Estradiol is the predominant, and the most potent, circulating estrogen. Bioavailable estradiol, which represents about 2% of the total protein-bound estradiol in the bloodstream , exits the bloodstream in capillary beds and enters target cells such as the brain, breasts, uterus, bone and heart. There, it binds to the estrogen receptors and activates an estimated 250+ genes that induce the synthesis of enzymes and other functional proteins involved in regulating a multitude of actions, including neurotransmitter synthesis and action in the brain, and activation of cell growth and proliferation and synthesis of progesterone receptors in the estrogen/progesterone target tissues that allows for subsequent counter-response to the growth promoting actions of estrogens.
If symptoms of estrogen imbalance are problematic this may be due to other hormonal imbalances with a symptom profile similar to low or high estradiol (e.g. low progesterone, low testosterone, low or high cortisol, low thyroid).
With the onset of menopause, low estradiol levels lead to hot flashes, night sweats, vaginal dryness, sleep disturbances, foggy thinking, and bone loss.
In reproductive age women, an excess of estradiol relative to progesterone, known as “estrogen dominance”, can explain many symptoms including endometrial hyperplasia, pre-menstrual syndrome, fibrocystic breasts, and uterine fibroids. Perimenopausal women can also experience symptoms of estrogen dominance, which include weight gain, fibrocystic and tender breasts, uterine fibroids, irritability, and water retention.
In men, too much estradiol, relative to testosterone, leads to feminizing effects such as breast enlargement and can result in a functional testosterone deficiency.
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