Estrogen Therapy: Is it Safe and Do I Need It?

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Don’t be disillusioned by misguided medical literature when it comes to making informed decisions about your feminine hormonal health.  While all medical interventions come with a level of risk and side effects, estrogen therapy in its natural or bio-identical state is generally safe and abundantly beneficial for your bone and cardiovascular health.  We’ve got the receipts.  

Hormone therapy, specifically estrogen therapy, has sparked much debate in medical circles, garnering controversy over its effectiveness and safety over the years.  Most of the fear and misgivings surrounding the topic of estrogen therapy stem from imprudent studies.  Consulting with a board-certified physician specializing in the field of hormone therapy is crucial to getting the treatment you need to not only feel like yourself but to protect your physical health.

In July 2002, the Women’s Health Institute Study published the results of a landmark study around a hormonal treatment trial that was eventually terminated due to adverse reactions in participants, such as heart disease, blood clotting, strokes, etc. Prempro was the study’s premier and evidently incriminating treatment drug – a synthetic estrogen combined with a synthetic progesterone.  Within months, half of the women in the United States who were taking estrogen therapy, whether natural or bio-identical, stopped their treatment.  Most of these women had no uterus or ovaries and were no longer producing enough estrogen to sustain a well-balanced, healthy life.  A follow-up study in 2013 by the American Journal of Public Health found that 91,610 women between the ages of 50 and 59 had subsequently died prematurely due to unnecessary avoidance of estrogen therapy.  The study concluded that estrogen could be beneficial for cardiovascular and bone health when administered in its natural form.  Natural or bio-identical estrogen inhibits the development of atherosclerosis and plaque buildup in the artery walls, maintaining optimal arterial blood flow.  Source

What is Estrogen?
Estrogen is one of the primary female hormones (besides progesterone) produced in the ovaries and found in small amounts throughout the body.  Estrogen levels fluctuate during a woman’s menstrual cycle, but these minor variations don’t usually present an alarm in most women.  It should be noted that men, too, produce estrogen (just as women also produce testosterone), but in minimal amounts. Typically, the body has an intrinsic way of balancing its crucial processes.

Estrogen is responsible for:

• Sexual development and secondary sex characteristics in pubescent girls
• Growth of uterine lining during the menstrual cycle and at the beginning of pregnancy
• Breast changes in sexually developing girls and pregnant women
• Regulating bone and cholesterol metabolism
• Regulating hunger/appetite, body weight, glucose metabolism, and insulin sensitivity

Symptoms of low estrogen include:

• Painful sex due to lack of lubrication produced in the vagina
• Increase in UTIs
• Irregular/absent periods
• Hot flashes
• Breast tenderness
• Increase in headaches/migraines
• Depression/mood irregularities
• Brain fog/difficulty concentrating
• Unexplained lethargy/lack of motivation

Another noteworthy symptom of low estrogen is the fracture or breaking of bones due to decreased density, as estrogen directly works with calcium, vitamin D, and other minerals to help keep bones resilient.  If left untreated, chronic estrogen deficiency can lead to infertility.  Low estrogen in women over 40 years of age indicates menopause is approaching and will continue to slow its production until menopause has been reached. Source

Causes of Low Estrogen in Women Under 40
Women under 40 who experience low estrogen production are not uncommon.  The following causes can contribute to slower than normal estrogen production in younger women:

• Excessive dieting/exercise
• Battling eating disorders, such as anorexia
• Dysfunctional pituitary gland
• Chronic kidney disease
• Turner Syndrome (a genetic condition caused by an abnormality of one of the sex chromosomes)

Estrogen Therapy
Estrogen therapy is recommended to help prevent bone loss, cardiovascular disease, and other hormonal imbalances.  While the actual dosage will depend on a woman’s estrogen level severity, the FDA recommends the lowest possible dosage for the shortest possible amount of time due to cancer risk.  Estrogen therapy can be administered orally, vaginally, topically, or via injection.  Most women experience optimal results after 1-2 years of estrogen therapy.  Estrogen therapy can relieve the common disruptive symptoms of menopause, such as hot flashes, insomnia, bone loss, painful intercourse, etc.  For women under age 40, estrogen therapy can reverse irregular periods, infertility, and dermatological disorders.  Reported side effects of estrogen include:

• Bloating
• Breast tenderness/swelling
• Dense breast tissue
• Vaginal bleeding
• Blood clots
• Heart attack
• Stroke
  Source

Do I Need Estrogen?  Diagnosing Low Estrogen
Diagnosing low estrogen is not a one-size-fits-all assessment and can be challenging. Prepare to discuss current problematic symptoms and a comprehensive evaluation of your family’s medical history and full-body exam with your physician.  Blood work will be performed to measure current hormone levels. A pituitary hormone test may be conducted to rule out any medical conditions that may or may not affect the functionality of the pituitary gland.  In some cases, a brain scan may be recommended.  Consulting with a physician whose disciplines are hormone and endocrine system-focused will help you take decisive action and make informed, educated choices when it comes to your body’s hormonal health.

If you feel you may benefit from lipedema revision surgery and would like to book a consultation with Dr. Jamie Schwartz to evaluate your current physical situation, as well as your medical and lipedema surgical history, be sure to contact our office to speak with any one of our compassionate, highly-knowledgeable staff members.  We look forward to hearing from you and we’re always here to help.