or have an MRI done. What are your thoughts? Aslo shayla is my middle (nickname) but NaEisha is fine.
I’ve had a lot of success over the past year and a half following the protocols in the Medical Medium books. Anthony William helped me put together a lot of connections with the issues I’ve had. If you haven’t checked him out, I highly recommend doing so. Here’s his first book: https://amzn.to/2z9TT74
Hey Aubree was searching online for this exact subject and came across your post, I have been on my health journey for ten years now with a variety of things going on, and it’s stikl not really improving but what I do know now is that I have endo, and also very low estrogen progesterone and testosterone! What a mess!suffer terrible mood swings from it all! Have been trying to tweak my diet for years to no avail.. wondered if you managed to raise your estrogen with it the side effect of making your endo worse?
Hi Angela. I haven’t had my hormones tested in years, so I’m not sure. I have eliminated a lot of my symptoms, so things have definitely improved with my hormones. That’s come from diet & lifestyle changes.
I’ve had a lot of success following the Medical Medium protocols. I highly recommend his books: https://amzn.to/2mE7F8N
And for hormonal type issues, check out Dr. Sara Gottfried’s book. She gives suggestions on what you can do naturally: https://amzn.to/2zXLTXp
Best of luck to you.
I also have low estrogen but have endometriosis, an ovarian cyst, and a large fibroid. Each month brings excruciating pain. I get a fever, nausea, dizzy, horrible cramps, and even trouble breathing. My periods are extremely light with barely any blood. I was on the pill for over 10 years. I’m now 36 and having trouble getting pregnant. Last month I tried CBD oil and I can’t believe how well that worked for my symptoms. I had no pain at all, it was amazing. It’s a miracle to feel normal again and not suffer with the pain I’ve had for so long. My period is still too light, so I need to figure out how to get my estrogen levels up. I’m not sure if CBD helps with hormone levels or not.
Hi Jessica. Good to hear the CBD’s helping you! It has helped me a lot too. Best of luck on your healing journey.
Do you mind if I ask which CBD oil brand you use? I suffer from the same thing.
I’ve had success with Joy Organics: https://joyorganics.com/#a_aid=5ba2da162d154
(Use code “peacewithendo” at checkout and save 10%)
Hi. Thank you for sharing. I was diagnosed with endo laparoscopically. Over two years ago. My saliva hormones test indicated very low dhea and testosterone. My estrogen levels were quite low as well and much lower than the progesterone. The rest also indicated the estrogen / progesterone ratio was out of balance which would require estrogen supplementation. I have very low vitamin D and I supplement with that. I also have hashimotos. Unfortunately my doctors refuse to give me estrogen because of my age (33) and my endometriosis diagnosis. My symptoms always worsen when I take progesterone, that includes bio identical and also an iud and birth control pills containing synthetic progestin. My symptoms were much worse when I took the cream and the iud. It’s very frustrating as its become debilitating with not only pain and fatigue but the anxiety worsening adhd and depression as a result. Your story brought me some hope. There has to be one doctor out there that will offer proper treatment As far as estrogen. I will keep going till I find someone.
Hi Denise – what I’ve found over the years of study with hormonal balance is the ticket is addressing your liver health. This will help balance things out naturally. Highly recommend Anthony William’s book, Liver Rescue: https://amzn.to/2TjeSzi
Best of luck to you. Much love.
This is a great post! I
‘m just wondering for others with low estrogen and endo: So your estrogen AND your progesterone were low. Do you know what the ratio was? Was your progesterone so low that you were still estrogen dominant, even with the low estrogen? If so, that changes things. You want to rebalance your hormones by INcreasing estrogen (naturally) at the same time as increasing progesterone, right?