Estrogen is often talked about in hushed tones, associated mainly with mood swings or “women’s problems.” But this limited framing fails to capture what estrogens truly are: vital hormones with wide-reaching effects on the entire body, for both men and women and at various stages of life. While estrogens are primarily female sex hormones, men need them for various reason as well, including maintaining bone health, regulating fat distribution, supporting sexual function, and influencing mood and cognitive abilities. Estrogens play a crucial role in balancing testosterone levels and overall health. Understanding how estrogens works and why it matters is the first step in removing the stigma and empowering better health decisions.
What is Estrogen, Really?
Estrogen isn’t a single hormone but a group of hormones — primarily estrone (E1), estradiol (E2), and estriol (E3) — that play roles in dozens of critical processes in the body. While it’s true that estrogen levels are highest in women of reproductive age, everyone, including men, produce and rely on estrogen to some degree.
The ovaries are the primary source of estrogen in females at birth, while smaller amounts are produced in fat cells and the adrenal glands. In men, estrogen is often synthesized through the conversion of testosterone via the enzyme aromatase. Aromatase is an enzyme responsible for transforming androgens (male hormones) into estrogens (female hormones), significantly influencing sexual development and hormonal balance in both men and women. It is essential for various physiological processes, including bone growth and the control of blood glucose levels.
Estrogen’s Role Across the Body
What makes estrogen unique is how *systemic* its impact is. It’s functions are not just about menstruation or fertility. Here are some of the key roles of estrogens:
- Brain Function: Estrogen helps regulate neurotransmitters like serotonin and dopamine, which are essential for mood stability and cognitive function. It also supports verbal memory and protects against neurodegenerative changes ([Henderson, 2014] (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010069/)).
- Cardiovascular Health: Estrogens have protective effects on the cardiovascular system. It improves lipid profiles by increasing HDL and reducing LDL cholesterol. Estrogen also keeps blood vessels flexible and reduces the buildup of arterial plaque by stimulating the body’s production of Nitric Oxide ([Manson et al., 2006] (https://www.nejm.org/doi/full/10.1056/NEJMoa0708709)). So they basically help maintain healthy cholesterol levels, promote vasodilation (widening of blood vessels), and reduce the risk of atherosclerosis (hardening of the arteries).
- Metabolic Regulation: Estrogens play a multifaceted role when is comes to metabolic regulation, such as influencing glucose and lipid metabolism, energy balance, bone health, inflammation, adipocyte function, and thyroid hormone regulation and can help prevent various metabolic disorders.
- Bone Health: Perhaps most critically estrogen help maintain bone density and inhibits bone resorption which is the process that can lead to osteoporosis in both men and women, especially post-menopause in women. While men obviously do not experience menopause, they can still develop osteoporosis ([NAMS, 2022] (https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf)).
- Skin and Connective Tissue: Estrogens support collagen production, skin thickness, and moisture retention. They also contribute to maintaining skin elasticity and moisture and the health and appearance of both the skin and hair. Drops in estrogens in females during menopause is closely tied to skin aging and joint pain.
- Genitourinary: Is known as the urogenital systems which includes the organs involved in both the urinary and reproductive systems, such as the kidneys, bladder, urethra, and reproductive organs in both males and females. “Hormone therapy remains the most effective treatment for vasomotor symptoms and the genitourinary syndrome of menopause.” North American Menopause Society (NAMS), 2022*
- Female Reproductive Health: For women, estrogens are crucial for the development and regulation of their reproductive system. They promote the growth of the uterus, fallopian tubes, and vagina, and play a significant role in the menstrual cycle and as well as fertility.
- Male Reproductive System: Don’t be fooled, men need estrogens as well. Estrogens are present in men, but in much smaller amounts and are important for sperm production and the maintenance of libido. They also contribute to the development of secondary sexual characteristics, such as the physical features that develop during puberty and distinguish the sexes from one another.
The 3 Types of Sex Hormones
The three type of sex hormones (Estrogens, Testosterone, and Progestogens) all play roles in both men and women, although their levels and specific functions differ between the sexes.
What Makes Estrogen Supplementation “Safe”?
Safety in hormone therapy is less about the hormone itself and more about how it’s used. The modern medical approach emphasizes:
- The Right Candidate: Therapy is most beneficial — and safest — when started in individuals under 60 or within 10 years of menopause onset. This is called the “therapeutic window” and is a cornerstone of the timing hypothesis in HRT (hormone replacement therapy) research ([Manson et al., NEJM 2013] (https://www.nejm.org/doi/full/10.1056/NEJMoa1209638)). However, women greater than 60 with symptoms of estrogen deficiency can still benefit with minimal risk as long as they are monitored appropriately.
- Lowest Effective Dose, Personalized to the Individual: There’s no one-size-fits-all dose. The goal is to relieve symptoms and maintain health using the minimum amount necessary. Adjustments are often needed as the body adapts.
- Balancing Estrogen with Progesterone (when needed): For women with a uterus, unopposed estrogen can increase the risk of endometrial cancer. Adding a progestogen, (either synthetic or bioidentical progesterone) protects the uterus and balances hormonal effects.
- Regular Monitoring and Follow-up: Hormone levels don’t always tell the whole story, but follow-ups help assess symptom control, detect side effects early, and guide long-term decisions. At All U Health, we monitor your hormones and customize a plan tailored specifically to your unique health and wellness needs.
Who Benefits from Estrogen Supplementation?
Estrogen supplementation isn’t one-size-fits-all — but it serves several key populations:
- Perimenopausal and Menopausal Women: As natural estrogen production declines, symptoms such as hot flashes, night sweats, vaginal dryness, and mood swings often emerge. Hormone therapy can offer significant relief and protection from long-term health issues.
- Women with Premature Ovarian Insufficiency (POI) or Surgical Menopause (caused by removal of the ovaries, formally known as an Oophorectomy): These individuals may experience an abrupt estrogen deficiency, which has health consequences that HRT can help address.
Breaking the Stigma
Both men and women, should maintain adequate estrogen levels essential for overall health and well-being, no matter their age.
Estrogen isn’t just a hormone; it’s also present in certain plants and is used by some animals for communication. For instance, estrogen-like compounds found in plants are known as phytoestrogens. These compounds can mimic the effects of estrogen in the human body and are found in foods like soybeans, flaxseeds, and some types of fruits and vegetables. Additionally, some species of birds use estrogen to influence the coloration of their feathers, which can be used to attract mates.
The discomfort many feel around supplementing estrogen is rooted in decades of misinformation, outdated research, and cultural gender bias. Estrogen therapy is often viewed with skepticism, despite robust data showing its safety and efficacy when used properly.
Many fears surrounding estrogen therapy stem from a single 2002 study — the Women’s Health Initiative (WHI) — which was later re-analyzed and shown to have serious limitations. It used older formulations, included many women in their 60s and 70s who were decades past menopause, and still showed no increased mortality from hormone use ([Manson et al., JAMA, 2017] (https://jamanetwork.com/journals/jama/fullarticle/2643761)). When therapy is individualized, started early, and monitored, the benefits often far outweigh the risks for healthy individuals.
Weight gain is another major concern — especially for those approaching or navigating menopause. But here’s the truth: menopause is often accompanied by changes in body composition, slowed metabolism, and reduced muscle mass — all of which can lead to weight gain, independent of hormone therapy. In fact, estrogen may help reduce the accumulation of visceral fat (the kind that surrounds organs and increase disease risk) and help maintain lean body mass when used during the menopause transition ([Davis et al., Climacteric, 2012] (https://pubmed.ncbi.nlm.nih.gov/23181497/)). Estrogen is not a magic weight-loss drug — but neither is it the culprit it’s often made out to be. The key drivers of weight gain in midlife are aging, lifestyle changes, and metabolic shifts — not estrogen supplementation itself.
The stereotype of the “hormonal” woman — volatile, moody, emotional — has been deeply embedded in Western culture for generations. Unfortunately, this has contributed to a widespread misunderstanding about what estrogen *actually* does to mood and mental health.
Estrogen plays a stabilizing role in brain chemistry. It helps regulate serotonin, dopamine, and GABA — neurotransmitters that influence everything from anxiety and energy to focus and emotional balance. Low estrogen levels, such as those that occur during perimenopause or after surgical menopause, are associated with:
- Increased risk of depression
- Irritability and mood swings
- Sleep disturbances
- Reduced stress resilience ([Soares, J Psychiatry Neurosci, 2014] (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916869/)) Estrogen therapy, particularly when initiated during the menopause transition, has been shown to improve mood, reduce anxiety, and even protect against depressive episodes in some individuals.
Here are two significant benefits of estrogen supplements for both men and women:
- Bone Health: Estrogen helps prevent bone loss and reduces the risk of osteoporosis. This is beneficial for both men and women, as it supports the maintenance of strong and healthy bones. This is especially relevant post-menopause for women and can also be crucial for men as they age.
- Heart Health and Mood Regulation: Estrogen plays a role in maintaining heart health and supporting mood regulation. Adequate levels of estrogen can contribute to cardiovascular health and emotional well-being in both genders.
The Facts Should Lead the Conversation
Estrogen therapy has suffered from decades of misunderstanding. The myths persist because hormone therapy was once widely overprescribed, then suddenly vilified — with little public education in between. We’re now entering a new era of hormone literacy, where individualized, science-based decisions are becoming the standard of care.
If you’re navigating hormone changes or considering estrogen therapy, it’s crucial to make decisions based on *your* needs — not outdated fears or social stigma. “We’ve learned that the risks of hormone therapy depend on age, timing, formulation, and health status. The new science should replace the old fear.” — *Dr. JoAnn Manson, lead WHI investigator, Harvard Medical School*
By optimizing estrogen levels, individuals can bolster their overall health, mitigate the risk of various health issues, and enhance their quality of life. At All U Health, we recognize the significance of this hormone and strive to optimize it according to your specific needs.