The female body produces 3 types of estrogen: estrone, estradiol and estriol. Estradiol is the strongest of the 3 and the most abundant during a woman’s reproductive years. The 3 work in conjunction under the direction of the hypothalamus to protect a woman throughout the different phases in her life. Estradiol is the most vital to a woman’s health while estrone and estriol have more minor roles.

A lot of us have seen and/or read the book “What to Expect When You’re Expecting” when pregnant but no one quite prepares us for the changes of midlife. We hear about the dreaded menopause but naively expect it won’t hit us until we’re old and gray. Women’s estrogen levels typically begin to decrease during her mid to late 40s. Many women complain of hot flashes, insomnia, vaginal dryness, weight gain, poor concentration, changes in their skin and hair. A lot of these troublesome symptoms disappear late into menopause. At that point there is an increased risk of osteoporosis, Alzheimer’s Disease, stroke and cardiovascular disease. Most of these are severe problems that most newly menopausal women are unaware of until it’s too late. 

Estrogen has proven to protect against or reduce the effects of the following: 

Heart Disease

Memory loss

Stroke

Osteoporosis

Elevated cholesterol levels

Alzheimer’s Disease

Menopausal symptoms

Urinary tract atrophy

Depression and mood swings

But some of us are thrust through that door prematurely when we undergo full or partial hysterectomies. Full hysterectomy will bring on menopause surgically rather than naturally. A woman will immediately experience the symptoms of menopause. To avoid the crash from the sudden cessation of her own hormones she should immediately be supplemented with estrogen, progesterone and testosterone. Sadly women are often started on an antidepressant to mask the effects instead of treating the underlying problem.. hormone deficiency. 

Without the replacement of these vital, health sustaining hormones women who experience a total hysterectomy are in just as much danger as those women who have gone through natural menopause. Both are susceptible to heart disease, osteoporosis and age related dementia.

Natural, or bioidentical, estrogen replacement therapy is true ally to our aging body. It can bolster bone health, protect against Alzheimer’s Disease, prevent heart disease. 

Unfortunately many women have been scared to start estrogen due to the panic that resulted from the publishing of the Women’s Health Initiative (WHI) in the spring of 2003. It demonstrated an increase risk of strokes, heart attacks, breast cancer and dementia. But, in reality, the risks were far more minimal than was publicized. The increased risk of breast cancer was less than 1 person per 1000. The WHI was a study that focused on synthetic estrogen (Premarin), and progestin (Provera). Provera is Progestin. For clarification, Provera is NOT Progesterone. There were multiple arms in the study each using different drug combinations. The arm of the study that included Premarin and Provera (PremPro) demonstrated an increased risk of breast cancer which was detected early in the study. This increased risk was attributed to the Provera portion of the regimen and NOT the estrogen. Progestins have been implicated in increasing the risk of breast cancer in women on other occasions as well. An article in the Journal of the American Medical Association noted that Premarin contained 10 estrogens not even found in the human body. Three more recent studies have demonstrated an eight fold increased risk of cancer when Provera was added to estrogen. Conclusion.. without a doubt Provera increase the risk of breast cancer. The only harm demonstrated in the estrogen only arm was a slight increase in stroke in women over the age of 65 who had also started on hormone replacement therapy after the age of 65.

When we discuss the natural replacement of a woman’s estrogen there needs to be a distinction made between a synthetic hormone replacement vs a bio identical hormone replacement. The most common synthetic hormones are conjugated estrogens that are derived from pregnant mare’s urine. They are equine hormones which are drastically different from human hormones. Medical studies have even demonstrated that they function differently from our own hormones. A bio identical hormone are indistinguishable from human hormones as they are molecularly identical. Although they are produced from a natural plant source their chemical structure is identical which makes them natural. The human body recognizes these hormones as identical to itself and what it naturally produces.

demonstrated benefits:

Increased sense of well being

Decreased depression. Estrogen is the body’s own natural mood stabilizer.

Decreased vaginal dryness

Decreased incidents of urinary tract infections

Improvement in skin: decreased thinning, increased collagen production due to adequate estrogen and estrogen

Decreased bone destruction so decreased incidences of osteoporosis and decreased fall related fractures

Cuts the risk of heart disease by as much as 50% Heart disease and stroke remains the leading causes of death in women (60%)

Can help lower LDL (bad cholesterol)

Can help raise HDL (good cholesterol)

Adds protection to the heart and arteries. Acts as a powerful antioxidant and limits the oxidative damage to the arteries that cause plaque

Multiple medical studies have demonstrated improved cognition and memory in women taking estrogen

Estrogen can be replaced naturally in a manner of ways: topically (creams), vaginally (creams, tablet), transdermally (patch) or orally.