Hormone Imbalance, Nitric Oxide, and Your Health

From research on hormone imbalance gathered by Beth Shirley, RPh, CCN.

Hormone imbalance has far-reaching effects in the body, and is often diagnosed or treated inappropriately. Many are not aware of the connection between hormone levels and adequate levels of Nitric Oxide. Nitric oxide (NO) is a vital molecule that plays a significant role in the health and function of our blood vessels. The endothelial cells lining the interior surface of our blood vessels rely on NO for proper homeostasis. In this blog post, we will explore the critical connection between hormones, nitric oxide, and your health. We’ll discuss how hormonal imbalances can impact NO production and contribute to several health issues. 

Hormones and health: 

Hormones play a crucial role in stimulating NO production. As we age, hormone production naturally declines, leading to a loss of NO. This decline can cause a decrease in eNOS function, the enzyme responsible for producing NO, leading to several health issues. 

For women, estrogen plays a vital role in eNOS function, but its production declines with age, especially around menopause. This decrease in estrogen can result in hypertension, and around 85 percent of women in the US are hypertensive by the age of 85. Progesterone is also essential for eNOS function, as it acts directly on epithelial cells of the endometrium and stimulates the expression of eNOS. 

In men, testosterone deficiency can lead to erectile dysfunction and/or vascular dysfunction. Testosterone has a dual action in the modulation of the NO cyclic signaling GMP pathway, which influences endothelial function and endothelial progenitor cells (EPCs), key for the endothelial repair system. 

Unfortunately, some medications can hinder hormone production, and thus NO production. For instance, aromatase inhibitors, such as letrozole and anastrozole, which are used in breast cancer treatment, hinder estrogen production. They are also frequently added to compounded prescriptions of testosterone replacement therapy for men. In addition, cortisol, the only hormone that naturally increases with age, increases in the absence of NO, leading to inhibiting iNOS and eNOS and causing cardiovascular complications such as hypertension and blood clotting. 

Other hormones that positively stimulate eNOS include DHEA, which can be metabolized into other estrogens and testosterone, and growth hormone (GH) and IGF1, which stimulate eNOS. However, low DHEA levels are associated with a higher risk of erectile dysfunction in men and low sexual responsiveness in women. 


NO plays a crucial role in the health and function of our blood vessels, and hormone production positively stimulates its production. As we age, hormone production declines, leading to a loss of NO, which can cause several health issues. It’s essential to prioritize our health and wellbeing as we age, which includes regular medical checkups, working with healthcare providers to address any hormone imbalances that may negatively impact NO production, and discovering simple ways to increase your body’s NO production.  

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