Iron and Menopause: Does Increased Iron Affect the Health of Postmenopausal Women?

Abstract

Estrogen deficiency has been regarded as the main causative factor in menopausal symptoms and diseases. Here, we show that although estrogen decreases by 90%, a concurrent but inverse change occurs in iron levels during menopausal transition. For example, levels of serum ferritin are increased by two-to threefold from before menopause to after menopause. This observation has led us to hypothesize that, in addition to estrogen deficiency, increased iron as a result of menopause could be a risk factor affecting the health of postmenopausal women. Further studies on iron and menopause are clinically relevant and may provide novel therapeutic treatments.

Estrogen contributes to regulating iron metabolism through governing ferroportin signaling via an estrogen response element

“…The reasons for elevated body iron burden are poorly understood in cancer patients. In light of iron metabolism in women, menopause and endogenous estrogen alteration have been postulated to physiologically account for the change of body iron mass [17,60]. Estrogen is a hormone that physiologically dictates the integrity and functions for a variety of cells.…”

“…Elevated body iron has been documented in postmenopausal women for unclear reasons [20,52,61]. For example, a previous study identified a negative correlation between serum ferritin and estrogen level in women [17]. The mechanisms underlying the correlation between estrogen and iron metabolism is still elusive thus far.…”

“…Considering the change of iron, several reasons should be taken into account. For example, reduction of monthly blood loss would certainly help to retain body iron [17]. Recent studies from our research group and another group have uncovered the regulation of hepcidin by estrogen, linking estrogen to iron homeostasis [22,23].…”

“…Estrogen is an indispensable hormone implicated in a wide spectrum of physiological functions for organs including breast, bone and skin, especially in females [17][18][19]. Within the life span of a woman, the endogenous level of estrogen greatly fluctuates, particularly after menopause [20].…”

“…Within the life span of a woman, the endogenous level of estrogen greatly fluctuates, particularly after menopause [20]. The pronounced manifestation of menopause is the cessation of menstruation, accompanied by estrogen deficiency and reduced functions of the ovaries [17]. A few previous studies have suggested the consequential change of iron levels after menopause [20,21].…”