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The Hidden Risks of Oral Estrogen: What Every Woman Should Know About Estrone
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Many women are prescribed oral estrogen without ever being told what happens after it enters the body. In this episode, Dr. Brendan McCarthy takes a deeper look at estrone, the estrogen metabolite created when estradiol is taken orally, and explains why the delivery method of hormone therapy matters. You'll learn: The difference between estradiol and estrone Why oral estrogen creates significantly higher estrone levels How estrone may contribute to inflammation and insulin resistance The connection between estrogen metabolism and weight gain during perimenopause and menopause Why monitoring labs is essential when using hormone therapy The importance of understanding risks, benefits, and treatment options before starting hormones Dr. McCarthy also discusses the role of inflammation, body fat, metabolic health, and hormone delivery systems in creating long-term outcomes for women navigating menopause. This episode is about education, informed consent, and helping women better understand the science behind their care. Citations: There is more than one estrogen; after menopause, estrone dominates Kuhl, Herbert. “Pharmacology of Estrogens and Progestogens: Influence of Different Routes of Administration.” Climacteric, vol. 8, no. S1, 2005, pp. 3–63. Body fat is an endocrine organ — aromatase converts androstenedione into estrone, and adipose becomes the dominant post-menopausal estrogen source Lee, Angel A., and Laura J. Den Hartigh. “Metabolic Impact of Endogenously Produced Estrogens by Adipose Tissue in Females and Males across the Lifespan.” Frontiers in Endocrinology, vol. 16, 2025, article 1682231. Inflamed fat raises IL-6; IL-6 tracks the insulin-resistant state Kern, Philip A., et al. “Adipose Tissue Tumor Necrosis Factor and Interleukin-6 Expression in Human Obesity and Insulin Resistance.” American Journal of Physiology-Endocrinology and Metabolism, vol. 280, no. 5, 2001, pp. E745–E751. IL-6 is part of the insulin-resistance machinery — it correlates with impai
This content is for education and is not medical advice. It does not replace an evaluation with a licensed provider, and no one should start, stop or change a medication on its basis.
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