As the strongest of the three estrogens, estradiol (E2) is an important player in the female reproductive system. Understanding this hormone will help women take better control of their reproductive health.
Estradiol is one of three estrogen hormones naturally produced in the body. While men and women have estradiol, and it has a role in both of their bodies, women have much higher levels of the hormone than men.
Functions:
Estradiol has several functions in the female body. Its main function is to mature and then maintain the reproductive system. During menstruation, increased estradiol levels cause the maturation and release of the egg, as well as the thickening of the uterus lining to allow a fertilized egg to implant. The hormone is made primarily in the ovaries, so levels decline as women age and decrease significantly during menopause.
In men, proper estradiol levels help with bone maintenance, nitric oxide production, and brain function. While men need lower levels than women, they still require this important hormone to function well.
In women, too much estradiol has been linked to acne, constipation, loss of sex drive, and depression. If the levels are extremely high they can cause uterine and breast cancer. Women with high estradiol levels may experience weight gain and cardiovascular disease. For men, it can lead to the development of female characteristics, and loss of sexual function or muscle tone.
If the body does not have enough estradiol, bone growth and development is hindered, and adults can develop osteoporosis. Girls may experience delayed puberty with low estradiol levels. Mood swings have also been connected to low estradiol levels.
Estradiol (E2) is about 10 times as potent as E1 and about 80 times as potent as E3 in its estrogenic effect.
Except during the early follicular phase of the menstrual cycle, its serum levels are somewhat higher than that of E1 during the reproductive years of females. Thus it is the predominant estrogen during reproductive years both in terms of serum levels and estrogenic activity. E2 to E1 conversion is generally favoured and the metabolites in the Dutch test tell you whether this occurring correctly. Incorrect conversion greatly increases the risk factors for certain reproductive cancers.
Estradiol and Menopause:
The effects of estradiol are clearly seen in women experiencing menopause. During this process, women naturally have lower levels of estradiol as the ovaries stop ovulating. This change often causes mood swings, vaginal dryness, hot flashes, and night sweats — the symptoms commonly associated with menopause. Over time, lower estradiol levels can lead to osteoporosis.
If the body does not have enough estradiol, bone growth and development is hindered, and adults can develop osteoporosis. Girls may experience delayed puberty with low estradiol levels. Mood swings have also been connected to low estradiol levels.
Why does estrogen decrease?
- Age (peri-menopause and menopause)
- Irregular cycles/skipped cycles/anovulation
- Hysterectomy with ovaries removed
- Anorexia
- Low cholesterol (backbone to hormones)
- Extreme exercise or training
- Extreme stress resulting in skipped menses
- Under appropriate body weight percentage for height/age (Mixed research: suggested <15% body fat = amenorrhea)
- Hypogonadism (ovaries fail)
- Hypopituitarism (pituitary not communicating)
- Decreased blood flow to the ovaries (Ex. Surgery or smokers)
- Breast feeding
- Hypothyroidism
- PCOS
- Fertility medications
- Opioid pain medications (in last 6 months)
- Hormonal birth control – pill, patch, ring, implant, injection
Common symptoms of low estrogen:
- In women - fatigue, depression, hot flashes, night sweats, vaginal dryness, pain with intercourse, low libido, joint pain, brain fog, migraines/headaches, fertility issues, dry skin
- In men - not generally considered symptomatic, but in very extreme cases men may have similar symptoms as in the list above for women
Common ways to raise estrogen:
In women - address the cause, phytoestrogens such as Red Clover, Dong Quai, Kudzu, soy, diosgenin, genistein, fennel, and Black Cohosh (although studies are mixed on whether it acts as a phytoestrogen or not), Maca, and bioidentical estrogen replacement
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In women, too much estradiol has been linked to acne, constipation, loss of sex drive, and depression. If the levels are extremely high they can cause uterine and breast cancer. Women with high estradiol levels may experience weight gain and cardiovascular disease. For men, it can lead to the development of female characteristics, and loss of sexual function or muscle tone.
Why do Estrogen levels increase?
- Overweight/obesity
- Peri-menopause = surges of estrogen
- Diabetes
- PCOS
- Estrogen supplementation
- Steroid medications
- Poor liver clearance so estrogens build up
- Dysbiosis/Estrobolome problems
- Over aromatization from testosterone
- Environmental estrogens (difficult to test however)
- Alcohol (2 or more glasses/day shown to increase estrogen)
- Ovarian cysts
- Having elevated testosterone levels – testosterone gets converted to estrogen through the aromatase enzyme. Therefore, having Polycystic Ovarian Syndrome (PCOS), over supplementing with testosterone or DHEA or generally having a high production of this hormone, can lead to more estrogen being produced as a byproduct.
In men – over aromatization from testosterone to estrogen due to inflammation and blood sugar/insulin issues, environmental/xenoestrogen exposure (this does not show up on DUTCH testing, but they can cause symptoms), moderate alcohol use, and obesity
Common symptoms of elevated estrogen:
- In women – mood swings, weight gain, breast tenderness, fibrocystic breasts, heavy menses, fibroid/polyp development.
- In men – breast development, weight gain, and mood swings.
Common ways to lower estrogen:
Please consult with your health care provider about advice/treatment/diagnosis. The following statements are general informational statements.
- In women - address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber (especially ground flax seeds), increased detoxification support, and weight loss
- In men – address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber, decrease blood sugar and insulin, increased detoxification support, weight loss, and things that block aromatase (Chrysin, Damiana, Zinc and pharmaceutical aromatase inhibitors)
Other general interventions to keep in mind that can be beneficial for everyone if you don’t know the status of your hormones includes:
- Avoiding xenoestrogen exposure. Here is a great link to the top endocrine disruptors to avoid your environment [L]:
- Eat more cruciferous vegetables from the Brassica family- broccoli, kale, Brussels sprouts, cauliflower, cabbage, kale, etc.
- Support your liver on-goingly – from the basic lemon water to increasing consumption of dandelion or dandelion tea, doing a liver cleanse twice a year and reducing consumption of sugar and alcohol.
- Make sure your bowels are going – lots of fluids and high fiber in your diet will help regulate your bowel movements and make sure your hormones are properly detoxified rather than sitting in your body and recirculating back in the system.
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