Menopause and Hormones: What Role Does Estrogen Play?

Hormones play a role in almost every function of our bodies. Think of them as biological messengers, telling tissues what they should do and when. Estrogen is one hormone that almost all women have heard of but may not fully realize how and why it’s needed. Especially when reaching perimenopause, estrogen becomes a familiar term - in more ways than one.

While estrogen is present in both females and males, for the purpose of this article we’ll be concentrating on its role for women.

What Is Estrogen?

Estrogen is a vital hormone provided by the ovaries and, in the case of pregnancy, also produced by the fetal-placental unit. It plays several different, important roles in a woman’s life, depending on her age.

When a female reaches puberty, the ovaries begin to release estrogen with each menstrual cycle. It’s also likely to be one of the reasons she experiences the mood disturbances that come with premenstrual syndrome (PMS). Estrogen serves to help regulate the menstrual cycle, trigger ovulation, and create a productive environment for fertilization and pregnancy. Estrogen also affects body shape, body hair, voice pitch, bone formation, vaginal PH levels that protect against bacteria, blood flow to the uterus, contractions during delivery, breast growth, and more.

Estrogen’s Role In Menopause

Perimenopause (the two to eight years leading up to menopause) is brought about by erratic estrogen levels. The fluctuation of estrogen (varied ranges of high production and deficiency) causes both physical and emotional changes such as hot flashes, depression, irregular menstruation, headaches, loss of libido, and mood swings.

Eventually, the ovaries stop releasing eggs. At this point menstruation ceases. When a woman has gone 12 consecutive months without menstruation, she is considered officially menopausal.

Unfortunately, lack of estrogen may continue to cause issues after this point. Symptoms such as hot flashes and mood swings can continue for some time. They may even be worse or better due to the fact that, unlike perimenopause, you no longer have any ups and downs since your body is now producing much less estrogen.

Replacing the missing estrogen in the body with medication can help relieve many of these discomforts.

The Benefits of Estrogen Treatment

Estrogen Replacement Therapy (ERT) comes in several different forms and methods but with the same goal: replenish the hormone that is missing from your body so the areas affected by the deficiency can resume normal, balanced function. In a nutshell, so you can feel like yourself again.

Estrogen treatment comes in four primary methods:

1. Oral pills - Taken once per day, pills are the most common form of ERT.
2. Skin patches - Available with estrogen or estrogen combined with progestin, patches are worn on the stomach and changed once or twice per week.
3. Topical cream, gel or spray - Like patches, these methods allow the estrogen to absorb through your skin and enter into your bloodstream. They are typically applied once per day.
4. Suppositories, rings, and vaginal creams - These methods involve administering the hormone directly to the vaginal area. It is especially beneficial for women who’ve experienced severe vaginal issues such as dryness or pain during intercourse. These therapies are required to be administered anywhere between daily to once every several months, depending on the method chosen.

Risks of HRT

While HRT can be very beneficial for many women dealing with menopause, there are risks that should be considered which can include the strokes in certain age groups, mental decline, breast cancer, and formation of blood clots. ET (estrogen-only HRT) can also increase the risk of endometrial (uterine) cancer and ovarian cancer. ET does not significantly increase the risk of breast cancer if used for less than seven years, according to University of Maryland Medical Center.

Choose What Is Best For You

If you are menopausal or perimenopausal, it’s best to speak with your doctor to discuss risks and which HRT, if any, would be right for you. While ERT has been around for many years, your physician will want to run tests and speak with you about your symptoms to make sure you receive with the method and dosage that would benefit your health the most.

Sources:

Estrogen: How Does Estrogen Work? Medical News Today. Retrieved November 5, 2015. http://www.medicalnewstoday.com/articles/277177.php

What Happens After Menopause? Everyday Health. Retrieved November 5, 2015. http://www.everydayhealth.com/menopause/post-menopause.aspx

Which Type of Estrogen Hormone Therapy Is Right For You? WebMD. Retrieved November 5, 2015. http://www.webmd.com/menopause/guide/which-type-of-estrogen-hormone-therapy-is-right-for-you

Menopause. University of Maryland Medical Center. Retrieved November 10, 2015. https://umm.edu/health/medical/reports/articles/menopause

Reviewed November 11, 2015
by Michele Blacksberg RN