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The Role of Estrogen in the Body
Estrogen is the main female sex hormone. However, both male and female bodies produce estrogen as well as testosterone and progesterone, and everyone needs a healthy balance of these hormones to maintain good health. Estrogen helps maintain appropriate levels of cholesterol and blood sugar, muscle and bone mass, brain function, immune response, collagen production, and more. While females often experience health concerns related to reduced estrogen, low estrogen levels are less of a concern for males and usually occur alongside low levels of other sex hormones.
Changing Estrogen Levels in Women
In females, estrogen levels increase until early adulthood and rise and fall with the menstrual cycle, peaking just before ovulation. Overall levels begin to fall during perimenopause, the transition period that precedes menopause. During this time, hormone levels can fluctuate dramatically. The duration of this phase is highly variable: for some women, it lasts for just a few months leading up to the end of menstruation, while others might enter perimenopause in their mid 30s and remain there for more than a decade.
During perimenopause, declining estrogen levels can produce symptoms including
- Irregular or skipped periods
- Insomnia
- Mood changes
- Hot flashes
- Vaginal atrophy, resulting in painful intercourse
- Urinary urgency, discomfort, and/or increased urinary tract infections
- Yeast overgrowth, resulting in more frequent yeast infections
Throughout perimenopause, fertility decreases, but it is still possible to become pregnant. In fact, because of hormonal fluctuations, the body is more likely to release more than one egg during ovulation, increasing the odds of twins or multiples. Menopause is defined as the time of life that follows twelve consecutive months without a menstrual period. During this time, estrogen levels drop further, and ovulation no longer occurs. Because estrogen affects fat distribution in the body, many women begin to accumulate fat around the waist after menopause.
Health Risks Associated with Low Estrogen
Because estrogen supports a number of important biological processes, the very low levels of estrogen present in the female body after menopause increase the risk of certain health conditions. Estrogen helps maintain healthy blood vessels and cholesterol levels. As a result, the risk of heart disease and strokeincreases after menopause: before age 55, women have a lower average risk of heart disease than men, but by age 70, the risk is about equal.
Declining estrogen levels are also associated with bone loss, which can lead to osteoporosis. In this condition, bones become more porous and brittle, making them easier to break. After age fifty, roughly half of women and a quarter of men experience broken bones as a result of osteoporosis. In some cases, patients can break bones by just sneezing or coughing.
Adopting healthy habits that increase the strength of your heart and bones can reduce your risk of heart disease and osteoporosis.
- Weight-bearing exercise like walking, jogging, dancing, yoga, or tai chi helps build stronger bones while supporting cardiovascular health.
- Exercise that builds muscle mass will help boost metabolism and help combat visceral fat.
- Eating a primarily plant-based diet that emphasizes whole grains and omega-3 fatty acids supports heart health.
- As always, limiting alcohol intake and avoiding tobacco are important for maintaining a healthy heart.
Addressing Issues Associated with Low Estrogen
Often, doctors prescribe hormone replacement therapy (HRT) to help alleviate troublesome symptoms of low estrogen, such as hot flashes, mood swings, vaginal discomfort, and excessive weight gain. Progesterone is typically prescribed in combination with estrogen. While effective, HRT is associated with health risks including blood clots, stroke, and certain types of cancer. As a result, if you’re considering HRT treatment, it’s important to thoroughly discuss its risks and benefits with your doctor.
There are also ways you can boost estrogen levels naturally. Before seeking HRT, you might try eating foods that contain phytoestrogens (plant-based estrogens) or talk to your doctor about supplements that support higher estrogen levels. Examples of phytoestrogen-containing foods include
- Soybeans, tofu, miso, and other soy-containing foods
- Seeds and nuts, including flax, sesame, sunflower, and almonds
- Vegetables including broccoli, brussels sprouts, kale, spinach, onions, and sprouts
- Grains like barley and oats
- Fruits, including berries, grapes, apples, pears, and plums
Supplements can include vitamins and minerals that help the body effectively produce and use estrogen as well as herbal remedies like black cohosh, red clover, and DHEA.
Screening for Post-Menopausal Health Risks
Low estrogen is simply a fact of life after menopause, and many women continue to enjoy good health for decades following this transition. To increase your odds of counting yourself among them, it’s important to get regular preventive health care, including recommended screening tests.
DEXA Scan
Dual-energy X-ray absorptiometry (DEXA) is a quick and simple screening test recommended for patients who are at risk for osteoporosis. It uses enhanced X-ray technology to measure bone mineral density and can assess the risk of bone fractures. Understanding your risk gives you the opportunity to take preventive measures and pursue treatment for osteoporosis before you break a bone.
Cardiac Calcium Scoring
A CT cardiac calcium test is recommended for patients who are at significant risk of coronary artery disease(CAD). The exam assesses the extent of calcified plaque in the coronary arteries to determine the presence of CAD and risk of associated health issues such as heart attack and stroke. This test can also provide insight into the risk of other serious conditions including COPD, kidney disease, and cancer.
The effects of declining estrogen levels can vary widely from one patient to the next. If you have health concerns, discuss them with your doctor to determine the best path forward. Your physician may recommend lifestyle changes, HRT, and/or screening tests. Iowa Radiology provides state-of-the-art medical imaging, including DEXA and CT cardiac calcium scoring, in a compassionate, patient-centered setting. Learn more about our services, or subscribe to our blog to stay up to date on our latest healthcare articles.
Resources
Cleveland Clinic. Perimenopause. Published February 8, 2022. Accessed July 24, 2023. https://my.clevelandclinic.org/health/diseases/21608-perimenopause.
Jewel T. Risk Factors of Having High or Low Estrogen Levels in Males. Healthline.com. Published March 16, 2023. Accessed July 24, 2023. https://www.healthline.com/health/estrogen-in-men.
North American Menopause Society. The Experts Do Agree About Hormone Therapy. Published May 12, 2016. Accessed July 24, 2023. https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/the-experts-do-agree-about-hormone-therapy.
Office on Women’s Health. Menopause and your health. WomensHealth.gov. Updated December 15, 2022. Accessed July 24, 203. https://www.womenshealth.gov/menopause/menopause-and-your-health.
UCLA Health. 3 ways to increase estrogen naturally. UCLAHealth.org. Published June 2, 2023. Accessed July 24, 2023. https://www.uclahealth.org/news/3-ways-increase-estrogen-naturally.
Villenes Z. Signs perimenopause is ending. MedicalNewsToday.com. Published February 15, 2023. Accessed July 24, 2023. https://www.medicalnewstoday.com/articles/signs-perimenopause-is-ending.
