December 25, 2024 • 15 mins
In this episode we talk about how estradiol is not just a “female hormone” and why men should consider using it too or at least not block it. We also discuss the amazing benefits it has for women and what types of supplementations are out there.
During the Q&A we answer the following questions
- Should men supplement with estradiol?
- Does a woman have to be on progesterone while on estrogen?
If you have any burning questions, you would like answered send them to customer-service@steelcity-trt.com and it might get answered on the podcast.
Check out the smart link below to see what services are offered at Steel City HRT and Weight Loss in addition to discounts, blogs and links to other social media content.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
So if you hate having erections, block the estrogen.
(00:20):
Welcome to Hormones Happen, a podcast designed for individuals like you who are curious about
the amazing benefits of hormone replacement therapy.
I'm your host Jeremiah and I'm a nurse practitioner who specializes in HRT.
I have seen firsthand the debilitating effects of hormone deficiency and have personally
experienced the benefits of optimization.
My goal is to arm you with information regarding the good, the bad, and even taboo aspects
(00:45):
of HRT while answering your burning questions.
Please join me for today's episode of the Hormones Happen podcast.
(01:08):
Welcome back everyone to the second episode of Hormones Happen.
Last week we talked about the benefits of testosterone for both men and women and today
we will discuss the amazing effects of estrogen, specifically estradiol.
Often overshadowed by testosterone and inaccurately labeled as a quote unquote female hormone,
(01:29):
estradiol is truly an unsung hero.
For context, it is important to first realize that estrogen is an umbrella term and encompasses
four different types of estrogens that we know of.
Estrion, E1, is the most prevalent type after menopause.
Estradiol, E2, is the most common type during a woman's fertile years and the most abundant
(01:52):
type in males.
Estriol, E3, is present in a female during pregnancy and estretrol, E4, is found in fetal
circulation.
The majority of benefits regarding bioidentical hormone replacement therapy, or HRT, is centered
around estradiol due to its affinity for estrogen beta receptors which slow growth and oppose
(02:17):
estrogen alpha receptors which cause growth.
In a female, estradiol is predominantly produced in the ovaries but is also made in the adrenal
glands and from aromatization of testosterone.
In males, small amounts of both estriol and estradiol are made in the testes and adrenal
(02:38):
glands but the majority is converted from testosterone.
Why do we care about estradiol at all?
Believe it or not, estradiol is not just a hormone that influences reproductive health
but has significant impact on bone mineral density, cardiac health, mood stabilization,
and even fat distribution.
(02:59):
Low estradiol levels in both men and women can cause symptoms such as fatigue, joint
pain, osteoporosis, irritability, and depression, and even difficulty losing weight.
Let's hone in on some of those benefits again for a second because I often get guys and
sometimes women tell me that they never knew estradiol had such an important role in overall
(03:24):
health.
In regards to preserving bone strength, women are at a particularly high risk of osteoporosis
after menopause as the estradiol levels fall.
Imagine this, you're carrying groceries and suddenly feel a sharp pain in your wrist.
You end up going to your primary care provider only to find out that your bones have become
weak and brittle in your older age.
(03:46):
While men are at much lesser risk of osteoporosis, if a man is intentionally blocking their estradiol,
they significantly increase it.
Let's take 40-year-old John Doe for example, who is on TRT while blocking the aromatization
of testosterone to estradiol with an aromatase inhibitor such as anastrazol.
(04:07):
Testosterone level is beautiful at around 1400 to 1500 and he falls at the airport fracturing
his hip.
This is not a normal occurrence for a quote unquote healthy 40-year-old to fracture a
hip.
On further evaluation, his estradiol level is undetectable and he too has osteoporosis.
(04:28):
The biggest issue with both of these scenarios is that they are completely preventable.
What about mental health?
That's important, right?
The number one complaint I get from women crossing from perimenopause to postmenopause
is increased agitation and anxiety.
When I take over care of a man from another clinic that was using estrogen blockers, he
(04:49):
will often report increased agitation as well.
Estradiol has a massive influence on mental health improvements by increasing the production
of serotonin which is called a feel-good neurotransmitter in the brain and by influencing the activity
of other mood-regulating chemicals like endorphins.
Estradiol can also help prevent dementia by protecting brain cells from damage, reducing
(05:13):
inflammation, promoting neuron growth and repair, and improving blood flow to the brain
resulting in what's called brain volumization.
Let's take 45 year old Jane Doe who has noticed that work has been causing her increased anxiety
and she has been forgetting simple tasks such as taking out the trash once a week.
(05:33):
These are real life examples guys of common occurrences that are also very preventable.
Age spots, wrinkles, loose skin, these are all common signs of aging but estradiol promotes
collagen production which gives the skin its elasticity, reduces wrinkles.
(05:54):
Estradiol is also responsible for keeping your hair thick and healthy in both men and
women.
This one's for the guys.
Let's go back to 40 year old John Doe taking TRT with an estrogen blocker.
He feels good.
He looks good.
But he comes to me because he is unable to get erections.
I'm not making these things up guys.
(06:15):
It happens more than you think.
I get an estradiol level only to find out it's undetectable.
This is real talk guys.
You have estradiol receptors on the penis.
So if you hate having erections, block the estrogen.
For the women, estradiol is known as the hormone of youth due to its role in giving a developing
(06:38):
woman all of the growth in the right places such as the breast, hips, buttocks, but it
also regulates sexual desire.
As a woman ages, she enters menopause.
Estrione is now the primary estrogen leading to negative growth such as tumors, cardiac
disease, vaginal atrophy, and uterine fibroids.
(07:01):
The list goes on and on.
Now that we can all agree that estradiol is our friend, how can we supplement it?
Just like with testosterone, estradiol comes in a variety of forms such as pills, creams,
patches, injections, and even pellets.
As I've said before, I am not a fan of pellets and feel that it is just a cash grab for the
(07:24):
companies that produce them.
I recommend creams as a first line therapy for women due to the ease of application,
versatility, and ability to adjust the dosage.
Regarding dosage and frequency, you have to take into account whether the patient is in
perimenopause, postmenopause, or 10 years postmenopause because each has its own considerations.
(07:49):
I do have a lot of patients that have been on oral estradiol at one point or another
and while that is a great once a day option, there have been some studies that show it
has a higher risk of blood clot development compared to the creams.
The reason is because oral estradiol elevates levels of coagulation factors and inflammatory
markers when it is metabolized by the liver, whereas the cream bypasses liver metabolism
(08:14):
and is absorbed through capillaries.
With that being said, lifestyle plays a large role in this and if your risk of blood clots
is inherently high from a sedentary lifestyle, smoking, or genetic predisposition, it doesn't
matter whether or not you are on creams or pills because you are still at high risk.
(08:35):
Some women prefer the injections, but honestly I'm not too familiar with this mode of administration
and mostly stick to creams.
I will be looking more into this though and will probably have some more insight in the
near future.
So to sum it up, estradiol is beneficial for both men and women for a variety of reasons.
(08:57):
Although it has been outcasted due to flawed studies such as the Women's Health Initiative
in the 2000s, estradiol is one of the safest and most effective therapies out there.
We live in a reactive society where we would much rather treat a disease instead of preventing
it from happening in the first place.
Now I may have to put my tin foil hat on here, but I truly believe this is due to the greed
(09:20):
of the pharmaceutical companies and the boatloads of money they make treating conditions caused
by hormone deficiency.
With all the endocrine disruptors in society, we are experiencing significant burdens on
our hormones and because of this we are developing secondary conditions such as insulin resistance
and metabolic disease.
(09:41):
They created the market because now we are not only treating the disease, but the side
effects of the treatments.
While HRT may not be the panacea to all of your problems, the fact that the government
regulates it so tightly must mean something.
In summary, estradiol is good for everyone except big pharma.
(10:05):
We interrupt this program to bring you an important announcement.
Do you experience excessive tiredness during the day?
Difficulty sleeping at night?
Increased anxiety or little to no libido?
These could all be signs of hormone deficiency.
We live in a highly inflamed society where war is being waged against our hormones.
(10:27):
The days of aging naturally are gone, but that doesn't mean you can't fight back.
At Steel City HRT and Weight Loss, we specialize in individualized care with an emphasis on
optimization with routine blood work and open channels of communication.
If you are experiencing any of these symptoms or want to join the fight for hormones, text
or call 719-669-4223 now.
(11:04):
Time for a little bit of questions and answers now.
Q&A time.
If you have any questions you would like to be answered on the podcast, be sure to send
them to the email that I have in the link below or post it to the Steel City HRT and
Weight Loss Facebook page.
I can't guarantee that I'll do a whole podcast on it, but I can at least feature it in the
(11:24):
Q&A section.
Question 1.
Should men supplement with estradiol?
This is a great question and while this is a bit taboo outside of gender reassignment,
I absolutely believe they should, on a case by case basis.
I have talked to several other providers in this space who have been supplementing estradiol
(11:49):
on their male patients on TRT.
Studies have actually shown a prostate protective effect of estradiol due to its interaction
with estrogen beta receptors which prevent growth.
That coupled with the improvement in bow mineral density, prevention of plaque build up in
the arteries, and improved erection strength sounds like a miracle drug, right?
(12:12):
The caveat is finding the sweet spot because when supplementing with estradiol, we narrow
the testosterone to estradiol ratio and risk developing estrogenic side effects such as
nipple tenderness, hot flashes, and night sweats.
I personally supplement with estradiol every other day for the protective properties and
(12:34):
have had my estradiol level as high as 110 picograms per milliliter.
But you have to understand that my testosterone levels were north of 1500 nanograms per deciliter
which is pretty common for most men on TRT.
I have never developed any estrogenic side effects and in fact noticed an improvement
in my physique and skin clarity.
(12:57):
This will vary from person to person and I don't make it a mainstay of therapy but as
time goes on and we learn more about the interplay between estradiol and male health, this is
probably going to change.
Question number 2.
Does a woman have to be on progesterone while on estrogen?
(13:17):
The answer is it depends.
Estradiol causes thickening of the uterine lining and increases the risk of endometrial
hyperplasia and even endometrial cancer if not regulated by progesterone.
Progesterone stabilizes and thins the uterine lining and in a physiological cycle counterbalances
(13:38):
estrogen's effects on the body, easing symptoms such as irritability, bloating, and breast
tenderness.
Technically, if a woman had a hysterectomy meaning she no longer has a uterus, then you
could argue that progesterone is not needed and while that is true in terms of endometrial
hyperplasia, progesterone does so many more amazing things for the brain that it would
(14:03):
be unfair to tell a woman to avoid it.
I do see this quite often that a woman has been put on estradiol as monotherapy after
having had a hysterectomy and while she will feel the benefit, it's a small piece of what
she could have with progesterone.
Our bodies make these hormones together and when we act on it in an unnatural way such
(14:27):
as surgical removal of an organ, our body doesn't know this.
We're trying to achieve a state of health similar to when we were young, healthy, and
carefree and while HRT won't literally make you younger, it can make you feel younger
and as the evidence shows, it will make you healthier.
(14:48):
So to sum that up, if a woman has a uterus, progesterone is required.
If she doesn't have a uterus, then technically it is not required.
I want to thank everyone for listening to today's episode of Hormones Happen and hope
(15:09):
that you were able to find some value in the information that was provided.
If you have any burning questions that you would like to have discussed on the podcast,
please send them to the email listed in the description or message us on the SteelCityHRT
and Weight Loss Facebook page.
Remember, you are not alone in the war on hormones.
Stay optimized.
So if you hate having erections, block the estrogen.
(00:20):
Welcome to Hormones Happen, a podcast designed for individuals like you who are curious about
the amazing benefits of hormone replacement therapy.
I'm your host Jeremiah and I'm a nurse practitioner who specializes in HRT.
I have seen firsthand the debilitating effects of hormone deficiency and have personally
experienced the benefits of optimization.
My goal is to arm you with information regarding the good, the bad, and even taboo aspects
(00:45):
of HRT while answering your burning questions.
Please join me for today's episode of the Hormones Happen podcast.
(01:08):
Welcome back everyone to the second episode of Hormones Happen.
Last week we talked about the benefits of testosterone for both men and women and today
we will discuss the amazing effects of estrogen, specifically estradiol.
Often overshadowed by testosterone and inaccurately labeled as a quote unquote female hormone,
(01:29):
estradiol is truly an unsung hero.
For context, it is important to first realize that estrogen is an umbrella term and encompasses
four different types of estrogens that we know of.
Estrion, E1, is the most prevalent type after menopause.
Estradiol, E2, is the most common type during a woman's fertile years and the most abundant
(01:52):
type in males.
Estriol, E3, is present in a female during pregnancy and estretrol, E4, is found in fetal
circulation.
The majority of benefits regarding bioidentical hormone replacement therapy, or HRT, is centered
around estradiol due to its affinity for estrogen beta receptors which slow growth and oppose
(02:17):
estrogen alpha receptors which cause growth.
In a female, estradiol is predominantly produced in the ovaries but is also made in the adrenal
glands and from aromatization of testosterone.
In males, small amounts of both estriol and estradiol are made in the testes and adrenal
(02:38):
glands but the majority is converted from testosterone.
Why do we care about estradiol at all?
Believe it or not, estradiol is not just a hormone that influences reproductive health
but has significant impact on bone mineral density, cardiac health, mood stabilization,
and even fat distribution.
(02:59):
Low estradiol levels in both men and women can cause symptoms such as fatigue, joint
pain, osteoporosis, irritability, and depression, and even difficulty losing weight.
Let's hone in on some of those benefits again for a second because I often get guys and
sometimes women tell me that they never knew estradiol had such an important role in overall
(03:24):
health.
In regards to preserving bone strength, women are at a particularly high risk of osteoporosis
after menopause as the estradiol levels fall.
Imagine this, you're carrying groceries and suddenly feel a sharp pain in your wrist.
You end up going to your primary care provider only to find out that your bones have become
weak and brittle in your older age.
(03:46):
While men are at much lesser risk of osteoporosis, if a man is intentionally blocking their estradiol,
they significantly increase it.
Let's take 40-year-old John Doe for example, who is on TRT while blocking the aromatization
of testosterone to estradiol with an aromatase inhibitor such as anastrazol.
(04:07):
Testosterone level is beautiful at around 1400 to 1500 and he falls at the airport fracturing
his hip.
This is not a normal occurrence for a quote unquote healthy 40-year-old to fracture a
hip.
On further evaluation, his estradiol level is undetectable and he too has osteoporosis.
(04:28):
The biggest issue with both of these scenarios is that they are completely preventable.
What about mental health?
That's important, right?
The number one complaint I get from women crossing from perimenopause to postmenopause
is increased agitation and anxiety.
When I take over care of a man from another clinic that was using estrogen blockers, he
(04:49):
will often report increased agitation as well.
Estradiol has a massive influence on mental health improvements by increasing the production
of serotonin which is called a feel-good neurotransmitter in the brain and by influencing the activity
of other mood-regulating chemicals like endorphins.
Estradiol can also help prevent dementia by protecting brain cells from damage, reducing
(05:13):
inflammation, promoting neuron growth and repair, and improving blood flow to the brain
resulting in what's called brain volumization.
Let's take 45 year old Jane Doe who has noticed that work has been causing her increased anxiety
and she has been forgetting simple tasks such as taking out the trash once a week.
(05:33):
These are real life examples guys of common occurrences that are also very preventable.
Age spots, wrinkles, loose skin, these are all common signs of aging but estradiol promotes
collagen production which gives the skin its elasticity, reduces wrinkles.
(05:54):
Estradiol is also responsible for keeping your hair thick and healthy in both men and
women.
This one's for the guys.
Let's go back to 40 year old John Doe taking TRT with an estrogen blocker.
He feels good.
He looks good.
But he comes to me because he is unable to get erections.
I'm not making these things up guys.
(06:15):
It happens more than you think.
I get an estradiol level only to find out it's undetectable.
This is real talk guys.
You have estradiol receptors on the penis.
So if you hate having erections, block the estrogen.
For the women, estradiol is known as the hormone of youth due to its role in giving a developing
(06:38):
woman all of the growth in the right places such as the breast, hips, buttocks, but it
also regulates sexual desire.
As a woman ages, she enters menopause.
Estrione is now the primary estrogen leading to negative growth such as tumors, cardiac
disease, vaginal atrophy, and uterine fibroids.
(07:01):
The list goes on and on.
Now that we can all agree that estradiol is our friend, how can we supplement it?
Just like with testosterone, estradiol comes in a variety of forms such as pills, creams,
patches, injections, and even pellets.
As I've said before, I am not a fan of pellets and feel that it is just a cash grab for the
(07:24):
companies that produce them.
I recommend creams as a first line therapy for women due to the ease of application,
versatility, and ability to adjust the dosage.
Regarding dosage and frequency, you have to take into account whether the patient is in
perimenopause, postmenopause, or 10 years postmenopause because each has its own considerations.
(07:49):
I do have a lot of patients that have been on oral estradiol at one point or another
and while that is a great once a day option, there have been some studies that show it
has a higher risk of blood clot development compared to the creams.
The reason is because oral estradiol elevates levels of coagulation factors and inflammatory
markers when it is metabolized by the liver, whereas the cream bypasses liver metabolism
(08:14):
and is absorbed through capillaries.
With that being said, lifestyle plays a large role in this and if your risk of blood clots
is inherently high from a sedentary lifestyle, smoking, or genetic predisposition, it doesn't
matter whether or not you are on creams or pills because you are still at high risk.
(08:35):
Some women prefer the injections, but honestly I'm not too familiar with this mode of administration
and mostly stick to creams.
I will be looking more into this though and will probably have some more insight in the
near future.
So to sum it up, estradiol is beneficial for both men and women for a variety of reasons.
(08:57):
Although it has been outcasted due to flawed studies such as the Women's Health Initiative
in the 2000s, estradiol is one of the safest and most effective therapies out there.
We live in a reactive society where we would much rather treat a disease instead of preventing
it from happening in the first place.
Now I may have to put my tin foil hat on here, but I truly believe this is due to the greed
(09:20):
of the pharmaceutical companies and the boatloads of money they make treating conditions caused
by hormone deficiency.
With all the endocrine disruptors in society, we are experiencing significant burdens on
our hormones and because of this we are developing secondary conditions such as insulin resistance
and metabolic disease.
(09:41):
They created the market because now we are not only treating the disease, but the side
effects of the treatments.
While HRT may not be the panacea to all of your problems, the fact that the government
regulates it so tightly must mean something.
In summary, estradiol is good for everyone except big pharma.
(10:05):
We interrupt this program to bring you an important announcement.
Do you experience excessive tiredness during the day?
Difficulty sleeping at night?
Increased anxiety or little to no libido?
These could all be signs of hormone deficiency.
We live in a highly inflamed society where war is being waged against our hormones.
(10:27):
The days of aging naturally are gone, but that doesn't mean you can't fight back.
At Steel City HRT and Weight Loss, we specialize in individualized care with an emphasis on
optimization with routine blood work and open channels of communication.
If you are experiencing any of these symptoms or want to join the fight for hormones, text
or call 719-669-4223 now.
(11:04):
Time for a little bit of questions and answers now.
Q&A time.
If you have any questions you would like to be answered on the podcast, be sure to send
them to the email that I have in the link below or post it to the Steel City HRT and
Weight Loss Facebook page.
I can't guarantee that I'll do a whole podcast on it, but I can at least feature it in the
(11:24):
Q&A section.
Question 1.
Should men supplement with estradiol?
This is a great question and while this is a bit taboo outside of gender reassignment,
I absolutely believe they should, on a case by case basis.
I have talked to several other providers in this space who have been supplementing estradiol
(11:49):
on their male patients on TRT.
Studies have actually shown a prostate protective effect of estradiol due to its interaction
with estrogen beta receptors which prevent growth.
That coupled with the improvement in bow mineral density, prevention of plaque build up in
the arteries, and improved erection strength sounds like a miracle drug, right?
(12:12):
The caveat is finding the sweet spot because when supplementing with estradiol, we narrow
the testosterone to estradiol ratio and risk developing estrogenic side effects such as
nipple tenderness, hot flashes, and night sweats.
I personally supplement with estradiol every other day for the protective properties and
(12:34):
have had my estradiol level as high as 110 picograms per milliliter.
But you have to understand that my testosterone levels were north of 1500 nanograms per deciliter
which is pretty common for most men on TRT.
I have never developed any estrogenic side effects and in fact noticed an improvement
in my physique and skin clarity.
(12:57):
This will vary from person to person and I don't make it a mainstay of therapy but as
time goes on and we learn more about the interplay between estradiol and male health, this is
probably going to change.
Question number 2.
Does a woman have to be on progesterone while on estrogen?
(13:17):
The answer is it depends.
Estradiol causes thickening of the uterine lining and increases the risk of endometrial
hyperplasia and even endometrial cancer if not regulated by progesterone.
Progesterone stabilizes and thins the uterine lining and in a physiological cycle counterbalances
(13:38):
estrogen's effects on the body, easing symptoms such as irritability, bloating, and breast
tenderness.
Technically, if a woman had a hysterectomy meaning she no longer has a uterus, then you
could argue that progesterone is not needed and while that is true in terms of endometrial
hyperplasia, progesterone does so many more amazing things for the brain that it would
(14:03):
be unfair to tell a woman to avoid it.
I do see this quite often that a woman has been put on estradiol as monotherapy after
having had a hysterectomy and while she will feel the benefit, it's a small piece of what
she could have with progesterone.
Our bodies make these hormones together and when we act on it in an unnatural way such
(14:27):
as surgical removal of an organ, our body doesn't know this.
We're trying to achieve a state of health similar to when we were young, healthy, and
carefree and while HRT won't literally make you younger, it can make you feel younger
and as the evidence shows, it will make you healthier.
(14:48):
So to sum that up, if a woman has a uterus, progesterone is required.
If she doesn't have a uterus, then technically it is not required.
I want to thank everyone for listening to today's episode of Hormones Happen and hope
(15:09):
that you were able to find some value in the information that was provided.
If you have any burning questions that you would like to have discussed on the podcast,
please send them to the email listed in the description or message us on the SteelCityHRT
and Weight Loss Facebook page.
Remember, you are not alone in the war on hormones.
Stay optimized.
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