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| | | Q | | Why don’t people assigned male at birth face complications from a lack of estrogen? | | | | A | | People assigned male at birth do not experience the same spectrum or severity of health complications from lower estrogen levels as postmenopausal people do. While everyone relies on estrogen for certain physiological functions, the consequences of estrogen deficiency differ due to distinct hormonal environments, tissue sensitivities, and baseline levels of estrogen and androgens.
In people assigned female at birth, the abrupt decline in estrogen at menopause leads to increased visceral fat, weight gain, and a higher risk of metabolic syndrome, cardiovascular disease, osteoporosis, and vasomotor symptoms such as hot flashes. This is because estrogen plays a central role in regulating energy homeostasis, fat distribution, and metabolic health.
The loss of estrogen shifts fat storage, increases body fat, and makes it harder for the body to process fats, which collectively drive weight gain and metabolic complications. People with vaginas may also experience unique symptoms such as genitourinary syndrome, mood disturbances, and sleep disruption due to estrogen deficiency.
Although low estrogen in people assigned male at birth can contribute to increased fat mass, bone loss, and sexual dysfunction, these effects are generally less pronounced than in people with vaginas.
People assigned male at birth do not experience the same rapid shift in fat distribution or the same degree of metabolic risk following a decline in estrogen. Essentially, they have more androgens (often called "male hormones," such as testosterone) and a different balance of sex hormones, which offsets the impact of estrogen deficiency. For example, testosterone itself supports lean mass and metabolic health, and its gradual decline with age is a major driver of changes in body composition and strength in men.
In summary, while low estrogen affects both sexes, the health consequences are more severe and wide-ranging in postmenopausal people due to differences in hormonal regulation, tissue sensitivity, and the abruptness of hormonal change.
| | | | | | | | Do you have any questions for our menopause experts? Let us know at menopause@healthline.com, and the answer may be featured in an upcoming edition! | | | |
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| HEALTHY TIP | | Eat more protein to speed up your metabolism | | A higher protein intake may boost your RMR and basal metabolic rate (BMR). This can help you burn more calories for several hours after eating and during sleep. High protein foods include lean meats, dairy, legumes, nuts, seeds, and soy products. | | | | | |
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