Whats Been Approved By The Us Food And Drug Administration
The U.S. Food and Drug Administration approves all estrogen therapy medications. Some hormones are sold as bio-identical hormones and are not FDA-approved. They are available without a prescription, and they are not held to the same safety standards as prescription medications. Despite marketing claims, these hormones are also not more natural than the FDA-approved treatments.
Hormone Replacement Therapy May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- headache
- changes in sex drive or ability
- nervousness
- brown or black skin patches
- acne
- swelling of hands, feet, or lower legs
- bleeding or spotting between menstrual periods
- changes in menstrual flow
- dark-colored urine
- light-colored stool
Hormone replacement therapy may increase the risk of developing endometrial cancer and gallbladder disease. Talk to your doctor about the risks of taking this medication.
Hormone replacement therapy may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
Treatment For Low Estrogen
One way to prevent symptoms of low estrogen is to replenish your estrogen supply. You can increase the levels of estrogen in your body through estrogen replacement therapies. At the Center for Womens Health, our team, led by Sharon Breit, MD, diagnoses and assesses your estrogen levels and symptoms in order to prescribe the best options for your issues.
Hormone replacement therapy comes in many forms, including pills, creams, patches, and injections, and with the hormone progestin or estrogen-only. Another option is BioTe® Hormone Pellet Therapy, which contains bioidentical hormones derived from plant extracts. ;
For more information on how estrogen affects your body and what you can do about it, call us at the Center for Womens Health in Wichita, Kansas, or make an appointment online.
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Here Are Some Questions You Can Ask Yourself And Discuss With Your Physician:
- Am I experiencing difficult menopause symptoms?
- Do I have any medical conditions or a family history of certain conditions that might make HRT beneficial for me?
- Do I have any medical conditions or a family history of certain conditions that might make HRT riskier for me?
- Have I considered alternatives to HRT?
Why Does The Body Need Estrogen And Progesterone
Estrogen and progesterone together thicken the lining of the uterus, preparing it for the possible implantation of a fertilized egg. Estrogen also influences how the body uses calcium, an important mineral in the building of bones, and helps maintain healthy levels of cholesterol in the blood.
As menopause nears, the ovaries reduce most of their production of these hormones. Lowered or fluctuating estrogen levels may cause menopause symptoms such as hot flashes, and medical conditions such as osteoporosis. Hormone therapy helps to replenish the estrogen, relieving some of the symptoms of menopause and helping to prevent osteoporosis.
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Causes Of High Estrogen
Males and females can develop hormonal imbalances.
The body may only produce high levels of estrogen, or it may produce high levels of estrogen and low levels of another hormone, such as testosterone or progesterone.
Estrogen levels can also rise in response to medications. For example, people taking estrogen replacement therapy, a treatment for menopause symptoms, may experience adverse effects of high estrogen.
Other medications that can increase estrogen levels include:
- hormonal contraceptives
- some herbal or natural remedies
- phenothiazines, which doctors use to treat some mental or emotional disorders
High estrogen can run in families. Also, certain health problems can cause estrogen levels to rise, including:
Perimenopause And Menopause Estrogen Levels
After menopause, estrogen levels drop dramatically, as there are few follicles in your ovaries. Additionally, these follicles are no longer growing and producing the estradiol spikes that occur during the menstrual cycle . The laboratory estradiol levels of postmenopausal women are generally less than 20 pg/mL .
During perimenopause, people may notice that their body changes in response to these lower levels of estrogen.
Symptoms of low estrogen during perimenopause and menopause
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Vaginal dryness is common. Without enough estrogen, the walls of the vagina are not able to maintain their thickness and are no longer as moist .
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Hot flashes are associated with decreasing levels of estrogen, and can be treated using estrogen therapy . Phytoestrogens, or estrogens from food, may be moderately beneficial, but more research is needed .
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Osteoporosis is a risk for post-menopausal people as estrogen levels decrease .
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What Happens When Testosterone Levels Rise Or Fall
If your body produces too much testosterone, you may have irregular or absent menstrual periods. You may also have more body hair than the average woman. Some women with high testosterone levels develop frontal balding. Other possible effects include acne, an enlarged clitoris, increased muscle mass, and deepening of voice.
High levels of testosterone can also lead to infertility and are commonly seen in polycystic ovarian syndrome . PCOS is an endocrine condition that is sometimes seen in women of childbearing age who have difficulty getting pregnant. Women with PCOS have symptoms similar to those produced by high testosterone levels. They include:
What Are The Dosages Of Estradiol
Dosages of Estradiol:
Dosage Considerations â Should be Given as Follows:
- Pediatric: Safety and efficacy not established
Vulvar and Vaginal Atrophyin Menopause
- Estrace: 1-2 mg orally once daily for 3 weeks, followed by 1 week off
- Valerate: 10-20 mg intramuscularly every 4 weeks
- EstroGel: 1.25 g/day 3 weeks on, 1 week off
- Alora, Climara Vivelle-Dot, Estraderm: Use transdermally and follow product-specific directions
- Prevention of osteoporosis: 0.5 mg orally once daily for 3 weeks, followed by 1 week off
- Metastatic breast cancer: 10 mg orally every 8 hours for 3 months
- Prostate cancer: 1-2 mg orally every 8 hours for 3 months or more
Hypoestrogenism from Castration, Hypogonadonism, or Ovarian Failure
- Oral : 1-2 mg orally once/day; titrate to use minimal effective dose
- Transdermal : Use transdermally and follow product-specific directions
- Valerate: 10-20 mg intramuscularly every 4 weeks
Hypoestrogenism
- Cypionate: 1.5-2 mg intramuscularly every 4 weeks
Osteoporosis
- Oral : 0.5 mg/day for 23 days of 28-day cycle used in clinical studies
- Transdermal : Follow product specific directions
Vasomotor Symptoms Associated with Menopause
- Estrace: 1-2 mg orally three times daily
- Valerate: 30 mg intramuscularly or more every 1-2 weeks
Find And Address The Cause Of The Stagnation For Long
While the above steps can help relieve the discomforts of estrogen dominance, you won’t find true relief until you find the cause. ;What’s causing things to get stuck in the first place? ;If you can figure that out and address it, you can cut off the discomforts at their root.;
Look at the list above, are there any that apply to you more than others?; That might be a good place to start
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What Happens When You Have No Estrogen
Symptoms can linger for a lifetime. And the continued low estrogen levels lead to more serious health concerns. The rate of bone loss speeds up, increasing your risk of low bone density, osteopenia and osteoporosis. You also have a higher chance of having a heart attack, stroke or other heart-related issues.
Low Estrogen Levels And Weight Gain: Is There A Connection
Sex hormones, such as estrogen, influence the amount of fat in the body. Estrogen regulates glucose and lipid metabolism. If your estrogen levels are low, it can result in weight gain.
Research suggests that this may be why women approaching menopause are likely to become overweight. Being overweight can increase your risk for obesity, diabetes, and cardiovascular disease.
If your estrogen levels are low and its affecting your weight, speak with your doctor. They can assess your symptoms and advise you on next steps. Its always a good idea to try to eat a balanced diet and exercise as often as possible. Talk with your doctor about developing a diet and exercise plan thats right for you.
Your Action Steps For Preventing Estrogen Dominance:
In my next few blog posts in this series on estrogen dominance, I’ll be giving simple powerful steps you can take to help your body keep estrogen and progesterone in balance. ;
Here’s an overview of how all the pieces of the puzzle fit together. ;Your action steps are to
- Eat right
- Avoid the worst hormone-disrupting chemicals
- Move enough & breathe deeply
- ADDRESS THE ROOT CAUSE
Bonus Tip: Include some broccoli sprouts in your diet each day, they have special micronutrients that support estrogen detoxification.
Watch for a blog coming soon on the most important hormone-disrupting chemicals to avoid & where you’ll find them.
Move! ;If you’re sitting, try to get up and move your arms and legs around and take some deep breaths every 30 minutes ;Try walking or bouncing on a rebounder a few minutes a day.;
Get to the root cause! ;Make sure your hormones don’t drop too low by supporting them with HRT or customized herbal remedies. ;There’s simply no substitute for something powerful enough to support your body in keeping your hormone levels, including progesterone, high enough. ;
No hormonal care plan is complete without this hormonal support componenent.; If you’re interested in using herbal remedies for this part of your hormonal care plan, they must be customized to your body and change with your hormones over time.
Learn more with the free resources below.;
Estrogen Why Do Fertility Patients Need It
Estrogen supplements during IVF? Theyre sometimes prescribed. And theyre essential for women having donor eggs, donor embryos or frozen-embryo transfers. So why do some doctors, and the leaflets in the packs, scare fertility patients by claiming estrogen can be dangerous during pregnancy? Its hardly the best news to give would-be mums. Heres the truth about the role estrogen plays before and after fertility treatment.
Estrogen helps to grow and maintain your endometrial lining and sustain a pregnancy. It also helps your placenta function, boosts blood flow to your uterus and primes your body for breastfeeding. In an IVF cycle, FSH medication creates multiple follicles. Estrogen production is then stimulated, causing the uterine lining to thicken.
Estrogen is certainly needed during fresh donor-egg cycles. Thickening your endometrial lining after your depot injection is mandatory. Depot injections down-regulate your ovaries, affecting your natural estrogen and progesterone production.
Oral estrogen pills , typically 6 mg per day, are the norm. Their start date forms part of the synchronisation between your and your donors cycle. A lining scan at least three days before your donors egg retrieval gives you time to adjust your estrogen intake.
You want a 7-mm lining, and ideally an 8-mm one, by your donors egg retrieval day. Thats the day you start your progesterone supplementation. Your lining wont thicken any more after that.
Side Effects Of Estrogen After Menopause
They may be;benefits of taking estrogen after menopause, but check out this drawbacks:
1. Inceased Risks of Breast Cancer
It is already wide known that any therapy involving estrogen increases risks of breast cancer, especially in older women . Therefore, a woman who wants to consume estrogen therapy should consult her doctor to get precise dossage of estrogen that she has to take every day.
2. Expensive
In developing or third world countries, estrogen replacement therapy is very expensive, because most of the time it is not covered by social security or general insurance companies. Only rich people can afford artificial estrogen. It is really not economical and can lead to poverty.
What Happens During Menopause
Absence of menstruation for 12 consecutive months is defined as menopause, after all other reasons are ruled out. The median age for natural menopause is about 52 years. Menopausal transition may take up to three years. Menopause may also occur earlier due to reasons other than natural such as surgery, radiation or chemotherapy.;
During menopausal transition, menstruation becomes irregular and the intervals increase. The ovarian function reduces and estrogen levels drop which give rise to early menopausal symptoms such as:
Many other conditions may mimic the vasomotor symptoms of menopause and must be ruled out with tests before starting hormone therapy. Post menopause, estrogen deficiency may lead to genitourinary syndrome of menopause which may cause:
- Genital symptoms such as:
- Burning or itching of vulva
- Sexual symptoms such as:
- Spotting or bleeding after intercourse
Menopausal women are at higher risk for developing diseases such as:
Effects Of Estrogen Treatment
Testosterone blockers are a necessary part of estrogen treatment for transfeminine people because testosterone acts more strongly in the body than estrogen does. Therefore, in order for transfeminine people to experience the effects of estrogen treatment, they must block their testosterone. The most common medication used to block testosterone is spironolactone or “spiro.” Some also have their testicles removed so that they can take a lower dose of estrogen and not need a testosterone blocker.
The purpose of estrogen treatment for transfeminine people is to cause physical changes that make the body more feminine. The combination of a testosterone blocker with estrogen can lead to the following types of desired changes in the body:
- breast growth
- softening and smoothing of the skin
- reduced acne
- slowed or stopped scalp balding
All of these are changes that can reduce gender dysphoria and improve quality of life. There are also some changes that occur that are less obvious. Some of these, like a reduction in testosterone, fewer penile erections, and a decline in blood pressure are generally considered to be positive changes. Others, like decreased sex drive and changes in cholesterol and other cardiovascular factors, may be less desirable.
Enhancing Healthcare Team Outcomes
Using estrogen to treat postmenopausal symptoms and as a component of the oral contraceptive pill to prevent pregnancy remains widely available on the market as FDA-approved therapy regardless of the known risk and benefits on women’s health.;For any patient of postmenopausal age, clinicians must ask patients about any history of estrogen hormone replacement therapy or use of estrogen oral contraceptive pills;be included;in the patient’s medical history and physical exam.;When clinicians first initiate estrogen therapies to patients, providers should evaluate patients for family history of breast cancer, endometrial cancer,;ovarian cancer, history of cancer, and risk of newly developed malignancies sensitive to estrogen.;
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from heat and moisture .
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
What Are The Benefits Of Taking Estrogen
Estrogen therapy, with or without progesterone, is consistently effective in relieving menopausal symptoms. Estrogen therapy is also beneficial for preventing some estrogen deficiency symptoms.
The benefits of taking estrogen are clear in some of the conditions arising from menopause, but results are mixed in some. Following is an analysis of estrogen therapy benefits in menopause-related conditions:
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
- insomnia
- frequently missed periods
Why Do Estrogen Levels Fall
There are many reasons why estrogen levels fall, including:
- Hypogonadism
- Anorexia nervosa
- Extreme exercise or training
Drugs that block estrogen include clomiphene, which tricks the body into thinking it has decreased levels of estrogen. Also, women experience low levels of estrogen immediately after childbirth and also during breastfeeding.