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The Physiology of Women’s Weight Loss Part I: Estrogen

Many people in the modern world believe that it is more difficult for women to lose weight than for men.   This is unfortunate, and it’s an over-simplification, but the idea is not precisely wrong.

A woman’s body is laced with hormonal complexities that a man’s is not.  This is strikingly born out in the simple fact that women are fetus-bearing organisms. For this reason, a woman’s body comes equipped with a whole suite of mechanisms designed to make sure that she has plentiful nutrients and energy to support another life growing inside of her.

These fat-aggregating mechanisms can be broken down into two primary factors: estrogen-driven fat deposition, and hypothalamic weight regulation. Both are complex; both interplay with one another; and both are crucial to understand in order for a woman to lose weight healthfully and easily.  This post is about estrogen.

See here for the post on hypothalamic weight regulation and click here for my book Weight Loss Unlocked.

Estrogen and the female body

Estrogen levels correlate with and are responsible for a woman’s menstruation.  For this reason, a woman’s estrogen levels begin to rise during puberty, peak in her 20s and 30s, and drop off in menopause.  This menopausal shift causes increased and shifted body fat mass in older women.

In women of reproductive age, on the other hand, estrogen levels rise and fall with her menstrual cycle.   During the luteal phase in which the uterus is preparing itself to be implanted with an egg a woman’s estrogen levels peak at four-six times the amount she might have at the low point in her cycle, the first day of menstruation.

There are three varieties of estrogen in a woman’s body.  They are differentiated by the number of -OH molecules attached to them, so they commonly go by E1, E2, and E3.

The most prominent form of estrogen in the female body, at least before menopause, is E2. (In menopause E2 drops off and E3 becomes more prominent.) E2 is called estradiol, so when most women get their hormones level tested, this is the most commonly tested form.  Yet, since E2 comprises the vast majority of a reproductive woman’s estrogen levels, and since all the forms of estrogen perform similar functions, calling E2 “estrogen” usually serves just as well.

In pre-menopausal women, the ovaries are the principle source of estrogen, which functions as a circulating hormone to act on distal target tissues.  This means that estrogen produced in the ovaries influences the whole body, such that ovarian estrogen can enhance weight gain or alter DNA expression in cells as far spread as a woman’s pinky finger or her spleen.

Why estrogen is commonly associated with weight gain

Estrogen is commonly associated with weight gain. But which begets the other?  Does the fat cause the estrogen, or is it the other way around?

It’s both.  First, fat cells beget estrogen production. But then elevated estrogen levels further slow down metabolism, such that estrogen plays a role in convincing a body to store more weight.  For many, this becomes a vicious cycle of accelerating weight gain.

The mechanism by which estrogen causes weight gain is through inhibiting thyroid function. In a normal-weight woman, estrogen and thyroid hormone play off of each other in an intricate balance.

Yet when a woman becomes overweight, her estrogen levels drive her thyroid function relentlessly downward. With impaired thyroid function, a woman can feel sluggish and fatigued, and therefore expend less energy, and also subconsciously down-regulate her metabolism such that her body is burning less and less fuel to get by and she is not even aware of it.   Up to 10 percent of American women have issues with hypothyroidism.

The enzyme by which a cell converts testosterone into estrogen is called aromatase.  Aromatase is the primary source of estrogen in men, as it converts testosterone to estrogen within cells.

Aromatase enzymes are present in all types of tissue, yet the aromatase expressed in adipose tissue accounts for the vast majority of non-ovarian estrogen production in men and in women.  This is why, in fact, many women suffer estrogen-deficiency symptoms when they lose too much weight.

Additionally, the aromatization of testosterone to estrogen increases as a function of body weight and advancing age.  This is a problem for men, as well as another compounding factor for menopausal women.  It can also lead fairly quickly to estrogen dominance, which causes it’s own slew of reproductive problems.

Why estrogen is actually an important factor in weight loss part I: within the cell

Be that as it may, estrogen is actually an important factor in weight loss, and for several reasons.  The first is that it decreases the activity of fat-absorption within a cell.  It does this by decreasing the activity of lipoprotein lipase (LPL). LPL is an enzyme which favours fat uptake into the cells, so having estrogen around inside of a cell helps prevent it from growing larger.

Secondly, estrogen increases the activity of another enzyme called hormone sensitive lipase (HSL).  HSL is the other big player in regulating a woman’s fat metabolism.   Epinephrine stimulates HSL, and then HSL incites lipolysis, which is a fancy word for the breakdown of fat.

HSL activity occurs most commonly in exercise.   So what estrogen is doing in a sense is making this exercise phenomenon more powerful and occur more often.  During aerobic exercise, increased body temperature and a greater concentration of epinephrine in the blood stream enhances HSL responsiveness to epinephrine.  This then triggers the fat-breakdown activity of HSL.

Estrogen has also been reported to stimulate the production of growth hormone. Growth hormone inhibits the uptake of glucose (carbohydrate) by fat tissues and increases the mobilization of fatty acids from fat cells.

GH works by inhibiting insulin production from the pancreas and stimulating HSL, the fat-burning enzyme described above. Insulin is the main hormone that promotes glucose transport into muscle cells to be used as energy, and it is a potent inhibitor of HSL.  For this reason, decreasing insulin levels via GH via estrogen helps speed HSL fat burning activity.

Why estrogen is actually an important factor in weight loss part II: determining site of fat storage

Women have more fat than men.  A “fit” woman can safely go down to around eighteen per cent body fat, but no further, whereas a fit man can go almost as low as he’d like with no problems.  Some male weight lifters manage to get down to around five percent.

Additionally, women store fat in different places than men.  When men gain weight, it is almost always concentrated around their abdomens.  This is called visceral fat, and it is the fat most highly associated with diabetes and other diseases of civilization.

The other kind of fat is called subcutaneous fat, and it’s the fat that appears underneath the skin spread out around the body.  A woman’s body prefers subcutaneous fat.  This phenomenon explains why women typically have less muscle definition than men–a tiny layer of fat is usually smoothing over all little muscular ripples.

It also explains why they have large hips instead of large abdomens.  Women have more subcutaneous fat than men in general, and they also store it preferentially in tissue around the hips, thighs, and buttocks.

As a side note, estrogen is also important, but not the only factor, for the development and size of breast tissue.

But women only have large hips versus abdomens so long as they have enough estrogen in their systems.  As soon as estrogen drops off, specifically in menopause, women see their fat mass shift to their middles.  This is a hazard to their health, as well as a bit of an affront to their identity as shapely, reproductive beings.  There are ways to mitigate that, of course, primary of which is eating a natural, anti-inflammatory diet, secondary of which is staying active and fit.

Estrogen causes an increase in the receptor known as anti-lipolytic alpha 2A-adrenergic receptor. (Anti-lipolytic = anti-fat.)  This is how subcutaneous cells maintain their fat mass while other cells do not.  In activating this receptor, estrogen increases the number of anti-fat breakdown receptors in subcutaneous fat. Because of the increase in these receptors, cells break down fat less often.

This is not a bad thing!  This is a glorious thing.  While it may sound like estrogen is making you fat and keeping your biceps hidden, what it is really doing is keeping the fat storage that your body naturally wants to do away from your abdomen and more in your breasts, hips, and buttocks.

Men are not so lucky.  They pack on the disease-causing abdominal fat like it’s their jobs. Estrogen, on the other hand, protects a woman from that phenomenon.  As well as making her body feminine.  Which is hot.  

Why estrogen is actually an important factor in weight loss part III: signalling energy abundance to the hypothalamus

Estrogen also plays a crucial role in moderating a woman’s energy expenditure and appetite.  This makes intuitive sense: if estrogen levels in the blood are high enough, this means that the ovaries are functioning and that a woman has enough fat on her in order to support a fetus.

The hypothalamus, which is the center of the brain which regulates appetite and feeding behavior, includes receptors for a number of hormones and metabolites.  Estrogen is one of them.

The more estrogen a woman has in her body, the more the hypothalamus detects energy sufficiency, and the less she needs to eat.  This also implies the converse: when estrogen levels drop to low levels, such as when a woman’s ovaries are removed or if she is anorexic, cravings and food intake increase exponentially.

All that said…

Estrogen plays a complicated role in a woman’s fat distribution and weight regulation. It is associated with high fat levels, but this is not necessarily because it makes a woman fat. Instead, this is possibly just because fat cells produce estrogen.

In fact, estrogen is often very helpful for weight loss. It helps the body know that it is fed. It upregulates fat metabolism.  And at the very least, estrogen is responsible for keeping a woman’s hips, breasts, and all glorious womanly parts exaltant in that glorious womanhood.

Without estrogen, women would not be women, and how possibly dull would the world be like that?


For more information on weight loss, check out the books I wrote here and here. Another favorite of mine, Why Women Need Fat, is available here.


So, just as a heads up - some links above may be my affiliate links, which means I get a small commission if you click on it and make a purchase. Doing so is no additional cost to you, but helps me tremendously. Your support is SO greatly appreciated, so thank you in advance if you choose to do so. Check out my entire disclosure to know exactly how things work.

Managing director of Paleo for Women and author of Sexy by Nature.


  1. Thank you for this extremely interesting post, Stefani! As someone who has been diagnosed with PCOS (well, the doctor is a little wishy washy about the label since I’m thin and this seems to frustrate him, but for all intents and purposes I have it) that has been trying to comprehend the mysterious ways of my dysfunctional hormones, your blog has been a great find. Like I said, I’m thin/normal (Just over 5 ft, 103 lbs) and haven’t gotten my period naturally in years. I’ve been on a roller coaster of progesterone pills, creams, etc. and have now been on Metformin for 8 months. It hasn’t done much – well, one period in those 8 months – but I feel great taking it so I keep on keeping on. My doctor seems pretty clueless, which is why I do a lot of my own research. It’s pretty awesome (not).

    Anyway, according to my hormone tests everything is in the normal range, however testosterone is 45 (15-76 is normal) while estradiol is 37 (18-570!! is normal) — which leads me to believe that my estrogen is comparatively low. My doctor just said everything is in the normal range, hormones are fine, end of discussion, even though clearly since I am not having a period – when he does an ultrasound after 5 months of no period, there’s no accumulation even in my uterus! – they are NOT FINE.

    Sorry this is a lot of background to get to my question! I’m not a science-brained person by any means, so it’s difficult for me to wrap my head around this, but after reading this post twice it seems that estrogen and fat have a mutually beneficial relationship. Eating more fat in my diet has not seemed to help my estrogen production, unfortunately. I’m wondering if there are certain types of fat that may better support estrogen production? My intuition (possible linked to my paelo brainwashing via blogs, ha) would be animal fats, but alas this is what I consume a good amount of with no luck.

    My doctor has recently put me on birth control for 2 months just to see how my body responds, and having estrogen in my body has felt pretty damn good. Clearer skin, more energy. Hungrier, but I’m down with that. I’ve been anti-BC pills in the past because I’ve viewed them as “so unnatural” but now of course I’m starting to re-think this. I want my body to make this type of estrogen on its own, and I feel so much frustration and resentment that such a natural process isn’t happening naturally for me. I won’t stay on BC for long, especially because I want to have a baby in the next year (will probably have to resort to Clomid) but.. well, I’m just hoping in your next articles that you have ideas about naturally boosting estrogen production 🙂

    Thank you for this blog. I devour each and every post!


    • Hi Carly!
      Lovely to hear from you.
      My estrogen levels are also in the basement. Or they have been, historically.
      You are right, estrogen and fat do have a mutually beneficial relationship. I wonder with you, however… have you always been this thin? Did you used to menstruate regularly even though you were this thin? You say you’re ‘just over five feet and 103 pounds’ and that’s “thin/normal” but I am just over five feet, too, but I weigh >120. Are you 5 feet tall, or 5,1, or 5,2? My BMI falls in the ‘reproductive’ range, but yours actually, if you are 5,2, like me, is a fair bit below what endocrinologists usually consider well-fed enough to have a baby. One of the big themes in this post is that estrogen is produced in fat cells. If a woman loses weight, she loses estrogen that her body may have been dependent upon. Ovaries, as such, develop with a “handicap.”
      If there is any amount of restriction in your diet, or exercise, or stress, then Hypothalamic Amenorrhea may also be at play in your diagnosis. Do you know your LH and FSH levels? If they are on the low end, then HA is probably also a fact of your reproductive health. The solution for that is to remove the stress, eat more, and put on some weight.
      I understand so much your frustration. I feel it in my own life as well. I have never tried estrogen pills–am still trying to do is ‘naturally’ and I think I might really be seeing improvements– but it has also meant that I had to come up from around 110 pounds to 120.
      Hope that helps– glad you like what I do!

      • Stefani – thanks so much for replying! I’m under 5’1″ – perhaps 5′ and 3/4″ and definitely at my lowest weight right now than I’ve been in years. In the past I’ve been as heavy as 117, more often 110, and while my period was never normal it was slightly more present when I was heavier. My LH is 6.31 and FSH 5.82 (well.. at the moment they are in fact frighteningly lower, like LH is .07 and FSH is .3 — I had a blood test yesterday and literally almost cried when I saw that BUT I have been on BC for the past month so I was told that’s normal?). I do exercise quite a bit because my wedding is in one month. Yes part of it is vanity (okay, a big part of it, but I’m really trying to take your posts to heart and not obsess about this) but a lot of it is stress relief. I find exercise and the time immediately after to be my calmest time of day and I sleep so much better on days that I exercise which helps with the stress as well. You are probably right about Hypothalamic Amenorrhea, and that weight gain would probably help. However, eating the paleo-ish way I’ve been eating, my weight is where it is now. I eat 3 meals a day and often have snacks, don’t restrict at all, rarely feel hungry, in fact I always eat until fullness even at times beyond full. I do cardio about 5 times a week. In terms of addressing the stress, I am starting a new job soon and the wedding will be over and done with so that should help 🙂
        How have you gained weight while eating paleo? I’m not strict by any means – daily I eat buckwheat, cottage cheese, whole milk, fruit, etc. but I find eating this way my weight has just been at 103. It sort of feels like my body WANTS to be like this, but I definitely want to gain weight if it could mean more estrogen.

      • Hi Stefani,

        Great post and very informative regarding the link between fat and estrogen. My situation is unrelated to other comments here but I believe it is directly related to your topic of fat & estrogen. I recently had liposuction of my inner/outer thighs, lower abdomen and love handles. Almost immediately after the procedure, (by week 3) I began to gain weight at an alarming rate. At first I did not realize what was happening due to the amount of swelling that occurs from the procedure and the lengthy recovery time that goes along with it and foolishly, I had not checked my hormone levels prior to the procedure, which was something I should have done at the young age of 49 but then again, I would not have made the correlation between estrogen and fat cells and how removing much of what I had left would cause so many problems.

        Your post has helped me to understand what is happening to me, and that has provided me with much relieve. I am on HRT in a patch form and I’m feeling much better but that was not the case for many months.

        I think it’s very important that women close to pre-menopause or women that are menopausal or post-menopausal take into consideration the estrogen / fat combination and how it affects your body before they make the decision to have a procedure like liposuction done. Knowledge is power.

        Thank you again for the information!

    • Also, yes, good call on the brainwashing! Your fat intake is fine. 🙂

    • Carly, there’s a book written on PCOS, “The Savvy Woman’s Guide to PCOS (Polycystic Ovarian Syndrome): The Many Faces of a 21st Century Epidemic….And What You Can Do About It”, I did not read it but I read dr. Vliet’s “It’s my ovaries, stupid!” book and she says a few things about PCOS in there. It’s the deficiency of estrogen that’s the main culprit and that is why you feel so much better on the BC. You were lucky to be put on something that has an adequate amount of estrogen. Birth control pills are not that bad but if you want to get off the pills and you do not want a pregnancy, there’s a patch and a ring that you can use but they still have the same synthetic estrogen and progesterone. I think that the safest option to supplement estrogen is by using one of those patches, creams or gels that contain bio-identical estradiol. And it is not true that estrogen makes you fat, as Stefani clearly explains in her post. It’s not having enough estrogen and too much unbalanced progesterone that makes us gain weight. The perimenopausal women taking estradiol patches or creams/gels keep complaining of symptoms of estrogen deficiency but are scared to increase the dose of estradiol and therefore, they keep gaining weight. Many of them also take cyclic progesterone and so they add up the amount of progesteroene. Same problem with the menopausal women, they take progesterone with their estradiol or they take the synthetic mix (Premarin/Provera). I am on Estrogel only and while I do not have PCOS, I had many issues with not being able to focus, sleep, etc while constantly gaining weight. I have a very strong reaction to even very little amounts of progesterone and I was treated for EXCESS estrogen for 6 months with progesterone by a dumb doctor who was in love for the “estrogen dominance” mantra, without studying in depth the fact that estrogen dominance was just a theory that was never proven right. Because of the fear of estrogen caused by the WHI, people are afraid to take as much as they need and so you can spend years trying to stick with a low dose and feeling miserable. I sleep well with 6 pumps of Estrogel daily. And it may not be because I need that much estradiol but because only a little bit gets absorbed. I will talk to the doctor see if a compounded estradiol will have better absorption as 6 bottles of estrogel monthly can get very expensive, not just for me, but for the insurance too, it doesn’t feel right to have the insurance pay $600 for the me each month, I believe it’s the greed of the pharmaceutical industry that drives our healthcare bankrupt. If the manufacturer made a bottle that contained a supply of 30 days at 4-6 pumps a day instead of one at a decent price, it would have been a different story. You have to find a doctor who knows what to do and how to guide you. I am certain that without enough estrogen you can’t even get pregnant. Also, having enough estrogen will lower your testosterone because it raises the SHBG (sex hormone binding globulin) that binds the testosterone and so you will have less free testosterone available, same free testosterone that’s causing you acne and growth of hair on your upper lip if you have that. Another thing: no amount of saturated fats will get your ovaries to produce enough estrogen once it started going down the hill, I tried that, eating coconut oil, cod liver oi and grass fed butter and ghee by the spoon. I did feel a little better but I haven’t felt as good as I feel on the Estrogel in many years. Best of luck!

    • Hi,
      Just wanted to comment about the PCOS diagnosis. I would in two shakes get a second opinion. I too was diagnosed with PCOS about 9 years ago. I am 5’5, and weighted about 105 lbs at the time. Had horrible periods and acne issues. Those were my only symptoms. A Nurse Practioner ran a blood test and said “You have PCOS”. I believed this dianosis, until I started doing my own research about it. I didn’t really have many symptoms at all. At the time I wanted to get on BC pills for the cystic acne issues(which I delt with since I was 15), and went to a gynocologist for a perscription. This doctor was SHOCKED by the diagnosis of PCOS because I was naturally very thin everywhere(I have very small bone structure) and didn’t show symptoms of excessive testostrone(facial or excessive body hair, being over weight, etc). About a year later I went to an alternative medicine health practicioner (Osteopath) who also was surprised by the PCOS diagnosis. I was feeling excessively tired all the time and had gained weight but only in my stomach area. At this time, she ran very indepth blood tests and saliva hormone tests that showed zero chance of PCOS. I was releaved, but still suffered from painful periods. Anyway, long journey/story short, 9 years later I have been on BC on and off the last decade which has helped immensly! I’m 33 now, and have been on a high dose bc pill for 4 years which has been great up until recently, which i’m starting to feel its been too high a dose the last few months. Anyway, I’d reccomend getting another opinion, especially from possibly someone who practices Otheopathic medicine. They look at all sorts of things thay regular mainstream doctors won’t address like adrenal fatigue, and in-depth thyroid issues. You won’t regret it. Good luck!

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  5. Just found your blog, and I love it! Always happy to find a new female perspective on ancestral health.

    I know this is an old post, but the bit about estrogen affecting fat distribution is very interesting to me. I’ve always stored fat in my middle, even as an otherwise-skinny tween. I’m very happy with my weight otherwise, but the disproportionate belly-bulge worries me health-wise (and vanity-wise, of course). I’ve always assumed this was either an annoying personal quirk or stress-related, but I never thought about it being a hormonal issue. Maybe I should get a hormone panel done. Have you found a good silver-bullet way to increase/balance estrogen, or is it just as incredibly complex as everything else in the human body? Let me guess… 😉

    • Commenting because I have the exact same problem and would like to hear any answers. Sounds like other women here have addressed it by taking birth control or bioidentical estrogen?

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  7. Can you help me out with this sentence, it seems it is unfinished or something?

    ” With impaired thyroid function, a woman can feel sluggish and fatigued, and therefore expend less energy, and also subconsciously down-regulate her metabolism such that her body is burning less and less fuel to get by and she is not even aware of it. … percent of American women have issues with hypothyroidism.”

    • Just the “ten” was missing.. I have no idea why. 🙂

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  9. Pingback: Paleo for Women | The Physiology of Women’s Weight Loss Part I: Estrogen « into ewe

  10. Pingback: Paleo for Women | The Physiology of Women’s Weight Loss Part I: Estrogen « into ewe

  11. Hi,
    I’ve recently been diagnosed with PCOS, although I’m not 100% sure that’s it. Apparently my estrogen levels were low. I hadn’t had a period for 18 months since coming off a tri-phasal pill but I do exercise a fair bit (was running a lot) and I probably weighed at least 5kgs less than I do now. I have been gaining weight and muscle but still nothing. My dr just put me on an estrogen pill, and I feel like I have a lot of extra weight on my hips/thighs now. Still no period though. My question is, will this extra estrogen now make me gain weight? I was accepting that I needed to gain a little…just not sure ths much! Does the pill affect food cravings?

    • Your weight can definitely fluctuate with the pill — it varies for all women. Food cravings as well. None of it is a certainty, though. And I would bear in mind that weight on the thighs / hips is not unhealthy — it is generally abdominal fat that is regarded as being associated with deterioration and disease.

  12. But then what about women that have basically 90% of their body fat in their belly area? What’s up with that? Women like that do exist, obviously. This post was super informative but it was all geared towards the woman that has most of her fat below the waist. What’s the dope on women with fat concentrated mostly on their abdomen (way before being menopausal)?

    For example, me. Flat-ish butt. Normal hips and thighs. Just got a little problem on my inner thighs but nothing too serious. Everywhere I look “average” except my belly. Please share some info or point me in the direction about this and how, scientifically, estrogen and all that jazz works in that type of body.

  13. Pingback: Hi everybody I have an estrogen question | Mark's Daily Apple Health and Fitness Forum page

  14. Thank you for the article, I was wondering if you can suggest how to loose those stubborn “hormonal” fat deposits, (perhaps due to excess estrogen) in my but, hips, and thighs. I am 39 yrs old,5’5 tall, and never been “fa” always watches my diet, eating healthy, no junk. But my weight loss always been an issue, I couldn’t stand extra inches on my lower body. I am not sure what is happening now, perhaps of restricting myself of calories in the past, done its job, and now I am gaining it all back? I haven’t exercises as i should in a while, just here and there, plus I’ve been not moving a lot. Winter blues, “depression”, low energy to blame, or hormonal imbalance. What you recommend in terms of food, supplements to loose those inches on my lower body. (I have been taking Vitex for years, to balance my lower body proportions, and hormones. (I take fermented cod liver oil, magnesium, multi for women,I know enough about nutrition, and read lots of info, and blogs, but this issue seems to keep haunting me. What am I doing wrong? (I have never had kids, so the weight is not from that 🙂
    Would appreciate your input on this. Thank you

    • hm, well, I always advocate whole foods. I’d be sure that my fat intake isn’t through the roof — some paleo people I think really over do it in terms of calories on accident by going wild over fat. You also seem to know pretty well what’s going on yourself — ‘not moving a lot’ is actually a pretty big determinant of our resting metabolic rates. I’d consider standing during the day, walking as much as possible, and finding movement that you really love.

      • Thank you, I’ve started moving, exercising at home,but its funny, i am 5’5 tall and weight 120 pounds,i thought it was normal weight for me, but I don’t feel 120pounds, i feel heavier..plus perhaps its the age issue? 39yrs old i am. its those specific parts on the lower part of my body that giving me an issue. But I did yo-yo diet in the past, perhaps I’ve ruined my metabolism? I’ve cut to two meals a day, plus some small healthy snacks. Do you recommenced running as an exercise at the moderate speed ?

      • what should I eat to build weight on my hips an thighs. I have always long to have just a little bit of weight around those areas. Please advise me.

  15. Hey Stefani, Thanks for all your posts and for your fabulous PCOS guide that I purchased with the Paleo Plan. I have a question for you that I am not sure you can answer. I have had very irregular cycles since 2009- I will go 6-11 months with no period and then have it due to having acupuncture or progesterone pills. I was diagnosed with stage 2 adrenal fatigue and had very low sex hormones as well as hypothyroid, so started taking DHEA and progesterone for 6 months in additional to a bunch of other supplements for digestion. I haven’t had a cycle for 6 months so just had my levels retested and progesterone and estrogen have decreased…my ND said she has never seen this happen before and seems baffled and now has just increased my dosages…again. This doesn’t seem to be getting to the root cause. I am only 30 and eat a Paleo diet with the exception of dairy here and there. Have you never heard of this? Thanks so much.

    • Hey Michelle — can you email me with your diet and lifestyle history at stefaniruper@paleoforwomen.com ? Let’s dig into this more closely than we could in the comments. 🙂

  16. Hi

    I found your ste while searching for more information on low estrogen levels.

    I have been tested twice once on day 21 and both thimes my estogen levels have been really low. My doctor has now advised i come on the pill i was on for 5 years (dianette) and wait anothe three months before being tested again. I have however noticed in the last few months it doesnt seem to matter what i eat or how much i exercise i keep putting on weight.

    Is this normal with low estrogen levels?

    I have a wheat allergy so i dont eat any preprared food and cook everything from scratch, i have not really changed what i eat. Its really starting to depress me and my doctor isn’t exactly great at explaining things.

    • I think that depends largely on what else is going on in your body and why your estrogen levels are low in the first place. It could just be that your body needs time to recover from being so reliant on birth control pills? The weight is likely related to your estrogen, but I couldn’t possibly begin to guess how. It could be due to a wide variety of factors that are all interrelated

    • I know this is an old post but I’m experiencing the same issues. I have low estrogen and have put on 40 lbs in the last year with still no period. Also it seems to not mater how hard are exercise or diet. I have not started any hormone treatments yet in hopes of healing naturally but I’m getting so depressed with the excess weight I feel as if I may have to give in. I. Have you and your doctor solved the issues or are you still suffering?

      • Hallie,

        Amen sister! I am with you. I have put on 20lbs in the past year and eat healthier than anyone I know. I see a ND / nutritionist every month for the past 2.5 years. I finally just am starting to hopefully figure something out. Look up Better by Dr Brooke – Frustrated Woman’s Guide To Fat Loss and look at the estrogen paragraph. It tells you there, that exercise doesn’t work if you have low estrogen. I was trying to copy and paste, but that didn’t work so you will need to search into it. http://betterbydrbrooke.com/ I have felt depressed as well, worthless and unattractive. My intelligent side knows this is not true, but the overwhelming feelings are still there. I am happy to chat anytime, it is nice to see someone else struggling with the same problems. I suggest you find a GOOD ND and start there with a full hormone panel and cortisol panel done.

  17. I have a question….So my dilemma
    is that iI have pcos but I have a history of blood clots so doctors will not give me a birth control with
    estrogen AT ALL…SO ALL MY WEIGHT IS IN MY STOMACH AND I HATE IT…I HAVE NO HIPS..BUTT OR THIGHS…I FEEL UNPROPORTIONED!!! So what do you recommend?My ob is trying to give me a progesterone only pill for a Bc method but its sounds like its going to make my situation even worse…I want my female curves back and get rid of this stomach and hair!!! Plzzz help

  18. Just have to say this article was a great read. My doctors think I have estrogen dominance from endometriosis. I have no idea if this is accurate but I have been taking progesterone supplements for the last 6 months. I feel since I have been taking this I am having trouble loosing weight (typical for me) but it seems I am putting on weight much more readily than usual. I was wondering if you had any advice for a healthy way to lose weight through exercise or supplements? I’ve heard DIM is a natural estrogen metabolizer and has helped other women with endo. My doctor just keeps saying let’s just wait and see, but I suffer pain almost every day and I am tired of waiting. Also, I’m not sure if this is important but I also suffer from excess facial hair.

  19. I am a naturally thin person- a size two and eat whatever I want but I had so many allergies. Ie. gluten that I had the mirena removed and lost weight too rapidly- 41 lbs in a year and a half. I liked the weight gain I had on mirena- a size 9 , full figured and energetic. I didn’t know that losing so much weight so fast would make me so sick because I couldn’t store estrogen. I was fatigued, wrinkles, and moody. It was horrible. The truth is that if your naturally thick because of genes or bad eating habits, that perhaps you should readjust your expectations. Maybe it’s not natural for you to be a size two or four. Maybe your skinny is a size 12. Thats not bad as long as you feel healthy. It sickens me that women feel that right for them is a size four. What’s worse is that if a women’s skinny is a size 12, then they blame hormonal failure. It’s not fair that all women aren’t created the same but we are not.

    • Yes!!!

  20. Very nice post. I love your blog and your writing.
    I have always had abdominal fat sadly and have been quite skinny in my butt and upper thighs. However it’s been 15 months since I have had my first child and recently I have found I am gaining weight in my butt hips and upper thighs. I am wondering if it has anything to do with hormones. something has changed since giving birth.
    Also I still have belly fat and my leanness has disappeared but I attribute that to not being able to workout well or eat like I did before I had the baby.
    Are there changes in levels of estrogen after giving birth or any other hormone that is probably making me store weight in my hips and upper thighs?
    I suspect my abdominal fat has to do with metabolic syndrome that was under control before the pregnancy but seems to be back again.

  21. Hello Stefani,
    Great article, its nice to see so many women in the same situation.
    Can i ask your advice, since having my daughter i been diagnosed with hypothalamic amenorrhea, and over time my estrogen has dropped lower and lower, after a year of observations my doctor is about to prescribe hormone replacements. I eat well, everything from scratch, done multiple whole 30’s and live a mostly paleo lifestyle, exercise well. I am 63kg (140lb) at 169cm (5’6?), so what i would consider a normal weight. However its a struggle, i gain weight so easily, i want to be able to relax whilst not feeling terrible about myself, I get crazy emotional, I’ve lost my sex drive (however my partner hasn’t). What can i do to lessen the symptoms? What can i do to raise my estrogen levels?
    Thanks in advance

    • Before I made any sort of guesses (and they’d still be wild guesses) I’d need to see a bunch of tests done and know your history and learn what “mostly paleo” means. For some people ‘mostly’ is just not enough – especially if you have an underlying gluten sensitivity or what-not. You may have an issue with your pituitary gland. You may be overly stressed, especially in the wake of a baby. You may have some sort of gut issue. You may have an imbalance of neurotransmitters. The first step to trying to address these issues is to learn as much as you can about what is actually going on in your body. It’s also just possible that your body needs time to adjust. If you were happy and healthy before the baby, then permit your body some forgiveness and time as it copes with the hormone changes.

      • Hello Stefani,

        Thanks for your reply, yes I suppose my questions were quite vague without any of my previous history.
        Over the couple years I have had many tests including an ultrasound, which showed a thin lining but healthy amount of follicles. A CT scan to rule out masses around my pituitary/hypothalamus, Dexa scan (bones are fine, win for paleo and weight bearing exercise). Unfortunately I don’t have any of my blood test results, but I can ask for them. What information should I ask/look for?
        Mostly paleo means I have been eating paleo aside from organic butter I use sparingly (maybe to cook a dinner once maybe twice a week), so pretty close in my opinion but maybe not enough. After my whole 30 attempts I found dairy does cause some bloating, grains cause to many mood swings, gluten is a no go especially but legumes seem fine. But no official testing has been done just my own observations. I’m working on buying better quality meat foods but I still balance a budget.
        My daughter is nearing 3 and I have not breast feed for 2 ½ years and have not been waking up at night for a year and a half, so I’m not sure I can play the new mum card any more  hehe
        Can you tell me more about gut issues and neurotransmitter issues? I don’t know what I should be looking for in regards to what is going on with my body. I know I am not the same person, I have a cry day at least once a week, this week it’s every second day, when I have never experienced this before. My weight is creeping up, whilst my sex drive and breasts are shrinking, it’s all feeling very menopausal but I am not 30 yet (and my doc ruled out)! Sorry for the vent ladies, just needed it out there.

        Confused, lost and mostly frustrated! Tilly

  22. I found this post really informative. I am 19 years old and have not had my period in the past two years. I am a runner. Last year, I was restrictive with my diet and got down to 90 pounds. I lost my period though when I began running track at around 105 pounds I am almost 5’2. I now am at a weight of 117, and find that my weight shoots up and I am continuing to gain weight even though I am really active and do not eat in excess. I maintain a healthy diet. I still do not menstrate and have had estrogen tests, saying my estrodiol was extremely low. I really need to get back down into the 105-110 range especially for racing. Could the estrogen be the reason for the weight gain? I was prescribed birth control but am very reluctant to take it for fear of gaining more. Any advice? I am fed up right now!

  23. Hi, i sure hope i can join this discussion and possibly get some answers. I am 47 and using bio-identical hormones. Progesterone 200mg day cream, testosterone and estriol. At first for at least 6 mths i didnt use the estriol because it didnt make sense to me to add estrogen if i was already estrogen dominant. But then i read all the benefits of this safe estrogen and strated using it. But my problem is weight gain since i started the hormones. Even before i used the estrogen. And using the estrogen hasnt helped the problem at all. I am 5′ 5″ and weighing in now at 145. That is absurd for me. I am very small framed. Most of this fat is right in my belly. Ive never been built with much of a butt or hips. I have had 5 children. After number 3 i weighed 102. When i entered the hospital to deliver number 1 i weighed 120. Yes, 120 being pregnant on delivery day. With number 4 i got up to 140 and took it all off back down to 110 where i felt comfortable. With number five i was older and got up to 160. I was only able to get back down to 127. But i learned to be ok with that. After suffering peri menopause for 8 yrs i was so glad to finally be listened to and given hormones. And i have my life back. I feel great. But i am hungry alot and crave sugar like crazy and i try so hard to lose weight and nothing works. What is going on with these hormones? I really need some knowledge and help. Everything i read says that progesterone will help with the menopause symptoms and get rid of the belly fat. I experience the opposite. On a positive note my hair has never been healthier. Matter of fact i have never had hair till now. It is past my arm pit now. Ive never been able to grow my hair. So thin like feathers so i just tried to do short haircuts that would mask how thin it was. I keep thinking that as long as my hair is growing so is my body as progesterone is a pregnancy hormone and at levels of 200mg a day it is meant to fatten up baby and subsequently mom too. For a wk now i have cut down to 100mg. I have had no periods since starting it. Does anybody out there know what i should do?

  24. Thank You for your post! I am 33 years old I had a full hysterectomy when I was 30 due to PCOS. I started gaining weight right before I was diagnosed,and had so many cysts on my ovaries they could not count. After my hysterectomy I did not go on HRT right away but started having night sweats,hot flashes, felt like I was loosing my mind, and my bones just ached. I started estradiol 1mg a day and that seemed to work for the most part really my wait stayed the same but could not lose weight when I tried. I am 5’5″ and weigh 170 and love to be active. Recently I gained 7 pounds, my bones are hurting,I can’t seemed to remember things, have no sex drive, my ph balance is off, and I was thinking that I needed more estrogen? I am really struggling right now I hurt from the extra weight I felt great when I weighed around 145 and I love to go hiking, camping,running,walking,swimming, and can’t seem to do any of those not to mention feel so tired and just depressed. I do take lexapro due to anxiety I have had since I was 22. Please Help, I want to feel good again and enjoy my family! My thyroid has been checked and is fine. Could I need a higher dose of estradiol?

    • I have the same story as you. Did you ever get a reply or find out information about this? I am considering taking more estrogen. I am currently taking 1mg estradiol a day.

  25. Try to make sure that your prolactin level is checked. This is a very important factor in the absence of periods at any age. High prolactin levels can cause the absence of periods, and cause infertility, until treated. High prolactin levels can be caused by thyroid problems- or also an adenoma in the pituitary gland, which is a crucial gland in regard to menstruated cycles and fertility. A woman could be regular with her periods for most of her life and due to unknown reasons- a spike in the prolactin levels will cause the absence of periods.

  26. I am 49, dealing with rather odd mouth issues that could be estrogen related. I still get my period, but am unsure where I am on the menopause cycle. The week before my period I get a dry bloody nose and then these vesicles appear in the back of my mouth on my soft palate. Been told I have an autoimmune disease but this cyclical stuff has me wondering. Mentioned it to every doc, but no one seems to see the cyclical occurrence but me. Can this be some extreme cause of low estrogen?

    • Hormones and autoimmunity are quite related! Your fluctating estrogen levels can flare up your autoimmunity, etc. The best treatment in that case really is to do your best with autoimmune, and for that I cannot recommend The Paleo Approach and the rest of Sarah Ballantyne’s work more highly. http://www.thepaleomom.com

  27. Hi there! I’m wondering if rapid weight loss/loss of breast tissue can possibly be the culprit of skin breakouts? I’ve lost a lot of weight recently after cutting out all carbs and sugar in my diet. I thought that eating lots of fruits and vegetables would lead to clearer skin (my skin was fine/normal before) but in fact my skin is worse than it has ever been. My thinking is weight loss–>decrease in estrogen–>breakout. Is this logical thinking? Thanks so much, so happy I stumbled across this very informative article! 🙂

    • Weight loss and low carb diets can both cause acne! Good thinking.

  28. I am 61 and have been on Climara 1.0 for 14 years. My pharmacy gave me generic patches this last 3 monthes. I have gained weight, hot flashes, night sweats, simply exhausted. I called my OBGYN to get the brand Rx approved. She told me I shouldn’t take it anymore. To try Estroven. If I don;t like it she will give me CLimara. Is it bad to be on bio -identical estrogen forever? I couldn’t get a clear answer in your blog. Sure it is there, it just became too complex for my simpleton brain.

  29. Man! My holistic internal doctor put me on swiss amino injections to boost my hormones naturally and boy did it but my testerone got so high we had to decrease them and then I decided to go off of them because I was getting discoloration on my face even though my hormone levels were good- the problem was being TYPE 1 DIABETIC I was not able to lose weight and I finally dropped 5lbs when I went on them.

    I had lipo August 2013. Stopped the injections Oct 1 2013 and it took 2 months to get completely out of my system – only a natural booster though for your own production. 7 months later now in May 2014, I am 7lbs heavier – exercise and food is just as healthy – no gluten, carb reduced heavier protein and veggies. Bottom line my hormones are causing the issue.

    Is there any way to naturally supplement without me going on hormone boosters to get my body cells to finally say “Let her fat go!”? I’m 5 lbs off my ideal BMI I mean seriously – so frustrating!

  30. It is literally impossible for me and the other naturally underweight women – all .08% of us – to reach 18% body fat. To say that women cannot safely go below 18% is uneducated and just ludicrous. I couldn’t reach 18% if someone paid me a million bucks, and I’m 44 years old, and to get there would actually require unhealthy means. Silly article.

  31. Hi, I am so glad that I ran across this information! I am 43 years old and was diagnosed with PCOS about 14 years ago. I have a small frame. I am 5′ 6″ and usually weigh about 120 pounds. I will admit I don’t eat the best, but I do watch what I eat. Normally I do not gain weight easily, but I do not lose it easily either. I have been on a high estrogen birth control pill for about the last 6 years or so. About a year ago I started having migraines around the time of my period. My OB/GYN said that I needed to go to a low estrogen birth control pill. I did that and felt absolutely awful. I was sluggish, bloated, and moody. I did not feel like myself at all! I thought it was the type of BC pill, so I tried another brand with the same result. I suspected that there was something to do with estrogen and asked for a higher estrogen pill. I am now taking a BC pill with more estrogen, but not a “high estrogen” pill like the one I was taking before. I struggle with being tired/low energy and I have gained weight in my stomach area. I am very frustrated because I have had to buy new clothes and I am unhappy with the way I look. Even though I was relatively thin before I did not have the perfect body by any stretch. I was OK with the way I looked, though. Now I am definitely not! Plus when I feel so tired and low energy it is hard to work out or spend the extra time and energy to cook healthy foods. Does it sound like I should take an estrogen supplement of some kind? I felt fine when I was taking the high estrogen BC pill, but my OB/GYN thinks I should not take it any more due to my age and the migraines that I experienced. Thanks so much for any advice 🙂

  32. Stefani,
    I enjoyed your article and I’m writing because I seem to have the opposite problem. I am 49 years old and I’ve gained weight over the past couple years where weight was never an issue with me. I am estrogen high and everything I take even vitamins and suppliments tend to drive my estrogen higher. I’ve had doctors tell me all my hormones are in perfect range. I’ve had doctors put me on progesterin, Iodine and even zinc and all that happens is my cycle becomes a mess.
    I don’t eat a bad diet and I honestly eat way less than I use to. I’ve changed my diet also to gluten free because my boyfriend is allergic to wheat.. I still gain weight. Is there any supplements I can take to help me lose weight that won’t raise my estrogen levels or anything you can think of? I’ve been going through all this for years now and I’m quite frustrated that my body is so sensitive to everything. Do you have any thoughts?
    Thanks in advance 🙂

  33. While you cited a factual information, keep in mind that high level of estrogen is dangerous. It may cause high blood pressure, ovarian cyst and other form of cancers. Though estrogen can help you lose weight, other hormones are also capable of this. Start eating organic fruits and cruciferous vegetables. Mustard greens and kale also help lower estrogen levels.

  34. I had a hysterectomy at 48 and have been on estrogen patch (generic Climara) ever since & down to .375 mg. I am 5’4″ tall and used to weigh 115 lb but every 10 years have gained about 5 lb and now at 64 years old I weigh 135 lb. The only part that I struggle with is around my belly. I am unsure whether to get off the patch or not as my mother had breast cancer & died of liver cancer at 58 yrs old. I think my doctor/ARNP thinks I should stop taking it but as I read your article I am thinking maybe my estrogen levels are too low. I also have to take .275 mg ambien to sleep at night. Any ideas for me? Thank you.

  35. I am 67 years old, had a hysterectomy at 27 yrs old and went thru menopause in my 40’s. I have been on an estrogen pill every since. Do I need to continue taking it the rest of my life?

    • I would probably stay on at least a very low dose. Estrogen can do some really great things for you, and you do need at least some in order to prevent osteoporosis. If you had a complete hysterectomy, there’s very little other method for your body to produce estrogen. In its fat cells is really the primary mechanism

      • What is considered a low dose of estrogen? I’m 55, had a total hysterectomy at 40, took Premarin for 5 years and felt fine, even lost weight that had piled on due to all the problems. Then my sister got breast cancer and I got scared and gave up the HRT completely for 5 years, then started vaginal cream — not that it does much… I have had horrible problems since, including weight gain that just won’t budge even on low-carb Paleo. Is it safe to start up estrogen again, and, again –what is considered low-dose? (BTW, my sister is cancer free!)

  36. I had a TLh with BSO three months ago and have been trying to get my estrogen up. Nothing I take estrogen pill and a testosterone combo but can get up. Ive gained 10 pounds around my waist. Lost a cup size in breasts and have all menopausal symptoms still. What are normal estrogen levels for women in surgical menopause when taking blood tests?


  37. Pingback: BCAAs, no sleep,no period.. - Page 4 | Mark's Daily Apple Health and Fitness Forum page 4


    • oh honey, I know thats horrific, and you need a big cuddle, but what i am about to say is going to be tough..
      You are not healthy, you need to eat more food to restore your hormones to be healthy. This may require gaining weight, you might find you return to your weight previous to this calorie restriction. Its a huge mental challeage, but you are beautiful and can handle it. Hormone replacement maybe necessary but try slowly increasing your calories from good quality foods for an extended period before resorting to HRT. I know its hard, i was diagnosed with perimenopause amongst other things at the age of 25, and had to break up with the tiny me and start looking after myself properly. It is totally worth it

  39. I know this post was a long time ago, but I just came across this. I am confused. I over the past few years have gained 35 pounds. I eat healthy. Lots of raw, organic, farmers market fruits and vegetables and no take out or processed pre packaged foods. All my weight has been stomach fat and breasts. I was always a 34D (even in high school) but now I’m a 36HH – yuck and ouch!!! No matter what I do I cannot lose the weight I ran 1.5 miles almost everyday + barre 3 workouts every other day for a month and 0 lbs gone. My legs and butt look amazing like a ballet dancers, but my upper body is sad it’s like two different bodies were sewn together in a mad scientists lab. I am happy and healthy at 135-140 lbs and a sz 6 or 8. But I’m not healthy with all this extra weight. I had a hysterectomy in October when I was 37. And I always assumed I was estrogen dominant but now I don’t know???? Any ideas?

  40. I am 63 and had a complete hysterectomy 15 years ago. I am taking .50 estradiol and have definitely put on weight, most all of it in my belly. I exercise daily, eat well and am VERY frustrated. My lab test shows that I am within “normal range” – that being said, I register the very lowest of normal range. In your article you mention growth hormone, would it be helpful and beneficial to take an over the counter HGH? I am currently also taking DIM, which I have found helpful. As I said, I am extremely frustrated by this belly fat. Any advice is very much appreciated. Thank you

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