Estrogen 101

Written by Dr. Nirvana

February 1, 2023

Hormones and nutrients work together to create balance in the body.  One cannot exist without the other. Micronutrients regulate, synthesize and detoxify hormones. Like nutrients, hormones work in balance and affect each other profoundly. In this article I want to discuss the basics of estrogens. By understanding these principles, we can learn more about their significance in our health.

Estrogen actually exists in three main forms, some of which are helpful and some of which are quite harmful.  Considered the primary female sex hormone, estradiol (E2) is one of the three major circulating hormones known collectively as estrogens – estrone (E1) and estriol (E3) being the other two.  Estradiol is by far the most active of the three estrogens.  It is 10 times stronger than estrone and 80 times stronger than estriol, meaning it has a strong affinity for estrogen receptors in tissue around the body and thus exerts a potent biological and clinical effects.

In women, estradiol is manufactured primarily in the ovaries before menopause and in the adrenal glands after menopause.  In men, small amounts of E2 are produced in the testes. An enzyme called aromatase can also convert testosterone into estradiol in both men and women.  Since this enzyme is found primarily in adipose tissue (fat cells), overweight women and men may have excess estradiol relative to other hormones like testosterone.

Estrogens are considered heart protective because they increase good cholesterol (high density lipoprotein, or HDL), improve smooth muscle tone in blood vessels and promote vasodilation, which expands arteries to allow healthy blood flow throughout the circulatory system.  Estradiol prevents bone loss, thus lowering risk of osteoporosis, and improves collagen formation which results in younger looking skin.  Estradiol also prevents loss of cognitive function as we age and increases the immune response.  However, estrogen also exerts a strong proliferative (overgrowth of tissue) effect on hormone sensitive tissue such as the breast, ovary and uterus. Excess estrogen, especially when progesterone is relatively low, can increase risk of breast, ovarian and uterine cancer as well as conditions associated with tissue proliferation that may not be cancerous such as uterine fibroids, fibrocystic breast disease, or breast tenderness that occurs during periods.   In men, estrogen plays a role in maintaining healthy sperm.

Low levels of estrogen can cause thinning skin, vaginal dryness, urinary tract infections or brain fog.  Excess estrogen manifests clinically as premenstrual related symptoms such as breast tenderness, endometriosis, weight gain, acne or depression or menopause related symptoms such as hot flashes and memory loss.  When not balanced by appropriate levels of progesterone, normal levels of estrogen can manifest clinically as excess estrogen, and this condition is often referred to as estrogen dominance.  Unopposed estrogens are exogenous estrogens that are not balanced (not opposed) with appropriate levels of progesterone, which selectively balances estrogen’s biological activity.  High estrogen levels may also indicate a need to improve estrogen detoxification, which is critical to reducing breast cancer risk.  High levels may also indicate insulin resistance since insulin causes the ovaries to decrease SHBG, which then allows more estrogens into circulation.

estrogen importance

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