Estrogen: 101

Estrogen: The Vibrancy Hormone  

Understanding the hormones that play a role in perimenopause is essential to navigating this transition smoothly. Hormones are responsible for a wide range of functions in the body, from regulating your metabolism to controlling mood and energy levels. In this series, we’ll focus on the key hormones involved in perimenopause, starting with estrogen—arguably one of the most important for a woman’s health during this phase of life. Estrogen plays a crucial role not just in reproductive health, but also in brain function, skin health, bone health, and cardiovascular well-being.

The Different Types of Estrogen

There are three primary forms of estrogen that naturally occur in a woman’s body:

1. Estradiol (E2): The most potent and predominant form of estrogen during a woman’s reproductive years. Estradiol regulates the menstrual cycle, supports bone health, maintains healthy skin and hair, and is vital for brain function.

2. Estrone (E1): After menopause, estrone becomes the dominant form of estrogen in the body. Produced mainly in fat tissue, estrone is weaker than estradiol, contributing to lower overall estrogen levels post-menopause.

3. Estriol (E3): The weakest form of estrogen, primarily produced during pregnancy. It has minimal impact on a woman’s body outside of that context.

Estrogen Pathways: Where It’s Produced Before and After Menopause

Before menopause, the ovaries are the primary producers of estrogen, particularly estradiol. This estrogen regulates everything from your menstrual cycle to bone density. Small amounts of estrogen are also produced by the adrenal glands and fat tissue.

As you transition into menopause, the ovaries gradually reduce their output of sex hormones, including estrogen. After menopause, the adrenal glands become the primary source of estrogen and other sex hormones. These glands, located on top of the kidneys, produce small amounts of estrone, which helps smooth out hormone levels after the ovaries stop functioning. Keeping your adrenal glands healthy is crucial during this phase because estrogen plays a role in maintaining bone and heart health, as well as providing neuroprotection.

The Role of Estrogen in Perimenopause

Estrogen plays a critical role in regulating many systems in the body, including the brain, heart, and bones. When estrogen levels fluctuate during perimenopause, women can experience a wide range of symptoms, including:

• Hot flashes and night sweats
• Mood swings and irritability
• Fatigue and low energy
• Brain fog and memory lapses
• Vaginal dryness and reduced libido
• Irregular periods
• Crawling skin (a sensation like bugs crawling under the skin)
• Restless legs
• Joint pain
• Dry eyes or blurry vision
• Sleep disturbances

These symptoms are a direct result of fluctuating estrogen levels. If estrogen becomes imbalanced, the impact can be felt in both physical and mental health.

Estrogen and Brain Health

Estrogen is not just a sex hormone—it’s also crucial for brain health. It supports cognitive function, memory, and mood by promoting the growth of neurons and protecting neural connections in the brain. This is why many women experience cognitive symptoms, such as brain fog and memory lapses, during perimenopause.

Recent research is also linking declining estrogen levels to an increased risk of neurodegenerative diseases, including Alzheimer’s and dementia. The drop in estrogen during perimenopause may leave the brain more vulnerable to cognitive decline later in life. Additionally, estrogen plays a role in maintaining a healthy gut microbiome, which impacts brain health through the gut-brain axis. A disruption in gut health due to fluctuating estrogen levels can lead to increased inflammation and affect overall cognitive well-being.

Why Hormone Replacement Therapy (HRT) Is Important

Hormone Replacement Therapy (HRT) can be a highly effective way to balance estrogen levels during perimenopause and menopause, helping alleviate symptoms and protect long-term health. By replenishing estrogen, HRT can help reduce symptoms like hot flashes, mood swings, and brain fog, while also supporting bone health and reducing the risk of cardiovascular disease.

However, one crucial aspect of HRT is that estrogen should never be taken alone—it must always be paired with progesterone. Taking estrogen alone can increase the risk of endometrial cancer in women who still have their uterus. Progesterone balances the effects of estrogen and helps protect against this risk, making it a vital component of safe HRT.

The 1990s Study on HRT: What Went Wrong

In the 1990s, the Women’s Health Initiative (WHI) study caused widespread fear of HRT by suggesting that it increased the risk of breast cancer, heart disease, and stroke. As a result, many women and doctors avoided HRT altogether. However, we now know that the study was flawed. It didn’t differentiate between the types of HRT used, and many of the women in the study were already past menopause and had preexisting health conditions, which skewed the results.

Since then, many of the original conclusions from the study have been retracted, and experts now agree that HRT is safe and effective for healthy women without a history of hormone-sensitive cancers. In fact, starting HRT before menopause can help maintain hormone balance, reduce the severity of symptoms, and protect long-term health.

Estrogen and the Cognitive Benefits of HRT

Given estrogen’s role in brain health, HRT can also be beneficial for preserving cognitive function. By supporting the brain’s energy metabolism and promoting healthy neural pathways, HRT may help reduce the risk of neurodegenerative diseases and protect against cognitive decline as women age.

The Importance of Diet and Exercise in Hormonal Balance

Diet and exercise play a key role in maintaining hormonal balance, particularly during perimenopause. A diet rich in healthy fats, protein, and low in refined carbs can help stabilize blood sugar levels, which in turn supports hormonal health. Regular physical activity, especially strength training, can also help regulate hormones by improving insulin sensitivity and reducing stress on the adrenal glands, which become a key source of hormone production post-menopause. Ensuring that you’re eating nutrient-dense foods and staying active can make a significant difference in how your hormones function during this transition.

Cycle Tracking as a Tool for Identifying Hormonal Imbalance

Tracking your menstrual cycle can be an invaluable tool for identifying hormonal imbalances during perimenopause. By monitoring symptoms such as mood changes, energy levels, sleep patterns, and physical signs like hot flashes or irregular periods, you can gain insights into how your hormones are fluctuating throughout the month. Keeping a record of these changes allows you to spot patterns and understand what’s normal for you, helping you recognize when something is off. Cycle tracking can also be a helpful resource to share with healthcare providers when discussing treatment options or exploring the need for HRT.

Conclusion: Taking Charge of Your Health

Balancing your estrogen levels during perimenopause is key to maintaining your health and quality of life. Whether through HRT or other supportive measures, it’s important to stay proactive and listen to your body’s signals. If you’re experiencing symptoms of estrogen imbalance, tracking them can help you understand what’s happening and take action.

Download my free cycle tracker to monitor your symptoms and get a clearer picture of how your hormones may be shifting. If you don’t have a healthcare provider who specializes in perimenopause, consider getting tested with the experts at ChooseJoi.co or ByWinona.com, both are online sources for hormone lab testing and HRT specialists. Either can help you create a personalized plan to keep your hormones balanced and support your well-being through this transition.