Estrogen replacement may be useful after menopause.
A woman's body makes several sex hormones during her childbearing years, including estrogen. This hormone is critical for reproductive function and has key roles in other body tissues and organs. When a woman's estrogen production falls, due to menopause or another reason, her doctor may recommend estrogen replacement medication to improve her health and well-being.
In women of childbearing age, the ovaries make estrogen during each monthly menstrual cycle. Critical in preparing the uterus and other organs for a possible pregnancy, estrogen production falls at menopause when a woman stops ovulating. Menopause begins gradually and it typically take years before menstrual cycles cease completely. Most women experience their last period at about age 51, according to the National Institute on Aging.
Although the onset of menopause is the most common cause of low estrogen, other conditions may also interfere with its production. For example, chemotherapy drugs or removal of the ovaries because of cancer or another disorder can lower estrogen production or block it entirely. A severe eating disorder or an extreme exercise program that causes low body weight can also suppress estrogen production. Certain genetic conditions can cause low or absent estrogen, although this is uncommon.
One of the most common reasons a doctor recommends estrogen replacement medicine after menopause is to relieve associated symptoms, particularly if they are severe and interfere with a woman's daily life and sense of well-being. Hot flashes are a common menopausal symptom, characterized by episodes of extreme warmth and sweating. Similar nighttime bouts of overheating, called night sweats, can cause sleeplessness and daytime tiredness. Without sufficient estrogen, the vaginal lining also thins and becomes fragile and dry, often causing itching, burning and painful sexual intercourse. These symptoms vary widely but can be severe and last for several years.
Replacing estrogen with an oral medication or with a skin patch improves menopausal symptoms for most women, according to a study published in March 2010 in "Menopause International." In some cases, estrogen may be combined with another female hormone, progesterone, which is normally made during the second half of a woman's menstrual cycle.
Estrogen replacement can benefit other tissues, organs and systems, including the bones and possibly the cardiovascular system. When estrogen production falls, the bones tend to become thin and more fragile, raising the risk for fractures. The authors of a May 2006 article published in the "Journal of Bone and Mineral Research" report that postmenopausal women who did not take estrogen had an increasing risk for fractures over a 10-year period. Replacing estrogen after menopause reduces the risk of fractures significantly, according to information published in March 2012 by the American Menopause Society in the journal "Menopause."
Estrogen replacement therapy may provide benefits for some other nonreproductive organs, according to the "Menopause" study. It may help reduce bladder symptoms that sometimes accompany menopause. It might also lower a postmenopausal woman's risk of developing diabetes, reduce her risk of developing cardiovascular disease and have positive effects on mood and mental ability. These potential benefits need further confirmation in large-scale research studies. In 2012, the U.S. Preventive Services Task Force recommended against the use of estrogen or a combination of estrogen and progesterone solely for the prevention of chronic diseases due to lack of evidence.
Risks and Recommendations
Although estrogen replacement medication can help improve health, it also has certain risks and may not be appropriate for all women. Estrogen replacement may raise the likelihood of a stroke caused by a blood clot in some women. Taking estrogen may also increase the risk of uterine cancer when not combined with progesterone. Estrogen replacement therapy might raise the risk of breast cancer slightly, especially when taken for many years.
To decide if estrogen replacement medication is appropriate for you, discuss your situation and the potential risks and benefits with your doctor.