Does Estrogen Make You Gain Weight?

Does estrogen make you gain weightPostmenopausal women suffering from hot flashes, may hesitate to take estrogen because they’ve heard it can cause weight gain. Who needs any extra help to gain weight? Is there any truth to all this?

What are Bioidentical Hormones?

When you’re replacing deficient estrogen, it’s important to respect the wisdom of the body. No drug we give can approach the amazing complexity of the endocrine system. However, you can start by giving a hormone that is identical to the hormone that’s missing. We call these bioidentical hormones.

Another important factor is the route of administration. Estrogen is most commonly given as a pill that’s taken orally. It’s convenient and easy to pop a pill. But easy isn’t always the best. If we’re wanting to mimic the body, how does the ovary deliver estrogen to your tissues? I assure you the ovary doesn’t dump a big load of estrogen in your stomach once a day!! A more natural way to take estrogen is by applying it to the skin as a patch or cream. Estrogen taken in a pill form overloads your liver with excessive amounts of estrogen that increase harmful proteins, clotting factors and proinflammatory substances leading to various problems. Let me explain how oral estrogen leads to weight gain.

Weight Gain & Oral Estrogen

Weight gain from oral estrogen causes visceral obesity, the medical term for increased fat around your middle from fat that gets deposited in vital organs like the heart, kidneys and liver. This increased fat mass leads to increases in leptin produced by the fat cells. Topical, but not oral, estradiol prevents this increase in body fat and leptin. An interesting fact about visceral obesity is that women who take NO estrogen can also get weight gain around their middle because they develop insulin resistance. This is a frequent complaint from older women who are not on estrogen!

Oral, but not topical, estrogen increases the production of thyroxine-binding globulin (TBG) the carrier for thyroid hormone. Higher levels of TBG lower the amount of available thyroid hormone thereby lowering your metabolism. Oral, but not topical, estrogen also suppresses IGF-1, a marker for growth hormone. Growth hormone is needed to build muscle and burn fat. All this explains a common complaint I hear from women who’ve been on oral estrogen. “After starting oral estrogen, I gained 15 pounds in the first month and I didn’t increase my calories or lower my exercise. Now I’m eating less and exercising more and I just keep gaining!” Estrogen from injections or pellets can also lead to weight gain because the blood levels produced are much too high.

Weight gain from oral or injectable estrogen occurs because these preparations violate the natural physiology of the body. The ovary is amazing…it releases tiny bits of estradiol throughout the day directly into the blood stream. Even topical estradiol preparations can’t reproduce this same elegant effect, but it’s the closest delivery system we have. That’s why your chances of maintaining a healthy metabolism and weight are best when you choose topical estradiol preparations.

References:
O’Sullivan, AJ, Crampton LJ, Freund, et al, “The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women,” The Journal of Clinical Investigation, vol 102, (1998): pp 1035-1040.
Lwin R., Darnell B. Oster R, et al, Effect of oral estrogen on substrate utilization in postmenopausal women,” Fertility and Sterility, vol. 90, no 4, (2008): pp 1275-1278
DeCarlo C, Tommaselli G, et al, “Serum leptin levels and body composition in postmenopausal women: effects of hormone therapy,” Menopause, vol 11, no 4 (2004): pp 466-473
Nachtigall LE, Raju U, Banerjee S, et al, “Serum estradiol binding profiles in postmenopausal women undergoing three common estrogen replacement therapies: association with sex hormone binding globulin, estradiol and estrone levels,” Menopause, vol 7, (2000): pp 243-250.
Slater CC, Hodis HN, Mack WJ, et al, “Markedly elevated levels of estrone sulfate after long-term oral, but not transdermal, administration of estradiol in postmenopausal women,” Menopause, vol 8, (2001): pp 200-203

Is it better to go through menopause naturally?

December 20th, 2015

 

I’m often asked by women, “Isn’t it better to go through menopause naturally?  If God’s design was for us to go through menopause, why should we still be taking estrogen?”

 

Menopause simply means the end of a woman’s ability to bear children.  In 1900, the average age of menopause was 51, just like it is today, BUT in 1900, the average life expectancy for a woman was 50!  Many women in the 1800s died in childbirth and men often remarried because of this loss.

 

Today in 2015, life expectancy for women is pushing 80!  So essentially with modern medical advances, God has graced women with 30 extra years of life!  What are we to do with this precious gift of 30 extra years that He’s given us?? Are we to squander that gift by letting our bodies fall apart?

 

I think of my body as God’s temple that He’s given to me on loan.  God expects us to be good stewards and care for our bodies.  Taking estrogen is simply putting back a substance that’s part of your original design. Estrogen is a vital hormone that has over 400 actions on a woman’s body.  When you were twenty, you took estrogen for granted because everything worked automatically.  When you become menopausal and your estrogen levels fall, only then do you appreciate it’s significance

 

Women who don’t take estrogen have a higher risk of heart disease, strokes, osteoporosis, dementia and Alzheimer’s.   If this risk can be reduced with estrogen, why would you want to deprive yourself of this potential benefit?

 

I’m not saying ALL women should take estrogen, but every woman at some time in her life needs to make this important decision.  I want women to make that decision based on facts, not from fear and misinformation!  That’s why I wrote my book, “Outliving Your Ovaries:  An Endocrinologist Review the Risks and Rewards of Treating Menopause with Hormone Replacement.”

 

As I close on this weekend before we celebrate Christmas, I want to take a moment to thank God for all the blessings that he’s given me. With all the flurry of gift-giving and social activities at this time, it’s easy for us to forget that Jesus is the reason for this season.

 

Merry Christmas and Happy New Year!

 

Dr. Johnson

Testosterone: Achieving a Delicate Balance

Testosterone and women

 

When a woman goes through menopause and her ovaries stop producing estrogen and progesterone, the pituitary responds by increasing FSH, a hormone from the pituitary gland that has regulated these hormones throughout her reproductive life. However, when all the eggs have been depleted, no further estrogen or progesterone can be produced. Nonetheless, the pituitary, which is “hard-wired” to respond to low estrogen, continues to make increasingly higher levels of FSH.

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Feel Absolutely Empowered!

“Outliving Your Ovaries” is a must read for every woman. Not only because it demystifies so many controversial and conflicting views in treating menopause, but mostly because one can put that book down and feel absolutely empowered! Women can now have the intelligent and informed conversation with their doctors about their bodies that so many of us have struggled to have.

How Long Can I Safely Stay On My Hormone Therapy?

How long can I safely stay on my hormone therapy?

I am frequently asked the question, “How long can I safely stay on my hormone therapy? and I usually ask the woman, How long do you want to continue to feel well?” In all seriousness, there are no long-term studies that enable me to answer this question. Taking hormones less than five years seems to carry very little risk. However, the longer you take hormones the higher your risk.

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Is It Too Late For Me to Take Estrogen?

Dr. Marina Johnson answers the question: Is it too late for me to take estrogen?

At the time of menopause, each woman has a window of opportunity during which she needs to make the important decision of whether to take hormones. As the estrogen levels fall, her body begins to go through degenerative changes that accelerate her risk of heart disease along with the other changes we have previously described. The sooner a woman starts HRT after menopause, the fewer degenerative changes she will experience. If a woman waits 10 years to start HRT, the heart protection from estrogen is greatly diminished. The same applies brain protection; once brain cells have been lost, it becomes difficult to retrieve normal function. However, for protecting bones, estrogen is effective even when started after age 75.

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Why Is It Important To Measure Estrogen Blood Levels? Part 2 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

3. YOU CAN’T JUST GO BY “HOW YOU FEEL!”

I strongly endorse monitoring estradiol and testosterone blood levels to ensure appropriate dosage and effectiveness of hormone therapy. Monitoring estradiol levels in thousands of women since 1986 has led me to develop more precise hormone regimens producing blood levels comparable to a low physiologic range. As noted earlier, monitoring blood levels is especially important with topical therapy. Most post- menopausal women who see me initially have NEVER had their estrogen level checked!

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Why Is It Important To Measure Estrogen Blood Levels? Part 1 of 2

Why Is It Important To Measure Estradiol Blood Levels?

 

Many women who initially see me for menopause have never had their estradiol level checked. Their previous physician may have diagnosed menopause with an elevated FSH, but usually no further tests are done. I’d like to go through various reasons why I believe it is important to monitor estradiol levels.

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Does Estrogen-Only HRT Decrease Breast Cancer Risk? Here’s The Rest of The Story!

Estrogen-Only Hrt

A recent study in Lancet Oncology looking at data from the Women’s Health Initiative (WHI) reported that the use of estrogen (Premarin) alone was NOT associated with an increased risk of breast cancer and the use of estrogen-progestin (Prempro) increased the risk of breast cancer.

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Natural Menopause

Natural Menopause

The average age for menopause is 50 to 55. I’ve seen an occasional woman who has regular monthly periods and then one month has her last period and never has another. However, this is the exception rather than the rule. Typically, women begin with perimenopausal symptoms in their forties. As a woman approaches the end of perimenopause, the periods become lighter and start to become more infrequent. She may skip several months without a period, and then finally the periods stop completely. When the decline in hormones occurs very gradually, a woman may not experience severe symptoms because her body has had time to compensate for the decline in estrogen and progesterone. Often the age of menopause is genetically determined and it is helpful to ask when an older sister or mother went through menopause. A catastrophic, stressful life event can bring on menopause earlier than expected.

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MARINA JOHNSON
M.D., F.A.C.E.
MEDICAL DIRECTOR

BOARD CERTIFIED
IN ENDOCRINOLOGY
& METABOLISM AND
INTERNAL MEDICINE

10670 N Central Expressway
Suite 510
Dallas, Texas 75231-2111

214.574.4376 office
214.574.4377 fax

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