The Importance of Estrogen      

I am smitten with estrogen, and it pains me terribly to see it constantly vilified. Big pharma has, for a long time, blamed the hormone for causing breast cancer and dementia. Birth control pills, which in fact contain NO estrogen at all, are marketed as containing the lowest dose, as if introducing even the smallest quantity into your body would result in disaster. So why does this amazing hormone get such bad press?

Well, for me, it started with the well meaning but poorly interpreted Women’s Health Initiative (WHI). The study, designed well over two decades ago, looked at the effects of a pseudo-hormonal product called Premarin on primarily post-menopausal women. If you’re wondering where estrogen comes into this, you only have to look at the drug’s name, which is short for PREgnant MARes’ urINe. It sounds like a medieval doctor’s cure, rather than the product of scientific endeavor! It came as no surprise to me to read that the estrogen component, taken orally, led to adverse effects. Women simply did not evolve to eat their estrogen – or, for that matter, its equine derivative.

But this isn’t a bashing of the WHI – this is a celebration of the source of life itself, the amazing hormone, estrogen! Human estrogen did not feature in the WHI. Estrogen is a small family of hormones, the dominant one being estradiol, which is synthesized by the ovaries throughout her reproductive life. Estradiol is the master hormone of love, life, and health, and someone must come to its defense – so it’s time I stepped up to the plate.

We all know estrogen has a prominent role in the reproductive functions of women. Together with its sidekick progesterone, they create the beautiful symphony of hormones responsible for the female menstrual cycle, so vital to conception. What is not widely known is that there is a “secret” life of estrogen, with many incredible roles throughout the body, making estrogen the unsung hero of female wellbeing.

The reasoning behind thinking of estrogen as a reproductive-only hormone is accurate, but the ability to have a menstrual cycle, ovulate, and get pregnant is not enough for the species to survive long term. To successfully carry the pregnancy to term, safely deliver the baby, and then feed, nurture, and raise the offspring is mandatory for the ultimate success of humanity. For all of that to occur, healthy mothers are a necessity – and that’s where the wonderful, life-giving effects of estrogen really come into their own. Far from being merely a reproductive hormone, estrogen plays a vital role in coordinating metabolism, cardiovascular system, GI tract, kidneys, and immune system.

It’s the loss of the beautiful hormonal symphony of estrogen and progesterone, the inborn dance of the hormones, which spells the end of optimal wellbeing of women, not its presence. This brings a host of challenges. As I have pointed out, estrogen and progesterone have effects throughout the body, and the loss of estrogen – in other words, menopause – results in a great diversity of symptoms including joint pains, anxiety and depression, insomnia, and weight gain. The metabolic effects of estrogen loss can also manifest with a high rate of hypertension, elevated cholesterol and triglycerides, osteoporosis, and an elevated incidence of breast and colon cancers, as well as high rates of obesity and diabetes. We cannot underestimate the importance of this wonderful hormone.

Armed with the new, comprehensive understanding of estrogen gained in the years since the WHI report, we must now make decisions about this situation. As nature has no great plans for women post-menopause and the bountiful source of our beloved estrogen disappears, no woman wants to take a wide array of pharmaceuticals to micromanage the specific negative impacts of its loss.

I see great benefit in using hormones, always bio-identical, for women going through menopause. Although we cannot recreate the ovarian function of a healthy 25-year-old, we can do far more than giving nothing. Women in menopause, without estrogen, must live the remainder of their lives in a perpetual state of estrogen deficiency. Why not do our best to replenish the estrogen stores? I can’t think of any reason why we should not prescribe estrogen and progesterone to the bulk of menopausal women. This is why I strongly advocate for quality human studies using physiological hormone regimens.

For those of us already in menopause, we simply cannot afford to wait for observational studies – our time is now. Instead of waiting and suffering the aftermath of hormonal deprivation, join me in support our beloved estrogen. We menopausal gals must demand to receive hormones and then monitor their effects. With a combination of hormones and healthy lifestyle choices, we will all be around to enjoy life for a long time to come.

Viera et al. Front Microbiol.2017;8:1884

Am J Physiol Endocrinol Metab.2008;295: E904-912

SaltikiK et al. Hormones.2007;6(1):9-24

Mol Cell Endocrinol.2011;334:31-38

Duckles et al. Molecular Interventions.2006; Vol6, No1, 26-35