Estrogenandprogesteroneare the primary reproductive hormones in people assigned female at birth. These hormones drive puberty, menstrual cycles, and pregnancy. They are also present in those assigned male at birth but to a lesser degree. Estrogen and progesterone imbalances can cause menstrual cycle disruptions, mood changes, hot flashes, and infertility. They can also have an impact on hormone receptor-positive (HR-positive or HR+) cancers.
This article reviews the differences between estrogen and progesterone, related conditions, the effects of low and high levels,hormone therapy, and ways to balance hormones naturally.
Vladimir Vladimirov / Getty Images
Biologically, What Do Estrogen and Progesterone Do?
While estrogen and progesterone are the primary sexual, or reproductive, hormones in people assigned female at birth, they also play a role in the male reproductive system. Estrogen influences the development of female reproductive organs and is responsible for sexual characteristic development during puberty, such as breast growth and hip widening.
Estrogen and progesterone are responsible for the following in females:
Types of Estrogen (Estradiol, Estrone, Estriol)
Estrogen encompasses a group of hormones, including:
18 Natural and Medicinal Ways to Balance Hormones
Estrogen’s Role
Estrogen has the following benefits:
In males, estrogen regulates bone density, sperm production, and libido (sex drive). Progesterone aids in producingtestosterone(the primary male reproductive hormone).
Guide to Increasing Estrogen With Fluctuating Hormone Levels
Progesterone’s Role
Progesterone production primarily occurs in thecorpus luteum, a natural, temporary cyst-like structure that develops on an ovary each menstrual cycle. In females, the following are the main functions of progesterone:
How to Increase Progesterone Levels Naturally
Conditions and Effects of Low Estrogen and Progesterone
Low estrogen or progesterone levels (or both) can occur due to menopause, health conditions, excessive exercise or calorie restriction, an unhealthy diet, or medical treatments.
During perimenopause, the time leading up to menopause, estrogen and progesterone levels fluctuate. Levels of both hormones decrease during menopause.
In addition to perimenopause and menopause,hormonal imbalancesmay occur in the following conditions or situations:
Conditions and Effects of High Estrogen and Progesterone
Estrogen dominance is ahormonal imbalancein which there is an excess of estrogen relative to other hormones, such as progesterone. It can occur due to the overproduction of estrogen or a change in how the body processes and excretes estrogen.
Hormone Receptor-Positive/Negative CancersHR-positive cancers have receptors that can bind with estrogen or progesterone (or both), stimulating their growth. Healthcare providers use biopsies (tumor tissue samples) to evaluateHR status, which helps guide treatment.For example, treatment for hormone-positive cancers involves medications that block the production or effects of estrogen or progesterone. But hormone receptor-negative (HR-negative or HR-) cancers would not respond to this treatment and typically require other therapies, such as chemotherapy.
Hormone Receptor-Positive/Negative Cancers
HR-positive cancers have receptors that can bind with estrogen or progesterone (or both), stimulating their growth. Healthcare providers use biopsies (tumor tissue samples) to evaluateHR status, which helps guide treatment.For example, treatment for hormone-positive cancers involves medications that block the production or effects of estrogen or progesterone. But hormone receptor-negative (HR-negative or HR-) cancers would not respond to this treatment and typically require other therapies, such as chemotherapy.
HR-positive cancers have receptors that can bind with estrogen or progesterone (or both), stimulating their growth. Healthcare providers use biopsies (tumor tissue samples) to evaluateHR status, which helps guide treatment.
For example, treatment for hormone-positive cancers involves medications that block the production or effects of estrogen or progesterone. But hormone receptor-negative (HR-negative or HR-) cancers would not respond to this treatment and typically require other therapies, such as chemotherapy.
Estrogen dominancecan lead to the following:
High estrogen in males can cause:
Higher progesterone levels compared to estrogen can cause:
Comparing Estrogen and Progesterone Hormone Therapy
Hormone replacement therapy (HRT)is a medical treatment involving synthetic estrogen, progesterone (progestin), or a combination of both to supplement or replace the body’s natural hormones.
Hormonalbirth controlsuch aspills, patches, shots, intrauterine devices (IUDs), implants, or vaginal rings are similar to HRT in that they use synthetic estrogen or progesterone. However, their purpose is to prevent pregnancy and regulate the menstrual cycle.
Hormonal Birth Control or Hormone Replacement Therapy?Healthcare providers typically prescribe hormonal birth control rather than HRT for those in perimenopause (the time leading up to the cessation of the menstrual cycle known as menopause), as females can still get pregnant during this transition. However, HRT is given to those in menopause because pregnancy prevention is no longer a concern.
Hormonal Birth Control or Hormone Replacement Therapy?
Healthcare providers typically prescribe hormonal birth control rather than HRT for those in perimenopause (the time leading up to the cessation of the menstrual cycle known as menopause), as females can still get pregnant during this transition. However, HRT is given to those in menopause because pregnancy prevention is no longer a concern.
Estrogen Replacement Therapy
Estrogen replacement therapy is effective for relieving menopausal symptoms, but it may increase the risk of uterine cancer when given without progesterone. Providers typically reserve it for menopausal females without a uterus. Adverse effects are higher with systemic (throughout the body) estrogen than local estrogens, such as vaginal estrogen creams.
Progesterone (Progestin) Replacement Therapy
Progesterone (progestin)replacement therapy istypically for females who:
Progestin may also be necessary for those with PCOS or recurrent miscarriages due to low progesterone.
Side effects of progestin may include:
The link between synthetic progesterone (progestin) andweight gainis a topic of debate and ongoing research. Some studies suggest that progestin may cause weight gain, while others have not found a link.
Combined Estrogen And Progesterone
Combined estrogen and progesterone(EPT) may be the best choice for those with a uterus. Progesterone helps counteract estrogen’s possible negative effect on the uterine lining, reducing the risk of endometrial cancer.
Estrogen replacement relieves menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and bone loss. However, taking estrogen alone increases the risk of uterine cancer.
It usually is given as follows:
How a Provider Diagnoses Potential Hormone Imbalances
Symptom tracking may be enough for a healthcare provider to diagnose and treat sexhormone imbalancesin some people. However, others may need diagnostichormone blood testsor imaging tests.
For example, a provider may prescribe hormonal treatment without further testing if you are in your mid to late 40s with perimenopausal symptoms.
But if you are younger, are experiencing infertility, or have had recurrent miscarriages, hormone blood levels and imaging studies provide helpful information.
HRT RisksRegardless of the type of hormone treatment, providers typically recommend the lowest dose possible over a short time to reduce the following risks, as follows:Estrogen only (ET) and combined estrogen and progesterone (EPT) increase the risk of blood clots and strokeEstrogen increases the risk of uterine cancer for those with a uterusCombined HRT slightlyincreases the risk of breast cancerRisks are greater in those over age 60Risks of blood clots and stroke are greater for those who smoke cigarettes
HRT Risks
Regardless of the type of hormone treatment, providers typically recommend the lowest dose possible over a short time to reduce the following risks, as follows:Estrogen only (ET) and combined estrogen and progesterone (EPT) increase the risk of blood clots and strokeEstrogen increases the risk of uterine cancer for those with a uterusCombined HRT slightlyincreases the risk of breast cancerRisks are greater in those over age 60Risks of blood clots and stroke are greater for those who smoke cigarettes
Regardless of the type of hormone treatment, providers typically recommend the lowest dose possible over a short time to reduce the following risks, as follows:
Ways to Balance Estrogen and Progesterone Levels
A healthy lifestyle can help decrease the risk of hormone imbalance. This includes:
Some experts note that ananti-inflammatoryor vegetarian diet helps prevent estrogen dominance. Supplements that may also help decrease the risk of inflammation and balance hormones include:
Estrogen BoostersIf you are low in estrogen, you can include phytoestrogens which arenatural estrogen boostersfound in foods such as:EdamameChickpeasLentilsFlaxseedTofuIf you have HR-positive cancer, check with your healthcare team before consuming large amounts of these foods.
Estrogen Boosters
If you are low in estrogen, you can include phytoestrogens which arenatural estrogen boostersfound in foods such as:EdamameChickpeasLentilsFlaxseedTofuIf you have HR-positive cancer, check with your healthcare team before consuming large amounts of these foods.
If you are low in estrogen, you can include phytoestrogens which arenatural estrogen boostersfound in foods such as:
If you have HR-positive cancer, check with your healthcare team before consuming large amounts of these foods.
Some herbs and supplements such asblack cohosh,evening primrose oil,red clover,maca root, andDong Quaimay help support hormone balance and help relieve perimenopausal and menopausal symptoms.
Summary
Estrogen and progesterone are the primary reproductive hormones that drive puberty, menstrual cycles, the sex drive, pregnancy, and lactation (breastfeeding) in people assigned female at birth. They also play a small role in male reproduction.
Imbalances between these hormones can cause menstrual cycle disruptions, mood changes, infertility, and impact hormone receptor-positive cancers. Hormone replacement therapy HRT and hormonal contraceptives are potential treatments for hormonal imbalances. However, they come with some risks. If you are experiencing symptoms of hormonal imbalance, talk to a healthcare provider for support and treatment options.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Beccuti G, Ghizzoni L.Normal and abnormal puberty. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. MDText.com:2015.Endocrine Society.Reproductive hormones.United States (U.S.) Department of veterans affairs (VA) whole health library.Estrogen dominance.Rochira V, Carani C.Estrogens, male reproduction and beyond. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText:2023.Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText;2018.Barbieri RL, Ehrmann DA.Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics). In: Snyder PJ, Crowley WF, Martin KA, eds.UpToDate. UpToDate;2023.Karia PS, Joshu CE, Visvanathan K.Association of oophorectomy and fat and lean body mass: Evidence from a population-based sample of U.S. women.Cancer Epidemiol Biomarkers Prev. 2021;30(7):1424-1432. doi: 10.1158/1055-9965.EPI-20-1849Wang J, Liu W, Yu D, Yang Z, Li S, Sun X.Research progress on the treatment of premature ovarian failure using mesenchymal stem cells: A literature review.Front Cell Dev Biol. 2021;9:749822. doi:10.3389/fcell.2021.74982Vellanki K, Kramer H.Amenorrhea and estrogen disorders in women with kidney disease. In:Endocrine Disorders in Kidney Disease: Diagnosis and Treatment. Springer;2019:127-38.Ehsani S, Wisinski KB.Genomic testing in the management of early-stage breast cancer.Journal of clinical outcomes management: JCOM. 2017;24(5):229. PMCID: PMC6110393.MedlinePlus.Estrogen receptor, progesterone receptor tests.Contraceptive Technology.Perimenopause.The North American Menopause Society.Hormone therapy: Benefits and risks.Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM.Progestin‐only contraceptives: Effects on weight.The Cochrane Database of Systematic Reviews.2016(8). doi:10.1002/14651858.CD008815.pub4Crandall CJ, Mehta JM, Manson JE.Management of menopausal symptoms: A review.JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.MedlinePlus.Hormone replacement therapy.Chopra S., Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: A practical guide for gynecologists.Journal of Mid-Life Health. 2019;10(4):165-172. doi:10.4103/jmh.JMH_155_19Santen RJ, Loprinzi CL. Patient education:Non-estrogen treatments for menopausal symptoms (Beyond the Basics). In: Snyder PJ, Crowley WF, and Martin KA, eds.UpToDate. UpToDate;2023.da Silva Leitão Peres N , Cabrera Parra Bortoluzzi L , Medeiros Marques LL, et al.,Medicinal effects of Peruvian maca (Lepidium meyenii): A review.Food Funct. 2020;11(1):83-92. doi: 10.1039/c9fo02732gKargozar R, Azizi H, Salari R.A review of effective herbal medicines in controlling menopausal symptoms.Electronic Physician. 2017;9(11):5826-5833. doi:10.19082/5826Drugs and Lactation Database (LactMed®).Dong Quai. Bethesda (MD): National Institute of Child Health and Human Development; 2021.Additional ReadingEndocrine Society.Reproductive hormones.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Beccuti G, Ghizzoni L.Normal and abnormal puberty. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. MDText.com:2015.Endocrine Society.Reproductive hormones.United States (U.S.) Department of veterans affairs (VA) whole health library.Estrogen dominance.Rochira V, Carani C.Estrogens, male reproduction and beyond. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText:2023.Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText;2018.Barbieri RL, Ehrmann DA.Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics). In: Snyder PJ, Crowley WF, Martin KA, eds.UpToDate. UpToDate;2023.Karia PS, Joshu CE, Visvanathan K.Association of oophorectomy and fat and lean body mass: Evidence from a population-based sample of U.S. women.Cancer Epidemiol Biomarkers Prev. 2021;30(7):1424-1432. doi: 10.1158/1055-9965.EPI-20-1849Wang J, Liu W, Yu D, Yang Z, Li S, Sun X.Research progress on the treatment of premature ovarian failure using mesenchymal stem cells: A literature review.Front Cell Dev Biol. 2021;9:749822. doi:10.3389/fcell.2021.74982Vellanki K, Kramer H.Amenorrhea and estrogen disorders in women with kidney disease. In:Endocrine Disorders in Kidney Disease: Diagnosis and Treatment. Springer;2019:127-38.Ehsani S, Wisinski KB.Genomic testing in the management of early-stage breast cancer.Journal of clinical outcomes management: JCOM. 2017;24(5):229. PMCID: PMC6110393.MedlinePlus.Estrogen receptor, progesterone receptor tests.Contraceptive Technology.Perimenopause.The North American Menopause Society.Hormone therapy: Benefits and risks.Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM.Progestin‐only contraceptives: Effects on weight.The Cochrane Database of Systematic Reviews.2016(8). doi:10.1002/14651858.CD008815.pub4Crandall CJ, Mehta JM, Manson JE.Management of menopausal symptoms: A review.JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.MedlinePlus.Hormone replacement therapy.Chopra S., Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: A practical guide for gynecologists.Journal of Mid-Life Health. 2019;10(4):165-172. doi:10.4103/jmh.JMH_155_19Santen RJ, Loprinzi CL. Patient education:Non-estrogen treatments for menopausal symptoms (Beyond the Basics). In: Snyder PJ, Crowley WF, and Martin KA, eds.UpToDate. UpToDate;2023.da Silva Leitão Peres N , Cabrera Parra Bortoluzzi L , Medeiros Marques LL, et al.,Medicinal effects of Peruvian maca (Lepidium meyenii): A review.Food Funct. 2020;11(1):83-92. doi: 10.1039/c9fo02732gKargozar R, Azizi H, Salari R.A review of effective herbal medicines in controlling menopausal symptoms.Electronic Physician. 2017;9(11):5826-5833. doi:10.19082/5826Drugs and Lactation Database (LactMed®).Dong Quai. Bethesda (MD): National Institute of Child Health and Human Development; 2021.Additional ReadingEndocrine Society.Reproductive hormones.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Beccuti G, Ghizzoni L.Normal and abnormal puberty. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. MDText.com:2015.Endocrine Society.Reproductive hormones.United States (U.S.) Department of veterans affairs (VA) whole health library.Estrogen dominance.Rochira V, Carani C.Estrogens, male reproduction and beyond. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText:2023.Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText;2018.Barbieri RL, Ehrmann DA.Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics). In: Snyder PJ, Crowley WF, Martin KA, eds.UpToDate. UpToDate;2023.Karia PS, Joshu CE, Visvanathan K.Association of oophorectomy and fat and lean body mass: Evidence from a population-based sample of U.S. women.Cancer Epidemiol Biomarkers Prev. 2021;30(7):1424-1432. doi: 10.1158/1055-9965.EPI-20-1849Wang J, Liu W, Yu D, Yang Z, Li S, Sun X.Research progress on the treatment of premature ovarian failure using mesenchymal stem cells: A literature review.Front Cell Dev Biol. 2021;9:749822. doi:10.3389/fcell.2021.74982Vellanki K, Kramer H.Amenorrhea and estrogen disorders in women with kidney disease. In:Endocrine Disorders in Kidney Disease: Diagnosis and Treatment. Springer;2019:127-38.Ehsani S, Wisinski KB.Genomic testing in the management of early-stage breast cancer.Journal of clinical outcomes management: JCOM. 2017;24(5):229. PMCID: PMC6110393.MedlinePlus.Estrogen receptor, progesterone receptor tests.Contraceptive Technology.Perimenopause.The North American Menopause Society.Hormone therapy: Benefits and risks.Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM.Progestin‐only contraceptives: Effects on weight.The Cochrane Database of Systematic Reviews.2016(8). doi:10.1002/14651858.CD008815.pub4Crandall CJ, Mehta JM, Manson JE.Management of menopausal symptoms: A review.JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.MedlinePlus.Hormone replacement therapy.Chopra S., Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: A practical guide for gynecologists.Journal of Mid-Life Health. 2019;10(4):165-172. doi:10.4103/jmh.JMH_155_19Santen RJ, Loprinzi CL. Patient education:Non-estrogen treatments for menopausal symptoms (Beyond the Basics). In: Snyder PJ, Crowley WF, and Martin KA, eds.UpToDate. UpToDate;2023.da Silva Leitão Peres N , Cabrera Parra Bortoluzzi L , Medeiros Marques LL, et al.,Medicinal effects of Peruvian maca (Lepidium meyenii): A review.Food Funct. 2020;11(1):83-92. doi: 10.1039/c9fo02732gKargozar R, Azizi H, Salari R.A review of effective herbal medicines in controlling menopausal symptoms.Electronic Physician. 2017;9(11):5826-5833. doi:10.19082/5826Drugs and Lactation Database (LactMed®).Dong Quai. Bethesda (MD): National Institute of Child Health and Human Development; 2021.
Beccuti G, Ghizzoni L.Normal and abnormal puberty. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. MDText.com:2015.
Endocrine Society.Reproductive hormones.
United States (U.S.) Department of veterans affairs (VA) whole health library.Estrogen dominance.
Rochira V, Carani C.Estrogens, male reproduction and beyond. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText:2023.
Reed BG, Carr BR.The normal menstrual cycle and the control of ovulation. In: Feingold KR, Anawalt B, Blackman MR, et al., eds.Endotext. MDText;2018.
Barbieri RL, Ehrmann DA.Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics). In: Snyder PJ, Crowley WF, Martin KA, eds.UpToDate. UpToDate;2023.
Karia PS, Joshu CE, Visvanathan K.Association of oophorectomy and fat and lean body mass: Evidence from a population-based sample of U.S. women.Cancer Epidemiol Biomarkers Prev. 2021;30(7):1424-1432. doi: 10.1158/1055-9965.EPI-20-1849
Wang J, Liu W, Yu D, Yang Z, Li S, Sun X.Research progress on the treatment of premature ovarian failure using mesenchymal stem cells: A literature review.Front Cell Dev Biol. 2021;9:749822. doi:10.3389/fcell.2021.74982
Vellanki K, Kramer H.Amenorrhea and estrogen disorders in women with kidney disease. In:Endocrine Disorders in Kidney Disease: Diagnosis and Treatment. Springer;2019:127-38.
Ehsani S, Wisinski KB.Genomic testing in the management of early-stage breast cancer.Journal of clinical outcomes management: JCOM. 2017;24(5):229. PMCID: PMC6110393.
MedlinePlus.Estrogen receptor, progesterone receptor tests.
Contraceptive Technology.Perimenopause.
The North American Menopause Society.Hormone therapy: Benefits and risks.
Lopez LM, Ramesh S, Chen M, Edelman A, Otterness C, Trussell J, Helmerhorst FM.Progestin‐only contraceptives: Effects on weight.The Cochrane Database of Systematic Reviews.2016(8). doi:10.1002/14651858.CD008815.pub4
Crandall CJ, Mehta JM, Manson JE.Management of menopausal symptoms: A review.JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140
Coddington CC, Cohen R.Chapter 6: Pregnancy loss and spontaneous abortion. In: DeFranco E, Evans AT, eds.Manual of Obstetrics. Wolters Kluwer Health; 2020:105-117.
MedlinePlus.Hormone replacement therapy.
Chopra S., Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: A practical guide for gynecologists.Journal of Mid-Life Health. 2019;10(4):165-172. doi:10.4103/jmh.JMH_155_19
Santen RJ, Loprinzi CL. Patient education:Non-estrogen treatments for menopausal symptoms (Beyond the Basics). In: Snyder PJ, Crowley WF, and Martin KA, eds.UpToDate. UpToDate;2023.
da Silva Leitão Peres N , Cabrera Parra Bortoluzzi L , Medeiros Marques LL, et al.,Medicinal effects of Peruvian maca (Lepidium meyenii): A review.Food Funct. 2020;11(1):83-92. doi: 10.1039/c9fo02732g
Kargozar R, Azizi H, Salari R.A review of effective herbal medicines in controlling menopausal symptoms.Electronic Physician. 2017;9(11):5826-5833. doi:10.19082/5826
Drugs and Lactation Database (LactMed®).Dong Quai. Bethesda (MD): National Institute of Child Health and Human Development; 2021.
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