• Hormone Replacement Therapy
• Menopause

Can Hormones in the Kidneys Affect Menopause?

Medically reviewed and edited by Lauren Cramer, PA- C

Published: August 07, 2025
Updated: November 12, 2025
5 mins

Estrogen, also known as the “female sex hormone,” plays a significant role in keeping the body functioning well. You need estrogen for immune system management, menstrual cycle regulation, and cardiovascular health to name a few. 

Hormonal fluctuations are a normal part of how your body operates and is a normal part of your body regulating your system throughout life. Hormonal fluctuations don’t always cause symptoms, but when they do it can be a sign of an underlying health condition. In the kidneys, hormones like estrogen assist in blood pressure management and ensuring your kidneys work efficiently. 

Women with very low estrogen levels will see changes in their health as this hormone decreases. Some women  may experience kidney complications when approaching menopause. While menopause does not always directly affect hormones in the kidneys, women with preexisting kidney disease may have more difficulties managing menopausal symptoms.

What Hormones are Produced in the Kidneys?

The kidneys produce three main hormones: renin, erythropoietin (EPO), and vitamin D3 (calcitriol). The kidneys also produce the following hormone-like substances:

• Natriuretic peptides

• Prostaglandins

• Endothelins

• Adrenomedullin

Renin

Several different groups of cells are involved in the release of renin. Cyclic GMP, calcium ions, and cyclic AMP (cGMP) all play a role in releasing renin. Cyclic AMP serves as a messenger between cells to activate proteins, while cGMP and calcium ions stimulate the release of renin in the kidneys.

Erythropoietin (EPO)

Pericytes (multifunctional cells in the body) create erythropoietin in the process of helping to transport oxygen to the kidneys.

1,25-dihydroxyvitamin D3 (calcitriol)

The process of producing calcitriol occurs in the skin, liver, and kidneys. Calcitriol is created when the skin is exposed to sunlight and other sources of vitamin D. From there, vitamin D3 is absorbed into the bloodstream and activated in the liver and kidneys.

RAAS (renin-angiotensin-aldosterone system)

Estradiol (a form of estrogen) helps to form RAAS. The hormone-like substance RAAS (renin-angiotensin-aldosterone system) is a system produced in the kidneys.

What is the Purpose of Hormones Produced in the Kidneys?

Hormones help the kidneys carry out essential functions that take place outside of the kidneys as well. The kidneys are responsible for filtering out blood, regulating blood pressure, and preventing a build-up of waste.

Renin function

Renin helps to control blood pressure and balance fluid in the kidneys.

Erythropoietin (EPO) function

In the kidneys, the hormone erythropoietin stimulates the production of red blood cells. Those with anemia, chronic kidney disease, or who have had surgery recently may see a decline in red blood cells. 

Healthcare providers may prescribe man-made EPO to patients with low hemoglobin. Premenopausal women with certain health conditions may experience more fatigue without enough erythropoietin.

1,25-dihydroxyvitamin D3 (calcitriol) function

Calcitriol (1,25-dihydroxyvitamin D) helps maintain blood calcium by increasing gut absorption and reducing urinary losses. Postmenopausal women often have low 25(OH)D (the storage form used to assess vitamin D status), but true calcitriol deficiency is more linked to kidney disease or severe vitamin D deficiency, not menopause per se. 

RAAS (renin-angiotensin-aldosterone system) function

The main function of RAAS is to regulate blood pressure, balance electrolytes, and manage fluid in the kidneys. Estrogen influences kidney and cardiovascular regulation, partly by moderating the RAAS. With the estrogen drop in menopause, RAAS activity often tilts toward vasoconstriction and sodium retention, contributing – along with aging and metabolic factors – to higher rates of hypertension and cardiovascular risk in postmenopausal women.

What Happens When You Have Kidney Complications

When the kidneys are having difficulty functioning efficiently, their hormone production can be affected. In the late stages of chronic kidney disease, when the kidneys can no longer function well on their own without medical treatment, the hormonal changes often become more pronounced.

Menopause does not always affect the kidneys, but the following kidney complications may affect the severity of menopausal symptoms and hormonal health in women:

Chronic kidney disease (CKD): The kidneys are damaged for at least three months before it's considered chronic kidney disease. Chronic kidney disease occurs in five stages. Those with chronic kidney disease may not experience symptoms until they enter the later stages of it.

Kidney failure: The kidneys can no longer function efficiently on their own. Those with kidney failure require a kidney transplant or dialysis.

Kidney complications can lead to imbalances with insulin, sex, and thyroid hormones. Chronic kidney disease can negatively affect bone health in postmenopausal women and may increase the risk of a woman going through menopause before the age of 45. 

Some women may experience more menopausal symptoms from changes in kidney function. Because of the risk of severe hormonal imbalance with CKD, a healthcare provider may more closely monitor postmenopausal women with chronic kidney disease as they approach menopause. Health experts are conducting more research to confirm whether there is a connection between CKD and early menopause.

Is Hormone Replacement Therapy Used for the Kidneys?

Hormone replacement therapy (specifically menopausal hormone therapy) is not a treatment for kidney complications. However, researchers have looked into how estrogen replacement therapy may help postmenopausal women with kidney disease better manage their menopausal symptoms. 

HRT for menopause is available in tablet, patch, cream, spray, gel, and injection form. Be sure to check with a licensed healthcare provider before starting HRT if you have a history of kidney complications.

Quick Tips for Managing Hormonal Imbalances

It’s normal for hormones to fluctuate over the course of a woman's menstrual cycle. It’s not until these hormonal imbalances become significant in perimenopause and menopause, that symptoms occur. Health conditions like kidney disease, thyroid complications, can cause symptoms to develop in postmenopausal women more intensely.

The following healthy habits may help you keep your hormones balanced and reduce the severity of menopausal symptoms:

• Eat a well-balanced diet

• Stay hydrated

• Prioritize more vitamin C and D

• Engage in physical activity daily

• Avoid drinking alcohol excessively

Where Can You Learn More About Hormonal Health?

Changes in your hormones are not always a sign of a health issue. However, connecting with a licensed healthcare provider can help ensure your kidneys, liver, and other essential organs are functioning optimally as you age. 

The LifeMD Women’s Health Program offers compassionate, personalized care for women entering or going through menopause. With LifeMD, a licensed healthcare provider can help you understand how hormones affect your overall health, guide you on steps to restore hormonal balance, and recommend preventative measures to protect your well-being.

Make an online appointment to see if you qualify and start addressing your daily health needs.

Lauren Cramer, PA- C

Lauren is a passionate and dedicated board-certified physician assistant. She received her Bachelor’s degree in Kinesiology and Exercise Science from SUNY Cortland — graduating magna cum laude while competing as a three-sport collegiate athlete in indoor and outdoor track and cross country. She went on to complete her Master’s degree in Biological Sciences and earn her Physician Assistant degree from Daemen College in Buffalo, New York. Lauren has years of focused experience in perimenopause, menopause, and postmenopause care, specializing in hormone replacement therapy (HRT), bone health optimization, and a functional medicine approach to women’s wellness. She integrates evidence-based hormone therapy with lifestyle, nutrition, and metabolic strategies to support long-term vitality, cognitive health, and bone density. In addition to her women’s health expertise, Lauren has a well-rounded background in allergy, asthma, otology, laryngology, and rhinology. Functional medicine has always been a passion of hers, and she continues to pursue advanced certification to deepen her ability to deliver personalized, root-cause care to her patients.

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