“Estrogen has over 400 crucial functions in the body.”
Our hormones are chemical messengers that support us in maintaining overall health and help regulate bodily functions, says Jamie Gabel, PA-C, director of Advitam, which offers anti-aging and metabolic aesthetic treatments. Estrogen is one of those essential sex hormones in women — and it has myriad roles in the body.
"Estrogen helps maintain memory, boosts mood, exerts antioxidant effects, supports energy and focus, impacts our metabolic rate, helps maintain bone density, decreases wrinkles — and more," adds Jordan Crofton, FNP, Director of Patient Care at THE WELL.
"You can think of estrogen as a ‘goldilocks’ hormone — having too much or too little both leads to problems," Crofton explains.
There are three major endogenous estrogens:
- Estrone (E1): the main estrogen the body makes post-menopause
- Estradiol (E2): the most potent and primary form of estrogen during reproductive years
- Estriol (E3): the primary form of estrogen during pregnancy
"Each estrogen specializes in different activities in our body, which is why it's important to evaluate more than just total hormone levels (something we make a point of doing in Functional Medicine). E1, E2 and E3 are all metabolized, detoxified and excreted differently in the body, and those metabolites can have a major impact on a woman’s health — including the long-term risk of breast and uterine cancer," says Crofton.
"Estrogen metabolism depends on multiple factors, including a woman’s genetic makeup and environmental factors like diet and lifestyle, which means there’s also a lot of tools we have to impact these processes," says Crofton.
Read on to learn what makes estrogen such a significant hormone — including new research that links it to increased motivation to exercise — and how to harness its power:
Increases sexual desire
Given that it is a sex hormone, it’s no surprise that estrogen is responsible for increased sexual desire and vaginal lubrication. “Having a happy sex life is important in maintaining a positive mental and emotional state as we age,” Gabel says. “This is one of the key reasons many women opt for hormone replacement therapy when their estrogen levels drop.”
Protects brain function
Estrogen is also neuroprotective, meaning it prevents degeneration of brain function. “During the aging process and into menopausal years, estrogen levels decline, which can lead to cognitive impairment, neuroinflammation and age-related disorders such as Alzheimer’s Disease,” Gabel says.
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Promotes healthy hair and skin
Gabel says healthy estrogen levels also promote hair thickness and growth and maintain healthy skin. “Replacing [estrogen] during and after menopause helps increase skin collagen content,” he adds. “It can assist in adding moisture to the skin, and there is some benefit in reducing wrinkles.”
Supports heart health
Estrogen also plays a part in maintaining healthy heart function, Gabel says, by helping decrease bad cholesterol, increasing good cholesterol, decreasing plaque accumulation in the arteries and regulating blood pressure.
A recent study on mice showed some interesting insights on the connection between estrogen and the motivation to exercise. Mice depleted of estrogen became less active, while those who received estrogen became more active.
“This [research] really helps validate some key benefits of estrogen in women and may be why they seem to gain weight and lose energy when their estrogen levels drop,” Gabel says. “Estrogen has over 400 crucial functions in the body, so as a woman's levels become depleted, she is likely going to notice some unwelcomed changes.”
Specifically, Anna Cabeca, MD, a triple-board certified OB-GYN and author of the upcoming book MenuPause: Five Unique Eating Plans to Break Through Your Weight Loss Plateau and Improve Mood, Sleep and Hot Flashes, notes that estrogen can lead to an increase in exercise because of its function on the melanocortin-4 (MC4R) receptor site. “Stimulation of MC4R receptor site has been associated with decreased appetite and improved energy expenditure, sexual appetite, reproduction, as well as glucose and lipid homeostasis,” she says.
Gabel adds that although it's been known that estrogen relates to MC4R receptors in the brain increasing energy and libido for a long time, “validation through science is critical to coming up with options and treatments to address the problems.”
How to Harness the Power of Estrogen
So, knowing the roles estrogen plays, especially as it relates to exercise, how can you direct its power? Dr. Cabeca recommends that women in perimenopause or menopause focus on empowering their own body’s ability to use estrogen in a healthy way by taking a food-as-medicine approach — that can help improve insulin sensitivity, alkalinity and hormonal balance.
For those who are still menstruating, syncing your workouts to your cycle can be helpful. “Periovulatory spikes in estrogen and the first half of the cycle can predispose to more intense exercise, motivation and commitment,” says Dr. Cabeca.
Having your hormones tested is also key in the years leading up to menopause. In particular, Dr. Cabeca testing for FSH, LH and estradiol ratio over time to track changes. “More importantly, there are four biomarkers that I always recommend looking at, and that is your hemoglobin A1C, HSCRP, DHEA and your vitamin D 25 hydroxy,” she adds. “These are even more important biomarkers for energy metabolism and hormone balance.” With hormone testing, though, Dr. Cabeca notes that you must be off any hormonal contraceptive to be able to look at your baseline levels.
The bottom line is that estrogen is a vital hormone that plays many important roles in a woman’s health and well-being. And balancing estrogen levels is an individualized journey. “There is an art to optimizing a woman's hormones in order to find that sweet spot,” Gabel says. “Too little and you don’t fix the problem, too much, and there can be unwanted side effects.”
Given that, educating yourself on the benefits of estrogen, recognizing the signs of depletion and working closely with your healthcare provider can help you benefit from its presence for a longer term.