Many people in the modern world believe that it is more difficult for women to lose weight than for men. This is unfortunate, and it’s an over-simplification, but the idea is not precisely wrong. A woman’s body is laced with hormonal complexities that a man’s is not. This is strikingly born out in the simple fact that women are fetus-bearing organisms. For this reason, a woman’s body comes equipped with a whole suite of mechanisms designed to make sure that she has plentiful nutrients and energy to support another life growing inside of her.
These fat-aggregating mechanisms can be broken down into two primary factors: estrogen-driven fat deposition, and hypothalamic weight regulation. Both are complex; both interplay with one another; and both are crucial to understand in order for a woman to lose weight healthfully and easily. This post is about estrogen. See here for the post on hypothalamic weight regulation.
Estrogen and the female body
Estrogen levels correlate with and are responsible for a woman’s menstruation. For this reason, a woman’s estrogen levels begin to rise during puberty, peak in her 20s and 30s, and drop off in menopause. This menopausal shift causes increased and shifted body fat mass in older women. In women of reproductive age, on the other hand, estrogen levels rise and fall with her menstrual cycle. During the luteal phase in which the uterus is preparing itself to be implanted with an egg a woman’s estrogen levels peak at four-six times the amount she might have at the low point in her cycle, the first day of menstruation.
There are three varieties of estrogen in a woman’s body. They are differentiated by the number of -OH molecules attached to them, so they commonly go by E1, E2, and E3. The most prominent form of estrogen in the female body, at least before menopause, is E2. (In menopause E2 drops off and E3 becomes more prominent.) E2 is called estradiol, so when most women get their hormones level tested, this is the most commonly tested form. Yet, since E2 comprises the vast majority of a reproductive woman’s estrogen levels, and since all the forms of estrogen perform similar functions, calling E2 “estrogen” usually serves just as well.
In pre-menopausal women, the ovaries are the principle source of estrogen, which functions as a circulating hormone to act on distal target tissues. This means that estrogen produced in the ovaries influences the whole body, such that ovarian estrogen can enhance weight gain or alter DNA expression in cells as far spread as a woman’s pinky finger or her spleen.
Why estrogen is commonly associated with weight gain
Estrogen is commonly associated with weight gain. But which begets the other? Does the fat cause the estrogen, or is it the other way around?
It’s both. First, fat cells beget estrogen production. But then elevated estrogen levels further slow down metabolism, such that estrogen plays a role in convincing a body to store more weight. For many, this becomes a vicious cycle of accelerating weight gain.
The mechanism by which estrogen causes weight gain is through inhibiting thyroid function. In a normal-weight woman, estrogen and thyroid hormone play off of each other in an intricate balance. Yet when a woman becomes overweight, her estrogen levels drive her thyroid function relentlessly downward. With impaired thyroid function, a woman can feel sluggish and fatigued, and therefore expend less energy, and also subconsciously down-regulate her metabolism such that her body is burning less and less fuel to get by and she is not even aware of it. Up to 10 percent of American women have issues with hypothyroidism.
The enzyme by which a cell converts testosterone into estrogen is called aromatase. Aromatase is the primary source of estrogen in men, as it converts testosterone to estrogen within cells. Aromatase enzymes are present in all types of tissue, yet the aromatase expressed in adipose tissue accounts for the vast majority of non-ovarian estrogen production in men and in women. This is why, in fact, many women suffer estrogen-deficiency symptoms when they lose too much weight. Additionally, the aromatization of testosterone to estrogen increases as a function of body weight and advancing age. This is a problem for men, as well as another compounding factor for menopausal women. It can also lead fairly quickly to estrogen dominance, which causes it’s own slew of reproductive problems.
Why estrogen is actually an important factor in weight loss part I: within the cell
Be that as it may, estrogen is actually an important factor in weight loss, and for several reasons. The first is that it decreases the activity of fat-absorption within a cell. It does this by decreasing the activity of lipoprotein lipase (LPL). LPL is an enzyme which favours fat uptake into the cells, so having estrogen around inside of a cell helps prevent it from growing larger.
Secondly, estrogen increases the activity of another enzyme called hormone sensitive lipase (HSL). HSL is the other big player in regulating a woman’s fat metabolism. Epinephrine stimulates HSL, and then HSL incites lipolysis, which is a fancy word for the breakdown of fat. HSL activity occurs most commonly in exercise. So what estrogen is doing in a sense is making this exercise phenomenon more powerful and occur more often. During aerobic exercise, increased body temperature and a greater concentration of epinephrine in the blood stream enhances HSL responsiveness to epinephrine. This then triggers the fat-breakdown activity of HSL.
Estrogen has also been reported to stimulate the production of growth hormone. Growth hormone inhibits the uptake of glucose (carbohydrate) by fat tissues and increases the mobilization of fatty acids from fat cells. GH works by inhibiting insulin production from the pancreas and stimulating HSL, the fat-burning enzyme described above. Insulin is the main hormone that promotes glucose transport into muscle cells to be used as energy, and it is a potent inhibitor of HSL. For this reason, decreasing insulin levels via GH via estrogen helps speed HSL fat burning activity.
Why estrogen is actually an important factor in weight loss part II: determining site of fat storage
Women have more fat than men. A “fit” woman can safely go down to around eighteen per cent body fat, but no further, whereas a fit man can go almost as low as he’d like with no problems. Some male weight lifters manage to get down to around five percent. Additionally, women store fat in different places than men. When men gain weight, it is almost always concentrated around their abdomens. This is called visceral fat, and it is the fat most highly associated with diabetes and other diseases of civilization.
The other kind of fat is called subcutaneous fat, and it’s the fat that appears underneath the skin spread out around the body. A woman’s body prefers subcutaneous fat. This phenomenon explains why women typically have less muscle definition than men–a tiny layer of fat is usually smoothing over all little muscular ripples. It also explains why they have large hips instead of large abdomens. Women have more subcutaneous fat than men in general, and they also store it preferentially in tissue around the hips, thighs, and buttocks. As a side note, estrogen is also important, but not the only factor, for the development and size of breast tissue.
But women only have large hips versus abdomens so long as they have enough estrogen in their systems. As soon as estrogen drops off, specifically in menopause, women see their fat mass shift to their middles. This is a hazard to their health, as well as a bit of an affront to their identity as shapely, reproductive beings. There are ways to mitigate that, of course, primary of which is eating a natural, anti-inflammatory diet, secondary of which is staying active and fit.
Estrogen causes an increase in the receptor known as anti-lipolytic alpha 2A-adrenergic receptor. (Anti-lipolytic = anti-fat.) This is how subcutaneous cells maintain their fat mass while other cells do not. In activating this receptor, estrogen increases the number of anti-fat breakdown receptors in subcutaneous fat. Because of the increase in these receptors, cells break down fat less often.
This is not a bad thing! This is a glorious thing. While it may sound like estrogen is making you fat and keeping your biceps hidden, what it is really doing is keeping the fat storage that your body naturally wants to do away from your abdomen and more in your breasts, hips, and buttocks. Men are not so lucky. They pack on the disease-causing abdominal fat like it’s their jobs. Estrogen, on the other hand, protects a woman from that phenomenon. As well as making her body feminine. Which is hot.
Why estrogen is actually an important factor in weight loss part III: signalling energy abundance to the hypothalamus
Estrogen also plays a crucial role in moderating a woman’s energy expenditure and appetite. This makes intuitive sense: if estrogen levels in the blood are high enough, this means that the ovaries are functioning and that a woman has enough fat on her in order to support a fetus.
The hypothalamus, which is the center of the brain which regulates appetite and feeding behavior, includes receptors for a number of hormones and metabolites. Estrogen is one of them. The more estrogen a woman has in her body, the more the hypothalamus detects energy sufficiency, and the less she needs to eat. This also implies the converse: when estrogen levels drop to low levels, such as when a woman’s ovaries are removed or if she is anorexic, cravings and food intake increase exponentially.
All that said…
Estrogen plays a complicated role in a woman’s fat distribution and weight regulation. It is associated with high fat levels, but this is not necessarily because it makes a woman fat. Instead, this is possibly just because fat cells produce estrogen. In fact, estrogen is often very helpful for weight loss. It helps the body know that it is fed. It upregulates fat metabolism. And at the very least, estrogen is responsible for keeping a woman’s hips, breasts, and all glorious womanly parts exaltant in that glorious womanhood. Without estrogen, women would not be women, and how possibly dull would the world be like that?
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Thank you for this extremely interesting post, Stefani! As someone who has been diagnosed with PCOS (well, the doctor is a little wishy washy about the label since I’m thin and this seems to frustrate him, but for all intents and purposes I have it) that has been trying to comprehend the mysterious ways of my dysfunctional hormones, your blog has been a great find. Like I said, I’m thin/normal (Just over 5 ft, 103 lbs) and haven’t gotten my period naturally in years. I’ve been on a roller coaster of progesterone pills, creams, etc. and have now been on Metformin for 8 months. It hasn’t done much – well, one period in those 8 months – but I feel great taking it so I keep on keeping on. My doctor seems pretty clueless, which is why I do a lot of my own research. It’s pretty awesome (not).
Anyway, according to my hormone tests everything is in the normal range, however testosterone is 45 (15-76 is normal) while estradiol is 37 (18-570!! is normal) — which leads me to believe that my estrogen is comparatively low. My doctor just said everything is in the normal range, hormones are fine, end of discussion, even though clearly since I am not having a period – when he does an ultrasound after 5 months of no period, there’s no accumulation even in my uterus! – they are NOT FINE.
Sorry this is a lot of background to get to my question! I’m not a science-brained person by any means, so it’s difficult for me to wrap my head around this, but after reading this post twice it seems that estrogen and fat have a mutually beneficial relationship. Eating more fat in my diet has not seemed to help my estrogen production, unfortunately. I’m wondering if there are certain types of fat that may better support estrogen production? My intuition (possible linked to my paelo brainwashing via blogs, ha) would be animal fats, but alas this is what I consume a good amount of with no luck.
My doctor has recently put me on birth control for 2 months just to see how my body responds, and having estrogen in my body has felt pretty damn good. Clearer skin, more energy. Hungrier, but I’m down with that. I’ve been anti-BC pills in the past because I’ve viewed them as “so unnatural” but now of course I’m starting to re-think this. I want my body to make this type of estrogen on its own, and I feel so much frustration and resentment that such a natural process isn’t happening naturally for me. I won’t stay on BC for long, especially because I want to have a baby in the next year (will probably have to resort to Clomid) but.. well, I’m just hoping in your next articles that you have ideas about naturally boosting estrogen production
Thank you for this blog. I devour each and every post!
Carly
Hi Carly!
Lovely to hear from you.
My estrogen levels are also in the basement. Or they have been, historically.
You are right, estrogen and fat do have a mutually beneficial relationship. I wonder with you, however… have you always been this thin? Did you used to menstruate regularly even though you were this thin? You say you’re ‘just over five feet and 103 pounds’ and that’s “thin/normal” but I am just over five feet, too, but I weigh >120. Are you 5 feet tall, or 5,1, or 5,2? My BMI falls in the ‘reproductive’ range, but yours actually, if you are 5,2, like me, is a fair bit below what endocrinologists usually consider well-fed enough to have a baby. One of the big themes in this post is that estrogen is produced in fat cells. If a woman loses weight, she loses estrogen that her body may have been dependent upon. Ovaries, as such, develop with a “handicap.”
If there is any amount of restriction in your diet, or exercise, or stress, then Hypothalamic Amenorrhea may also be at play in your diagnosis. Do you know your LH and FSH levels? If they are on the low end, then HA is probably also a fact of your reproductive health. The solution for that is to remove the stress, eat more, and put on some weight.
I understand so much your frustration. I feel it in my own life as well. I have never tried estrogen pills–am still trying to do is ‘naturally’ and I think I might really be seeing improvements– but it has also meant that I had to come up from around 110 pounds to 120.
Hope that helps– glad you like what I do!
Stefani
Stefani – thanks so much for replying! I’m under 5’1″ – perhaps 5′ and 3/4″ and definitely at my lowest weight right now than I’ve been in years. In the past I’ve been as heavy as 117, more often 110, and while my period was never normal it was slightly more present when I was heavier. My LH is 6.31 and FSH 5.82 (well.. at the moment they are in fact frighteningly lower, like LH is .07 and FSH is .3 — I had a blood test yesterday and literally almost cried when I saw that BUT I have been on BC for the past month so I was told that’s normal?). I do exercise quite a bit because my wedding is in one month. Yes part of it is vanity (okay, a big part of it, but I’m really trying to take your posts to heart and not obsess about this) but a lot of it is stress relief. I find exercise and the time immediately after to be my calmest time of day and I sleep so much better on days that I exercise which helps with the stress as well. You are probably right about Hypothalamic Amenorrhea, and that weight gain would probably help. However, eating the paleo-ish way I’ve been eating, my weight is where it is now. I eat 3 meals a day and often have snacks, don’t restrict at all, rarely feel hungry, in fact I always eat until fullness even at times beyond full. I do cardio about 5 times a week. In terms of addressing the stress, I am starting a new job soon and the wedding will be over and done with so that should help
How have you gained weight while eating paleo? I’m not strict by any means – daily I eat buckwheat, cottage cheese, whole milk, fruit, etc. but I find eating this way my weight has just been at 103. It sort of feels like my body WANTS to be like this, but I definitely want to gain weight if it could mean more estrogen.
Also, yes, good call on the brainwashing! Your fat intake is fine.
Carly, there’s a book written on PCOS, “The Savvy Woman’s Guide to PCOS (Polycystic Ovarian Syndrome): The Many Faces of a 21st Century Epidemic….And What You Can Do About It”, I did not read it but I read dr. Vliet’s “It’s my ovaries, stupid!” book and she says a few things about PCOS in there. It’s the deficiency of estrogen that’s the main culprit and that is why you feel so much better on the BC. You were lucky to be put on something that has an adequate amount of estrogen. Birth control pills are not that bad but if you want to get off the pills and you do not want a pregnancy, there’s a patch and a ring that you can use but they still have the same synthetic estrogen and progesterone. I think that the safest option to supplement estrogen is by using one of those patches, creams or gels that contain bio-identical estradiol. And it is not true that estrogen makes you fat, as Stefani clearly explains in her post. It’s not having enough estrogen and too much unbalanced progesterone that makes us gain weight. The perimenopausal women taking estradiol patches or creams/gels keep complaining of symptoms of estrogen deficiency but are scared to increase the dose of estradiol and therefore, they keep gaining weight. Many of them also take cyclic progesterone and so they add up the amount of progesteroene. Same problem with the menopausal women, they take progesterone with their estradiol or they take the synthetic mix (Premarin/Provera). I am on Estrogel only and while I do not have PCOS, I had many issues with not being able to focus, sleep, etc while constantly gaining weight. I have a very strong reaction to even very little amounts of progesterone and I was treated for EXCESS estrogen for 6 months with progesterone by a dumb doctor who was in love for the “estrogen dominance” mantra, without studying in depth the fact that estrogen dominance was just a theory that was never proven right. Because of the fear of estrogen caused by the WHI, people are afraid to take as much as they need and so you can spend years trying to stick with a low dose and feeling miserable. I sleep well with 6 pumps of Estrogel daily. And it may not be because I need that much estradiol but because only a little bit gets absorbed. I will talk to the doctor see if a compounded estradiol will have better absorption as 6 bottles of estrogel monthly can get very expensive, not just for me, but for the insurance too, it doesn’t feel right to have the insurance pay $600 for the me each month, I believe it’s the greed of the pharmaceutical industry that drives our healthcare bankrupt. If the manufacturer made a bottle that contained a supply of 30 days at 4-6 pumps a day instead of one at a decent price, it would have been a different story. You have to find a doctor who knows what to do and how to guide you. I am certain that without enough estrogen you can’t even get pregnant. Also, having enough estrogen will lower your testosterone because it raises the SHBG (sex hormone binding globulin) that binds the testosterone and so you will have less free testosterone available, same free testosterone that’s causing you acne and growth of hair on your upper lip if you have that. Another thing: no amount of saturated fats will get your ovaries to produce enough estrogen once it started going down the hill, I tried that, eating coconut oil, cod liver oi and grass fed butter and ghee by the spoon. I did feel a little better but I haven’t felt as good as I feel on the Estrogel in many years. Best of luck!
Hi,
Just wanted to comment about the PCOS diagnosis. I would in two shakes get a second opinion. I too was diagnosed with PCOS about 9 years ago. I am 5’5, and weighted about 105 lbs at the time. Had horrible periods and acne issues. Those were my only symptoms. A Nurse Practioner ran a blood test and said “You have PCOS”. I believed this dianosis, until I started doing my own research about it. I didn’t really have many symptoms at all. At the time I wanted to get on BC pills for the cystic acne issues(which I delt with since I was 15), and went to a gynocologist for a perscription. This doctor was SHOCKED by the diagnosis of PCOS because I was naturally very thin everywhere(I have very small bone structure) and didn’t show symptoms of excessive testostrone(facial or excessive body hair, being over weight, etc). About a year later I went to an alternative medicine health practicioner (Osteopath) who also was surprised by the PCOS diagnosis. I was feeling excessively tired all the time and had gained weight but only in my stomach area. At this time, she ran very indepth blood tests and saliva hormone tests that showed zero chance of PCOS. I was releaved, but still suffered from painful periods. Anyway, long journey/story short, 9 years later I have been on BC on and off the last decade which has helped immensly! I’m 33 now, and have been on a high dose bc pill for 4 years which has been great up until recently, which i’m starting to feel its been too high a dose the last few months. Anyway, I’d reccomend getting another opinion, especially from possibly someone who practices Otheopathic medicine. They look at all sorts of things thay regular mainstream doctors won’t address like adrenal fatigue, and in-depth thyroid issues. You won’t regret it. Good luck!
Just found your blog, and I love it! Always happy to find a new female perspective on ancestral health.
I know this is an old post, but the bit about estrogen affecting fat distribution is very interesting to me. I’ve always stored fat in my middle, even as an otherwise-skinny tween. I’m very happy with my weight otherwise, but the disproportionate belly-bulge worries me health-wise (and vanity-wise, of course). I’ve always assumed this was either an annoying personal quirk or stress-related, but I never thought about it being a hormonal issue. Maybe I should get a hormone panel done. Have you found a good silver-bullet way to increase/balance estrogen, or is it just as incredibly complex as everything else in the human body? Let me guess…
Can you help me out with this sentence, it seems it is unfinished or something?
” With impaired thyroid function, a woman can feel sluggish and fatigued, and therefore expend less energy, and also subconsciously down-regulate her metabolism such that her body is burning less and less fuel to get by and she is not even aware of it. … percent of American women have issues with hypothyroidism.”
Just the “ten” was missing.. I have no idea why.
Hi,
I’ve recently been diagnosed with PCOS, although I’m not 100% sure that’s it. Apparently my estrogen levels were low. I hadn’t had a period for 18 months since coming off a tri-phasal pill but I do exercise a fair bit (was running a lot) and I probably weighed at least 5kgs less than I do now. I have been gaining weight and muscle but still nothing. My dr just put me on an estrogen pill, and I feel like I have a lot of extra weight on my hips/thighs now. Still no period though. My question is, will this extra estrogen now make me gain weight? I was accepting that I needed to gain a little…just not sure ths much! Does the pill affect food cravings?
Your weight can definitely fluctuate with the pill — it varies for all women. Food cravings as well. None of it is a certainty, though. And I would bear in mind that weight on the thighs / hips is not unhealthy — it is generally abdominal fat that is regarded as being associated with deterioration and disease.
But then what about women that have basically 90% of their body fat in their belly area? What’s up with that? Women like that do exist, obviously. This post was super informative but it was all geared towards the woman that has most of her fat below the waist. What’s the dope on women with fat concentrated mostly on their abdomen (way before being menopausal)?
For example, me. Flat-ish butt. Normal hips and thighs. Just got a little problem on my inner thighs but nothing too serious. Everywhere I look “average” except my belly. Please share some info or point me in the direction about this and how, scientifically, estrogen and all that jazz works in that type of body.