The standard of care for losing certain hormones, like thyroid or insulin, is dealt with swiftly by providing replacements. Why is the replacement of estrogen, progesterone, and in some cases, testosterone, not the same? The decline in sex hormones does not get the same attention, research focus, or respect. Other hormones, when in a state of decline are considered a disease process, yet the loss of sex hormones is considered “normal aging”.

But is that really the truth? Yes and no.

In women, the loss of estradiol and progesterone plays a significant role in our overall health and well-being AND in disease processes. Sex hormones play a crucial role in women’s health. As women age, their hormone levels naturally decrease, leading to changes in their bodies, starting around the mid-30s. During this time, the role of estradiol becomes increasingly important as it helps to manage symptoms and prevent disease processes. In this blog, we will explore the role of estradiol in women’s health as they progress through perimenopause into menopause, including the disease processes that can be avoided when supplementing with hormone replacement therapy (HRT).

What is Estradiol?

Estradiol is a type of estrogen hormone produced primarily in the ovaries that is responsible for maintaining homeostasis in the female body. Most people know it plays a vital role in regulating a woman’s menstrual cycle and reproductive system. In addition to the health of a woman’s cycle, estradiol is also responsible for maintaining healthy bones, reducing inflammation, brain health, gut microbiome health, cancer prevention, immune system strength, lipid profiles, muscle quality & quantity, and supporting cardiovascular health. As women age, the levels of estradiol in their bodies naturally decrease, leading to changes in their bodies.

Perimenopause

Perimenopause is the period of time leading up to menopause when a woman’s hormone levels begin to decline. During this time, women may experience a variety of symptoms, including hot flashes, night sweats, mood swings, and irregular periods. These symptoms are due to fluctuations in estrogen and progesterone levels. Supplementing with HRT starting in perimenopause can help alleviate symptoms and improve quality of life and reduce the risk of many avoidable chronic disease processes.

Menopause

Menopause marks the end of a woman’s menstrual cycle and is defined as a singular point in time that marks 12 months without a menstrual period. The levels of estradiol in a woman’s body continue to decline, leading to additional changes in her body. Women may experience symptoms such as vaginal dryness, sleep disturbances, and an increased risk of osteoporosis and heart disease. Keep in mind, the changes occurring are not just symptoms she feels. Changes are happening to her entire body.

The Role of Estradiol in Women’s Health

Estradiol plays a crucial role in women’s health throughout their lives. During perimenopause and through post-menopause, the role of estradiol becomes increasingly important as it helps manage symptoms and prevent disease processes. Below are some of the ways estradiol impacts women’s health during this time:

1. Cardiovascular Health

   Estradiol helps maintain healthy blood vessels and reduces inflammation, which is why it plays a critical role in cardiovascular health. Women who take HRT have been shown to have a lower risk of heart disease, stroke, and blood clots compared to those who do not.

2. Bone Health

   Estradiol is essential for maintaining healthy bones. As women age and estrogen levels decline, they become at higher risk for osteoporosis and bone fractures. HRT can help prevent bone loss and reduce the risk of fractures.

3. Brain, Thyroid and Metabolic Function

   Estradiol plays a critical role in cognitive function, including memory and concentration. Women who take HRT have been shown to have better cognitive function than those who do not. The lack of estradiol has been linked to Alzheimer’s disease because of estradiol’s role in insulin regulation, thyroid function, and reducing systemic inflammation.

4. Vaginal Health

   Estradiol is necessary for maintaining healthy vaginal tissue. As estrogen levels decline during menopause, women may experience vaginal dryness, itching, and pain during intercourse. HRT can help alleviate these symptoms and improve overall vaginal health.

5. Microbiome Health

   When estradiol becomes low, the gut suffers. Most women experience poor gut health as weight gain, but a lowered microbial diversity with a resulting dysbiosis ignited by low estradiol is at the root. The secretion of specific enzymes goes haywire and GI disorders begin to develop (or intensify). Similar issues are seen in women with menstrual disorders like endometriosis, irregular periods, and PCOS.

Disease and the use of HRT

1. Osteoporosis

   HRT can help prevent bone loss and reduce the risk of fractures in women with osteoporosis.

2. Heart Disease

   HRT can help reduce the risk of heart disease and stroke in women by maintaining healthy blood vessels and reducing inflammation.

3. Colorectal Cancer

   HRT may reduce the risk of developing colorectal cancer in women.

4. Alzheimer’s Disease & Cognition

   HRT has been shown to have neuroprotective effects and may help to prevent or slow the progression of AD. In addition to its neuroprotective effects, estradiol also has positive effects on mood, sleep, and other cognitive functions.

5. Immune Function

   Estradiol has been shown to enhance both innate and adaptive immune responses, leading to improved resistance to infections and increased ability to fight off pathogens. Estradiol has been shown to increase the production of cytokines, which are important signaling molecules that help to coordinate the immune response. Studies have shown that women (and men) with higher levels of estradiol have improved immune function and a lower risk of infections.

There’s more to menopause than just hot flashes. Replacing estradiol (and progesterone) is more than just symptom management. Estradiol is involved in every system in our body.

Will HRT “reverse” aging? NO! But it will keep your body from aging poorly.

Estradiol is used for nearly every organ and operating system in the body. Just because the ovaries have stopped producing estrogen does not mean supplying our body with it exogenously (HRT) is wrong.

• If your body isn’t producing thyroid hormone, it’s replaced.

• If your body doesn’t produce any insulin, it’s replaced.

• If your body doesn’t make enough testosterone (especially in men), it’s replaced.

Physicians relying on poor studies (WHI) done over a decade ago are partially responsible for the injustice done to women’s health today.

Estradiol has more to do with alleviating symptoms like hot flashes.

Replacing estradiol is about whole body health.