NAMS Menopause Certification Practice Exam 2025 – Complete Test Prep Guide

Oral estrogen has been shown to increase cortisol binding globulin (CBG), which is a protein that binds cortisol in the bloodstream. When estrogen is administered, it stimulates the liver to produce more CBG. This increase in CBG can lead to a rise in the amount of cortisol that is typically bound in the system, which can subsequently affect the availability of free cortisol in the body.

The physiological significance of this increase is notable: it can alter the cortisol levels that are biologically active and may impact various metabolic and stress response pathways. Understanding how oral estrogen influences CBG helps healthcare providers anticipate changes in cortisol dynamics that could affect overall health, particularly in menopausal women undergoing hormone therapy.

The other options do not accurately represent the interaction between estrogen and CBG. While some may suggest no effect or a decrease, these assertions do not align with the established understanding of how oral estrogen affects liver protein synthesis and, consequently, CBG levels.