Can birth control pills with estrogen (ethinyl estradiol) and a progestin help increase low estrogen levels?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: October 31, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Birth Control Pills Can Help Increase Low Estrogen Levels

Yes, birth control pills containing ethinyl estradiol and a progestin can effectively increase low estrogen levels in women who need supplementation. 1

Mechanism of Action

  • Combined oral contraceptives (COCs) containing ethinyl estradiol provide exogenous estrogen that can supplement low endogenous levels 1
  • The ethinyl estradiol component in birth control pills is rapidly and almost completely absorbed, with bioavailability of approximately 93-99% 1
  • COCs also induce sex hormone-binding globulin (SHBG) synthesis, which affects the balance of free hormones in circulation 1

Estrogen Content in Birth Control Pills

  • Standard "low dose" pills contain 30-35 μg of ethinyl estradiol, which is typically sufficient to address symptoms of low estrogen 2
  • Modern formulations may contain as little as 20 μg of ethinyl estradiol, which still provides significant estrogenic effects 3
  • Newer options include pills with natural estrogens (estradiol valerate, estetrol) that may have different metabolic profiles than synthetic ethinyl estradiol 4, 5

Selecting the Right Formulation

  • For women specifically seeking to increase estrogen levels, formulations with higher ethinyl estradiol content (30-35 μg) would be more effective than ultra-low dose options 2, 6
  • The progestin component should also be considered, as some newer progestins like drospirenone have additional benefits such as anti-androgenic and anti-mineralocorticoid effects 7, 8
  • Formulations containing natural estradiol may have a milder impact on the body compared to synthetic ethinyl estradiol 9

Special Considerations

Medical Conditions That Affect Choice

  • Women with antiphospholipid antibodies should avoid estrogen-containing contraceptives due to increased thrombosis risk 2
  • Women with SLE (especially with moderate to severe disease activity) should use progestin-only or IUD contraceptives rather than combined estrogen-progestin formulations 2
  • Women with hereditary angioedema may experience worsening of symptoms with estrogen-containing contraceptives 2

Potential Benefits Beyond Estrogen Supplementation

  • COCs provide reliable contraception with typical-use failure rates of 9% in adults 2
  • They can help regulate menstrual cycles and reduce menstrual bleeding 6
  • Certain formulations may improve androgen-related disorders such as acne and hirsutism 7

Potential Risks and Side Effects

  • Estrogen-containing contraceptives may increase blood pressure in some users 4
  • The risk of venous thromboembolism is increased with estrogen-containing contraceptives 2
  • Women with polycystic liver disease should be cautious with estrogen-containing contraceptives as they may aggravate the condition 2

Monitoring and Follow-up

  • Blood pressure should be assessed before initiating any estrogen-containing contraceptive 4
  • Women with risk factors for cardiovascular disease should be monitored more closely 2
  • Breakthrough bleeding may occur, especially with lower estrogen doses, and may lead to discontinuation 3

Birth control pills represent an effective option for women with low estrogen levels, providing both symptomatic relief and contraceptive benefits. The choice of specific formulation should be based on the individual's estrogen needs, medical history, and risk factors.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Oral Contraceptive Pills and Thyroid Function

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Estradiol valerate and dienogest: a new approach to oral contraception.

International journal of women's health, 2011

Research

Evolution of progestins. Focus on the novel progestin drospirenone.

The Journal of reproductive medicine, 2002

Research

Safety and efficacy of a new oral contraceptive containing drospirenone.

The Journal of reproductive medicine, 2002

Guideline

Estrogen Content Comparison in Contraceptives

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.