Estrogen, Menopause & Weight Gain

Is there something about hormones, change in hormones and menopause that makes women gain weight? The answer is yes. Almost every woman has some complaint or observation about this. Is it just related to age or is it real? It is real!

When we talk about hormones, balance is key! We need to have our hormones in balance or things don’t work quite right. If you do something to one hormone, it can affect other hormones. When we talk about the hormones associated with menopause, we start talking about treatments. Often you will hear us talk about bioidentical hormones or synthetic hormones. Bioidentical hormones mean it looks exactly the way your body made it. There are three types of human estrogen. The chemical structure of human vs. bioidentical hormones is basically the same. The point is that your body will react the way it always does. The chemical structure of synthetic hormones is not the same as human hormones. The big deal of this is that your body doesn’t react the same to synthetic hormones as it does to bioidentical hormones. That’s where a lot of these problems with hormones can arise. When you hear about people talking about hormones causing blood clots, heart problems, and other problems, they are typically referring to synthetic hormones. It’s the synthetic hormones that cause the problems, not the bioidentical hormones. Bioidentical hormones actually prevent some of these problems.

Why would anyone use synthetic hormones? Part of the reason is that’s all the major drug companies can produce.  No one can patent something that occurs in nature. If something already occurs in the human body I can’t patent that. In order for me to patent something I have to actually change it. I would have to make it slightly different.

Hormones are chemical messengers that communicate between one part of the body and another. It’s different human tissues communicating between each other. This hormone making tissue sends it out through the bloodstream. Only tissue with receptors to that hormone will respond to that hormone (lock and key). You have to have the right key to open the lock. It’s basically just sending a message so the receptive tissue will do something. Hormones are one of the main tools your body uses to maintain homeostasis (balance). Cortisol and thyroid hormones are important in sex hormone function, but we won’t be discussing them today. Hormone balance is a key concept. We need to keep the hormones in balance so things will work correctly the way we need them to.

All the sex hormones are derived from cholesterol.  We would die without cholesterol. It’s needed in every single cell in our body. The sex hormones include: testosterone, progesterone, and estrogen. There are three types of estrogen: Estrone (E1), Estradiol (E2), and Estriol (E3). Estradiol is the most important one. Men and women all share these hormones. The only difference is the absolute number and the relative amounts of them. The sex hormones all come from the cholesterol molecule.  All the sex hormones look similar chemically. They just have side chains on them and they do different things.

As we get older our hormone levels change. Testosterone levels go down. After the late teens/early 20’s men and women we lose about 1% of our testosterone every year.  Women tend to lose it sooner.  Testosterone is your “feel good” hormone. It’s your vitality hormone. It certainly affects your libido. It also affects sleep, exercise, metabolism, clarity of thought and more. It preserves our lean body mass. It’s an extremely important hormone throughout our lifetime. As women age testosterone naturally declines. The other thing that happens is the sex hormone binding globulin tends to go up. This works against testosterone because it actually binds the testosterone. So even if we had the same amount of testosterone, it wouldn’t work as well. There’s a double whammy. This is true for both men and women. It’s the free testosterone that is the working molecule. You don’t want it bound up against something else. If it is bound up then it won’t work as well.  It is something that changes with age.

A little bit of testosterone is made by the adrenal glands and ovaries. Most of it is made by the ovaries for women and testicles for men. In women, testosterone is critical for optimum function of many systems: sex drive, heart health, preservation of bone and muscle mass, and sense of well-being.  Osteoporosis is very common. It’s a huge problem for women. It’s testosterone that is the true bone builder. We can increase someone’s bone density by about 8% a year with testosterone. The heart is a muscle. Testosterone can help with the way the heart beats. Women typically produce about 10% of the testosterone that males produce. Part of the reason is that women are more sensitive to it. Production of testosterone by the ovaries decreases by 50% from age 20-40 and continues to fall until menopause. It also tends to drop during pregnancy. For women who have had multiple pregnancies, it tends to drop quicker (Nature’s “family planning” with a lower sex drive). The more children women tend to have, the lower the testosterone levels go. Some of the testosterone breaks down to estrogen. That’s how men get their estrogen. We’re finding out some interesting things. Some people think testosterone is linked to prostrate problems. It’s probably not true at all. The issue is that estrogen levels start to go up. It’s most likely the estrogen in men that affects the prostrate. The ratio gets out of whack.

Progesterone is a woman’s hormone. It’s the natural antagonist, or balancer, to estrogen. We don’t want estrogen levels to be too high or too low. We need to keep that balance. It’s the ying and yang of the female hormone system. The relative balance determines either a state of physical and emotional well-being or unpleasant symptoms. Progesterone is produced mainly by the ovaries, but also small amounts by the brain and adrenal glands. Receptors are found in the brain, breasts, blood vessels, bones and reproductive glands. They wouldn’t be found in all these organs if they weren’t needed. Low progesterone levels put women at risk for fibroids, endometriosis, and uterine cancer.

Three Types of Female Hormones

Estrogen is the primary female hormone. There are three types. Estradiol is the important one.  The adrenal glands make estrogen, but it’s mainly the ovaries. When women go through menopause, the ovaries quit working. Then, a small amount comes from the adrenal glands. Estrogen receptors are widely distributed throughout the body: brain, breast, bone, blood, blood vessels, and reproductive organs. Estrogen is an important hormone to send a message to these different organs. It’s critical for sexual maturation, puberty, and the reproductive cycle. Adult women produce 3 primary estrogens: estradiol, estrone, and estriol. Estriol is very important in pregnancy.

Estradiol is the strongest of the estrogens and the main one produced by the ovaries. The balance of estrogen and progesterone shifts back and forth during a woman’s monthly cycle.  Disturbances in this ratio can lead to anxiety, emotional changes, and insomnia. These are some of the things that occur in that pre-menopausal period. It’s not that you aren’t producing the hormones, but the ratios are starting to get a little out of whack. Estradiol production remains relatively steady during your 30’s and 40’s. Then it becomes erratic in your late 40’s with surges and falls. It finally falls dramatically during menopause. The ovaries quit working so the estrogen levels go really low.

Estrone is the next strongest estrogen. It’s produced by conversion of estradiol in the tissues. There can be conversion back and forth. Estrone is the main post-menopausal estrogen. Estrone can be produced by the fatty tissue.

Estriol is the weakest of the 3 estrogens. Normally it’s produced in high levels only during pregnancy. It’s important in both pregnancy and breast cancer protection. It acts to block the potent effects of estradiol on breast tissue growth and possible cancer promotion.

When you approach menopause you may get the night sweats and hot flashes. As you’re approaching menopause, you have pre-menopausal symptoms. That means there is estrogen dominance. That means you’ve started making less progesterone. That balance is no longer there. Even if the estrogen levels are where they should be, it’s still referred to as estrogen dominance.

The average age of menopause is 51. The ovaries basically quit working and no longer produce estrogens. All of the total estrogen levels fall, especially estradiol. Estrone can still be made by fat cells. What does this have to do with your weight?

The major ways that sex hormones can affect weight is by their influence on a critical enzyme used in fat storage. That hormone is called lipoprotein lipase (LPL). LPL is the “gatekeeper” for fat accumulation. You have to turn on this enzyme in order to store fat. Any cell that uses fatty acids for fuel or stores fatty acids uses LPL to make this possible. LPL can actually be used to help burn fat or store fat. It depends on what tissue it’s on. If it’s on fat cells, it stores fat. If it’s on muscle cells, it’s burning fat. The more LPL activity on a cell type, the more fatty acids that cell will absorb.

Insulin is the primary regulator of LPL activity, but it’s not the only one. In fat cells, insulin increases LPL activity. In muscle cells, insulin decreases LPL activity. Women have higher LPL activity in their adipose tissue. Women can store fat easier than men. In men, LPL activity is higher in the abdominal region, but in women LPL is higher in the hips and buttocks. That changes as they get older. The sex hormones also influence LPL activity. Testosterone suppresses LPL activity in the abdomen. So as men age, testosterone decreases (and insulin increases) and they tend to develop a “gut.” They lose the testosterone so they lose that protective effect.

Progesterone increases the activity of LPL, especially in the hips and butt. Estradiol can actually decrease the LPL activity. Estradiol tends to remain high in women until about their 40’s. The estradiol actually helps preserve the lean body mass. As you go through menopause estradiol levels decrease. It’s the decrease in this estrogen (during menopause) that leads to an increase in fat storage. Women lose that LPL suppression.  Estrone levels go up and it’s made by the fatty tissue. Estrone increases the LPL activity leading to more fat deposition. When you go through menopause, estradiol levels go way down so you lose the protection. Estrone levels start going way up which cause an increase in LPL activity. There’s a double whammy there. It’s a hormonal thing, not a how much you’re eating thing.

Carb rich meals increase LPL activity in the fat tissue. Interestingly, fatty meals do not! Another interesting finding is that obese individuals have higher LPL activity in their fat cells, meaning that a larger person can gain weight much more easily than a thin person. The more overweight you are, the easier it is to gain weight. It’s a snowball effect.

Hormones, menopause, and weigh gain are all closely related. This has nothing to do with how many calories you are eating. It does have a lot to do with how many carbs you are eating. Age and hormone changes (as well as a loss of LBM) have a lot to do with it. As estradiol decreases, and estrone increases (as well as testosterone decreasing) it becomes easier to store fat. This is one more reason you might want to consider Bioidentical Hormone Replacement Therapy.

Call to schedule your labs and initial consultation with us.  We offer a webinar that will help to explain the process and benefits of BioIdentical Hormone Replacement Therapy.