Estrogen Part 1

Today we are going to talk about estrogen. Part 1…

Hormone receptors are on every cell in our body. Sex hormone and thyroid hormone receptors are present in every body system. 17 beta estradiol is the most potent estrogen in circulation and this is what we want to replace. As mentioned in an earlier blog post, the Women’s Health Initiative study in the 1990s showed a link between estrogen and blood clots. However, the study used conjugated equine estrogen instead of estradiol and the route was oral. All studies to date show no harm of estradiol non-oral in contrast to conjugated equine estrogen and synthetic progestin.

When we think about estrogen there is so much more to it than hot flashes. Estrogen is involved in sexual health, heart disease, bone density, cancer, chronic pain, brain health, Alzheimer’s, mood, memory.

Estrogen has anti inflammatory properties making higher levels of estrogen stroke and heart attack preventive. This property also helps with chronic pain and Alzheimer’s disease prevention.

Osteoblasts, osteocytes, and osteoclasts are responsible for breaking down and building our bones. Estrogen, along with testosterone, are crucial in osteoporosis prevention. There are estrogen and testosterone receptors all over osteoblasts and osteoclasts. Suppression of estradiol results in bone loss. The key is long term hormone use to protect against osteoporosis and fractures. Studies show that hormone therapy use of less than five years does not have long term bone protection. In the Raisz study, results showed that women treated with estradiol and testosterone therapy combined showed significant increases in serum bone formation markers as opposed to estrogen alone. A two-year study of estradiol pellets showed a marked increase in bone density with no adverse effects of clotting and blood pressure was unaffected.

Estradiol and testosterone are neuroprotective. Women are 8 times more likely to develop Alzheimer’s disease than men and women with lower estradiol levels are at an even greater risk. Evidence shows that both estrogen and testosterone decrease cell death and beta-amyloid deposition. Compared to non-users, women who are on estrogen therapy 15 years showed increase cerebral flow and decreased rates of dementia. Brain imaging studies demonstrate that middle-aged women exhibit increased indicators of Alzheimer’s Disease as compared to men of the same age starting at perimenopause. Not only does estrogen protect against cell death but it also stimulates the birth of new neurons. One study showed estrogen persevered spatial memory, prevents axonal damage, and has long lasting effects on neuronal survival, learning, and memory.

The menopause and post menopause transition are accompanied by a wide range of emotional, cognitive, and physical symptoms that can affect quality of life and brain health. One pilot study concluded that personalized menopausal hormone therapy led to improvements in cognitive clarity, emotional well-being, and social connectedness. The study further concluded that hormone therapy may serve as a whole-person intervention integrating neuroendocrine, cognitive, and emotional domains.

There are complex interactions between estradiol, testosterone, and progesterone in the brain. The key is to replace all hormones. The three main reasons for stopping hormone therapy are resolution of menopausal symptoms, media hype, and fear of adverse effects. With these blog posts we are hoping to start to eliminate that fear and highlight the benefits of hormone replacement therapy.

In part 2 of our blog post on estrogen, we will focus on estrogens effect on inflammation, heart disease and stroke, pain, breast cancer, and the effects of blocking estrogen in men.

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Thank you for reading and I hope you have a wonderful day,

-Dan and Janae with Maple Leaf Health and Wellness