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How to Increase Estrogen Naturally (and When to Consider HRT)

Written by Dr. Michael Ruscio, DC on December 6, 2024

Written by Dr. Michael Ruscio, DC on December 6, 2024 — Reviewed by Dr. Hannah Hamlin

• Low Estrogen: When to Act|
• 7 Helpful Herbals|
• Other Supplements|
• Diet|
• Lifestyle Treatment|
• What About HRT?|

If you’re tired of battling hot flashes, sleepless nights, and emotional ups and downs caused by low estrogen, you’re not alone—and relief is within reach.

Estrogen, a vital sex hormone, supports reproductive health, regulates the menstrual cycle, and helps maintain bone density. Cyclically produced each month throughout the fertile years, estrogen levels naturally decline as menopause approaches.

Absent or irregular periods, hot flashes, disrupted sleep, night sweats, and low mood are some of the most common signs of low estrogen. These symptoms most commonly affect women during menopause and the period leading up to it (known as the perimenopausal stage of life). But women of any age can have low estrogen levels, contributing to symptoms that include 1 2:

• Tender breasts
• Weak or brittle bones
• Poor concentration and brain fog
• Menstrual migraines
• Reduced sex drive
• Dryness and thinning of the vagina
• Fatigue and insomnia

Learn how to increase estrogen levels using natural treatments in this guide. We’ll also share when and why hormone replacement therapy (HRT) might be more helpful.

Low Estrogen: Causes and When to Take Action

Estrogen levels drop as the ovaries become less active. This is a normal change as women get older—not a medical condition 2 3.  

For younger women, however, low estrogen levels can signal a health issue. Common causes of low estrogen for women in their teens, twenties, and thirties include 4:

• Over-exercising or low body weight
• Surgical removal of the ovaries
• Certain medical treatments, such as cancer treatments that damage the ovaries

A sure sign that your estrogen levels have fallen too low as a younger woman is if your periods stop entirely. In this case, it’s crucial to seek medical advice rather than attempting to resolve the issue through diet and supplements alone.

For more mature women, however, herbal and natural treatments can provide helpful relief for the symptoms of low estrogen while transitioning into menopause.

Natural remedies can also help women of all ages if estrogen gets out of sync with its opposing hormone, progesterone. Such an imbalance often creates a relative excess of estrogen—so-called estrogen dominance 5—but can cause a relative deficiency of the hormone, too 6.

Outlined below are the natural treatments we’ve found most helpful at the clinic to improve estrogen levels. They split broadly into herbals, other supplements, diet and nutrition, and lifestyle therapies.

Each treatment has been selected for its research backing or consistent effectiveness with clients. 

Many of these therapies don’t exclusively raise estrogen; instead, they help create a more harmonious hormone environment overall, making them beneficial across various types of hormonal imbalance.

7 Herbal Supplements for Low Estrogen

Herbs are some of the most effective remedies for influencing hormones. Here are seven herbal supplements that can increase estrogen levels while balancing hormone levels more generally.

1. Ashwagandha 

Ashwagandha is one of a range of adaptogenic herbs widely used in Indian Ayurvedic medicine to bring the body back into balance.

Ashwagandha has been associated with a statistically significant increase in the form of estrogen called estradiol in the blood serum of postmenopausal women 7. Those taking the herb also had reduced menopausal symptoms,  including psychological symptoms like anxiety.

Suggested dose: 300 mg ashwagandha root extract twice daily is a typical dose—check with your doctor to learn what’s best for your needs.

2. Vitex Agnus-Castus (Chasteberry)

This popular herb can be as effective as low-dose estrogen for normalizing the menstrual cycle and rebalancing hormones in women with polycystic ovary syndrome (PCOS) 8.

Menopausal women who take Vitex Agnus-Castus also tend to have reduced symptoms overall, including anxiety 9.

Suggested dose: The typical dosage in studies is 20–40 mg/day for 3 months 10.

3. Fenugreek 

In menopausal women, fenugreek greatly increased estrogen and reduced hot flashes, eliminating them entirely in some cases 11. 

For menstruating women, fenugreek can increase estradiol and testosterone levels while boosting sexual desire and arousal 12.

Suggested dose: Studies have used 1,000 mg/day for postmenopausal women or 600 mg/day for menstruating women. 

4. Licorice

Licorice had a similar effect to hormone replacement therapy (HRT) on the frequency and duration of hot flashes in one study 13. That said, the severity of flashes wasn’t reduced as much by licorice as it was by HRT. 

Licorice is the main ingredient in Estro-Harmony and Progest-Harmony products—check with your doctor to see if one of these is right for you.

Suggested dose: The study used 1 g/day. 

5. Hops

Hops extract can effectively reduce menopausal symptoms like anxiety, depression, sexual dysfunction, and hot flashes 14. 

In postmenopausal women, a hops-based gel applied topically to the vagina was as effective as an estrogen gel in improving sexual desire, arousal, and vaginal dryness 15.

Suggested dose: 100 mcg hops extract. Check with your doctor before topical application.

6. Black Cohosh 

Black cohosh can help relieve menopausal symptoms like mood swings and hot flashes 16 17. It can also improve hormone balance and the chance of getting pregnant in women with PCOS 18.

Suggested dose: Studies used 40–120 mg/day. Check with your doctor.

7. Combination Herbals

Combination therapy using a blend of herbal ingredients may be more effective for raising or balancing estrogen levels than individual herbs 19. You may also be able to use slightly lower doses of herbs when you combine them. This certainly matches our clinical experience.

One herbal combination product we use a lot with our female clients struggling with low estrogen levels is Estro-Harmony, which contains some of the herbs listed above.

If the issue is more about rebalancing hormone levels, especially in pre-menopausal women, Progest-Harmony is the formula we are more likely to use.

Suggested dose: As recommended on the label or by your doctor.

Other Helpful Supplements

Certain dietary supplements can support hormonal health—there’s an at-a-glance roundup in the table below. 

Although these supplements don’t directly boost estrogen in the same way as specific herbs, they support the underlying hormonal environment, making it easier to restore balance and ease hormonal symptoms.

Your Diet Can Support Estrogen Levels

Research has suggested that a Mediterranean-style diet helps improve ovarian function, which can result in a more finely tuned balance of estrogen and progesterone 29. 

Fresh, unprocessed foods, particularly antioxidant-rich berries, nuts, colorful veggies, and greens, dampen inflammation and are what make the Mediterranean diet so healthy. 

These foods are also at the heart of a balanced Paleo diet. Many of our female patients find the Paleo way of eating particularly helpful for promoting good hormonal balance.

Both Mediterranean and Paleo diets also have the added benefit of being good at controlling blood sugar and insulin levels, which is a key strategy in dealing with unbalanced hormone conditions such as PCOS 30.

Some specific foods that are worth including in any healthy hormone-balancing diet are:

Omega-3-rich Oily Fish

Omega-3 fats support hormone production and reduce inflammation. They have also been linked to improvements in women with premenstrual syndrome and PCOS 31 32.

Here’s what to eat:

• Salmon, sardines, and mackerel are rich in omega-3s.
• Walnuts and chia seeds are plant-based alternative sources of omega-3s for those on plant-based diets 6.

Phytoestrogen-rich Foods

Phytoestrogens are natural compounds in plant foods that can mildly boost estrogen when levels are low. Supplements, such as those containing red clover extract, provide a more consistent and concentrated source of isoflavones (a type of phytoestrogen), but dietary sources are valuable too 33 34 35 36.

Foods high in phytoestrogens include: 

• Soybeans and soy products like tofu, tempeh, soymilk, and edamame provide a class of phytoestrogens called isoflavones that may help ease low-estrogen symptoms. 
• Flaxseed and sesame seeds are rich in lignans, another phytoestrogen type. Adding these seeds to smoothies or salads is a simple way to incorporate them into your diet.

Prunes

Prunes (dried plums) were found to benefit bone health in postmenopausal women who have low estrogen levels:

• Eating five to six prunes daily effectively reduced bone loss in one randomized controlled trial, perhaps as a result of the phenols in the fruit limiting bone breakdown 37.

How to Increase Estrogen With Lifestyle Therapies

Certain lifestyle habits can positively impact estrogen balance and reduce low estrogen symptoms. 

Exercise

Exercise can increase muscle and have a beneficial effect on postmenopausal females with osteoporosis 38. 

Twelve weeks of an aerobic and strength program based on official exercise guidelines also improved estradiol levels in one study 39.  

The Physical Activity Guidelines for Americans equate to 40:

• 30 minutes minimum of moderate-intensity aerobic activity (e.g., brisk walking or rapid cycling), five days a week OR 25 minutes minimum of vigorous-intensity aerobic activity (like running), three days a week.
• PLUS 2 sessions weekly of muscle-strengthening activities such as lifting weights, pushups, and squats.

In general, the more exercise you can do the better. But excessive workouts can harm your body, so strike a balance between exercise and recovery.

Mindfulness and Other Stress-Busting Therapies

Research hasn’t established a direct link between stress and low estrogen levels, but many of our female clients notice fewer hormonal symptoms and an improved hormonal balance when they manage stress effectively.

A recent meta-analysis found that stress-management techniques—such as mindfulness, cognitive behavioral therapy, and physical activity—significantly improved sleep quality in peri-menopausal and menopausal women 41.

In turn, better sleep may support sex hormone balance.

Acupuncture

Acupuncture is another therapy that might be of use for low estrogen levels.

A 2020 systematic review and meta-analysis looked at how effective acupuncture was at treating premature ovarian failure (early menopause). The review concluded that 42:

• Acupuncture was as effective as HRT at improving menopausal symptoms.
• Acupuncture and acupoint embedding both improved estrogen (estradiol) levels.

Acupuncture is another useful strategy for easing the sleep difficulties that plague so many menopausal women 43.

Is Hormone Therapy a Better Choice for You?

While doing things naturally is a good goal, hormone replacement therapy (HRT) is a more powerful treatment if natural treatments don’t work effectively enough for low estrogen symptoms. 

HRT replaces estrogen and progesterone in the body to help relieve symptoms of menopause. 

FDA-approved HRT is available by prescription and includes bioidentical hormones with the same chemical structure the body produces itself. 

It’s important that you discuss the pros and cons of hormone therapy for menopause with your healthcare provider. However, these pointers may help: 

• Beyond the alleviation of hot flashes and symptoms like anxiety, HRT has wider health benefits that include:
  • Decreased risks of bone fracture, diabetes, and esophageal, gastric, and colorectal cancers 44 45 46 47 48
  • Possible reduced risk of heart disease and death in women under 60 or who went through the menopausal transition less than 10 years ago 48
• The downsides include a slightly increased risk of breast cancer and blood clots 48 49 50 51.
• Estrogen creams are generally safer (less likely to cause clots) than estrogen swallowed in tablet form. Bioidentical progesterone taken alongside estrogen protects the wall of the womb from estrogen-related thickening 52. 

Overall, the negative side effects of HRT may likely be overhyped and the treatment appears not to significantly raise health risks if used for no more than five to 10 years 52.

What About DHEA?

DHEA is a hormone produced by the body’s adrenal glands, which is available as a supplement (no prescription needed). Research shows that it increases estradiol in women over 60 who take it at a dosage of 50 mg per day for at least six months 53.

Generally, DHEA supplements have been safely used in studies for up to two years without severe side effects 54 55. 

However, DHEA can have potent effects and is not regulated by the FDA like HRT. So I’d strongly advise discussing usage with a clinician well-versed in using this supplement before getting started.

Low Levels of Estrogen Can Be Improved

With the right diet and supplements, figuring out how to increase estrogen becomes an easier puzzle to solve. A combination of herbs can be particularly useful for gently shoring up estrogen levels at menopause or for balancing out an estrogen deficiency at any time of life.

Acupuncture is something else to consider, or if more help is needed, hormone replacement therapy is worthy of consideration—under the right circumstances, it can be safe and very effective.

For more individualized support around hormonal health, you can request a consultation at the Ruscio Institute for Functional Medicine.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, including the hormone-balancers Estro-Harmony and Progest-Harmony, please click on the relevant links. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.