“Here’s How I Knew I Had Low Estrogen”: A Patient’s Story of Sudden Menopausal Symptoms

Estrogen is one of the body’s key sex hormones, essential for reproductive health, bone density, brain function, and mood regulation. When estrogen levels drop, it can trigger a wide range of symptoms. Common low estrogen symptoms include irregular periods, hot flashes, fatigue, mood swings, vaginal dryness, and low libido.

While estrogen naturally declines during menopause, it can fall earlier than expected due to certain medical conditions, lifestyle factors, or treatments like chemotherapy or surgical removal of the ovaries. According to the National Institutes of Health (NIH), around 1.3 million women in the U.S. enter menopause each year, making it the most common life stage associated with low estrogen. But younger women can also develop estrogen deficiency.

The Cleveland Clinic notes that primary ovarian insufficiency (POI) affects about 1% of women between ages 15 and 44—and conditions like eating disorders and autoimmune diseases or activities like extreme exercise can also trigger early hormone imbalances. Whether estrogen drops gradually or suddenly, the symptoms can be confusing and often dismissed.

There are effective treatments for low estrogen, and many women find lasting relief with the right diagnosis and care. That was the case for a 39-year-old woman from Orlando, Florida, who began experiencing menopausal symptoms years ahead of schedule and decided to take action.

Ahead, we share her story and when it’s time to consult your doctor for low estrogen symptoms.

How I Knew I Had Low Estrogen

By Kelly G. as told to Dr. Patricia Varacallo, DO

My low estrogen symptoms

I never imagined I’d be dealing with menopausal symptoms at just 38. My husband and I had just celebrated our one-year wedding anniversary in May 2024 and had recently bought our first home. I felt like I was hitting my stride career-wise, too.

But then, seemingly out of nowhere, I started waking up in the middle of the night drenched in sweat. At first, I thought it was the Florida heat, or maybe stress—I had a lot of projects on my plate at the time. I’d throw off the covers, crank the fan, and try to fall back asleep.

But then other unusual things started happening. My periods, which had always been perfectly regular, became completely unpredictable. I skipped two months in a row, then had an unusually heavy cycle, followed by nothing again. My mood was all over the place—one minute I’d be snapping at my husband for no reason, the next I’d be tearful and emotional. It felt like PMS had taken over the entire month.

The most troubling symptom, though, was the fatigue. I’ve always been active, but suddenly I was dragging by mid-afternoon and struggling to stay focused at work. To make things worse, my sex drive disappeared completely—and when we did try to be intimate, it was uncomfortable. I was dealing with vaginal dryness, something I’d never experienced before. The exhaustion didn’t help, either. I did what most of us do: I went online, and the more I read, the more convinced I became that I might be going through menopause. But I was only 38.

Concerned, I decided not to wait for my next annual exam. I called and made an appointment with my OB/GYN.

Being diagnosed with primary ovarian insufficiency

As I walked through all of my symptoms—night sweats, irregular periods, vaginal dryness, low libido—my gynecologist nodded thoughtfully. “It’s unusual at your age,” she said, “but it does sound hormonal. Let’s run some blood tests to check your hormone levels.” She ordered a full panel, including estradiol and FSH (follicle-stimulating hormone), to get a clearer picture of what was going on.

When the results came back, they confirmed it: My estradiol (estrogen) was extremely low for someone my age, and my FSH was very high—exactly the pattern doctors see in menopause. That’s when she gently explained that I was likely experiencing primary ovarian insufficiency (POI) or premature ovarian failure—meaning my ovaries were starting to fail years earlier than expected. In other words, I had low estrogen. My hormone levels looked like I was already in menopause.

The first thing that came out of my mouth was, “Does this mean I can’t have children?” That was the hardest part to process. I hadn’t had kids yet, and while it wasn’t something I was actively pursuing at the time, the idea that the choice might no longer be mine hit me hard. She explained that POI often leads to infertility because ovulation stops, but it can be unpredictable. There was still a chance I could ovulate occasionally. She referred me to a fertility specialist to explore what that might look like.

It was a lot to take in. I left that appointment with long-awaited answers, but also a brand-new set of worries.

My treatment for low estrogen symptoms

I worked closely with my gynecologist and a reproductive endocrinologist she recommended to come up with a treatment plan. Because I was still years away from natural menopause, we agreed that hormone replacement therapy (HRT) would be the right move. I started using a low-dose estrogen patch, which I change twice a week, along with a daily micronized progesterone pill to protect my uterus.

Within a month, my night sweats and hot flashes had improved by about 90%. The relief was incredible—I was finally able to sleep through the night again. My mood leveled out, too. I felt more like myself and less like I was riding an emotional rollercoaster. A couple of months in, I also noticed that sex became comfortable again—something I hadn’t realized had changed so much until the dryness started to improve. (I use a vaginal moisturizer too, which makes a big difference.)

Beyond managing symptoms, my doctors explained that HRT would also help protect my bones and heart, since being low in estrogen at my age could carry long-term health risks.

On the fertility front, I did some soul-searching and had long talks with my husband. We decided to try conceiving sooner rather than later, knowing it might be difficult. The reproductive endocrinologist discussed possibly using donor eggs if my ovaries weren’t producing viable eggs. That was a heavy conversation, but I felt grateful there were options to consider. As of now, we haven’t made definitive moves on that path. What’s important is that we have a medical team monitoring my health closely. I get regular check-ups and bloodwork. We also did a bone density scan which, thankfully, was normal (likely because I hadn’t been low-estrogen for too long yet). I’ve started taking calcium and vitamin D supplements as a precaution.

Life as I manage low estrogen

It’s been about 10 months since I was diagnosed with low estrogen and POI, and I’m in a much better place. The phrase “quality of life” really resonates with me because mine has improved in ways I didn’t think were possible when this all started. Emotionally, it’s been a journey to accept this diagnosis, especially at my age, when none of my friends are talking about menopause yet. But I’ve learned to be gentler with myself and grateful that I didn’t dismiss my symptoms as just stress or getting older.

I feel more empowered now, actively managing my health and making choices that support my overall health. Menopause came early for me, yes—but I’m facing it head-on, with a lot of strength and support.

What to do if you suspect you have low estrogen

If you’re noticing low estrogen symptoms like irregular periods, hot flashes, mood changes, or vaginal dryness, it’s time to speak with a healthcare provider. Start by making an appointment with your OB/GYN or primary care doctor. Bring a list of your symptoms and note any changes in your menstrual cycle, sleep, or energy.

Your doctor may order blood tests to check estrogen and related hormone levels, such as FSH and LH (luteinizing hormone). Depending on the results, they might recommend treatment options like hormone replacement therapy, non-hormonal medications, or lifestyle adjustments to help relieve symptoms and protect your long-term health.

In some cases, especially for younger women or those facing fertility concerns, a referral to an endocrinologist or reproductive specialist may be helpful.

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