The Impact of Estrogens on Glucose Metabolism and Insulin Resistance with Dr. Ben Bikman

In this episode of The Metabolic Classroom, Dr. Ben Bikman explores the metabolic effects of estrogens, particularly their role in glucose metabolism.

Estrogens, mainly produced in the gonads, play a crucial role in regulating blood glucose by enhancing insulin sensitivity. Dr. Bikman explained that estrogens improve insulin signaling through pathways such as PI3 kinase and AKT, which are essential for glucose uptake in muscle and fat tissues. Additionally, estrogens activate AMP-activated protein kinase (AMPK), further promoting glucose uptake and maintaining healthy blood glucose levels.

Estrogens also suppress glucose production in the liver by inhibiting key enzymes involved in gluconeogenesis, helping to prevent excess glucose release into the bloodstream. In contrast, progesterone decreases insulin sensitivity and promotes insulin resistance, counteracting some of estrogen's beneficial effects. This hormonal interplay affects glucose metabolism during the ovarian cycle, with estrogen-dominant phases being more favorable for glucose control.

During menopause, the significant drop in estrogen levels leads to increased insulin resistance and shifts in fat storage, often resulting in more central fat accumulation. While hormone replacement therapy (HRT) can mitigate some of these changes, it comes with risks that need careful consideration. Ben emphasizes the significant role of estrogens in glucose metabolism and their broader impact on metabolic health, especially in women.

01:19 - Overview of Estrogens and Progesterone
02:20 - Cholesterol as the Precursor to Sex Hormones
03:34 - The Role of Aromatase in Estrogen Production
04:32 - Understanding the Family of Estrogens
05:56 - Estrogens and Glucose Metabolism: Key Signaling Pathways
06:54 - Insulin Signaling Pathway Overview
08:57 - How Estrogens Enhance Insulin Sensitivity
10:04 - The Role of AMPK in Glucose Uptake
12:11 - Estrogens' Dual Mechanism in Regulating Glucose Levels
13:18 - The Impact of Estrogens on Liver Glucose Production
15:33 - Estrogens' Role in Suppressing Gluconeogenesis
17:07 - Why Women Have Lower Risk of Type 2 Diabetes
18:19 - The Contrasting Role of Progesterone in Glucose Metabolism
19:28 - Metabolic Effects During the Ovarian Cycle
21:54 - Progesterone’s Influence on Insulin Resistance and Fat Storage
23:07 - Metabolic Changes During Menopause
25:16 - The Shift in Fat Storage Patterns Post-Menopause
26:16 - Hormone Replacement Therapy: Metabolic Considerations

#Estrogens #GlucoseMetabolism #InsulinSensitivity #DrBenBikman #Menopause #HormoneHealth #Progesterone #MetabolicHealth #WomensHealth #Type2Diabetes #HormoneReplacementTherapy #AMPK #OvarianCycle #InsulinResistance #FatStorage #BiomedicalScience #CellBiology #Endocrinology #HealthLecture #MetabolicClassroom #InsulinIQ

References:

[SydneyCollin]

During peri-menopause, I was fortunate enough to have an Ob Gyn who placed me on bio-identical estradiol & progesterone, dosed in a monthly cycling pattern. Now in menopause, dosages have increased & a small amount of replacement testosterone has been added. I haven't gained weight, haven't lost muscle mass, I sleep well, all labs are great, and I feel good.

[sheila]

I Finally have an answer as to why my glucose has been going up. THANK YOU THANK you THANK YOU!!! I am on an aromatase inhibitor due to my cancer, which steals most all my estrogen…… now I am almost diabetic even though I am eating good, exercising, lost weight, etc. I wanted to know WHY and HOW it is going up. You explained it all. Thank you so much! I have been trying to convince my oncologist that the “pill” I am on has caused this problem in my body and my oncologist said they are not related. They absolutely are! You are a wonderful person to take the time to explain all this to us. THANK YOU! Thank you!!❤❤❤❤❤

[Magpie-]

Ladies, due to the lack of knowledge and training of OB/GYN’s, and continually advancing science, it is extremely difficult to find a doctor who can help you in your menopause journey. Start your research early and stick to legitimate sources (there are some wacky people/theories out there). HRT isn’t right for everyone, but you should make your personal decision based on science, not outdated or unfounded information. Fortunately menopause discussion is seen more frequently in the headlines now so there are sources available to you to learn what to expect and what your options are peri-post menopause.

[Annalwayslearning]

Progesterone may make us less insulin sensitive but when it dropped off in perimenopause it left me with pretty significant anxiety and insomnia. I’ve added it back in with HRT and feel much better for it 💛

[אלהזינגרמן]

Dear dr Ben!
I am listening to you from Israel.
I am an English teacher and as a teacher I can see you are doing what you are doing out of love. You enjoy teaching the audience out of pure knowledge and not for the sake of money in order to sell us something. I am almost sure that as a professor having a stable position, you don't need that money unlike other you tubers 😮.
Continue doing what you are doing.
I appreciate you, your deep knowledge, enthusiasm and time you dedicate to your students/listeners.

[cattleprods]

Finding Dr Ben has been one of the greatest things in my life, God bless you!

[ZsuzsaKarolySmith]

Progesterone plays a crucial role in thyroid hormone production. Low progesterone = hypothyroidism = metabolic problems. Progesterone is not the bad guy in this equation. In fact, in perimenopause, when problems first start, progesterone is the first hormone to diminish while oestrogen production can be sky high. If oestrogen is responsible for better insulin sensitivity and progesterone causes insulin resistance then perimenopausal women should be at the top of their metabolic health and that’s definitely not the case! The key is to balance these two hormones, so in perimenopause women would need more progesterone to balance the sometimes crazy high oestrogen levels, while in menopause both oestrogen and progesterone need to be supplemented in adequate quantities to achieve a good balance. My glucose metabolism has improved a lot since starting HRT - previously my oestrogen levels were relatively high but my progesterone levels were zero causing all sorts of problems including reactive hypoglycaemia (frequent blood sugar crashes) and rising A1C.

[SolankiJanvi-wglq]

I have read many books, I listened to many Youtube videos by many of the worlds leading gurus and health experts but nothing came close to the hidden herbs by anette ray. I recommend everyone giving it a read.

[deboramathias]

So great that scientists are beginning to pay more attention to us menopausal women ❤❤❤

[lindabirmingham]

I would love to take a Physiology 101 course by Dr Dr Bikman. I took physiology a few decades ago, but my instructors didnt teach it well. Dr Bikman motivates me to learn.

[Maryvogel-mt]

I’ve been on an aromatase inhibitor for 4 years. Now I understand why I am on the brink of metabolic syndrome.despite not being overweight, and getting vigorous exercise . My body shape has changed significantly. Thank you so much for all the detail.

[deboramathias]

Would love to hear more about menopausal fat storage & how to get rid of it

[casapilanola]

So glad you showed up in my Youtube! Your ability to communicate science is top level Thank you so much! my dear Mama was in a diabetes research lab at the NIH under Dr. Cushman for 33 years and glucose transport was their thing, I think she would have loved your lecture.

[claudiawilkinson]

For the most up to date information on HRT which is then not controversial I suggest people watch videos but Dr Louise Newson and episode 42 of The Drive podcast where Peter Attia discusses all the misinformation from the WHI studies with Avrum Bluming & Carol Tavris who wrote the excellent book Oestrogen Matters.

[zenamatthews]

This is incredible information! I appreciate how much I trust you and that trust is hard to come by in the medical field.

[theeventhorizon-valebridge]

Thank you so much for sharing your knowledge on this channel Dr Bikman. You are literally saving lives, potentially many millions, by highlighting the biggest medical issue of our age; insulin resistance, which is the underlying cause of 85% of other modern diseases (so Dr Robert Lustig thinks).

[ivalani]

Unfortunately HRT for most menopausal women means trying to balance the estrogen with progesterone, so seems the metabolic benefits are once again diminished. I for one can’t tolerate progesterone (I took bio identical micronized oral progesterone pills to counteract the estradiol patch). Gained a lot of weight and after 5 months stopped HRT. Weight returned to normal.

[ashleydove]

Gestational diabetes question: I’m currently 30 weeks pregnant. Last week I did my 1-hour GTT with the 50g glucose drink. I expressed concern to my doctor that I don’t eat sugar. Ever. Only in the form of fresh fruits such as berries. A heavy carbohydrate day for me would be about 80g carbs spread out through multiple meals over the day. Not in a few minutes like the glucose drink. My one hour glucose for the 50g test was 140, so my doctor said I would need to do further testing; 100g glucose drink with measurements over 3 hours. My fasting glucose was 84, 1 hour post 135, at 2 hours 116, at 3 hours <20/undetectable.
I would love some insight as to why this happened and what does it mean. My doctor seams pretty clueless. And apparently there isn’t an alternative testing method for pregnant women who practice low carb eating styles. Help!

[hocheefatt]

Dr Ben,
You are the BEST of the best.
If only I could shake your hand one day....
Cheers from Malaysia

[SteveMark-vw]

Good stuff, Dr. Bikman. Would like to hear your thoughts on the effects of phyto-estrogens, and/or estrogen-emulating substances in our modern world (plastics and such), in terms of their magnitude compared with people's normal values, and as to how they may affect the balance, or substitute themselves for actual estrogen, possibly leading to problems.