Estrogen and the Immune System

Estrogen and the Immune System

It is a known fact that females have more circulating estrogen than male counterparts. There are several physiologic reasons for this, the predominant being menstrual cycle regulation for purposes of reproduction. Estrogen comes in three forms, estrone, estradiol and estriol, which are produced in the ovaries as well as in fat tissues and adrenal glands. This is how body composition and stress can play a role in hormone balance! Estriol is the only estrogen that is produced from the placenta during pregnancy. Estradiol is the strongest and most abundant of the estrogens during a woman’s reproductive years.

Recent research of the differences in the female and male immune system has zeroed in on estrogen being responsible for the robust responses the female immune system mounts when compared to the male. Scientists have found that estrogen promotes stronger immunity down to a genetic level, upregulating more expression of immune promoting genes! The strength of women’s immune systems does have potential for problems as well. Women are more prone to developing autoimmune diseases which occur when the immune system mounts an attack against its own tissues. Estrogen has been shown to increase pro-inflammatory responses against pathogens, thereby, giving the female a better chance of resisting infection. However, this is a double edge sword when it comes to autoimmunity, where an overactive immune response to the bodies’ own tissues can create irreparable damage.


Most common autoimmune conditions female to male ratio.

Hashimoto’s thyroiditis 10:1

Systemic lupus erythematosus (SLE) 9:1

Sjorgren’s syndrome 9:1

Grave’s disease 7:1

Rheumatoid arthritis (RA) 3:1

Multiple sclerosis (MS) 2:1


It is no coincidence that estrogen imbalances can affect several organ systems as there are receptor sites for estrogen found throughout the body including the brain, liver, heart, bone, breasts and uterus. Estrogen is not exclusively a female hormone; males also have smaller amounts of circulating estrogens which are shown to aid in the development of sperm, improve memory and protect the cardiovascular system.

The intimate relationship between estrogen and the immune system cannot be disputed. But, can improving hormone balance really help restore equilibrium to an immune system that has gone awry?

Did you know many autoimmune diseases go into remission during pregnancy?

Calming down estradiol and upregulating the other estrogens can have a tremendous influence on the immune system, both anti-cancer properties as well as anti autoimmune. Though this happens beautifully during pregnancy, there are ways to promote good estrogen balance in any season of a woman’s life.

Estrogen excess

Symptoms of estrogen excess include breast tenderness, menstrual cramping, irregular vaginal bleeding, decreased libido, sugar cravings, weight gain, emotional liability and depression. Contributing factors to increased endogenous estrogen, estrogen produced in the body, include obesity, diabetes, certain medications and estrogen secreting tumors of the ovary or adrenal glands.

Exogenous estrogen, estrogen from the environment, has also been shown to create symptoms of estrogen excess. Exogenous estrogens can come in the form of phytoestrogens, plant estrogens like soy, or xenoestrogens, chemical estrogens like from plastics or pesticides.

Estrogen deficiency

Symptoms of estrogen deficiency include hot flashes, night sweats, vaginal dryness, fatigue, frequent headaches, irregular vaginal bleeding, emotional instability, depression, osteoporosis and episodic of tachycardia. Contributing factors to estrogen deficiency include menopause, polycystic ovarian syndrome (PCOS), anorexia nervosa and extreme exercise training.

There are several ways in which to assess estrogen levels including taking a sample blood, urine or saliva. With several factors playing a role in why estrogen dominance or deficiency develops it is important to discuss your symptoms with your health care practitioner to determine your particular goals and treatment.

The Metabolism of Estrogen

Overall balance of estrogen and the types of estrogens is certainly important, however, balancing estrogen metabolism is also a key component to supporting a happy immune system.

Estrogen has three choices when being metabolized in the body: 2-hydroxyestrone, 4-hydroxyestrone and 16-hydroxyestrone. Without getting to heavy into the science, the healthiest path for estrogen to take is 2-hydroxyestrone. The more pro-inflammatory pathway is 16-hydroxyestrone.

We do know that certain autoimmune conditions, such as Rheumatoid Arthritis and Lupus have been shown to have higher amounts of immune promoting estrogen metabolites and lower amounts of anti-inflammatory metabolites.  These metabolites can be evaluated in a urine test and may give more insight than simply looking at total estrogen levels. Currently there are clinical trials evaluating types of estrogens and estrogen metabolites and their effects on breast cancer, multiple sclerosis and other autoimmune disease, from lupus to Sjogren’s syndrome.

How do we balance estrogen?

Estrogen balance comes from balance in nutrition, lifestyle, stress, detoxification and specific nutrients. No two women necessarily have the same cause. For some women increasing leafy greens and B vitamins may be the answer to balancing estrogen. Other women may need to reduce stress and improve body composition. Assessing the estrogen equilibrium and then the underlying cause of any imbalance will not only solve hormone symptoms, but also help prevent cancer and autoimmune disease.

Dr. Ashley Burkman and Dr. Lauren Young are a board certified naturopathic physicians at Connecticut Natural Health Specialists, LLC. They are accepting new patients for their family practice in Manchester, Connecticut. To schedule an appointment, please call (860)533-0179.


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