Women’s reproductive health is based on hormones, and everything must work perfectly for pregnancy to occur. Good hormonal balance can even influence menopause, so it doesn’t affect women too intensely. There are several important hormones in these processes, but one of the highlights is estrogen and, among them, estradiol.
Menarche – First Menstruation
The first menstruation is called menarche. It usually happens between ages 10 and 14. This event occurs because the ovaries begin producing hormones from the onset of puberty1.
So how does the cycle work? As the word itself suggests, it is cyclical and results from the secretion of four main hormones that alternate: estrogen and progesterone (secreted mainly by the ovaries), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH). The last two come from the pituitary gland, a gland located at the base of the brain.
When menstruation happens, at the beginning of each cycle, the pituitary releases small amounts of FSH and LH. Together, these cause the growth and maturation of ovarian follicles. The growth of these follicles, in turn, promotes the progressive increase in estrogen production, stimulating the endometrium and peaking, on average, in the middle of the cycle.
At first, this high estrogen concentration will reduce LH and FSH levels, but soon after, there is a sudden increase in these hormones, which stimulates ovulation (i.e., the rupture of the follicle and release of the egg). After ovulation, the elements forming the ruptured follicle give rise to the corpus luteum (a temporary gland that forms post-ovulation). The corpus luteum then produces estrogen and progesterone2, aiming to maintain the pregnancy until the placenta takes over this function.
And, if fertilization does not occur, progesterone and estrogen levels drop, leading to a decrease in LH and FSH production, which then causes the corpus luteum to regress, further reducing progesterone and estrogen production, causing the endometrium to shed and menstruation to occur, starting a new cycle.
Headache Before Menstruation
You know that annoying headache before your period? And increased irritability? All because of estradiol and other types of estrogens. But without them, pregnancy would be impossible. And not just that: without them sexual intercourse would be painful and uncomfortable, as they are responsible for vaginal lubrication and fertile mucus. Estradiol is also responsible for keeping the skin elastic and radiant.
Anyone planning to get pregnant should keep an eye on hormone levels, be it estradiol (or other types of estrogen in general), progesterone, LH, FSH or prolactin. There are other hormones, but these are the main ones for those who wish to conceive. For example, a thinner endometrium, under 4.0, makes pregnancy very difficult. The recommended thickness is above 8 or 10mm.
Uncontrolled Estradiol Levels
We already know that an appropriate level of estradiol is necessary for pregnancy, but what happens if estradiol is too low or too high? When estradiol is too high, for example, some problems may occur such as:
- sudden mood swings
- urinary tract infection
- insomnia
- excessive tiredness
- hot flashes (the famous “hot flushes”)
Now, when estradiol is far below ideal, this can negatively affect the menstrual cycle, since FSH, LH, and estradiol are hormones that play vital roles in it.
Estradiol levels are also often helpful when assessing ovarian reserve. That’s because when they are below normal, it can be a marker of low ovarian response.
Estradiol in Pregnancy
During pregnancy, the main hormone is estriol, a type of estrogen that is secreted especially by the placenta, and this hormone can be an indicator of fetal health. Just so you know, in pregnancy, estradiol is produced in micrograms, whereas estriol is produced in milligrams, making estradiol present in a smaller amount3.
Estradiol for Fertility
Estradiol treatment can last approximately 3 to 6 months. There are also estradiol therapies for those undergoing other fertility treatments, such as IVF (in vitro fertilization) or IUI (artificial insemination). In these cases, the woman complements the treatment using inducers with synthetic hormones to assist the procedure. Some contraceptives can also contain estradiol in their formula, but it is a small amount. Usually, it is combined with other hormones that inhibit ovulation.
Estradiol Replacement
If you need estradiol replacement, your doctor will prescribe a medication to supplement the lack of the hormone. However, there are also foods that are rich in estrogen. These foods can help with replacement and, in some cases, may even be enough. This is the case with yam, which is rich in a phyto-hormone called diosgenin. Diosgenin is capable of stimulating hormone production in the brain, helping to balance hormone levels. It can be difficult to eat yams every day with meals, so a great tip are yam capsules, which are easy to take and use. Learn more about yam capsules here.
If you are already trying or planning to get pregnant at some point, here’s another tip: keep your hormone tests up to date. Have them done at least every 6 months to avoid unpleasant surprises.
Readers’ Questions:
How to decrease or increase estradiol?
There is no way to increase or decrease estradiol levels overnight. To control estradiol levels, hormonal treatment is necessary, usually with contraceptives or specific medications for this. The treatment response time varies from person to person as it depends on the individual’s body.
How is the test to detect estradiol done?
The test to measure estradiol levels is performed by collecting a blood sample. It is known as the E2 test and detects estradiol in the body.
How to control estradiol?
In addition to hormonal therapy, a diet rich in estradiol-containing foods may be interesting. These foods help control levels naturally and without side effects, as can happen with contraceptives and hormonal medications.
