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Estrogen's Effect on Fertility And Menopause (Part I)

Updated: Feb 8, 2020

In a premenopausal woman, elevated stress hormones end up "shutting down" estrogen (and progesterone) production on many levels. Additionally, estrogen-sensitive tissues ignore the "hormonal messages" of both estrogen and progesterone, particularly if it is reproductive in nature.

This increase in one set of hormones can culminate into such problems as delayed puberty, infertility, and miscarriage. The effect of cortisol on reproduction have clearly been demonstrated in women with Cushing’s Disease (hypercortisolism) as evidenced by their lack of ovulation, lack of menses, and infertility.

Interestingly, in aging women, cortisol tends to rise, and it is believed this may be partially responsible for postmenopausal women’s propensity towards weight gain, mood disorders, inflammation and autoimmune disease, insulin resistance, and increased risk for cardiovascular disease.

TESTOSTERONE The beneficial roles of testosterone in men (heart, bone, sense of well being, etc.) are equivalent to those of estrogen in women. In men, testosterone is produced in the testes, but in women, both the ovaries and adrenal glands make testosterone. Male sex characteristics, such as facial hair, deep voice, and muscle growth depend upon ample amounts of testosterone. But this hormone is also important in both sexes for maintaining energy levels, sex drive, mood, bones, and mental function.

Perhaps one of testosterone’s most important functions in men is to protect the heart. In fact, there is considerable evidence to suggest that testosterone deficiency may contribute to the onset, progression, (or both) of cardiovascular disease (CVD). The mechanism through which low testosterone levels contribute to heart disease include increased levels of total and LDL (‘bad) cholesterol, increased inflammation, increased thickness of the walls of the arteries, insulin resistance, and endothelial (lining of the blood vessel) dysfunction.

In general, cortisol and testosterone have a "love/hate" relationship. Elevated cortisol can cause reductions in testosterone and vice versa.

For example, studies have shown a correlation between elevated levels of testosterone and aggressiveness and socially delinquent behaviour. Presumably because of its testosterone-lowering actions, cortisol has been shown to moderate these aggressive behaviours in males with behaviors thought to be caused by excess testosterone excess.

PROGESTERONE Many people think of progesterone as the "pregnancy hormone." However, progesterone is also involved in the reproductive cycle in other ways, after being produced as a result of ovulation. But its actions are even more far reaching. Progesterone also plays a critical role as an: anti-inflammatory, anti-muscle spasm, anti-anxiety, and anti-uterine cancer and anti- breast cancer hormone. Ask any woman who has had a hysterectomy and takes estrogen only as hormone replacement how she feels without progesterone (which is not typically prescribed)… You are likely to get quite an earful!

Another underappreciated function of progesterone is its capacity to function as a neuroprotective hormone, protecting and supporting the brain and therefore improving thought process, focus, and memory. In fact, several studies have found progesterone useful as neuroprotective in patients with brain injuries.

Under normal circumstances, our bodies actually use progesterone to produce cortisol (as well as aldosterone, testosterone, DHEA, and estrogen). And, progesterone levels rise with cortisol in response to stress, in part to serve an anti-inflammatory role. During periods of acute and chronic stress, an interesting phenomenon called "the progesterone steal syndrome" can occur whereby available progesterone is funnelled into cortisol production to meet the increased demand. This can cause a woman to experience low progesterone symptoms such as PMS during periods of stress.

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