The hot flushes you had expected. But the stiff fingers in the morning, the feeling of walking through fog and that dry skin suddenly wrinkling faster? Many women blame those complaints on stress or age, while together they can point to something else: falling oestrogen.
My point here: the well-known symptoms get all the attention, but it is the unexpected signals that are most often overlooked.
12 oestrogen deficiency symptoms
The table below lists the twelve signals, with how widely they are recognised and where they come from. Use it as a checklist: the more rows you recognise, the more worthwhile it can be to have your values measured.
| Signal | How well known | Where it comes from |
|---|---|---|
| 1. Hot flushes and night sweats | Well known | Disrupted temperature regulation |
| 2. Irregular periods | Well known | Fluctuating cycle |
| 3. Sleep problems | Fairly known | Oestrogen affects sleep quality |
| 4. Mood swings | Fairly known | Serotonin and dopamine fall too |
| 5. Fatigue | Fairly known | Disrupted sleep and energy |
| 6. Vaginal dryness | Fairly known | Thinner mucous membrane |
| 7. Joint pain and stiffness | Underestimated | Loss of anti-inflammatory effect |
| 8. Concentration problems | Underestimated | Effect on brain blood flow |
| 9. Dry skin and wrinkles | Underestimated | Less collagen production |
| 10. Hair loss | Underestimated | Less follicle protection |
| 11. Reduced libido | Underestimated | Role in sexual desire |
| 12. Belly fat | Underestimated | Shift in fat distribution |
The familiar four
Hot flushes and night sweats are the classics: a sudden wave of heat, often followed by sweating that disrupts your sleep at night. Your cycle also becomes shorter, longer or unpredictable, and falling and staying asleep can get harder. Mood swings belong here because oestrogen stimulates the production of serotonin and dopamine.
The underestimated eight
This is where this article earns its place. Joint pain and morning stiffness are rarely linked to hormones, while oestrogen has an anti-inflammatory effect on your joints. Concentration problems ("brain fog"), drier skin, thinning hair, a reduced libido and a shift of fat toward your belly can also fit falling oestrogen. According to the NVOG, joint complaints and concentration problems belong to the broad symptom pattern of menopause, even if they get less spotlight than hot flushes.
Why these signals are so easily missed
The tricky thing about falling oestrogen is that the complaints rarely arrive together and clearly. They creep in: first a bit worse sleep, months later stiff joints, then drier skin. Each symptom on its own seems explainable by something ordinary, pressure at work, getting older, a bad night. Only when you add them up does a pattern emerge. On top of that, oestrogen does not decline in a straight line during perimenopause but fluctuates: one month you feel fine, the next you have a string of complaints. That erratic course makes it confusing, even for yourself. Keeping a simple symptom diary, with date and cycle day, helps you and your doctor see the common thread.
Not everything is oestrogen
An honest caveat: the same twelve complaints can also belong to other things. Fatigue and hair loss fit a thyroid disorder or iron deficiency just as well, and low mood by no means always has a hormonal cause. That is why a broad picture is more valuable than zooming in on oestrogen alone. So do not draw conclusions from this list alone, but use it as a starting point for a conversation with your doctor or for a targeted test.
When does testing make sense?
If you recognise several of these signals and they affect your daily life, having your hormone values checked is worthwhile. A blood test on estradiol and FSH gives a concrete starting point. Keep in mind that the same complaints can also belong to a thyroid problem, iron deficiency or vitamin D deficiency. Thuisarts.nl advises looking beyond one hormone with persistent, unexplained fatigue. A broad test such as our menopause test can help here.
The best moment to draw blood depends on your situation. If you still menstruate, day 2 to 5 of your cycle gives a usable baseline for estradiol and FSH. If you have not menstruated for a long time, the cycle moment no longer matters and you can test at any time. In both cases, note your age, your last period and the complaints you experience, so your doctor can place the result in context. A number without a story says little, especially for oestrogen, which naturally fluctuates.
Further reading
Want to know what you can do? Read oestrogen deficiency: symptoms, causes and what you can do and increase oestrogen: natural ways and when to test.
Frequently asked questions
Can I have these symptoms while still young?
Yes. Oestrogen deficiency can occur at any age and in younger women can relate to intensive exercise, low body weight or stress. Do not carry on with complaints, but have them investigated.
Do these symptoms go away on their own?
It depends on the cause. With menopause the complaints usually stabilise over time, though that can take years. With other causes it is important to address the underlying reason.
Can I have several symptoms at once?
Yes, that is even common. Oestrogen affects so many body systems that a deficiency can show up on several fronts at once.
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