Estrogen therapy is often used in the treatment of symptoms that may occur when a woman goes through menopause. A variety of estrogen preparations are available to help to alleviate symptoms or concerns related to menopause. Some women may choose systemic estrogen; that is, estrogen preparations in which estrogen is absorbed throughout the body. These preparations may help with one of the most common symptoms of menopause: hot flashes. However, other women may be suffering from vaginal dryness along with pain during intercourse. In such cases, vaginal estrogen preparations may be a better choice.
Estrogen Pills
Dr. Kathryn Martin and Dr. Robert Barbieri, writing in the medical reference UpToDate, explain that systemic estrogen therapy can be especially useful in treating the unpleasant menopause symptom of hot flashes. One common type of systemic estrogen is an oral estrogen preparation -- a pill that contains estrogen that is derived either from plants or animals. Examples of estrogen-containing pills include Premarin, which is derived from equine estrogen; and Enjuvia, which contains a plant-based synthetic estrogen. Estrogen pills are available in several doses. For example, Premarin doses can range from 0.3 mg to 1.25 mg; women who are having especially severe hot flashes or other symptoms may benefit from higher doses.
Estrogen Patches
An alternative way to take systemic estrogen is to use a transdermal estrogen patch. A variety of patches are available. As explained in the medical reference UpToDate, some patches, such as the Estraderm patch, are placed on the skin and changed twice a week. Others, such as the patch called Menostar, may be kept in place for up to one week. Because estrogen is absorbed via the skin throughout the body, using this type of supplement may be most beneficial to women who are suffering from the vasomotor, or blood vessel-related, symptoms of menopause. The most typical example of a vasomotor symptom is that of the hot flash. Drs. Robert Casper and Richard Santen, writing in UpToDate, explain that about 75 percent of menopausal women in the United States experience this uncomfortable sensation. Furthermore, a hot flash is often not just a sensation of heat -- along with the sudden feeling of intense heat along the face and chest, a woman may perspire much more than usual, feel as though her heart is racing, and experience shivering and chills. An estrogen patch may help improve these uncomfortable episodes.
Vaginal Estrogen
Vaginal atrophy may be another component of menopause; according to MayoClinic.com, it occurs because decreasing estrogen levels lead to a thinning in the lining of the vagina. Vaginal atrophy often causes dryness, pain during intercourse and itching, and may be treated with vaginal estrogen. The advantage of using a vaginal estrogen preparation is that the estrogen is absorbed primarily in the vagina and not throughout the body. So, a woman who is experiencing mainly vaginal symptoms of menopause can get symptom relief without worrying about the effects of estrogen on other parts of her body. Examples of vaginal estrogen preparations include vaginal cream, such as Estrace; a vaginally inserted tablet, called VagiFem; and a low-dose estrogen vaginal ring, called Estring. Any of these preparations may help with the uncomfortable symptoms associated with vaginal atrophy, but will not benefit women who are experiencing more systemic symptoms such as hot flashes.
References
- "UpToDate;" Treatment of Menopausal Symptoms with Hormone Therapy; K. Martin and R. Barbieri; June 2010
- "UpToDate;" Preparations for Postmenopausal Hormone Therapy; K. Martin and R. Barbieri; June 2010
- Mayo Clinic: Vaginal Atrophy
- "UpToDate;" Menopausal Hot Flashes; R. Casper and R. Santen; June 2010
- "UpToDate;" Estradiol: Drug Information; Lexi-Comp, Inc.; 2010
