Tag Archives: hormones

Estrogen & COVID-19 Severity in Women

September 17, 2020

Growing clinical evidence reveals that the intensity of COVID-19 infection and incidence of related complications are more prominent in male patients. Current data suggests that men experience a greater risk than women for more severe COVID-19 symptoms and poorer outcomes regardless of their age. These burgeoning findings signal that sex may function as a determinant of COVID-19 infection severity.

While the body of evidence examining sex differences in virus outcomes is lacking, researchers believe the functional modulation of angiotensin-converting enzyme 2 by estrogen may explain disparities in morbidity and mortality. Further reasons for higher male sex-specific COVID-19-related mortality are likely multi-fold and may include lifestyle differences such as higher rates of tobacco smoking and alcohol consumption as well as innate immunity. The mounting evidence suggesting sex-based differences in clinical outcomes emphasizes the need for an assessment of sex-specific hormone activity – in particular, estrogen – in COVID-19 pathogenesis.

Sex-Specific Differences in COVID-19 Outcomes 

A recent study conducted by researchers at the Wake Forest Baptist Medical Center attempts to elucidate the mechanisms underlying these notable differences. Led by Leanne Groban, MD, professor of anesthesiology at Wake Forest School of Medicine, a team of researchers conducted a review of published literature to determine whether sex plays a role in COVID-19 outcomes by examining pre-clinical data on sex-specific hormone activity.

Beneficial Impact of Estrogen

The study’s authors reported that angiotensin-converting enzyme 2 – attached to cell membranes in heart, arteries, kidneys, and intestines – acts as a cellular receptor of the coronavirus responsible for COVID-19 infections and helps the virus gain access to cells of those organ systems. According to the researchers, their review also pointed to estrogen’s impact on ACE2 levels in the heart; the hormone lowered ACE2 levels. This may modulate the severity of COVID-19 in women, while higher levels of ACE2 present in tissues could account for why the disease presents worse in men.

“We know that coronavirus affects the heart and we know that estrogen is protective against cardiovascular disease in women, so the most likely explanation seemed to be hormonal differences between the sexes,” said the lead author of the review, Dr. Groban told ScienceDaily in an interview.

“We hope that our review regarding the role of estrogenic hormones in ACE2 expression and regulation may explain the gender differences in COVID-19 infection and outcomes and serve as a guide for current treatment and the development of new therapies,” Groban said.

An enhanced understanding of the role of estrogenic hormones in ACE2 expression and regulation may not only help uncover potential mechanisms that explain sex differences in COVID-19 clinical outcomes, but also guide future disease management techniques and spur the discovery of novel therapeutic methods.

Top Clinical Endocrinology Topics You Can’t Miss at the BHRT Symposium

September 25, 2019

A growing understanding of the intricacies of thyroid health, hormonal imbalances and therapies, as well as advancements in other facets of the burgeoning field of clinical endocrinology have drawn increased attention to novel treatment modalities and their potential to relieve –and even prevent – many symptoms of the aging process. To optimize treatment strategies and patient health outcomes, it is increasingly important for clinicians to stay up-to-date on the latest developments in hormone health. At one of our most popular events, the Bioidentical Hormone Replacement Therapy Symposium, a panel of experts will review the most recent and relevant research available, analyze the medical evidence surrounding hormone therapies, and delve into strategies for safely and effectively merging them into clinical practice. From thyroid optimization to growth hormone deficiency, attendees will have the opportunity to explore the most clinically current topics in the field through a series of expert-led sessions curated to provide a comprehensive overview of the latest updates in endocrinology.

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The Truth Surrounding Hormone Replacement Therapies

September 14, 2017

Earlier this week, JAMA published findings surrounding the uses and consequences of menopausal hormone therapy: a subject that has been considered contentious and controversial for several decades–in large part due to the outcome of the Women’s Health Initiative Study, which was halted prematurely in 2002 because of data that indicated the combination of Premarin (estrogen) and Provera—an artificial form of progesterone known as progestin—increased heart disease and breast cancer.

Yet the results are far more complex and nuanced: most people are unaware of the fact that women who had hysterectomies only received the premerin, while other women received the combination pill. The only increase in breast cancer that occurred was in the latter group; when estrogen is combined with progestin, the ability of estrogen to cause stimulation of breast tissue is increased—yet estrogen alone does not. The group who only received estrogen actually showed a decreased risk of breast cancer; moreover, the estrogen was protective even when women were diagnosed with breast cancer.

Jennifer Landa, MD, Chief Medical Officer of BodyLogicMD, has dedicated her practice to bioidentical hormone therapy and preventive medicine, in order to assist men and women resolve menopausal and andropausal symptoms. Dr. Landa explains that results are often contingent upon the ways in which hormones are administered, in addition to the fact that not all hormones are created equally. “Only someone trained as an expert knows the good and bad, and really understands the studies. When we talk bioidentical, it is a way of saying the same exact chemical structure of what is in our body naturally. People do not realize that there are already plenty of prescriptions with bioidentical hormones.”

Bioidentical hormone replacement therapy technically refers to the use of hormones that mimic the endogenous hormones produced by our bodies. Landa clarifies that much of the hormone literature is inaccurate, because most of the studies are conducted with ‘bad’ hormones, like progestin. Landa further discusses a study at Yale, years after the 2002 study—after which women came off of hormones in droves—in which researchers and scientists state that the women only taking estrogen should have stayed on it, and that many more women died of heart disease because they were taken off of their hormones. After retrospectively analyzing and assessing the data of the Women’s Health Initiative study, it was found that women who began hormones during menopause had decreased risks of heart disease. Landa terms this the ‘timing hypothesis,’ stating: “Timing is of the essence in hormone therapy. Unfortunately, many doctors are still not schooled properly in this area. Even the American College of OBGYN has agreed that we should not be taking older women off of hormones, as symptoms will likely recur.”