SYNOPSIS
Evidence from basic, preclinical, and clinical research points to an important role of estradiol (E2) in the regulation of body composition and bioenergetics. There is consistent evidence from basic and preclinical research that the disruption of E2 signaling, through either genetic manipulation (e.g., estrogen receptor deletion) or surgical intervention (e.g., ovariectomy), accelerates fat accumulation, with a disproportionate increase in abdominal fat. Clinical evidence for the regulation of body composition and bioenergetics by E2 is less consistent. Evidence exists both for and against menopause as the mediator of changes in body composition. This is likely related to the prolonged nature of the menopause transition in women and the associated complexities of distinguishing effects of the loss of gonadal function from other phenomena of aging. However, a need remains to better understand the metabolic actions of estrogens in women because of the potential impact on health after the menopause.