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Ovarian failure, also known as primary ovarian insufficiency (POI), occurs when the ovaries stop functioning normally before age 40. It is caused by decreased production of estradiol and other hormones due to premature loss of ovarian follicles. The Estradiol blood test is the most important test for diagnosis because it directly measures the primary hormone produced by the ovaries.
Ovarian failure is caused by premature depletion of ovarian follicles, which are the structures in the ovaries that contain eggs and produce hormones like estradiol. This depletion can result from genetic conditions like Turner syndrome or Fragile X syndrome, autoimmune disorders where the body attacks ovarian tissue, chemotherapy or radiation therapy, surgical removal of ovaries, or unknown factors in many cases. When the follicles are depleted or damaged, the ovaries can no longer produce adequate levels of estradiol and other reproductive hormones, leading to irregular periods, infertility, and early menopause symptoms before age 40.
The Estradiol blood test is the most important test for ovarian failure because it directly measures the primary hormone produced by the ovaries. When ovarian function declines, estradiol levels drop significantly, which explains symptoms like missed periods, hot flashes, and infertility. Low estradiol levels combined with elevated FSH (follicle-stimulating hormone) levels confirm the diagnosis. The Estradiol test is essential because it provides clear evidence of reduced ovarian hormone production and helps distinguish ovarian failure from other causes of irregular periods. Your doctor may also order additional hormone tests including FSH and LH to get a complete picture of ovarian function.
You should get tested if you are under 40 years old and experience irregular or missed periods for three or more months, have difficulty getting pregnant despite regular unprotected intercourse, notice hot flashes or night sweats similar to menopause symptoms, experience vaginal dryness or decreased sex drive, or have a family history of early menopause or ovarian failure. Getting tested early is important because early diagnosis allows for timely treatment to manage symptoms, protect bone health, and preserve fertility options. If you have received chemotherapy or radiation, have an autoimmune condition, or carry genetic risk factors like Fragile X premutation, you should get tested even before symptoms appear.
What this means
Your estradiol levels are below the optimal range, which may explain symptoms like irregular periods, low energy, or difficulty with fertility. Low estradiol can affect your menstrual cycle, bone health, and overall hormonal balance, and may benefit from further evaluation.
Recommended actions
Maintain a healthy body weight through balanced nutrition, as being underweight can lower estrogen
Include healthy fats from avocados, nuts, seeds, and fatty fish to support hormone production
Manage stress levels with relaxation techniques like yoga or meditation
Consider retesting in 6-8 weeks, ideally on day 3 of your menstrual cycle if applicable
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