Estrogen may give women the edge in COVID-19 survival

After two years living with COVID-19, we’ve learned a lot about what can raise your risk factors for severity and death from the illness.

So far, those factors include being over the age of 65, having heart disease or diabetes, being a slow walker, taking steroids for conditions like inflammatory bowel disease, suffering from sleep apnea, and having low levels of vitamin D and zinc. Low levels of testosterone in men can also increase COVID-19 severity and death risk.

Now, there’s another risk factor that older women need to be aware of…

Estrogen levels could play a role in COVID-19 severity

According to a Swedish study, higher levels of estrogen in older women appear to be protective against severe COVID-19 infection and death risk. These results show it may be worth testing whether supplemental hormone therapy in postmenopausal women could reduce the severity of COVID-19.

Even after accounting for other factors, women seem to have a lower risk of contracting severe COVID-19 than men. This has proven true for other serious viral respiratory infections as well, such as MERS.

Theorizing that estrogen could play a role in this gender gap, the researchers compared how raising and lowering estrogen levels affected COVID-19 infection severity.

They used national data from the Swedish Public Health Agency, Statistics Sweden and the National Board of Health and Welfare to obtain their study sample. Of the 14,685 women included, 2 percent had been previously diagnosed with breast cancer and were on estrogen-blocking drugs to lower their risk of cancer recurrence. And 17 percent were taking hormone replacement therapy (HRT) to relieve menopausal symptoms.

The rest of the women, who weren’t on any treatment to enhance or reduce their estrogen levels, acted as the comparison group.

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When compared with those taking no treatment to affect their estrogen levels, the women on estrogen blockers were twice as likely to die from COVID-19. By contrast, the women on HRT had a 54 lower risk of COVID-19 death. The odds for the HRT group remained roughly the same even when accounting for influential factors such as age, income, education, and preexisting health conditions.

When looking solely at these influential factors, each extra year of age raised COVID-19 death risk by 15 percent. Each additional preexisting condition increased the death odds by 13 percent. And those with the lowest household incomes were nearly three times as likely to die from COVID-19 as those in the highest income brackets.

The researchers caution that because this is an observational study, it can’t establish cause. No data was available on weight, smoking or the exact doses and duration of the HRTs or estrogen blocker drugs.

Despite these factors, the researchers conclude the study shows enough of an association between estrogen levels and COVID-19 severity and death to warrant clinical trials of estrogen boosters as a therapy for reducing COVID-19 severity in postmenopausal women.

Natural estrogen support — the right way

No one knows better than women that hormone replacement therapy carries risks — including an increased risk of heart attack, stroke, pulmonary embolism, and even breast cancer — that differ from woman to woman depending on her health history.

One must consider how those risks stack against a particularly severe COVID-19 infection, and perhaps other existing health problems, to determine which threat may be greater.

But supporting your body’s natural estrogen production may help keep your body and overall health balanced — and nutrition sources may help.

Vitamins B₂ and B₆ in particular, are associated with healthy estrogen levels. Studies have also shown a link between low levels of vitamin D and low levels of estradiol, the strongest estrogen hormone.

Modifying your diet can also help preserve the estrogen you have and keep your levels from dropping so dramatically as you age. Women who follow a more plant-based eating plan often have milder menopause symptoms — or sometimes none at all — compared with women who eat a diet rich in animal fat and protein. This is due to the phytoestrogens many plants contain that simulate the action of the estrogen your body produces.

However, bear in mind that phytoestrogens have a milder impact than pure estrogen replacement therapies. So you may need to supplement if your estrogen levels are particularly low or you’ve passed through menopause.

Sources:

Oestrogen levels linked to risk of COVID-19 death in older women — BMJ Open

Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study — BMJ Open

Estrogen, vitamin D may protect metabolic health after menopause — Medical News Today