Estrogen and Athletic Performance

Estrogen and Athletic Performance

You’ve heard of estrogen, and you know it’s in your body, but what is it and what on earth does it do?

Estrogen Overview

Estrogen is a steroidal hormone made by the ovaries in young and adult women who haven’t started menopause yet. The ovaries turn cholesterol into estrogen. There are three main types of estrogen.

  1. Estradiol: Most important for women who haven’t hit menopause
  2. Estrone: Most important for post-menopausal women
  3. Estriol: Most important for pregnancy

Estrogen and Sports Performance:

  • Muscles: Research shows that as estrogen levels increase, so does muscle mass, strength, and recovery.
  • Ligaments and Tendons: These tissues are composed mainly of collagen. Estrogen increases collagen, which can decrease stiffness. Stiffness is protective against injury, meaning that women with higher estrogen levels may be at heightened risk for tendon and ligament injuries. 
  • Bones: Bones break down over time, but estrogen turns off the cells that break down bone (osteoclasts). So, having healthy levels of estrogen can protect the body from osteoporosis. Estrogen is also vital for bone growth during puberty. Thus, it’s important for athletes to have adequate estrogen levels to build skeletons that support what they ask of their bodies. 
  • Injury Risk: Low estrogen levels can increase the risk for musculoskeletal injury, especially as seen in women who have gone through menopause. Additionally, high levels may lead to increased risk of injury in the ligaments and tendons. The rise of estrogen during the follicular phase decreases ligament stiffness and makes women more susceptible to ACL injuries.
  • Heart Health: Higher levels of estrogen have been linked with healthier, more efficient hearts. Estrogen reduces cholesterol levels, meaning healthy levels decrease the risk of cardiovascular issues including coronary artery disease. 

Other Roles of Estrogen:

  • Breast Health: Estrogen is responsible for the development of breast tissue during puberty.
  • Immune System: Estrogen has anti-inflammatory effects, which may assist in healing infections and wounds.  

Estrogen Changes

Estrogen levels peak twice during the menstrual cycle. The first peak occurs at the end of the follicular phase which causes the release of luteinizing hormone (LH) to signal the start of ovulation. Estrogen levels then drop. The second peak occurs to prepare the uterus for pregnancy by working with progesterone to thicken the wall of the uterus. Estrogen levels then drop, resulting in bleeding.
Changes in estrogen over the menstrual cycle.

Estrogen and the Aging Athlete 

Research strongly supports estrogen’s protective effects against osteoporosis, a common problem among aging adults. It may also protect against other age related diseases such as heart disease and Alzheimer's disease by its antioxidant effects which protect the central nervous system and heart muscle. 

Estrogen is a complex hormone that affects many parts of the body, but optimal estrogen levels are important for quality of life. There is still much research to be done to better understand women’s health and to offer guidance for optimizing female athletes’ performance.

by: Carlyn Johnson


Chidi-Ogbolu, N., & Baar, K. (2019). Effect of Estrogen on Musculoskeletal Performance and Injury Risk. Frontiers in physiology, 9, 1834. 

Cui, J., Shen, Y., & Li, R. (2013). Estrogen synthesis and signaling pathways during aging: from periphery to brain. Trends in molecular medicine, 19(3), 197–209. 

Delgado BJ, Lopez-Ojeda W. Estrogen. [Updated 2023 June 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

Di Gioia, G., Crispino, S. P., & Maestrini, V. (2023, December 13). Cardiovascular Effects of Chronic Hormone Therapy: Study on Olympic Female Athletes. The American Journal of Cardiology. 

Harding, A. T., & Heaton, N. S. (2022). The Impact of Estrogens and Their Receptors on Immunity and Inflammation during Infection. Cancers, 14(4), 909. 

Lee, C. A., Lee-Barthel, A., Marquino, L., Sandoval, N., Marcotte, G. R., & Baar, K. (2015). Estrogen inhibits lysyl oxidase and decreases mechanical function in engineered ligaments. Journal of applied physiology (Bethesda, Md. : 1985), 118(10), 1250–1257. 

Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA):, Inc.; 2000-. Available from:

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