The secret life of hormones

Female sex hormones are essential for puberty, periods and pregnancy. But they also work wonders outside of the reproductive system.

We look at how oestrogen and progesterone (two of the main female sex hormones) affect other parts of the body, from your mood to your heart.

Plus, experts share their tips for when hormonal changes throw things off balance.

Heart

Oestrogen plays a starring role in heart health and is one of the reasons younger women are somewhat protected from heart disease – they have relatively high levels of the hormone.

Professor Garry Jennings AO, Chief Medical Advisor at the Heart Foundation, explains that oestrogen helps keep our cholesterol levels in check. Around menopause, declining oestrogen levels can lead to a rise in LDL (‘bad’) cholesterol and a drop in HDL (‘good’) cholesterol, he says. This, combined with other changes, “can lead to high blood pressure and sometimes high blood sugar (glucose) levels, which are important risk factors for heart disease”.

Fortunately, there are ways to protect your heart. Professor Jennings recommends heart health checks and a healthy lifestyle, including eating well, keeping active, avoiding smoking and minimising alcohol intake.

Hormones are chemicals that affect the way we function, including our appetite, stress levels and ability to reproduce.

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Urinary tract

Sex hormones can affect our urinary tract, meaning our trips to the toilet to wee.

According to Jean Hailes Urogynaecologist Dr Payam Nikpoor, oestrogen helps strengthen the tissues in the bladder and surrounding areas. When levels of this hormone naturally drop around menopause, he says the tissues can shrink and become less elastic. This means some women may be more prone to bladder infections and needing to wee more urgently and often.

For those struggling through menopausal symptoms such as these, Dr Nikpoor says vaginal oestrogen medication may be suitable. “Women should be encouraged to discuss all matters related to menopause and changes in their pelvic floor function with their doctor, physiotherapist or specialist.”

Declining oestrogen levels can also affect vulval and vaginal tissues, causing dryness. For more information, visit our symptoms of menopause page.

Skin and hair

Acne, dry skin, thinning hair or luscious locks! Dermatologist Dr Michael Freeman explains that “oestrogen acts directly on the skin and hair cells”, helping the hair to grow and the skin to stay plump and moisturised. It’s why hair is often fuller during pregnancy, when oestrogen levels rise, and why it tends to thin around menopause, when oestrogen levels fall, he says.

According to Dr Freeman, acne flare-ups are more common in older women before their period, when oestrogen is low, plus they are often seen in those taking oral contraceptives containing progesterone. “Menopause [also] causes the skin to thin from collagen and elastin loss, mostly from the loss of oestrogen,” he adds.

To manage bothersome menopausal symptoms that affect the skin, Dr Freeman suggests using warm (not hot) water when washing; applying a good-quality moisturiser that contains ceramides (oily substances); and trying a peptide serum (a mixture usually applied to the face) at night.

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Mind

Professor Jayashri Kulkarni AM, Director of HER Centre Australia, says sex hormones can have a big impact in the brain.

Some women might notice this before a period, when oestrogen is low and progesterone levels have started to decline. Professor Kulkarni describes progesterone as a “complex hormone” for the brain. It can have a calming effect in some, and lead to anxiety and lowered mood in others.

Meanwhile, oestrogen can contribute to better mood and thinking, she says. Its levels are highest around ovulation (when an ovary releases an egg). But when oestrogen levels drop, some women experience mood changes.

In severe cases, these hormonal changes throughout the menstrual cycle can cause depression and other problems. Around menopause, changing hormone levels are also linked to depression, anxiety and brain fog, adds Professor Kulkarni. Although, every woman responds to her fluctuating hormones differently.

To protect your mental health, Professor Kulkarni recommends being careful around drugs and alcohol, eating well, moving regularly and staying socially connected. “Also, be aware that some women feel depressed or angry when taking certain types of the contraceptive pill (‘the Pill’). If this happens to you … speak to your doctor.”

For information about when to see a doctor if menopause is affecting your mind health, check out our fact sheet.

Bones

Oestrogen and progesterone are “critical” for bone health – “especially oestrogen”, says Jean Hailes Endocrinologist Dr Sonia Davison.

From puberty to around age 30, rising levels of oestrogen and other hormones help build and strengthen our bones. “After this time, bone density [strength] gradually falls,” explains Dr Davison.

One of the most critical times for bone health is around menopause, when oestrogen levels decrease dramatically, meaning bones tend to lose their strength, she adds. 

So, what can you do? Dr Davison says to avoid “alcohol excess, smoking, vitamin D deficiency and a sedentary [inactive] lifestyle. Try to maintain a healthy weight, do regular weight-bearing exercise and consume enough calcium”. If you have a family history of bone conditions or fractures, tell your doctor.

Also, it’s important for women of all ages to seek treatment for medical conditions that can cause oestrogen deficiency, such as anorexia nervosa, she adds.

Happy hormones

Our sex hormones affect many parts of our body, and their fluctuating levels can bring on welcome and not-so-welcome changes. If you think you might be struggling with a hormone-related issue, check in with your doctor.

Illustration of monstera leaves and ferns.

© 2023 Jean Hailes Foundation. All rights reserved. This publication may not be reproduced in whole or in part by any means without written permission of the copyright owner. Contact: licensing@jeanhailes.org.au

Words by Kate Cross. Illustrations by Tam Bower.

Published August 2023

This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.

Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.

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