Estrogen (US English) or oestrogen (Commonwealth English) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal activity: estrone (E1), estradiol (E2), and estriol (E3). Estradiol, an estrane, is the most potent and prevalent. Another estrogen called estetrol (E4) is produced only during pregnancy.
Estrogens are synthesized in all vertebrates and some insects. Quantitatively, estrogens circulate at lower levels than androgens in both men and women. While estrogen levels are significantly lower in males than in females, estrogens nevertheless have important physiological roles in males.
Like all steroid hormones, estrogens readily diffuse across the cell membrane. Once inside the cell, they bind to and activate estrogen receptors (ERs) which in turn modulate the expression of many genes. Additionally, estrogens bind to and activate rapid-signaling membrane estrogen receptors (mERs), such as GPER (GPR30).
In addition to their role as natural hormones, estrogens are used as medications, for instance in menopausal hormone therapy, hormonal birth control and feminizing hormone therapy for transgender women, intersex people, and nonbinary people.
Synthetic and natural estrogens have been found in the environment and are referred to as xenoestrogens. Estrogens are among the wide range of endocrine-disrupting compounds and can cause health issues and reproductive dysfunction in both wildlife and humans.
Types and examples
The four major naturally occurring estrogens in women are estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4). Estradiol (E2) is the predominant estrogen during reproductive years both in terms of absolute serum levels as well as in terms of estrogenic activity. During menopause, estrone is the predominant circulating estrogen and during pregnancy estriol is the predominant circulating estrogen in terms of serum levels. Given by subcutaneous injection in mice, estradiol is about 10-fold more potent than estrone and about 100-fold more potent than estriol. Thus, estradiol is the most important estrogen in non-pregnant females who are between the menarche and menopause stages of life. However, during pregnancy this role shifts to estriol, and in postmenopausal women estrone becomes the primary form of estrogen in the body. Another type of estrogen called estetrol (E4) is produced only during pregnancy. All of the different forms of estrogen are synthesized from androgens, specifically testosterone and androstenedione, by the enzyme aromatase.
Minor endogenous estrogens, the biosyntheses of which do not involve aromatase, include 27-hydroxycholesterol, dehydroepiandrosterone (DHEA), 7-oxo-DHEA, 7α-hydroxy-DHEA, 16α-hydroxy-DHEA, 7β-hydroxyepiandrosterone, androstenedione (A4), androstenediol (A5), 3α-androstanediol, and 3β-androstanediol. Some estrogen metabolites, such as the catechol estrogens 2-hydroxyestradiol, 2-hydroxyestrone, 4-hydroxyestradiol, and 4-hydroxyestrone, as well as 16α-hydroxyestrone, are also estrogens with varying degrees of activity. The biological importance of these minor estrogens is not entirely clear.
Biological function
The actions of estrogen are mediated by the estrogen receptor (ER), a dimeric nuclear protein that binds to DNA and controls gene expression. Like other steroid hormones, estrogen enters passively into the cell where it binds to and activates the estrogen receptor. The estrogen:ER complex binds to specific DNA sequences called a hormone response element to activate the transcription of target genes (in a study using an estrogen-dependent breast cancer cell line as model, 89 such genes were identified). Since estrogen enters all cells, its actions are dependent on the presence of the ER in the cell. The ER is expressed in specific tissues including the ovary, uterus and breast. The metabolic effects of estrogen in postmenopausal women have been linked to the genetic polymorphism of the ER.
While estrogens are present in both men and women, they are usually present at significantly higher levels in biological females of reproductive age. They promote the development of female secondary sexual characteristics, such as breasts, darkening and enlargement of nipples, and thickening of the endometrium and other aspects of regulating the menstrual cycle. In males, estrogen regulates certain functions of the reproductive system important to the maturation of sperm and may be necessary for a healthy libido.
Estrogens promote lung function in rodents by supporting alveoli and protect from acute kidney injury in females.
Female pubertal development Estrogens are responsible for the development of female secondary sexual characteristics during puberty, including breast development, widening of the hips, and female fat distribution. Conversely, androgens are responsible for pubic and body hair growth, as well as acne and axillary odor.
Breast development
Estrogen, in conjunction with growth hormone (GH) and its secretory product insulin-like growth factor 1 (IGF-1), is critical in mediating breast development during puberty, as well as breast maturation during pregnancy in preparation of lactation and breastfeeding. Estrogen is primarily and directly responsible for inducing the ductal component of breast development, as well as for causing fat deposition and connective tissue growth. It is also indirectly involved in the lobuloalveolar component, by increasing progesterone receptor expression in the breasts and by inducing the secretion of prolactin. Allowed for by estrogen, progesterone and prolactin work together to complete lobuloalveolar development during pregnancy.
Androgens such as testosterone powerfully oppose estrogen action in the breasts, such as by reducing estrogen receptor expression in them.
Female reproductive system Estrogens are responsible for maturation and maintenance of the vagina and uterus. Estradiol is involved in ovarian function and regulates the ovarian cycle such as maturation of ovarian follicles. A surge in estrogen levels induces the release of the luteinizing hormone, which then triggers ovulation by releasing the egg from the Graafian follicle in the ovary. In addition, estrogens play an important role in regulation of gonadotropin secretion. For these reasons, estrogens are required for female fertility.
Estradiol, together with progesterone, promotes and maintains the endometrium in preparation for implantation of fertilized egg and maintains of uterus function during gestation period. It also upregulates oxytocin receptors in the myometrium.
Metabolism Estrogens are heavily involved in energy homeostasis and metabolism. Estrogen deficiencies are linked to metabolic disorders and obesity, which men under abnormal circumstances, such as a high-fat diet, are more susceptible to. Estradiol has a stronger anti-obesity effect than testosterone.
Estrogens promote gynoid fat distribution; increased fat storage or estrogenic fat in body parts such as the breasts, buttocks, and legs. They decrease abdominal and visceral fat (androgenic obesity).
Estradiol inhibits ferroptosis, a type of programmed cell death.
Neuroprotection and DNA repair
Estrogen regulated DNA repair mechanisms in the brain have neuroprotective effects. Estrogen regulates the transcription of DNA base excision repair genes as well as the translocation of the base excision repair enzymes between different subcellular compartments.
Estrogen provides neuroprotection by modulating the endocannabinoid system activity, primarily through the regulation of fatty acid amide hydrolase (FAAH) enzyme expression and the endocannabinoid receptor Cβ1 levels. The protective effects appears to work through a fine-tuning mechanism where by estrogen both suppresses excessive endocannabinoid signaling at the Cβ1receptor (which can be neurotoxic under stress) while simultaneously maintaining physiological endocannabinoid tine needed for normal neural function.
Brain and behavior
Sex drive
Estrogens are involved in libido (sex drive) in both women and men. In women, estrogen levels are elevated during the periovulatory period of the menstrual cycle, which is associated with increased sexual motivation.
Libido is dependent on androgen levels only in the presence of estrogens. Without estrogens, free testosterone level actually decreases sexual desire. Sexual desire in women who have hypoactive sexual desire disorder can be restored by administration of estrogen (using oral contraceptive).
Estrogens are required for female mammals to engage in lordosis behavior during estrus. This behavior is required for sexual receptivity in these mammals and is regulated by the ventromedial nucleus of the hypothalamus.
Cognition Verbal memory scores are frequently used as one measure of higher level cognition. These scores vary in direct proportion to estrogen levels throughout the menstrual cycle, pregnancy, and menopause. Furthermore, estrogens when administered shortly after natural or surgical menopause prevents decreases in verbal memory. In contrast, estrogens have little effect on verbal memory if first administered years after menopause. Estrogens also have positive influences on other measures of cognitive function. However the effect of estrogens on cognition is not uniformly favorable and is dependent on the timing of the dose and the type of cognitive skill being measured.
The protective effects of estrogens on cognition may be mediated by estrogen's anti-inflammatory effects in the brain. Studies have also shown that the Met allele gene and level of estrogen mediates the efficiency of prefrontal cortex dependent working memory tasks. Researchers have urged for further research to illuminate the role of estrogen and its potential for improvement on cognitive function.
Mental health Estrogen is considered to play a significant role in women's mental health. Sudden estrogen withdrawal, fluctuating estrogen, and periods of sustained low estrogen levels correlate with a significant lowering of mood. Clinical recovery from postpartum, perimenopause, and postmenopause depression has been shown to be effective after levels of estrogen were stabilized and/or restored. Menstrual exacerbation (including menstrual psychosis) is typically triggered by low estrogen levels, and is often mistaken for premenstrual dysphoric disorder.
Compulsions in male lab mice, such as those in obsessive-compulsive disorder (OCD), may be caused by low estrogen levels. When estrogen levels were raised through the increased activity of the enzyme aromatase in male lab mice, OCD rituals were dramatically decreased. Hypothalamic protein levels in the gene COMT are enhanced by increasing estrogen levels which are believed to return mice that displayed OCD rituals to normal activity. Aromatase deficiency is ultimately suspected which is involved in the synthesis of estrogen in humans and has therapeutic implications in humans having obsessive-compulsive disorder.
Local application of estrogen in the rat hippocampus has been shown to inhibit the re-uptake of serotonin. Contrarily, local application of estrogen has been shown to block the ability of fluvoxamine to slow serotonin clearance, suggesting that the same pathways which are involved in SSRI efficacy may also be affected by components of local estrogen signaling pathways.
Parenthood Studies have also found that fathers had lower levels of cortisol and testosterone but higher levels of estrogen (estradiol) than did non-fathers.
Binge eating