How To Improve Low Estrogen And Get Pregnant Naturally (especially if you've been told IVF or Donor Eggs are the only option)

Estrogen plays a crucial role in reproductive health and fertility [1]. When estrogen levels fall below optimal ranges, it can lead to various fertility challenges. In this post, we'll explore the causes of low estrogen and its impact on fertility, as well as discuss potential strategies for addressing this hormonal imbalance.

What is Estrogen?

Estrogen is a group of hormones that includes three primary forms: estrone, estradiol, and estriol. Of these, estradiol is the most potent and plays a significant role in the reproductive system [2]. Estradiol is vital for:

• Regulating the menstrual cycle [3]
• Preparing the uterus for implantation [4]
• Supporting early pregnancy [5]
• Maintaining bone density [6]
• Influencing mood and cognitive function [7]
• Supporting cardiovascular health and glucose metabolism [53]

How Does Low Estrogen Affect Fertility?

Low estrogen levels can impact fertility in several ways:

• Irregular or absent ovulation [8]
• Thinning of the uterine lining, making implantation difficult [9]
• Changes in cervical mucus, affecting sperm transport [10]
• Decreased libido, potentially reducing the frequency of intercourse [11]

It's important to note that while low estrogen can affect fertility, a person can still be estrogen dominant in relation to progesterone. This underscores the importance of getting hormone levels tested to understand the full picture.

What Causes Low Estrogen?

Several factors can contribute to low estrogen levels:

1. Hormonal Imbalances

The delicate balance of hormones in the body can be disrupted by various factors, leading to low estrogen. This includes:

• Hypothalamic-Pituitary-Gonadal Axis Dysfunction: Chronic stress, nutrient deficiencies, and environmental toxins can disrupt this crucial hormonal feedback system [12].
• Thyroid Dysfunction: Both hypothyroidism and hyperthyroidism can affect estrogen levels and fertility [13].
• Adrenal Dysfunction: The health of your adrenal glands and the HPA axis can significantly impact estrogen levels. In fact, what may appear to be early menopause could actually be related to adrenal issues.

2. Premature Ovarian Insufficiency (POI)

POI, also known as premature ovarian failure, occurs when the ovaries stop functioning normally before age 40. This can lead to decreased estrogen production and fertility challenges [14].

3. Excessive Exercise and Low Body Fat

While regular exercise is beneficial for overall health and fertility, excessive exercise can lead to a condition called hypothalamic amenorrhea, characterized by low estrogen levels. This is particularly common in athletes and women with low body fat percentages [15].

4. Nutritional Deficiencies

Certain nutrients are essential for estrogen production and metabolism. Deficiencies in these nutrients can contribute to low estrogen levels:

• Vitamin B6: Crucial for estrogen metabolism [16]
• Vitamin D: Supports overall hormonal balance [17]
• Omega-3 fatty acids: Important for hormone production [18]

5. Stress

Chronic stress can significantly impact hormone production, including estrogen. High stress levels have been shown to lower estradiol levels and inhibit peak estradiol levels during the menstrual cycle [19].

6. Environmental Factors

Exposure to endocrine-disrupting chemicals (EDCs) can interfere with estrogen production and metabolism. Common sources of EDCs include:

• Plastics containing BPA [20]
• Pesticides [21]
• Certain personal care products [22]

Research has shown that EDCs can mimic or block natural hormones, potentially leading to hormonal imbalances [23].

7. Gut Microbiome

Imbalance in the gut microbiome impact fertility and hormone balance.  An imbalance in the microbiome can disrupt estrogen contributing to irregular menstrual cycles and ovulation disorders.

Assessing Low Estrogen

Here at Fab Fertile, we use several advanced testing methods to assess estrogen levels and overall hormonal balance:

• DUTCH Test: This dried urine test provides comprehensive insights into hormone metabolites, including estradiol and adrenal function [24].
• Blood Sex Hormone Panel: Measures estrogen, progesterone, FSH, LH, Sex Hormone Binding Globulin (SHBG), and DHEAS levels in the blood [ 25].
• Thyroid Panel: Assesses thyroid function, which can impact estrogen levels [28].
• GIMAP Test:  This test can give insight into beta-glucuronidase the third phase of estrogen metabolism. When beta-glucuronidase is low there can be lower levels of estrogen. Plus intestinal flora can influence estrogen balance.

Why AMH Is Not A Good Indicator Of Pregnancy Success

• Anti-Mullerian Hormone (AMH) Test: Provides insight into ovarian reserve [27]. However, it's important to note that AMH is a poor predictor of live birth outcomes and doesn't check for egg quality, uterine receptivity or the ability to get pregnant naturally. While we want to know this number, we don't focus solely on this biomarker for healing.

Addressing Low Estrogen for Improved Fertility

Our fertility clinic takes a whole body approach to treating low estrogen:

1. Nutritional Support

• Incorporate phytoestrogen-rich foods: While soy is often recommended, it's important to note that it's a top allergen. Consider an elimination diet. If you're not intolerant, you can bring soy back into your diet, ensuring you use non-GMO, organic soy products [29].
• Red clover: Consider red clover tea, 3 times a day [36]. Red clover has been shown to help with perimenopausal symptoms such as hot flashes and night sweats. It contains isoflavones that can mimic estrogen in the body, potentially helping to balance hormones during this transitional period.
• Ensure adequate caloric intake: Undereating can suppress hormone production [30].
• Focus on nutrient-dense foods: Emphasize foods rich in B-vitamins, vitamin D, and omega-3 fatty acids [31].
• Include cruciferous vegetables: Broccoli, cauliflower, and kale contain phytochemicals that support estrogen metabolism [42].
• Prioritize healthy fats: Dietary fat is crucial for hormone production. Include sources like fatty fish (for omega-3s), coconut products, avocados, nuts, seeds, olive oil, and sardines [54, 55, 56, 57].

2. Lifestyle Modifications

• Stress management: Implement stress-reduction techniques such as meditation, yoga, or mindfulness practices [32].
• Exercise balance: Maintain a healthy exercise routine without overtraining [33].
• Sleep optimization: Prioritize quality sleep to support overall hormonal balance [34].

3. Supplementation

Consider targeted supplements:

• Indole-3-carbinol and DIM: Support Phase I estrogen metabolism [44]. However, it's crucial to check hormone levels with a DUTCH test before using DIM.
• B-complex, magnesium, choline: Aid in Phase II estrogen metabolism [46, 47, 48].
• Calcium-D-glucarate and fiber: Support Phase III estrogen metabolism [51, 52].
• Adaptogens & DHEA: Adaptogens: DHEA and herbs like ashwagandha or rhodiola can help manage stress and support overall hormonal balance.

4. Environmental Detoxification

• Reduce exposure to EDCs by choosing organic foods and natural personal care products [39].
• Support the body's natural detoxification processes through diet and targeted supplements [40].

5. Gut Microbiome

• Address gut infections (i.e. parasites, bacteria, fungal infections) using GI MAP stool test
• Retest to ensure all pathogens have been eliminated and gut microbiome is optimal

6. Hormone Support

In some cases it may be beneficial to consider bioidentical hormones which can be obtained from a compounding pharmacy.  BIoidentical hormones have a lower risk of side effects compared to synthetic hormones. Always consult with a healthcare professional before starting hormone therapy.

Consider Onas Naturals for natural progesterone and estrogen support.

Conclusion

Low estrogen can significantly impact fertility, but with proper assessment and a comprehensive approach, it is possible to restore hormonal balance and improve the chances of conception. Remember, it's crucial to consider the balance between estrogen and progesterone, as well as the role of adrenal function in hormone health. 

Let’s connect and talk about how the Fab Fertile Program could help you and your partner achieve pregnancy success! Book your free 15 minute call here.

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