As women age their bodies produce less estrogen, and the effects can include mood swings, hot flashes, memory problems and other undesirable conditions. There has been some controversy over whether or not to artificially replace the estrogen in a woman's body and whether to replace it with a pharmaceutical or a more natural substance.
Estrogen
Estrogen is the main sex hormone in women. It is produced in the ovaries and to a lesser extent in fat and is responsible for the development of secondary sexual characteristics and the regulation of the menstrual cycle. Of the three major forms of estrogen that the body produces, estradiol is usually the one that is replaced. Ironically, estradiol is produced from testosterone in the body. During menopause, a woman's body stops producing the hormones that cause and regulate the menstual cycle. The loss of these hormones can cause various forms of discomfort.
Benefits
Hot flashes are a sudden sensation of heat, accompanied by sweating and red skin. A nervous feeling sometimes accompanies the heat. During perimenopause and menopause, some women have hot flashes so severe they cannot sleep through the night and their days are disrupted. The hot flashes are caused by fluctuating hormones, including estrogen, during this period. Without estrogen, a woman's skin can become dry and lose elasticity, she may grow hair on her face and have vaginal discomfort, among other unpleasant menopausal symptoms. Replacing the estrogen can alleviate or mitigate these conditions. Also, women who are at risk for osteoporosis receive some protection by replacing estrogen. Hormone replacement therapy may help reduce the chance of heart disease. It also may be necessary for a young person to take hormones if the body never started producing estrogen in sufficient amounts. Men who wish to appear as women also take estrogen.
Risks
From the 1930s to the 1960s, hormone replacement therapy (HRT), administering estrogen in the form of pills, was common. But time showed an increased incidence of reproductive cancers, especially breast cancer, plus other problems in those who took estrogen. The book "Women and the Crisis in Sex Hormones" by Barabara Seaman, among other publications, alerted the public that in many cases the risks of HRT outweighed the benefits. As of 2010, when HRT is prescribed, the dose is much lower and progestin is added to help protect against endometrial cancer. Even at a reduced dose, taking the pill still increases the possibility of strokes, blood clots and heart attacks and certain cancers. In fact, these risks continue for three years after the treatment is discontinued.
Replacing Estrogen
Premarin Cenestin, Climara, Estraderm, Estrasorb, Menostar and Provera are some of the many names of the preparations commonly prescribed to replace estrogen in menopausal women. They are most commonly in pill form, but may also be gels, creams and sprays. Many are a synthesized from mare's urine. The preparations may come as estrogen only, progestin only or a combination of the two. Estrogen with progestin is given to women who have their uterus in tact and without progestin in women who have had their uterus removed. Its primary ingredient is estrone. Note that none of these restore youth, nor do they stop menopause. They are simply for symptom relief.
Bioidenticals
Another way to replace estrogen is with bioidenticals. These hormones come in pill or cream form and may be derived from plants instead of animal products. They are considered more "pure" than the synthetic hormones because they do not have modified structures. But because their active ingredients are chemically identical, they have the same benefits as well as the same side effects. Neither type of hormone therapy is recommended for women with a history of breast cancer. Bioidenticals are often produced by a compounding pharmacy which will tailor ingredients based on the individual, but their methods of assessing those needs may not be reliable, such as testing saliva instead of blood. Bioidenticals are created in a lab, but consuming the estrogens directly is another option. It is possible to replace some estrogen by consuming phytoestrogens (plant estrogens) that occur in substances such as soy. The only problem is concentration and dosing.
