Estrogen has many beneficial effects in the body, including helping optimize the action of insulin, the hormone that prevents high blood sugar levels. Consequently, low estrogen levels may lead to insulin resistance, or impaired insulin action. Insulin resistance is linked to metabolic syndrome, a group of traits and medical conditions that increase the risk of health problems such as diabetes, heart attack and stroke. Low estrogen levels and insulin resistance can have negative health consequences, and your doctor can best guide you on how to manage and treat these health concerns.
Insulin resistance is a distinguishing feature of metabolic syndrome, a cluster of conditions including the elevated blood sugar levels found in prediabetes and type 2 diabetes (T2DM); central or abdominal obesity; high blood pressure; and abnormal blood lipids -- specifically elevated levels of triglycerides, a blood fat, and low levels of HDL, a protective cholesterol made by the body. Metabolic syndrome affects about 35 percent of U.S. adults, according to a study published in the May 2015 issue of "The Journal of the American Medical Association." The relationship between metabolic syndrome, insulin resistance and estrogen is complex, and more research is needed to clarify the interplay of these hormones in health and disease.
Estrogen and Insulin Resistance
A review of animal and human studies published in the March 2016 "Journal of Diabetes Research" discussed the known association between estrogen and insulin action. In addition to impairing insulin action, low estrogen levels may hinder the secretion of insulin from the pancreas, suggest the study authors. Insufficient insulin causes the liver to produce excess glucose and send this surplus into the blood. Estrogen deficiency may also cause inflammation, which can further impair insulin action. Adding to the complexity of this issue, certain conditions characterized by insulin resistance -- obesity, pregnancy and polycystic ovarian disease -- are associated with high estrogen levels. Therefore, additional quality research is warranted to fully understand the effects of low estrogen on the body.
Natural and Replacement Estrogen
The majority of the body's estrogen is produced in the ovaries. However, men make estrogen too -- small amounts are produced by fat cells and the adrenal glands, which are hormone-producing glands near the kidneys. In women, estrogen production peaks during the physical changes of puberty, and levels remain high until menopause.
Estrogen can also be made artificially, and used in contraceptives and for hormone replacement therapy (HRT) -- an approved treatment for menopause and osteoporosis. At face value, it would seem that replacing estrogen can improve insulin action and negate the consequences of insulin resistance. However, there are risks associated with high levels of estrogen, including a risk of breast cancer, so individualized treatment of low estrogen is essential.
Warnings and Precautions
Insulin resistance increases the risk of serious health problems, and low estrogen levels may be related to insulin resistance. While insulin resistance usually occurs without any symptoms, it may be more likely to occur if you have gained unwanted weight or have extra belly fat. Other signs of insulin resistance include excessive skin tags, and a skin condition called acanthosis nigricans, which is a darkening of skin in the folds in the neck, armpits and groin. If you have insulin resistance or metabolic syndrome, work with your doctor on a treatment strategy that should include regular physical activity and a healthy weight loss plan. If you are postmenopausal, or if you suspect you have low estrogen levels, speak with your doctor for guidance on treatment options.