Oestrogen Deficiency
Oestrogen deficiency is reduced oestrogen production or effect causing changes in menstrual function, temperature regulation, genital tissue and bone.
Key takeaways
- Menopause is common, but premature ovarian insufficiency, low energy availability, pituitary disease and medical treatment require different evaluation.
- Hot flushes need systemic treatment, while isolated vaginal dryness may respond to local therapy with much lower systemic exposure.
- Oestrogen without adequate endometrial protection can increase uterine-lining cancer risk when a uterus is present.
The listings below are not suitable for every cause; age, bleeding, clot risk, cancer history and reproductive goals guide selection.
Establishing the cause and impact
Cycle history, pregnancy testing and targeted hormone tests are interpreted by age and context. Early deficiency raises concern for bone, cardiovascular and fertility effects. Thyroid, prolactin, nutrition, exercise and genetic or autoimmune factors may need assessment.
Replacing hormone safely
Systemic oestrogen can treat vasomotor symptoms and protect bone in selected younger deficient patients. Progestogen protects the endometrium where needed. Vaginal oestrogen targets genitourinary symptoms. Route and dose are chosen around migraine, clot, liver and cancer considerations.
When to seek urgent care
Arrange prompt assessment for bleeding after menopause. Seek urgent care for heavy bleeding, chest pain, sudden breathlessness, a painful swollen leg, fainting or new neurological symptoms.