Despite popular narratives, perimenopause isn’t just about hot flashes, night sweats, sex hormones, ovulation, and the natural transition to menopause. It extends beyond hormones to impact muscle mass, bone density, cardiovascular health, cognitive function, mood, skin health, sex, and more.

Perimenopause of course is a natural phase before menopause when a woman’s body starts shifting, causing irregular periods, mood swings, and other changes due to fluctuating hormone levels, marking the transition to the end of reproductive years. It’s like a rollercoaster ride for the body, with ups and downs, as it prepares for the next stage of life.

Hormone Imbalance Symptoms Graphic

In this post, I call attention to how low estrogen caused by perimenopause can negatively impact your health, and what you can do to slow and even reverse the progression of health conditions related to declining estrogen.

Addressing Muscle Loss

Muscle loss for women typically begins in one’s 30s or 40s and becomes more pronounced with aging. It’s a gradual process, and its progression can vary among individuals in response to numerous factors, including the person’s health history, genetics, exercise regimen, diet, and stress. A decline in estrogen levels during menopause (usually occurring in the late 40s or 50s) can contribute to the acceleration of muscle loss in women.

One important aspect of healthy aging is to avoid the loss of muscle mass or, even better, build muscle mass as you age. This is entirely possible to accomplish with the right combination of hormone replacement therapy (HRT), exercise, proper diet, and medication to stimulate growth hormone.

It’s no secret that as we age, we tend to lose muscle mass, but muscle is more than what meets the eye. It has a range of impacts on the body, including functional strength and independence, metabolic and hormonal health, bone health and prevention of chronic disease. Here are a few ways that muscle health impacts overall health:

  • Exercise stimulates the release of protein messengers called myokines, which support body weight regulation, insulin sensitivity, suppression of tumor growth, and improvement of cognitive function.
  • Muscle acts as a metabolic fat burner leading to improvements in body composition. When you have more muscle, you burn more calories.
  • Muscles move bones and subject them to shearing forces that strengthen the bone. This is one reasonweight training is important as a person ages.
  • Normal muscle mass is associated with better liver health. A person with fatty liver will have reduced muscle mass.

As important as muscle mass and strength are to overall health, patients rarely come to see me complaining about muscle loss. That’s usually considered a point of vanity or something important only for athletic-minded individuals seeking to optimize their physical fitness. However, muscle loss can have a serious negative impact on overall health and wellbeing. Don’t overlook or dismiss its importance.

Exploring the Link Between Low Estrogen and Bone Loss

A women’s estrogen level is closely linked to her bone health. That’s because estrogen helps regulate the balance between bone formation and resorption of minerals from bone, ensuring that bones remain dense and therefore strong. As women age and estrogen levels decline, they become more susceptible to osteoporosis — a condition characterized by weakened and brittle bones. HRT can help mitigate this risk by maintaining adequate estrogen levels. Estrogen improves bone strength and density in four ways:

  • Stimulates osteoblasts. Osteoblasts play a fundamental role in the process of bone formation, continuously renewing and strengthening the bone.
  • Inhibits osteoclasts. Osteoclasts are responsible for breaking down bone tissue to enable the resorption of minerals. By inhibiting osteoclasts, estrogen helps to prevent bone loss.
  • Maintains the bone matrix. In addition to maintaining bone quantity, estrogen contributes to improving the quality of bone tissue by supporting the bone matrix — the framework that provides structural support.
  • Maintains muscle mass. As mentioned earlier in this post, estrogen helps to maintain muscle mass, which, in turn, contributes to strengthening bones, just as gravity works to strengthen our bones and muscles by providing resistance.

Recognizing Estrogen’s Other Health Benefits

In addition to improving muscle mass and bone density, estrogen plays a key role in heart health, brain function, mood, sexual health, and skin health:

  • Heart health: Estrogen plays a protective role for the heart. It keeps blood vessels healthy and controls cholesterol levels. As women age and estrogen levels drop, they might become more prone to heart issues. Using hormone replacement therapy (HRT) has been studied and found to potentially improve heart health by reducing the risk of heart disease and supporting healthier blood vessels.
  • Brain function: Some research suggests that estrogen may help protect brain cells and maintain cognitive function as women age. Cognitive functions include memory, learning, reasoning, problem-solving, verbal fluency, and visual-spatial abilities.
  • Mood and emotional well-being: Changes in hormones during menopause can cause mood swings, irritability, and make someone more likely to feel depressed or anxious. Estrogen is connected to controlling chemicals in the brain that affect mood, like serotonin and dopamine. Using hormone replacement therapy (HRT) can help keep moods more stable, ease feelings of depression, and make emotional health better overall.
  • Sexual health: As estrogen levels decrease, it can cause problems with vaginal health like dryness, thinning of the vaginal walls, and discomfort during sex. Using estrogen therapy, whether as creams directly applied or through hormone replacement treatment, can ease these symptoms. This helps enhance sexual health and makes life better for women as they get older.
  • Skin health: Estrogen helps skin stay healthy by boosting collagen and keeping it elastic. When estrogen levels drop, some women might see changes in skin texture, including an increase in the appearance of wrinkles. Some research hints that hormone replacement therapy (HRT) could potentially enhance skin quality, making it look fresher and more youthful.

Estrogen is a vital hormone that plays a key role in women’s health — from maintaining muscle mass, bone density, and heart health to supporting cognitive function, emotional well-being, and sexual health. Ultimately, estrogen, whether natural or supplemented through HRT, can be a valuable ally in helping women age gracefully and maintain their vitality. Specifically, HRT can help to alleviate a host of symptoms associated with low estrogen, such as the following:

  • Anxiety
  • Depression
  • Dry skin
  • Fatigue
  • Hair loss
  • Hot flashes
  • Loss of libido
  • Vaginal atrophy
  • Vaginal dryness

The Solution: Estrogen and Human Growth Hormone

Many adverse health conditions that develop in women as they age can be addressed by increasing levels of estrogen and human growth hormone (HGH).

HRT is used to increase estrogen levels. It is most effective for preventing bone loss and muscle loss when started during perimenopause, but it can also be effective in later stages of menopause. By combining HRT with exercise, diet, and lifestyle changes, you can build bone and muscle. Many women benefit from complete HRT, including estrogen, progesterone, and testosterone. Of course, each person’s individual needs and health goals need to be considered.

HGH can be increased by stimulating the pituitary gland to release more of it. There are several ways to stimulate the release of HGH:

  • Practice intermittent fasting — for example, not eating for 10-12 hours a day or eating only one meal a day. There are many ways to practice intermittent fasting.
  • Exercise, especially high intensity interval training (HIIT) — alternating periods of high-intensity strength-building exercise with brief recovery periods.
  • Reduce your sugar consumption.
  • Improve your sleep quantity and quality — sleep is restorative.
  • Supplement with gamma aminobutyric acid (GABA) — at least one study showed that taking a GABA supplement led to a 400 percent increase in HGH at rest and a 200 percent increase following exercise.
  • Supplement with a HGH secretagogues, such as Sermorelin, which is a growth hormone-releasing hormone (GHRH). (Secretagogues are substances that stimulate the secretion of other substances; Sermorelin stimulates the pituitary gland to release more HGH.) In the past, I recommended a combination of CJC-1295 (a synthetic GHRH) and Ipamorelin (a growth hormone releasing peptide — GHRP), but I have found Semorelin alone is more effective.

For more about increasing HGH, see our previous post “Benefits of Boosting Human Growth Hormone (HGH) for Recovery and Resilience.”

The take-home message here is that while aging is inevitable, feeling miserable is not. You have the power to slow and possibly even reverse some of the health conditions associated with aging. If you’re feeling too tired or weak to do anything, you’re not as mentally sharp as you used to be, or you’ve lost your libido, do something about it. Take the first step on the path toward feeling your best self — schedule an evaluation with a functional medicine practice near you or contact us for a consultation.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), Dr. Lewis has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa and elsewhere.