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The role of estrogen though a woman's life stages


To highlight Women’s Health Week 2023, we are featuring a hormone synonymous with women – ESTROGEN


Estrogen is a group of hormones.

  • Estrone (E1) is the form of estrogen that is made after menopause, largely in adipose (fat) tissue

  • Estradiol (E2) is the most potent form of estrogen made during reproductive years, mostly produced by the ovaries, plus some made by the adrenal glands and fat tissues

  • Estriol (E3) is a form of estrogen made by the placenta during pregnancy.

Supplemental sources of estrogen may be synthetic or body-identical estrogen on prescription, phytoestrogens can come from the diet such as soy products, and xenoestrogens can come from environmental toxins such as plastics and pesticides.


Estrogen helps initiate physical changes that happen to girls during puberty, helps regulate the menstrual cycle during a woman’s childbearing years and controls the growth of the uterine lining. But its not just a reproductive role that estrogen plays. Estrogen travels through the bloodstream and binds to estrogen receptors on cells in the brain, bone, liver, heart, skin, and other tissues in the body. Hence estrogen is important for a women’s overall health.


Low estrogen (and low progesterone) is typical of childhood and menopause. In menopausal women the reduction in estrogen impacts bone density and tissue integrity, increasing risk of osteoporosis, heart disease, insulin resistance, joint and tendon disorders, muscle loss, and vaginal issues such as prolapse, infections and dryness. Many of these conditions can be mitigated or prevented with attention to health before menopause and with treatment during if required. The eventual plateau of no progesterone and low estrogen can also be a liberating and more settled experience in life for many women.


During puberty and perimenopause there are phases of estrogen dominance, which is very normal, where there are increased estrogen levels relative to progesterone. This may cause heavy or irregular periods, menstrual and breast pain, headaches, and mood swings. In perimenopause, symptoms can also include hot flushes and night sweats.


Estrogen dominance can also be abnormal - the result of overproduction of estrogen by the body, exposure to environmental estrogens, and/or changes in estrogen metabolism, and is implicated in conditions like breast and uterine cancers, fibroids, endometriosis, and polycystic ovarian syndrome.


In pregnancy, both estrogen and progesterone are very high. Post-natally these hormones remain low while breastfeeding for at least 3-6 months. In some women this can impact mood, can contribute to aches and pains, and can impact vaginal tissue health.


Higher estrogen states such as pregnancy, the fluctuations during a menstrual cycle, estrogen dominant disorders, or perimenopause, can predispose some women to outbreaks of thrush (candida), conversely the low estrogen phases of a menstrual cycle, or during menopause increase risk of bacterial vaginosis (BV) and urinary tract infection (UTIs).


The role estrogen plays in a woman’s health is astounding! Women’s health physiotherapists need a thorough knowledge base to manage conditions through all of a woman’s life stages.


At Balance Health we have:

Casey Cleeland who has completed a post graduate certificate and is qualified to fit support pessaries for vaginal prolapse. Her passion is treating pregnant and post-natal women.

Kara Cassells treats women’s and men’s pelvic health. Kara particularly enjoys the rehabilitation of diastasis recti (abdominal separation).

Kristine Miles is also qualified in women’s pelvic and breast health, and is a qualified Lactation consultant (IBCLC). She also has a special interest in nutrition and the vaginal microbiome.

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