Hypoestrogenism

Hypoestrogenism, or estrogen deficiency, refers to a lower than normal level of estrogen, the primary sex hormone in women. In general, lower levels of estrogen may cause differences in the breasts, genitals, urinary tract, and skin.

Hypoestrogenism is most commonly found in women who are postmenopausal, have premature ovarian failure, or are suffering from amenorrhea; however, it is also associated with hyperprolactinemia and the use of gonadotropin-releasing hormone (GnRH) analogues in treatment of endometriosis. It has also been linked to scoliosis and young women with type 1 diabetes mellitus.

Causes

• Hypogonadotropic hypogonadism such as due to hyperandrogenism, lactation, certain medications (e.g., androgens/anabolic steroids, progestogens, prolactin releasers, GnRH analogues), pituitary gland/hypothalamus damage, or isolated hypogonadotropic hypogonadism (e.g., Kallmann syndrome, CHARGE syndrome, GnRH insensitivity)
• Hypergonadotropic hypogonadism such as due to menopause, premature ovarian failure, certain medications (e.g., aromatase inhibitors, CYP17A1 inhibitors), gonadotropin insensitivity, or inborn errors of steroid metabolism (e.g., aromatase deficiency, 17α-hydroxylase deficiency, 17,20-lyase deficiency, 3β-hydroxysteroid dehydrogenase deficiency, and cholesterol side-chain cleavage enzyme or steroidogenic acute regulatory protein deficiency)

Symptoms

Presentations of low estrogen levels include hot flashes, headaches, lowered libido, and breast atrophy. Reduced bone density leading to secondary osteoporosis and atrophic changes such as pH change in the vagina^[1] is also linked to hypoestrogenism.

Low levels of estrogen can lead to dyspareunia and limited genital arousal because of changes in the four layers of the vaginal wall.^[2]

Hypoestrogenism is also considered one of the major risk factors for developing uncomplicated urinary tract infections (UTIs) in postmenopausal women who do not take hormone replacement therapy.

Treatment

Hormone replacement therapy (HRT) with estrogen can be used to treat hypoestrogenism both in premenopausal and postmenopausal women.

See also

• Aromatase deficiency
• Estrogen insensitivity syndrome
• Aromatase excess syndrome
• Hypogonadism
• Hyperestrogenism
• Hypoandrogenism
• Hypergonadism
• Hyperandrogenism

References

External links

• Gonadotropin-releasing hormone agonist-induced hypoestrogenism and blood flows in cerebral arteries.