Estrogen, Progesterone, And Women’s Cardiovascular Health: The Important Connection

What comes to mind when you hear the terms estrogen and progesterone? For many, these hormones immediately conjure thoughts of their roles in reproductive health and the menstrual cycle. However, the influence of these mighty hormones extends far beyond reproductive health. They also play a pivotal role in another important aspect of women’s well-being – cardiovascular health.

In part 1 of this 2-part blog series , we'll explore the intricate relationship between estrogen, progesterone, and women's cardiovascular health. And in part 2, we’ll explore some powerful ways you can protect your cardiovascular health once these heart-healthy hormones begin declining. Let’s start by defining what estrogen and progesterone are.

What Is Estrogen?

Estrogen is a steroid hormone, belonging to a class of hormones derived from cholesterol. It circulates in the bloodstream and interacts with specific receptors known as estrogen receptors (ERs) located in various tissues throughout the body. Just like all hormones, estrogen acts as a signaling molecule. When estrogen binds to receptors, it instructs cells to carry out specific tasks or functions by triggering a cascade of molecular events inside the cells – ultimately leading to changes in gene expression and cellular function.

Estrogen is primarily associated with the female reproductive system – playing a crucial role in things like puberty, menstrual cycle regulation, pregnancy support, and breast health. Due to its pivotal role in female reproductive well-being, ovaries are the primary site of estrogen production in females (although smaller amounts of estrogen are also produced in other tissues, including the adrenal glands and fat cells).?

While estrogen undoubtedly plays a central role in female reproductive health, it’s by no means the only important role this hormone plays. But before we dive into estrogen's effects on cardiovascular health, let’s first zoom in on another closely related hormone – progesterone.

What Is Progesterone?

Progesterone is a steroid hormone, similar to estrogen, that binds to progesterone receptors throughout the body. And just like estrogen, when progesterone binds to receptors it serves as a signaling molecule that instructs cells to perform specific tasks or functions by dictating gene expression or cellular function.

Estrogen and progesterone are closely intertwined – with both hormones being primarily produced by the ovaries and both playing central roles in menstrual cycle regulation, pregnancy support, and breast health. Estrogen and progesterone work together in a delicately balanced relationship to regulate various aspects of the female reproductive system. Throughout the menstrual cycle, their levels fluctuate to achieve different goals, such as preparing the uterine lining for potential pregnancy, triggering ovulation, and maintaining a supportive environment for fertilization and early pregnancy.?

Together, these hormones orchestrate the intricate processes necessary for reproductive function, ensuring the optimal conditions for conception and gestation. But this dynamic duo also plays a pivotal role in another aspect of your health – your cardiovascular system.

How Does Estrogen Affect the Cardiovascular System?

Estrogen has been found to have some potent effects on your cardiovascular system – with some of it’s most prominent effects including:

Vasodilation:

Estrogen promotes vasodilation, which is the widening of blood vessels, through various mechanisms – namely via the production of a compound known as nitric oxide (NO). Nitric oxide acts as a vasodilator by relaxing the smooth muscle cells in blood vessel walls, increasing blood flow, and decreasing vascular resistance. This vasodilatory effect helps maintain healthy blood pressure levels and improves circulation throughout the body.3

Cholesterol Metabolism:

Estrogen influences cholesterol metabolism by impacting the production of two key types of cholesterol:4

• Low-Density Lipoprotein (LDL) Cholesterol: LDL cholesterol is often referred to as “bad” cholesterol because high levels of LDL cholesterol in the blood can lead to the buildup of plaque in the arteries, increasing the risk of atherosclerosis and cardiovascular disease.
• High-Density Lipoprotein (HDL) Cholesterol: HDL cholesterol is often referred to as “good” cholesterol because it helps remove cholesterol from the bloodstream and transport it to the liver for excretion. High levels of HDL cholesterol are associated with a reduced risk of cardiovascular disease.

Estrogen has been found to increase the production of “good” HDL” cholesterol while simultaneously decreasing the production of “bad” LDL cholesterol – subsequently reducing the risk of plaque formation and atherosclerosis.

Endothelial Function:

The inside of your blood vessels are lined with specialized cells known as endothelial cells. Together, these cells form a thin layer known as the endothelium. Overall, endothelial cells play critical roles in maintaining vascular homeostasis, regulating blood flow, preventing thrombosis, modulating inflammation, and supporting tissue function throughout the body.?

Estrogen has been found to enhance endothelial function in two distinct ways:5

1. By promoting endothelial cell survival and proliferation – contributing to the integrity and repair of blood vessel linings.
2. By upregulating the production of endothelial nitric oxide synthase (eNOS) – the enzyme responsible for synthesizing nitric oxide (NO) in endothelial cells. NO produced by endothelial cells plays a key role in regulating vascular tone, platelet function, and vascular remodeling, all of which are critical for cardiovascular health.

This combination of effects makes estrogen especially important for endothelial health and function.

Anti-inflammatory and Antioxidant Effects:

Estrogen exhibits potent anti-inflammatory and antioxidant properties within the cardiovascular system. Estrogen inhibits the expression of pro-inflammatory cytokines and adhesion molecules in endothelial cells. In simpler terms, that means estrogen reduces the production of certain molecules in endothelial cells that promote inflammation and the sticking of immune cells to blood vessel walls.?

Estrogen also protects against oxidative stress in blood vessel walls by scavenging reactive oxygen species (ROS) that can damage cells and promote vascular inflammation and dysfunction. By reducing oxidative stress, estrogen helps preserve the function and structure of blood vessels.

These anti-inflammatory and antioxidant effects help ward off the risk of cardiovascular diseases such as atherosclerosis, hypertension, heart attacks, and strokes to name a few.6 Now that you have an understanding of the specific cardioprotective effects of estrogen in women, let’s zoom in on how progesterone impacts your cardiovascular system.

What Is the Effect Of Progesterone On the Cardiovascular System??

Some of progesterone’s most notable effects on the cardiovascular system include

Vascular Tone and Cholesterol Metabolism:

Similar to estrogen, progesterone can influence vascular tone, affecting the diameter of blood vessels. Progesterone can also exert vasodilatory effects by promoting the relaxation of smooth muscle cells in blood vessel walls – leading to increased blood flow and decreased vascular resistance. This adds lower and healthier regulation of blood pressure.

And just like estrogen, progesterone can also modulate cholesterol metabolism within the cardiovascular system by increasing the production of high-density lipoprotein (HDL) or “good” cholesterol.7,8

Inflammatory Response:

Progesterone can modulate the inflammatory response within the cardiovascular system – reducing the production of pro-inflammatory cytokines and inhibiting immune cell activation. By dampening inflammation in blood vessel walls, progesterone may help protect against the development of atherosclerosis and other cardiovascular diseases.9

Endothelial Function, Coagulation, and Thrombosis:

Progesterone receptors are present in endothelial cells, suggesting that progesterone may directly affect endothelial function – thus impacting the health and integrity of blood vessel linings. Progesterone has also been found to influence two other important factors, which are:

• Coagulation: Coagulation is the process by which blood forms clots to stop bleeding when a blood vessel is injured.?
• Thrombosis: Thrombosis occurs when blood clots form inside blood vessels where they shouldn't – potentially blocking blood flow and leading to serious health issues such as heart attacks or strokes.

Progesterone has been shown to have both pro-thrombotic and anti-thrombotic effects – sometimes enhancing platelet aggregation and coagulation and other times having anticoagulant properties that inhibit thrombus formation. Various factors can influence how progesterone influences coagulation and thrombosis, but research indicates there is a clear link between the two.10,11

Interactions with Estrogen:

Progesterone often interacts with estrogen to influence cardiovascular health – with their combined effects impacting vascular tone, inflammation, lipid metabolism, thrombosis, and more. The balance between estrogen and progesterone levels, as well as their ratio, may play a role in determining cardiovascular risk and outcomes in women.

With estrogen and progesterone both playing such crucial roles in women’s cardiovascular health, what exactly happens when the production of these hormones declines during menopause?

So, What Impact Does Menopause Have On Cardiovascular Health?

Menopause can have a major impact on women’s cardiovascular health! You see, the hormonal changes that occur during menopause extend much further than your reproductive health – with the gradual decline of estrogen and progesterone making you more susceptible to cardiovascular disease.?

In fact, a woman's risk for cardiovascular-related conditions (including heart attack and stroke) climbs significantly after menopause. And what’s more concerning, is that the earlier the onset of menopause, the higher your risk. That’s because earlier menopause means a longer period of time over a woman's life with decreased estrogen and progesterone levels.12

So what’s the solution? What can you do to proactively protect your cardiovascular health if you’ve gone through menopause or are approaching menopause?

Can Hormone Replacement Therapy Help Protect Cardiovascular Health After Menopause?

The answer to this question is – yes, hormone replacement therapy may indeed be able to help combat the development of cardiovascular-related conditions in post-menopausal women. Research has uncovered some promising results that might just give us a leg up when it comes to protecting the health of your heart and cardiovascular system during and after menopause.

I dive much deeper into how exactly hormone replacement therapy can help protect cardiovascular health after menopause in part 2 of this blog series. So be sure to click here and read part 2: Hormone Replacement Therapy: The Key To Protecting Cardiovascular Health After Menopause.

And if you want to dive deeper into more science-backed resources, tips, and products to help you take your health to the next level, be sure to download my Resource Roadmap . This easy-to-navigate roadmap will help you cut through the noise and zero in on what’s most applicable to you – that way you can shortcut your path to creating the vibrant health, happiness, and longevity you deserve. Click here to get access to your Resource Roadmap today !

Resources:

1. Estrogen – StatPearls – NCBI Bookshelf ( nih.gov )
2. Physiology, Progesterone – StatPearls – NCBI Bookshelf ( nih.gov )
3. Estrogen and vascular function – PubMed ( nih.gov )
4. Estrogens in the Regulation of Liver Lipid Metabolism – PMC ( nih.gov )
5. Estrogen improves endothelial function – ScienceDirect
6. Estrogen is a modulator of vascular inflammation – Chakrabarti – 2008 – IUBMB Life – Wiley Online Library
7. Boots for Achilles: Progesterone's Reduction of Cholesterol Is a Second-Order Adaptation on JSTOR
8. Physiology, Progesterone – StatPearls – NCBI Bookshelf ( nih.gov )
9. Progesterone as an Anti-Inflammatory Drug and Immunomodulator: New Aspects in Hormonal Regulation of the Inflammation – PMC ( nih.gov )
10. Female Hormones and Thrombosis | Arteriosclerosis, Thrombosis, and Vascular Biology ( ahajournals.org )
11. Effect of Progesterone and Synthetic Progestins on Whole Blood Clot Formation and Erythrocyte Structure – PubMed ( nih.gov )
12. Estrogen and cardiovascular disease – ScienceDirect

* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease. ? The information in this article is not intended to replace any recommendations or relationship with your physician. ?Please review references sited at end of article for scientific support of any claims made.