Estrogen plays a role in regulating the female reproductive system, immune system, menstrual cycle, fertility, bone health, heart health, and female secondary sex characteristics.
During perimenopause, estrogen fluctuates and declines. Estrogen has systemic effects on the body and its fluctuating levels are connected to the majority of perimenopausal symptoms.
Changes in estrogen during perimenopause
During perimenopause, estrogen levels first start to fluctuate, then ultimately decline.
- Fluctuations: Estrogen fluctuates erratically during perimenopause. Higher levels of estrogen can be experienced in some cycles, and then very low levels of estrogen the next cycle. These fluctuations start to occur as the ovaries decrease less and less estrogen.
- Decline: Estrogen, while erratically fluctuating, will be gradually declining throughout perimenopause. This is associated with the depletion of the ovarian follicles, and eventually the ovaries will become less responsive to the hormonal signals from the brain leading to a greater decrease in estrogen production.
Symptoms caused by estrogen changes during perimenopause
Symptoms for the fluctuating and declining estrogen will vary person to person, causing more than 37+ different perimenopausal symptoms. Some of the most common symptoms associated with high and low estrogen are as follows:
High:
- Irregular cycles
- Infertility
- Breast swelling or tenderness
- Fibrocystic breasts
- Uterine fibroids and uterine polyps
- Worsening PMS or PMDD symptoms
- Weight gain
- Constipation
- Acne
- Low sex drive
- Depression or anxiety
- Fatigue
- Mood swings
Low:
- Menstrual periods that are less frequent or that stop
- Hot flashes (suddenly feeling very warm) and/or night sweats
- Trouble sleeping
- Vaginal dryness and thinning
- Migraine, a bad headache right before their menstrual period, because of the drop in estrogen.
- Low mood
- Fatigue
You can record any or all of these symptoms in the Oova app in the features section.
Managing symptoms from low or high estrogen
A provider might prescribe estrogen supplements (hormonal replacement therapy) to help decrease the discomfort of some of the perimenopausal symptoms.
Estrogen supplementation can be a helpful treatment if you’re experiencing difficult perimenopause or menopause symptoms that interfere with your everyday life. However, it’s important to consult with a healthcare professional to discuss your unique health situation and potential risks.
Oova will still work if you’re taking estrogen supplements. Oova can provide quantitative results on your specific E3G (an estrogen metabolite) levels to help you and your healthcare provider understand your hormones and how they might correspond with your symptoms.
Monitoring your estrogen while on supplements is still helpful to ensure they're working correctly.