Does Estrogen Affect Sexual & Reproductive Health Only? The Heart Disagrees

Estrogen is the feminine hormone and you may contrast it with androgen which is the male counterpart.

Estrogen, a hormone that is produced by the ovaries in women, plays a very important role when it comes to the reproductive cycle. But this hormone is not just present in women, men too make estrogen, the quantity is much smaller in comparison.

In the male body, there's a specific enzyme that transforms testosterone into estrogen. The hormone also plays some part in regulating the body weight for both men and women.

Then we have estrogen receptors that play a protective in cardiovascular diseases. But how is a hormone that many of us thought of was meant for reproductive purposes connected to the heart?

FIT dives into this with Dr Vaibhav Mishra, Director and Head - CTVS, Max Super Speciality Hospital, Patparganj, and Dr Meshva Patel, Consultant, Aveya IVF & Fertility Center, Rajouri Garden, to understand better.

What is estrogen and how is it connected with cardiovascular health?

"Estrogen is the feminine hormone and you may contrast it from androgen which is the male counterpart. Both hormones have different roles, but if we talk about cardiovascular protection estrogen does offer some protection."

Dr Vaibhav Mishra, Director and Head - CTVS, Max Super Speciality Hospital, Patparganj

Adverse cardiovascular events like heart attacks are much much lower in females of reproductive age group when estrogen levels are high, and the incidence increases with menopause.

So what exactly does estrogen do to lower the risk?

Dr Meshwa explains – "Estrogen affects plasma lipids by increasing high-density lipoproteins (HDL) and triglyceride levels while decreasing low-density lipoproteins (LDL) and total plasma cholesterol. This reduces the risk of coronary artery disease with early use in postmenopausal women."

Can estrogen affect the rate at which the heart beats?

Estrogen can increase or decrease the good cholesterol and the bad cholesterol. It can also decrease the tone of blood vessels, keeping hypertension and atherosclerosis in check.

"Palpitations are usually experienced by women during menopause. Reduced levels of estorgen can cause multiple vasomotor symptoms like hot flashes, sweating, anxiety palpitations."

Dr Meshva Patel, Consultant, Aveya IVF & Fertility Center, Rajouri Garden

What are the risks of taking estrogen?

As the period of menopause commences, estrogen levels decrease and after this risk of having adverse cardiovascular events in women rise, although it may not reach to same level to that of man.

Estrogen replacement is offered to many people and many times it is used for treatment of many conditions like endometrial cancer and is also part of oral contraception, but excessive estrogen also affects cardiovascular health.

But there are risks associated with taking estrogen, like:

• Minor risks – Nausea, vomiting , breast heaviness and tenderness , water retention, weight gain.

• Major risks - Very rare thromboembolism, breast cancer, endometrial cancer , stroke, hepatic adenoma.

Does estrogen help with hypertension? If yes, then how?

Estrogen engages several mechanisms that protect the body against hypertension, such as activation of the vasodilator pathway mediated by nitric oxide and prostacyclin and the inhibition of the vasoconstrictor pathway mediated by the sympathetic nervous system and angiotensin.

But when large doses of oral estrogen is given for a long period of time through its effect on hepatic first pass metabolism, the concentration of renin increases which in turn increases blood pressure and causes hypertension.

How can one naturally replace estrogen?

Apart from medicinal estrogen replacement certain plant diets have high levels of the hormone, and can contribute to replacements. Phytoestrogens are plant derived compounds that can act as a natural replacement for estrogen.

They are present in:

• Soya products

• Red cloves

• Black cohosh