Estrogen is one the main sex hormone in women and it is responsible for the sexual and reproductive development in females. Research now shows that estrogen helps almost every organ system in the body. Some of the other Important functions of Estrogen hormones are…
1. Helps to regulate body weight by helping to control metabolism
2. Plays a role in promoting a healthy heart and blood vessels
3. Plays a role in the development and growth of healthy bone tissue
Reasons for Low estrogen in women
As women get older and approach menopause, their estrogen levels decline because the ovaries reduce their production and that normally leads to perimenopause- a time when estrogen levels fluctuate. It then progresses to full menopause where a woman goes without a period for 12 consecutive months.
Other reasons for estrogen hormone decline include:
– Damage or surgical removal of the ovaries
– Excessive exercise
– Thyroid conditions
– Eating disorders like anorexia and bulimia
– Kidney disease
– Low functioning pituitary gland
Symptoms of low estrogen
Low estrogen levels can have life-altering effects on women’s health and their quality of life. Some of the symptoms are: 
- Difficulty sleeping, leading to fatigue
- Painful Intercourse. Because estrogen hormone helps to keep the vaginal cavity lubricated, as the level of the hormone decline, the walls of the vagina becomes thin and dry and that can lead to pain sex
- Hot Flashes and Night Sweats. Estrogen regulates body temperature and when the hormone levels drop, an increase in body temperature can occur, causing body temperature to rise to very uncomfortable levels.
- Difficulty sleeping or staying asleep, leading to fatigue
- Trouble concentrating or remembering things
- Changes in mood
- Breast tenderness
Women with low estrogen level tend to lose bone density, making bone fragile and more adapt to fracture or break more easily. That is because estrogen works with calcium and Vitamin D and other minerals to build bone.
Treatment for Low Estrogen with Hormone replacement therapy (HRT)
Women with low estrogen may be prescribed estrogen in various dosage forms to help bring estrogen levels back to normal. Estrogen can be prescribed in a variety of forms:
Orally, topically or transdermally, vaginally, or in pellet form.
Oral vs. Topical Estrogen: what the literature shows about health Risk of Estrogen HRT
While experts agree that estrogen therapy has very good health benefits in menopausal women, researchers disagree on how estrogen should be administered. The overwhelming evidence has shown that compared to topically applied estrogen, oral estrogen replacement increases the risk of blood clot formation in a vein. Studies also show that there are many other side effects associated with taking estrogen by mouth and they include:
– increase blood pressure
– increase in triglycerides
– increase in occurrence of gallstones
– increase on liver enzymes
– increase in sex binding globulins, which then lowers available testosterone for the body to use
– lower growth hormone levels
– increase in carbohydrates cravings
Other medical trials that compared oral and topical estrogen replacement also discovered that typically administered estrogen did not show many of the above increased risk.
While estrogen replacement therapy is very helpful in alleviating the symptoms of low estrogen levels, it is not right for everyone. It is best to consult your healthcare provider to discuss what is best for your individual case. If estrogen replacement therapy isn’t the best option for, our compounding pharmacist can discuss non-hormonal options with you and your provider.
Call our pharmacy at 770-635-7697 if you have any questions about estrogen replacement therapy.
Click here for a questionnaire and a short video from our compounding pharmacist.
References:
1. Billeci AM, Paciaroni M, Caso V, Agnelli G. Hormone replacement therapy and stroke. Curr Vasc Pharmacol. 2008;6(2):112-123.
2. Chu MC, Cosper P, Nakhuda GS, Lobo RA. A comparison of oral and transdermal short-term estrogen therapy in postmenopausal women with metabolic syndrome. Fertil Steril. 2006;86:1669-1675.
3. Hendrix SL, Wassertheil-Smoller S, Johnson KC, et al. Effects of conjugated equine estrogen on stroke in the Women’s Health Initiative. Circulation. 2006;113:2425– 2434.
4. Ho JY, Chen MJ, Sheu WH, Yi YC, Tsai AC, Guu HF, Ho ES. Differential effects of oral conjugated equine estrogen and transdermal estrogen on atherosclerotic vascular disease risk markers and endothelial function in healthy postmenopausal women. Hum Reprod. 2006;21(10):2715-2720.
5. Mendelsohn ME, Karas RH. Protective effects of estrogen on the cardiovascular system. N Engl J Med. 1999;340:1801–1811.
6. Menon DV, Vongpatanasin W. Effects of transdermal estrogen replacement therapy on cardiovascular risk factors. Treat Endocrinol. 2006;5(1):37-51.
7. Nelson HD, Humphrey LL, Hygren P, Teutsch SM, Allan JD. Postmenopausal hormone replacement therapy. Scientific review. JAMA 2002;288:872–881.
8. Centers for Disease Control and Prevention. (2019). What is venous thromboembolism? Retrieved from https://www.cdc.gov/ncbddd/
9. National Heart, Lung, and Blood Institute. (n.d.). Venous thromboembolism. Retrieved from https://www.nhlbi.nih.gov/
10. Nabulsi, A. A., Folsom, A. R., White, A., Patsch, W., Heiss, G., Wu, K. K., & Szklo, M. (1993). Association of hormone-replacement therapy with various cardiovascular risk factors in postmenopausal women. The New England Journal of Medicine, 328(15), 1069–1075. https://doi.org/10.1056/
11. Lowe, G. D., Upton, M. N., Rumley, A., McConnachie, A., O’Reilly, D. S., & Watt, G. C. (2001). Different effects of oral and transdermal hormone replacement therapies on factor IX, APC resistance, t-PA, PAI and C-reactive protein — A cross-sectional population survey. Thrombosis and Haemostasis, 86(2), 550–556.
12. Vinogradova, Y., Coupland, C., & Hippisley-Cox, J. (2019). Use of hormone replacement therapy and risk of venous thromboembolism: Nested case-control studies using the QResearch and CPRD databases. The BMJ, 364.https://doi.org/10.1136/