A study published not long ago in the Journal of the American Geriatrics Society is a reminder that even natural estrogen at higher levels than the proper physiological range is detrimental. The authors aimed…

“To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT).”

The study participants were a representative sample of 509 women aged 65 and older living the Chianti region of Italy. What did their data show?

“Higher E2 levels were associated with a greater likelihood of death…independent of age, waist:hip ratio, C-reactive protein, education, cognitive function, physical activity, caloric intake, smoking, and chronic disease…The excessive risk of death associated with higher total E2 was not attenuated after adjustment for total testosterone and after further adjustment for insulin resistance…Total E2 was highly predictive of death after more than 5 years and not predictive of death for less than 5 years.”

This study highlights the importance of the functional management of estrogen levels even when HRT is not being used. All the more reason for cautious objective validation with the appropriate lab test (free-fraction bioactive estrogen) if we bear in mind the investigators’ conclusion:

“Higher total E2 concentration predicts mortality in older women not taking HRT.”