Female hormones and their role in women's health

It's wrong to think that the sex hormones are produced only when the puberty strikes in since it is produced since birth and even also plays a vital role in the development of the baby.

When puberty kicks in the hormones then play a role in a way that then it makes the women sexually active and capable of conceiving a baby.

During pregnancy and post pregnancy there is a significant change in the levels of female hormones in the body.

The next change in the level of hormones in the blood occurs after menopause.

Estrogen: 

This hormone plays an essential role in the growth and development of female secondary sexual characteristics, such as breasts, pubic and armpit hair, and the regulation of the menstrual cycle and reproductive system.

During the menstrual cycle, estrogen produces an environment suitable for fertilization and implantation, since it helps in the thickening of the inner lining of uterus called the endometrium. It also helps in the development of the placenta which provides nutrition for the developing embryo.

It helps in maintains bone strength by working with calcium, vitamin D and other minerals to prevent bone loss.

In females, estrogen affects various parts of the body, such as:

• Ovaries: where it helps in the formation and the growth of egg follicle.
• Vagina: stimulates the growth of vagina to its adult size, increases the vaginal acidity which prevents bacterial infection. It also helps in vaginal lubrication.
• Fallopian tubes: growth of a thick muscular wall in the fallopian tube which then supports the movement which aids in the fusion of sperm and the egg.
• Uterus: growth and maintenance of the endometrium lining. It also assists in delivery by supporting the contraction movement of the uterine muscles, and in the removal of dead uterine tissues during menstruation.
• It also plays an important role in the development of mammary glands and the increase in breast size on the onset of puberty.
• In cervix it facilitates the movement on sperm cell to an egg and enables fertilization.

Interestingly an insignificant amount of estrogen is also found in males, where it is essential for modulating the formation of sperms (spermatogenesis) and maintaining the sexual drive. And it also helps in erectile function.

Progesterone: 

Produced by the corpus luteum until about 10 weeks of gestation, the main role of this hormone is to prepare the inner lining of the uterus for potential pregnancy after the ovulation, in the second half of the menstrual cycle. If there is no pregnancy the body lowers the level of progesterone and thus triggers menstruation, and in case of pregnancy the high level of progesterone is maintained in the blood.

It also inhibits contraction of the uterine wall, which can otherwise restrain the adherence of the egg to the wall thus supports pregnancy.

Progesterone is necessary for breast development during puberty and breastfeeding.

It complements some effects of estrogen, another female hormone.

It also works with testosterone, the precursor for adrenal hormones. Men produce a small amount of progesterone to help in sperm development.

Human chorionic gonadotropin: is the main female hormone produced only during pregnancy. It is this hormone which helps in detection of pregnancy both in urine and blood.

hCG is produced in large amounts in early phase of pregnancy. hCG's primary role is to keep the corpus luteum functioning, so that the corpus luteum continues to produce estrogen and progesterone.

In addition to keeping the corpus luteum alive, hCG also:

• stimulates the production of fetal testosterone, helping to develop the masculine sexual organs, and
• enhances corticosteroid production, which helps in suppression of the maternal immune responses. 

Testosterone: 

it is essentially a male hormone but is also present in the female body in a very small amount. It plays a vital role in bone strength, brain function and the overall development of lean muscle mass and strength in the female body. It also helps contribute to a general sense of well-being and higher energy levels. And perhaps most crucial is its effect on a woman’s libido or sex drive.

Apart from the above hormones, there are few more female hormones which play an important role during menstruation and pregnancy.

• Gonadotropin-releasing hormone: Along with estrogen, this hormone is also responsible for the formation and release of gonadotropins (FSH and LH). FSH and LH are called gonadotropins because their role is to maintain the structure and function of gonads.
• Follicle stimulating hormones (FSH): It is responsible for the growth of egg (ovarian follicle) and increasing estradiol production. This plays a major role in the maturation of ovarian follicles to be released at the time of ovulation.
• Luteinizing hormone (LH): LH controls the production of estrogen and release of the developed and mature follicle from the ovary at the time of ovulation.
• Prolactin: This hormone is mainly responsible for the development of mammary glands and the production of milk.
• Oxytocin: Oxytocin facilitates the contraction of the uterus during childbirth and helps increase the milk formation during breastfeeding. It also increases the production of prostaglandins which further aids in the womb contraction, easing the process of delivery.
• Relaxin: Relaxin works with estrogen to prepare the endometrium for pregnancy. It relaxes your pelvic muscles so your uterus can expand for accommodating the growing foetus. Also, relaxin helps in maintaining an increased blood flow during pregnancy by relaxing blood vessel walls.

All the female hormones can be detected by the blood, urine and saliva test.

Estrogen: 

Estradiol test is performed to check the level of estrogen in the blood, it detects all the three types of estrogen, E1, E2 and E3.

For menstruation-related issues or for the issues regarding puberty the main estrogen levels to be checked are E1 and E2, while during pregnancy the main estrogen type becomes E3.

Normal levels of estradiol (E2) for menstruating women range from 15 to 350 picograms per millilitre (pg/mL). For postmenopausal women, normal levels should be lower than 10 pg/mL.

If your estradiol or estrone levels are higher than normal, it may be due to:

• A tumour of the ovaries, adrenal glands, or testicles
• Cirrhosis
• Early puberty in girls, and it is also responsible for the late onset of puberty in males
• Hyperthyroidism

If your estradiol or estrone levels are lower than normal, it may be due to:

• Primary ovarian insufficiency, a condition that causes a woman's ovaries to stop working before she is 40 years old, before the actual age range for menopause
• Turner syndrome, a genetic disorder in which a woman's sexual characteristics don't develop properly. In this condition, the female has one X chromosome instead of two.
• An eating disorder, such as anorexia nervosa
• Polycystic ovary syndrome, in which the female produces higher than normal amount of male hormones. It is one of the leading causes of female infertility.

Progesterone: 

Progesterone levels are also checked by a simple blood test.

In general, normal serum progesterone test results fall in the following ranges:

• Men, postmenopausal women, and women at the beginning of their menstrual cycle: 1 ng/mL or under
• Women in the middle of their menstrual cycle: 5 to 20 ng/mL
• Pregnant women in their first trimester: 11.2 to 90 ng/mL
• Pregnant women in their second trimester: 25.6 to 89.4 ng/mL
• Pregnant women in their third trimester: 48.4 to 42.5 ng/mL

High levels of progesterone: If you’re not pregnant, but the test shows increased amounts of progesterone, it may be due to the following reasons:

• Ovarian cysts
• A rare form of ovarian cancer
• Overproduction of progesterone
• Adrenal cancer

Low levels of progesterone: If the test shows a lower than normal level of progesterone in the serum, it could be due to:

• Toxaemia due to gestational hypertension- a condition that can happen late in your pregnancy that could be serious if not treated
• Improper functioning of the ovaries
• Amenorrhea
• Miscarriage

Testosterone: 

The testosterone levels in women range from 15-70 ng/dL.

A higher level of testosterone may be due to:

• Malfunctioning of adrenal glands,
• Polycystic ovarian syndrome (PCOS).

Human chorionic gonadotropin:

This hormone is released exclusively during pregnancy, so, if the hCG test shows a positive result then it is an indication of pregnancy. It reaches a peak at about 8 weeks of pregnancy (120 to 130 IU/ml) and then decreases gradually, reaching a lowest at about 16 weeks (20-30 IU/ml). A negligible amount of hCG is found in the blood after the 16th week of pregnancy till childbirth. 

Hormonal balance is a vital aspect for healthy living.

A woman experiences hormonal changes several times in her lifetime. These include:

• Onset of puberty
• Menstruation
• Pregnancy
• Perimenopause (ovaries start producing less estrogen), menopause and postmenopause.

Changes in the female hormone levels can be best observed with the changes in the menstrual cycle.

A proper menstruation cycle shows that there is a correct balance between the hormones in the female body. However, any irregularities or changes in the menstrual cycle may indicate a hormonal imbalance.

Symptoms of hormonal imbalances in women include:

• Heavy period, irregular periods, or painful periods
• Osteoporosis (weak, brittle bones)
• Hot flashes (it is the sudden feeling of heat) and night sweats
• Vaginal dryness and irritation
• Breast tenderness
• Indigestion
• Constipation and diarrhoea
• Acne during or just before menstruation
• Uterine bleeding
• Increased hair growth on the body
• Infertility
• Weight gain
• Thinning hair or hair loss
• Deepening of the voice
• Clitoral enlargement

Some basic ways to deal with hormone imbalance are:

• Having a balanced diet along with the intake of supplements such as fish oil which helps in maintaining a balance between sex hormones.
• Regular exercise
• Managing stress, and getting proper sleep
• Reduce or eliminate consumption of alcohol (red wine causes increases in estrogen level).

Hormone supplement therapy or hormone replacement therapy is yet another option. Though it comes with many side effects.

Estrogen

Low level of estrogen can be corrected by:

• Eating foods rich in estrogen-like compounds which are derivative of plants (phytoestrogens), such as soybean, green tea, grapes, flaxseeds, green leafy vegetables, citrus fruits.
• Cutting down the consumption of estrogen unfriendly drinks such as alcohol.
• Avoiding stress
• Practising yoga.

Whereas a high level of estrogen can be managed by:

• Taking enough fibres in diet
• Avoiding plastics: Plastic water bottles, food containers, bags, and more often contain chemicals like bisphenol-A (BPA) and bisphenol-S (BPS), which mimic estrogen in the body.
• Chose natural and organic products for skin care. Most of the synthetic skin care products contain xenoestrogens. These are the manmade chemicals which mimic estrogen in the body.
• Regular work out

Progesterone

Low levels of progesterone can be managed by:

• Taking foods which stimulates the production of progesterone, such as beans, broccoli, spinach, nuts, fish, oysters.
• Taking healthier fats in your diet.
• Reducing stress, even over exercising leads to stress.
• Maintain a healthy body weight.

High levels of progesterone is manageable by:

• Proper exercising
• Avoiding smoking, since nicotine affects the functioning of the adrenal gland, causing hormone imbalance.
• Reducing the consumption of caffeine.

High testosterone levels can be controlled by achieving and maintaining a healthy body weight.

Not only the chemical supplements but even the natural sources of female hormones can be detrimental to health if consumed in larger quantity.

Prolonged use of phytoestrogens like soybeans and other soy products can cause breast cancer. Apart from this, individual hormone supplements are also associated with some side effects. Let us have a look at them:

• Side effects of estrogen: nausea, vomiting, bloating, stomach cramps, breast tenderness.
• Side effects of progesterone: drowsiness, headache, breast pain, mood change.
• Side effects of testosterone: irregular periods, baldness, excess body hair.
• Side effects of human chorionic gonadotropin: fatigue, restlessness, headache.

The side effects of hormone replacement therapy include the risk of getting a heart attack due to increased blood clotting. It can also cause endometrial cancer in women. Some milder side effects of hormone replacement therapy include nausea, bloating, dizziness, acidity, vaginal irritation. If you have any of these symptoms, immediately stop the supplement and consult a doctor.