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Medically Reviewed by Dr. George Touliatos
Both oestrogen and testosterone are primary sex hormones that play many crucial roles in the body. Testosterone is mainly associated with male physiology, while oestrogen is predominantly found in females. However, these hormones exist in both sexes, albeit in different concentrations.
Proper balance between these hormones is essential for the overall well-being of a person. Fluctuations in their levels can lead to various health problems.
In this article, we will talk about testosterone and oestrogen to help you understand why they are important in women and what happens when they’re imbalanced.
In women, oestrogen is generally present in higher concentrations compared to men. It plays an important role in regulating the menstrual cycle, developing breasts, and maintaining reproductive health. Testosterone, although present in smaller quantities than oestrogen, also controls many important functions, such as supporting bone health, sex drive, and body composition.
Oestrogen brings physical changes in girls that turn them into women. Examples of these changes are the development of breasts and pubic hair growth. Oestrogen is mainly produced in the ovaries. Adrenal glands present above the kidneys and adipose tissues (fat cells) also make it.
There are three main oestrogen hormones in women. These are:
Estrone (E1): It is the main type of oestrogen that is even produced in postmenopausal women (women who do not have periods anymore). It regulates body temperature and bone density in them.
Estradiol (E2): It is an important hormone that your body produces during reproductive years. It is required for fertility. It also supports bone and brain health. Its levels change throughout a woman’s menstrual cycle.
Estriol (E3): It is mainly produced during pregnancy by the placenta (an organ that provides necessary nutrients and oxygen to the growing foetus). Measuring its levels during pregnancy gives an idea of foetal health. It helps maintain pregnancy and prepares the body for delivery. Non-pregnant women and men also produce it but in smaller quantities.
Apart from these naturally occurring forms of oestrogen, there are some synthetic forms of oestrogen as well. These include mestranol and ethinyl estradiol. They are used during hormone replacement therapies (HRT) to increase serum oestrogen levels.
Oestrogen levels fluctuate throughout a woman’s life depending on various factors such as age, stage of the menstrual cycle, pregnancy, and overall health. Monitoring them through blood tests can give you a better idea of your oestrogen levels and help determine if any hormonal imbalances exist.
| Life stages | Estradiol levels in picograms per milliliter (pg/mL) |
| Pre-menopause | 30 to 400 |
| Post-menopause | 0 to 30 |
During pregnancy, oestrogen levels increase significantly to support physiological changes occurring in the body. The specific ranges during this period can differ from person to person depending on the trimester and individual circumstances.
Testosterone levels also fluctuate in women throughout their lives. They become highest during puberty and then decline gradually as women get older.
In women, the average testosterone levels range from 15 to 70 ng/dL of blood, much lower than the average testosterone level in men, ranging from 300 to 1,000 ng/dL.
The oestrogen-to-testosterone ratio in women refers to the balance between oestrogen and testosterone hormones present in their bodies. It shows the relative concentrations of these two hormones in circulation. It can vary among individuals throughout different stages of their lives.
An imbalance in the oestrogen-to-testosterone ratio, where either testosterone or oestrogen levels are low or high, can lead to various symptoms, such as hot flashes and depression.
Oestrogen imbalance occurs when your body produces either too much or too little oestrogen hormone. It can be a natural part of a particular life stage or occur due to an underlying medical condition.
Consistent oestrogen imbalance can bring many changes to the body, influencing your overall health negatively. Hence, if you doubt you have an oestrogen imbalance, you should discuss your hormone health with your doctor without delaying the matter.
Common symptoms of low oestrogen in women are:
These include:
Since oestrogen is mainly produced in ovaries, any disturbance to ovarian function can lead to abnormal oestrogen levels.
Women may have low oestrogen due to the following reasons.
Levels of oestrogen in your body can rise due to the following reasons.
Women experiencing symptoms of oestrogen imbalance should consult with a hormone specialist for an accurate diagnosis of the problem.
Hormone specialists are knowledgeable individuals who use different methods to diagnose and treat hormonal problems. They first get your medical history and perform a physical examination. Then they’ll recommend tests based on your symptoms.
The most commonly used test for oestrogen imbalance is the oestrogen blood test. It is like a simple blood test in which a small blood sample is drawn and sent to the laboratory for examination. It measures concentrations of E1, E2, and E3 in the blood.
After diagnosing oestrogen imbalance, your doctor may ask you to have a few other tests like a follicle-stimulating hormone (FSH) test, luteinising hormone (LH) test, CT scan, MRI, etc., to find the medical condition that may be causing hormonal imbalance.
It is chosen based on the underlying cause of the hormonal imbalance. Sometimes, lifestyle changes like eating a balanced diet and exercising regularly can help bring hormonal balance to the body. But when it does not work, your doctor may prescribe treatments like hormone replacement therapy (HRT), hormonal contraceptives, etc.
One of the most commonly used effective treatments for low oestrogen is hormone replacement therapy (HRT), which involves the administration of oestrogen to raise its levels in the blood. It is usually used to treat menopause symptoms like hot flashes, mood swings, and vaginal dryness.
You can have it in different forms, such as injections, patches, gels, creams, and tablets. The specific form and dosage are selected based on your individual preferences and desired therapeutic results.
There are two types of HRT or oestrogen therapy for women. The first one is called oestrogen-alone therapy, which involves the administration of oestrogen alone. It is mostly used for women who have undergone a hysterectomy.
The second one is called oestrogen-progesterone therapy. As the name indicates, it involves the administration of two hormones – oestrogen and progesterone. It is usually used for women who have an intact uterus. Progesterone used in this therapy helps prevent uterine cancer risk caused by estrogen intake.
The potential benefits of HRT in women are:
HRT has some potential side effects, including:
Some old studies show increased the risk of cardiovascular disorders and breast cancer in women taking HRT. However, many latest studies claim there is no such risk associated with HRT. Given the concerns surrounding HRT, you should discuss HRT benefits and side effects with your doctor to decide whether it is the right treatment plan for you or not.
High oestrogen treatment depends on the cause of raised oestrogen levels. Your doctors may prescribe you medicines like aromatase inhibitors and Gonadotropin-releasing hormone (GnRH) agonists that reduce oestrogen production in the body.
They may suggest surgery if you have cancer that is disturbing your oestrogen levels. Dietary changes can also help improve oestrogen balance.
Oestrogen and testosterone are important sex hormones found in both men and women. Their levels should stay balanced for the body to function normally. Any fluctuation in their production can produce numerous symptoms.
Treatment for hormonal imbalance is selected based on its cause. Your doctors may prescribe HRT if your oestrogen levels are low due to menopause or some other issue. Evaluate its pros and cons to determine whether you should have it.
References/Further reading/Scientific studies/ Bibliography
Yu, Z., Jiao, Y., Zhao, Y. and Gu, W., 2022. Level of Estrogen in Females—The Different Impacts at Different Life Stages. Journal of Personalized Medicine, 12(12), p.1995.
Ala-Fossi, S.L., Mäenpää, J., Aine, R. and Punnonen, R., 1998. Ovarian testosterone secretion during perimenopause. Maturitas, 29(3), pp.239-245.
Yaffe, K., Sawaya, G., Lieberburg, I. and Grady, D., 1998. Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. Jama, 279(9), pp.688-695.
This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.
References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
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If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
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Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
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