What is Estrogen?
Estrogen is a growth hormone that stimulates the development of adult sex organs during puberty. At puberty, estrogen promotes development of a woman’s breasts and hips with what we think of as natural fat deposits and the resulting contours. Estrogen helps retain calcium in bones, a function that keeps bones strong and whole during childbearing years. It also regulates the balance of HDL and LDL cholesterol in the bloodstream and helps lower your body’s total cholesterol level. Estrogen aids other body functions, such as regulating blood sugar levels and emotional balance.
Estrogen also helps keep skin supple and elastic through its nonstop job of replacing dead cells and maintaining proper collagen structure (the basic structural component of skin and supporting structures). Estrogen promotes healthy, well-nourished vaginal tissue to help maintain flexible, moist, and elastic vaginal walls.
Estrogen may help strengthen the brain’s blood supply and therefore aid in the protection of memory and cognitive functions. Estrogen helps keep all of your body’s cells and muscles healthy and well-toned.
Estrogen and Menopause
Your body doesn’t stop producing estrogen when you stop ovulating, but it produces dramatically lower levels of estrogen as your ovarian function declines. The amount of hormones your ovaries are able to secrete gradually diminishes in your late forties, so your body produces lower amounts of estrogen and other hormones. In the early stages of perimenopause, the pituitary gland in the brain produces its own hormones to try to stimulate the ovaries to produce more estrogen, and it works, for a while. The ovaries occasionally are able to give up enough estrogen to trigger a menstrual period. However, in this transition phase a woman may experience widely fluctuating levels of estrogen for a number of years, until the ovaries shut down completely.
HRT - Hormone Replacement Therapy (also know as HT - Hormone Therapy) was once considered the front-line response to alleviate the symptoms of menopause (as though menopause was a dreaded disease to avoid.) Now, most doctors are advocating a balanced approach to the use of HRT, and consider each woman individually before making the decision to prescribe. All of us have a different medical history to consider, and this weighs the pros and cons of therapy to prescribe or not prescribe.
Summary of the Pros and Cons of HRT Therapy:
Pros:
- Reduces the risk of bone loss associated with osteporosis
- Relieves the physical symptoms of menopause: hot flashes and the decreased sense of well-being
- Lowers the overall risk of colon cancer and macular degeneration of the eye
- Reduces risk of heart disease
Cons:
- Increases the risk of stroke and blood clots
- May increase the risk of developing breast cancer and uterine cancer, especially during long-term use
- May increase the risk of developing gallbladder problems
- Increases blood pressure in some women
The Benefits of HRT
First off, HRT isn’t for everyone. Your family or personal medical history may make you a poor candidate for hormone replacement therapy (outlined below). Or you may choose to use other methods for maintaining your health and alleviating menopausal symptoms. However, your choice should be based on facts—not unnecessary fears or unfounded beliefs about the safety or beneficial impact of this treatment option. This section attempts to outline those facts.
Your trained, licensed health care provider is your best source of complete information and advice about HRT, how it works, and what risks and benefits it offers you.
Hormone Replacement Therapy is used by fewer than half of all menopausal women in the United States. HRT does help maintain bone health and prevent osteoporosis. Nearly 30 percent of all women over age sixty-five have osteoporosis, and many of them don’t know it until symptoms become obvious, as happens when a bone crumbles or snaps. Most studies show that women who use estrogen and progestin HRT compounds reduce their risk of hip fracture by 11 percent for each year of HRT treatments.
HRT can alleviate hot flashes, vaginal dryness, and other menopausal sensations. HRT may help protect memory functions by improving circulation and increasing the flow of nourishing blood to the brain; some studies seem to indicate that it may help delay or prevent the onset of Alzheimer’s disease.
HRT may be effective in protecting the health of the eyes, postponing or preventing the onset of macular degeneration—the leading cause of blindness in those age sixty-five and older.
HRT also reduces the risk of contracting colorectal cancer by as much
as a third in most studies.
The Drawbacks of HRT
Recent research raises great concerns over the use of HRT. Many studies have found increases in breast cancer rates, especially among women who have had a previous breast cancer diagnosis. Uterine cancer rate increases have also been noted. Strokes and blood clots are another risk, especially assocaited with longer-term use of hormone therapy. HRT also increases a woman's risk of gallbladder disease by a factor of 2 - 3x.
Some women experience upleasant side effects while taking hormone therapy. These include irregular menstrual bleeding, sensation of bloating, migraines and other headaches, breast pain and tenderness and simply, an overall grumpiness. (Sound like PMS, doesn't it!) These side-effects may minimize with a decrease in dose or the even changing the balance of each hormone prescribed. But many women who start using HRT will discontinue it within six months due to the side-effects above.
You should carefully outline your medical history and definitely mention the following to your physician or health-care provider when considering hormone therapy:
- migraine headaches (especially migraine with aura)
- high cholestorol
- history of gallbladder disease
- history of liver disease
- history of cancer of the uterus or ovaries
- history of fibroids or endometriosis
Ultimately, the decision to utilize HRT therapy is best decided by a woman and her health care provider together, weighing all of the risk factors carefully to see what options pose the greatest health benefit over time. Don't hesitate to read scientific studies and ask questions—information is the key to help guide you to the right decision for you.
