Evidence Of Risks And Benefits
Many women reconsidered taking HRT due to recent studies on the long-term use of HRT. The Heart and Estrogen-Progestin Replacement Study found in the first year of HRT there was a 50% increase in heart attack and stroke. But, after two years of HRT, they had a decrease in these diseases.
The Womens Health Initiative performed a larger study. Its the largest study that examined the effects and risks of HRT in menopausal women.
In 2002, the WHI stopped giving women both estrogen and progestin therapy. Data from this group found an increased risk of heart disease, breast cancer, stroke and blood clots in the lungs and legs.
In 2004, they ended the group taking only estrogen because results indicated an increased risk of blood clots, stroke, and heart attack.
Due to these studies, they created new guidelines for prescribing HRT. These include:
- Stopping the use of HRT as a prevention of heart attack or stroke.
- Weigh the pros and cons of using HRT for prevention of osteoporosis
- Women with pre-existing heart disease should think about other options.
- Use in only the short-term for menopausal symptoms.
- Discourage long-term use
Estrogen Side Effects And Risks
Hormone therapy is not without its risks. In fact, hormone therapy is not used as widely as it once was because research began revealing complications with long-term use, such as cancer and heart risks.
However, thanks to these studies, doctors and medical researchers have a better understanding of who will benefit most from estrogen therapy and who should try other treatments.
The risk factors and side effects associated with estrogen use include:
- Blood clots: Estrogen increases your risk of blood clots, which can cause stroke, heart attack, and even death.
- Cancer: Estrogen may increase your risk of certain cancers, specifically breast cancer. Talk with your doctor about your personal health history, your family history, and your risk of breast cancer.
- Birth defects: If youre using estrogen or hormone therapy and become pregnant, your pregnancy may end prematurely. If youre able to carry a pregnancy to full term, birth defects are common for babies born to women using estrogen.
- Dense breast tissue: Women who take estrogen may develop dense breast tissue. Dense tissue makes reading mammograms harder, so detecting breast cancer in its early stages may be difficult.
What Are The Risks Of Taking Hormone Therapy
While hormone therapy helps many women get through menopause, the treatment is not risk-free. Known health risks include:
- An increased risk of endometrial cancer .
- Increased risk of blood clots and stroke.
- Increased chance of gallbladder/gallstone problems.
- Increased risk of dementia if hormone therapy is started after midlife. HT started during midlife is associated with a reduced risk of Alzheimers disease and dementia.
- Increased risk of breast cancer with long-term use.
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Concerns Over The Safety Of Hrt A History
HRT was first available in the 1940s but became more widely used in the 1960s, creating a revolution in the management of the menopause. HRT was prescribed commonly to menopausal women for the relief of their symptoms such as hot flushes, night sweats, sleep disturbances, psychological and genito-urinary problems urinary frequency and vaginal dryness and for the prevention of osteoporosis.
In the 1990s two of the largest studies of HRT users were undertaken, one clinical randomised trial in the USA and one observational questionnaire study in the UK . The published results of these two studies during 2002 and 2003 raised concerns regarding the safety of HRT. These safety concerns revolved around two main issues: 1) that the extended use of HRT may increase the risk of breast cancer and 2) that the use of HRT may increase the risk of heart disease.
The results of the studies received wide publicity, creating panic amongst some users and new guidance for doctors on prescribing.
After the results were published, the UK regulatory authorities issued an urgent safety restriction about HRT, recommending that doctors should prescribe the lowest effective dose for symptom relief, should use it only as a second line treatment for the prevention of osteoporosis, and advised against its use in asymptomatic postmenopausal women.
Herbs And Supplements During Menopause
Many over-the-counter natural products are promoted in stores and online as helpful with menopausal symptoms. These include vitamins and soy-based and herbal products . There are also endless arrays of special blends of herbs and vitamins that claim to reduce the discomforts of menopause.
These products are considered dietary supplements . They have not been evaluated by the Food and Drug Administration to be sure that they work or even that they are safe. Some supplements have been tested in small clinical trials, but often the studies only looked at taking the substance for a short time , so it isnt clear how safe it would be if taken for a long time. Another concern has been applying the results of a study of a particular version and dose of a supplement to others that werent tested.
Most of the plain herbs that are touted for menopausal symptoms carry a low risk of harm for most women, but some can interact with other drugs and/or cause unexpected problems. You should discuss herbs or supplements with your doctor before taking them.
Well-controlled scientific studies are needed to help find out if these products work and if they are any safer than the hormone therapy drugs now in use.
You can learn more in Dietary Supplements: What Is Safe?
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Major Health Risks Of Low Estrogen
Osteoporosis. Estrogen helps maintain strong bones by preventing calcium loss. Too little calcium can increase the risk of fractures in the spine, hips, and leg and arm bones. Women who drink a lot of alcohol, who smoke, who are not active, and who are thin or petite are at greater risk. A family history of osteoporosis may also increase risk.
Heart disease. Estrogen made by the body seems to protect against heart disease. It may do this by raising the level of HDL cholesterol in the blood. After menopause, the risk for heart disease rises sharply. Talk with your healthcare provider about ways to protect your heart health.
What Hormones Are Used To Treat The Symptoms Of Menopause
The hormones most commonly used to treat symptoms of menopause are estrogen and progesterone. . Often, these 2 hormones are used together, but some women are given estrogen alone. Its important to know which hormones you are talking about when looking at the risks.
Common estrogen preparations used to treat menopausal symptoms include conjugated equine estrogens and estradiol, but several forms or types of estrogen are available.
There are also many progestins available, but medroxyprogesterone acetate , is often used with an estrogen to treat menopausal symptoms. Some preparations contain both an estrogen and a progestin.
Androgens are also sometimes used to treat menopausal symptoms. This is not common, though, and because only a few studies have looked at this practice, it isnt clear how safe it is in the long run.
Tibolone is a synthetic hormone drug that can act like estrogen, progesterone, and testosterone in different tissues of the body. Because this drug isnt available in the US, its not discussed here.
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How Is Low Estrogen Diagnosed
Diagnosis and treatment of low estrogen can help prevent many health issues.
If youre experiencing symptoms of low estrogen, talk with your doctor. They can assess your symptoms and make a diagnosis if needed. Early diagnosis may help prevent further complications.
During your appointment, your doctor will discuss your family health history and assess your symptoms. Theyll also perform a physical exam. Blood tests will likely be needed to measure your hormone levels.
Your follicle stimulating hormone levels may also be tested to determine whether your estrogen is low if youre experiencing:
- hot flashes
Symptoms Of Low Estrogen
Hot flashes, flushes, and night sweats are the most common symptoms of low estrogen. At times, blood rushes to your skins surface. This can give you a feeling of warmth . Your face may look flushed. Hot flashes while you are sleeping are called night sweats.
Mood swings are another effect of low estrogen. You may feel sad, anxious, or frustrated. Shifting hormone levels and night sweats may disrupt your sleep. This can cause fatigue, which may make mood swings worse.
Thinning tissues may cause discomfort. Skin may appear more wrinkled. Thinning in the urinary tract may lead to bladder infections. You may also have an urgent need to urinate. Or you may lose bladder control . Thinning of the vagina may cause dryness and painful sex.
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Watch The Herbs For Menopause Mini
Give me 10 minutes, and I’ll show you how the hormonal puzzle fits together, so you can handle any menopausal symptom that appears with safe, natural herbal remedies.
What does estrogen dominance feel like?
It often feels like things are backed up, stuck, bloated, swollen, and puffy.
You know that feeling you get at the height of PMS when you just feel like a bloated blob ready to burst? It’s that feeling. And in perimenopause you can get that feeling, then skip a period, and stay that way without relief for weeks or months. It’s not a good feeling.
And it really is things being stuck, not flowing and moving around your body well. In Chinese medicine we call this stagnation.
And if things stay in this stuck, stagnant state for too long, the energy that’s stuck can turn into actual physical accumulations of stuk energy like lumps and nodules – think fibrocystic breasts, cysts, fibroids, endometriosis, nodules, and even tumors – all can be related to estrogen dominance.
Why is estrogen dominance common during menopause?
During the menpausal transition your estrogen and progesterone levels are both dropping. It’s common for progesterone to drop first and estrogen to drop later on. If progesterone drops too low too fast and estrogen stays high, you get the type of high estrogen to low progesterone ratio that can cause estrogen dominance symptoms.
Benefits Of Taking Estrogen After Menopause
- Post author Scientific review: Dr Hebenâs Team
In this article, I will explain the benefits of taking estrogen after menopause. Menopause happens in middle-aged women . Menopause is a condition where menstrual cycle stops, or the end of reproductive period. This is a natural condition, and all women will experience this. But the menopause symptoms give anxiety in women, since the stopping of menstrual cycle means the stopping of reproductive hormone production, such as estrogen and progesteron.
Estrogen is a steroid hormone, produced by theca follicle cells in ovaries. Estrogen functions are: promotes secondary sexual signs in women, promotes proliferation of endometrium cells, influences electrolytes balance, and improves protein anabolism with growth hormones, as in growth of reproductive organs such as the womb and vagina.
When a woman reach pre-menopause period, her estrogen production is much decreased. The symptoms are:
- irregular menstruation
- reduced bone density, which will lead to osteoporosis and bone fractures
- increased risk of atherosclerosis and cardiovascular disease
1. Prevents Dryness in Vagina
Vaginal dryness is caused by lack of estrogen. This makes difficulties and pain during sexual intercourse, which can lead to physical and psychological trauma . Taking estrogen after menopause can maintain vaginal lubrication and elasticity.
2. Increases Libido
Article continues below
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Why Does Your Estrogen Level Matter
Estrogen is a hormone. Although present in the body in small amounts, hormones have big roles in maintaining your health.
Estrogen is commonly associated with the female body. Men also produce estrogen, but women produce it in higher levels.
The hormone estrogen:
- is responsible for the sexual development of girls when they reach puberty
- controls the growth of the uterine lining during the menstrual cycle and at the beginning of a pregnancy
- causes breast changes in teenagers and women who are pregnant
- is involved in bone and cholesterol metabolism
- regulates food intake, body weight, glucose metabolism, and insulin sensitivity
Girls who havent reached puberty and women approaching menopause are most likely to experience low estrogen. Still, women of all ages can develop low estrogen.
Common symptoms of low estrogen include:
Low Estrogen During Menopause: Symptoms
The best way to confirm if symptoms are due to low estrogen levels caused by menopause is to see a health care provider. They will evaluate any symptoms and measure current hormone levels.
People in their late 40s or early 50s who are experiencing any or all of the symptoms listed below could be beginning the menopausal transition. These symptoms can include the following:
- Changes in skin texture
- Dry eyes
- Frequent urinary tract infections
These symptoms associated with perimenopause and menopause can be inconvenient at times, but there are solutions. Currently, researchers are studying natural ways to control these symptoms with phytoestrogen-rich foods in cases where hormone replacement therapy isnt possible.
For now, there is not enough data on the effects of phytoestrogens. The claims about the potentially beneficial effects of phytoestrogens for menopausal symptoms might be overstated. Some clinical trials have found that the positive effects phytoestrogens can have on menopausal symptoms are about as good as those from a placebo. In addition, researchers may ignore the potential adverse effects in the hopes of finding a treatment that works. Before making changes in your diet, consult a health care provider and discuss possible outcomes for your health.
Lots of people want to know which foods are rich in phytoestrogen. Here are five different options for foods high in phytoestrogen, which some people claim might reduce typical symptoms associated with menopause.
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How Your Estrogen Levels Affect You
During menopause, your estrogen levels can fluctuate wildly. Estrogen is the hormone that regulates your menstrual cycle and helps to regulate fluid and sodium retention. When levels of estrogen fluctuate, it can be the cause of a variety of menopause symptoms, like vaginal dryness, itchy skin, and irregular periods.
The simple remedy to this is to balance out your estrogen levels attain that ideal level where all your menopause woes disappear. Unfortunately, the science behind this is more complicated than the simple theory suggests.
What Changes At Menopause
Unlike most essential minerals, iron is not excreted through the urine. The main way for the female body to rid itself of excess iron is through blood loss. So, as menopause approaches and periods become fewer, iron can potentially build up in the body. In fact, there is an inverse relationship between estrogen and iron at menopause: as estrogen declines, iron increases. Considering that estrogen and iron are two of the most important growth factors in the female body, this imbalance can be extremely damaging to your health if not corrected.
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Benefits Of Progesterone After Menopause
Medically reviewed by Rosanna Sutherby, PharmD on March 25, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
As a postmenopausal or menopausal woman, you may experience frustrating symptoms like hot flashes, vaginal dryness, and weight gain. While some postmenopausal women may find that these menopausal symptoms dissipate after a few years, you may be one of the women who deals with them for a decade or longer.
If you have used a Postmenopause Test to test your hormone levels and are now looking for relief, hormone replacement therapy with progesterone could be for you. Read on to learn about the benefits of progesterone after menopause, the types of progesterone therapy, and whether you should take this hormone as a form of menopausal hormone therapy.
Menopause Symptoms And Hrt
Menopause symptoms that may be relieved by HRT include:
- hot flushes and night sweats
- vaginal dryness
- hair loss or abnormal hair growth
- dry and itchy eyes.
Other therapies, including vaginal oestrogen products, antidepressants or other medications, may be used depending on the symptoms and risk factors. Seek advice from your doctor.
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The Role Of Estrogen In Your Body
In its role as the major sex hormone in your body, estrogen does some pretty important things that aren’t related to fertility. As a hormone, estrogen acts on the parts of your body that have estrogen-specific hormone receptors. Estrogen is involved with numerous important functions throughout your body.
Vaginal Symptoms And Sexual Dysfunction
Vaginal symptoms become apparent 45 years after the menopause and objective changes as well as subjective complaints are present in 2550% of all postmenopausal women . Symptoms may include vaginal dryness , dyspareunia , vaginal itching, burning and pain . Dyspareunia can adversely affect a postmenopausal woman’s sexual quality of life or intensify pre-existing sexual disorders .
Locally administered vaginal oestrogens are effective in the treatment of menopause-related vulval and vaginal symptoms and a Cochane review reported equal efficacy across all products tested creams, pessaries, tablets and vaginal rings . Local oestrogen therapy will lower vaginal pH, thicken the epithelium, increase blood flow and improve vaginal lubrication .
A 2009 review of topical oestrogen concluded that no studies show evidence of endometrial proliferation after 624 months of use, therefore it does not support the concomitant use of progestins with topical oestrogens and is endorsed by the International Menopause Society .
Vaginal oestrogen is controversial in women with a history of hormone-dependent cancer such as breast cancer, in whom vulval and vaginal symptoms are common, particularly those on endocrine therapy and although an increase in recurrence has not been reported, some oestrogen is absorbed into the systemic circulation .
Non-hormonal treatment options include lubricants and moisturisers both of which can be effective although usually only in the short term .
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How To Get Started On Hrt
Speak to a GP if you’re interested in starting HRT.
You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first.
A GP can explain the different types of HRT available and help you choose one that’s suitable for you.
You’ll usually start with a low dose, which may be increased at a later stage. It may take a few weeks to feel the effects of treatment and there may be some side effects at first.
A GP will usually recommend trying treatment for 3 months to see if it helps. If it does not, they may suggest changing your dose, or changing the type of HRT you’re taking.