Estrogen is a hormone typically related to reproduction and sexual characteristics, but it also promotes vascular elasticity, encourages cholesterol balance, and has anti-inflammatory properties that prevent heart disease.
The hormone estrogen is best known as a sex hormone, but like most substances in the body, its effects go beyond its primary designation in the reproductive system. Estrogen is also vital in the functions of your skeletal system, central nervous system, metabolic system, and cardiovascular system, among others.
Researchers consider estrogen as a substance that protects the body from heart disease. Estrogen benefits the heart and blood vessels in various ways, supporting cardiovascular function and longevity.
Some people may experience low estrogen levels during menopause. A 2023 study suggests that low estrogen increases the risk of cardiovascular disease in people assigned female at birth. Estrogen plays a role in several protective mechanisms that prevent heart disease. When the estrogen levels become low, the cardiovascular risk factors may increase.
Cholesterol regulation
Estrogen binds to receptor sites in your liver, affecting the genes involved in lipid metabolism and their expression. Lipid metabolism controls the way your body breaks down, stores, and utilizes fats. It also plays a key role in the formation and removal of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterols.
Estrogen lowers total cholesterol in your bloodstream. It increases circulating HDL and decreases circulating LDL. Low total cholesterol, high HDL, and low LDL all
Vascular health
Estrogen’s effects on your vascular system are also beneficial for heart health. Estrogen activates signaling pathways by binding to endothelial cells in the lining of your blood vessels. It increases the calcium level within cells, leading to the formation of nitric oxide (NO).
NO is a vasodilator that relaxes the walls of your blood vessels, promotes vascular elasticity, and lowers blood pressure.
Anti-inflammatory effects
Estrogen has body-wide anti-inflammatory properties. It helps suppress the production of substances that cause inflammation in your cardiovascular system, like pro-inflammatory cytokines (a type of protein) that can damage blood vessels and reduce elasticity.
At the same time, estrogen promotes the formation of anti-inflammatory cytokines and supports antioxidant activity against substances that damage the endothelial lining of blood vessels.
These processes, combined with estrogen’s ability to help LDL cholesterol clear from the bloodstream, help protect the structure and integrity of your blood vessels. Estrogen also helps reduce the risk of plaque buildup and atherosclerosis (hardening of the arteries).
Menopause is a time in life when people assigned female at birth experience a decline and eventual end of fertility. It occurs as the ovaries stop producing hormones, including estrogen, and the menstrual cycle permanently ends.
In people assigned female at birth, the ovaries are the primary producers of estrogen for the body. When their function declines, levels of estrogen naturally decrease, and the risk of cardiovascular conditions increases.
According to the American Heart Association, menopause is
- aging
- changes in the lipid profile
- elevated blood pressure
Additionally, people assigned female at birth who enter menopause early by the age of 40 years (early menopause) have a
The benefits of estrogen for heart health are not limited to people assigned female at birth.
People assigned male at birth also produce estrogen, though at lower levels by the conversion of testosterone. For males, estrogen provides the same cardiovascular protective properties. The relationship is less clear when compared with people assigned female at birth.
According to a small, single study from 2019, low levels of estrogen and testosterone in older men (ages 65 years and older) were related to coronary heart disease and heart attack.
Estrogen balance is key
The protective benefits of estrogen for your heart are based on having enough estrogen or the appropriate estrogen balance necessary for your body.
Having high estrogen does not mean you gain more cardiovascular benefits. Increased estrogen levels in people assigned male or female at birth have a link with negative health effects, like an increased risk of blood clots and a condition called venous thromboembolism.
Previous studies suggested that hormone replacement therapy (HRT), which involves supplementing your body with estrogen, increases cardiovascular risk. However,
Your age, underlying causes of estrogen depletion, and co-existing medical conditions are the factors your doctor will consider before recommending HRT treatment.
HRT isn’t suitable for everyone. Doctors do not usually
If you are experiencing menopause symptoms, your doctor will discuss with you the risks and benefits of starting HRT. They may also discuss lifestyle changes that can help with symptoms, including:
- maintaining an optimal weight
- reducing stress
- exercising regularly
Estrogen protects against heart disease in people assigned male or female at birth, but keeping it in balance is the key. Low estrogen levels can increase your risk of cardiovascular conditions, but high estrogen levels can also have a negative effect on your heart.
Depending on your individual circumstances, your doctor may recommend lifestyle changes to boost estrogen or prescribe HRT as an option to support your heart health.
