Dr Michelle O'Driscoll: The important role of Oestrogen

WE have three main sex hormones: oestrogen, progesterone and testosterone. They rise and fall at specific times of the month, and work together to create a dynamic balance in the body that allows for optimal functioning of everything.

Dr Mary Claire Haver, menopause specialist, speaks about how we’re living longer, and doing so despite this drop-off of hormones in our body, which over many years has a number of health implications.

The amount of oestrogen and progesterone women’s bodies produce peaks around puberty, then begins a gradual decline, with a more pronounced drop-off as we approach menopause, where it becomes a fraction of what we once had.

Peri-menopause is the years preceding the menopause itself, which is actually just one day in our lives where we mark one year without a period, and this is then followed by post-menopause.

Peri-menopause is very much diagnosed or determined by presenting symptoms. Our hormone levels will have been declining for a little while, but peri-menopause is the time where that decline becomes problematic for our bodies and their normal functioning.

The body begins to think ‘something isn’t quite right here’, and issues start to emerge, which vary greatly from person to person.

Once we’re post-menopausal, there has been a very significant reduction in these hormone levels and the impact on our health increases.

So, what role does oestrogen specifically have in all of this? What does it contribute to keeping things functioning smoothly?

We tend to associate it just with fertility, but oestrogen is utilised in practically every organ in the female body, and acts as an anti-inflammatory, so its roles are numerous. Below are four key areas of oestrogen action.

Heart health – The cardiovascular system utilises oestrogen in its functioning, in that oestrogen protects the cardiovascular system from disease, helping to maintain cholesterol levels and reducing blood pressure. Heart disease is one of the leading causes of morbidity and mortality post-menopause, which reflects the role that oestrogen plays in our systems.

Bone and joint health – in our earlier years, we are constantly regenerating our bones – breaking down old bone cells and laying down new ones. This process keeps our bones strong and healthy, and less likely to break should a fall occur. When oestrogen declines in later years, this leads to more bone being broken down than is being replaced, causing porous bones that are brittle and fracture-prone.

Fractures, particularly of the hip, greatly reduce quality of life, and risk of death. Joints also benefit from oestrogen, due to a reduction of inflammation in the area. Frozen shoulder is a common complaint of women in their forties or fifties, which is now thought to be due to reduced hormone levels.

Mood and brain – Oestrogen helps to keep mood balanced, and aids with drive and motivation. In the first two weeks after our period, oestrogen levels rise, and this tends to be when we’re at our most energetic, most productive. Lack of oestrogen, either in the final 1-2 weeks of our cycle, or as we hit peri- menopause, can cause a lowering of the mood.

Oestrogen also helps to keep our thinking clear, and our neurons firing. Without adequate oestrogen levels, thinking becomes more ‘foggy’, and our mental acuity reduces.

Genito-urinary health – Oestrogen keeps the tissues between our pubic bone and our tail bone healthy, elastic and lubricated. Without oestrogen, the area becomes dry, inelastic and uncomfortable. This can lead to sexual function issues, but also to increased numbers of recurring urinary tract infections, which in themselves can be a risk to health via infection.

Knowing the wide range of roles oestrogen plays alongside our other hormones can help us better understand problems we encounter as we age. Depending on the impact of hormonal decline, consideration may be given to lifestyle, dietary and/or hormonal replacement approaches to increase its levels and minimise the fallout, whilst always weighing up all benefits and risks with our doctor.

Our hormone levels will have been declining for a little while, but perimenopause is the time where that decline becomes problematic.

ABOUT THE AUTHOR 

Dr Michelle O’Driscoll is a pharmacist, re searcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally.