The first thing that comes to mind when talking or reading about low estrogen levels, also known as hypoestrogenemia , is related to the physiological process of menopause. However, it is necessary to clarify certain basic terms, as well as to understand that clinical signs of hypoestrogenemia may occur without a direct relationship with menopause.
What are estrogens
They are steroid-type sex hormones. There are several types known as estrone, estriol and estradiol, with some variations in biosynthesis and function, but which are generally produced mainly at the ovarian level.
Other tissues such as the adipose, placental and adrenal glands are capable of producing estrogens in a lower proportion compared to the ovaries.
What is the role of estrogens
Estrogens participate in multiple functions, being fundamental in the reproductive aspect. They exert direct effects on the uterus at the cavity and cervical level, favoring the proliferation and growth of endometrial cells (cells that line the inside of the uterus), necessary for the implantation and maintenance of pregnancy.
Likewise, it acts at the ovarian level to favor the development of a follicle that will later ovulate, being equally necessary the adequate levels of another very important hormone that acts in conjunction with estrogens known as progesterone.
Estrogens are also capable of acting at the level of the Central Nervous System through an endocrine regulatory function of its own levels (known as feedback) and of the levels of other hormones and neurotransmitters in order to maintain a necessary balance for proper functioning. of the organism.
Estrogens are closely related to the development and generation of secondary sexual characteristics in women, such as breast and genital development, the appearance of pubic hair, changes in fat distribution, including changes related to behavior and personality once reached adolescence and early adulthood.
Likewise, it is important to note that they not only affect the reproductive system, but also estrogen levels have an influence on the cardiovascular, muscular, urinary, bone, nervous and immune systems.
Under what conditions is it possible to have low estrogen levels?
As we mentioned at the beginning of this article, not only does menopause generate a decrease in estrogen levels, which, as we already know, is a physiological or natural process.
There are also pathological situations such as early ovarian failure, which either for genetic, immunological or pathological reasons leads to the loss of ovarian activity with a drastic decrease in estrogen levels, mainly generating infertility problems.
Other pathological conditions that can damage or affect estrogen levels are neoplastic pathologies (cancer) both centrally (hypothalamic - pituitary) and gonadal, directly in the ovary, radiation being required in some cancer treatments that can damage and affect the ovarian reserve severely and with it, its endocrine and reproductive function.
The decrease in estrogen levels may be associated with some therapies. There are some medications such as those used in fertility and cancer treatment that can affect estrogen levels.
Obviously, estrogen levels also decrease in ovarian surgery, when both ovaries must be removed (surgery known as bilateral oophorectomy).
Signs of hypoestrogenemia
Just as the consecutive elevation of hormonal levels at the beginning of puberty produces different changes in the adolescent, the decrease in estrogens is also perceived by women through secondary signs and symptoms.
Among the most common are menstrual changes (irregularity in terms of days of onset of the rule as in the duration and amount of bleeding), the presence of hot flashes or hot flashes (sudden changes in the perception of temperature), emotional lability and alterations in the state of mind, decreased libido (sexual desire).
Also, it brings changes in the color of the nipples and areola, as well as a decrease in breast and genital turgor, with an equal decrease in lubrication that produces discomfort at the time of sexual intercourse, favoring prolapses (descent of pelvic organs) that are a consequence of the decrease in collagen synthesis and decrease in the resistance of the pelvic connective tissue, which secondarily generates an increase in the frequency of genital and urinary infections.
Finally, there are consequences of the decrease in estrogen levels that occur after a long period (greater than two years), such as the decrease in bone resorption (loss of bone mass or osteopenia) that can even become a a real problem when the bone is greatly weakened and is a risk factor for spontaneous fractures.
The risk of cardiovascular disease also increases due to the increase in the formation of atheroma plaques (occlusion of blood vessels), as well as the risk of cerebrovascular accidents.
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