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What Is The Role Of Oestrogen In Menopause

What Are The Symptoms Of Low Estrogen

Oestrogen what is it & why does it cause menopause symptoms

First off, it is worth saying that low estrogen symptoms can be also a result of smoking, hereditary predisposition, and excessive exercising. So, whenever a woman wants to prevent the fast onset of menopause, she should avoid such activities, and inform a dedicated expert about signature genetic details. In such a case, he will be able to appoint hormone replacement therapy or recommend health supplements that will stabilize the levels as much as possible. Besides, such treatment can alleviate the symptoms of low estrogen, and let the woman live a comfortable life.

Estrogen And Progesterone: Understanding The Role Of Each When Ttc

Kelly Berry

Katerina Shkodzik

M.D., OB-GYN

Two of the most important hormones for women are estrogen and progesterone, but there can be a lot of confusion surrounding these two hormone powerhouses. We often refer to hormones as a group because they work together and their balance is essential to good health. However, when it comes to estrogen and progesterone, it can be helpful to look at them individually.

In this post well cover what estrogen and progesterone do, where theyre produced, and how their levels impact your health.

What Are The Roles Of Oestrogen And Progesterone In The Menstrual Cycle

Oestrogen is produced by the ovaries and makes the lining of the uterus repair itself and grow again after menstruation. Progesterone is produced by the empty follicle in the ovary after the egg has been released. This hormone maintains the lining of the uterus during the second half of the menstrual cycle.

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Estrogen And Lower Urinary Tract Function

Estrogen is known to have an important role in the function of the lower urinary tract further, it has been demonstrated that receptors of both estrogen and progesterone are found in the vagina, urethra, bladder and pelvic floor musculature.5,6 Estrogen is involved in a significant way in the continence mechanism such that bladder and urethral function become less efficient with age.7 With regard to urinary continence, estrogens may increase urethral resistance, raise the sensory threshold of the bladder, or increase alpha-adrenoreceptor sensitivity in the urethral smooth muscle.8,9 Postmenopausal-associated estrogen deficiency results in atrophic changes and may be associated with lower urinary tract symptoms such as frequency, urgency, nocturia, urge incontinence, and recurrent infection these urinary symptoms may also coexist with genital and sexual symptoms as outlined in TABLE 1. Of note, genitourinary prolapse can also cause urinary symptoms, with the prolapse itself causing voiding difficulty this consideration underscores the importance of a vaginal examination as part of a urinary continence assessment.10

What Can I Do To Help

Natural Estrogen Hormones

Supplements

Now, the things to look at are taking some kind of phytoestrogen supplements. So, that might be things like our menopause support or black cohosh. It’s also looking about supporting the nervous system.

Water & diet

Remember the water because that can help with just about everything. And also, look at the foods you’re eating. There is a huge group of foods that all contain phytoestrogens and can help your body get that little bit extra on a daily basis. And the foods that you want to be looking at are things like your dark-green, leafy vegetables. There are whole grains in moderation. Things like your lentils, and beans, and pulses. Your nuts and seeds are a great source. Having a portion of those every day is a really good idea for the menopause.

Fruits

We look at fruits. Things like your berries, your apples and plums. Flaxseed is another really great phytoestrogen food. And a great thing about flaxseed is take it on a daily basis, it can help with those sluggish bowels which is really common in menopause too. Green tea is another one. Again, a nice idea to substitute some of your cups of tea and coffee with green tea. And also, licorice. A nice little licorice supplement will go a long way, but not the sweets.

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Symptoms Of Low Estrogen

  • Hot flashes, flushes, and night sweats are the most common symptoms of low estrogen. At times, blood rushes to your skins surface. This can give you a feeling of warmth . Your face may look flushed. Hot flashes while you are sleeping are called night sweats.

  • Mood swings are another effect of low estrogen. You may feel sad, anxious, or frustrated. Shifting hormone levels and night sweats may disrupt your sleep. This can cause fatigue, which may make mood swings worse.

  • Thinning tissues may cause discomfort. Skin may appear more wrinkled. Thinning in the urinary tract may lead to bladder infections. You may also have an urgent need to urinate. Or you may lose bladder control . Thinning of the vagina may cause dryness and painful sex.

Is Hrt The Same As Birth Control

No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.

After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.

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A Change In Recommendations

These studies were the first large-scale trials that looked for cause and effect with heart disease and HRT. HRT does offer some benefits, such as preventing osteoporosis and reducing the risk of colon cancer. But the data on heart-related risks from these studies were very compelling. As a result, the American Heart Association and the U.S. Food and Drug Administration developed new guidelines for the use of HRT:

  • HRT should not be used for prevention of heart attack or stroke.
  • Use of HRT for other problems such as preventing osteoporosis should be carefully considered and the risks weighed against the benefits. Women who have existing coronary artery disease should consider other options.
  • HRT may be used short-term to treat menopausal symptoms.
  • Long-term use is discouraged because the risk for heart attack, stroke and breast cancer increases the longer HRT is used.
  • The bottom line, say physicians at the Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic: weigh the benefits of HRT against the risks and discuss the whole subject of HRT with your physician to be able to make an informed decision.

    What Is The Menopause

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    The menopause refers to that time in every womans life when her periods stop and her ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but in a few exceptional cases women may become menopausal in their 30s, or even younger. This is then known as a premature menopause, or premature ovarian insufficiency.

    The menopause is influenced by hormones or more correctly, by a change in hormone levels. During a womans fertile years, her ability to produce an egg each month is associated with the release of three reproductive hormones , that are referred to collectively as oestrogen. Oestrogen is mainly produced by the ovaries, though small amounts are also made by the adrenal glands and by the placenta of a pregnant woman.

    It is oestrogen which stimulates female characteristics at puberty and controls a womans reproductive cycle: the development and release of an egg each month for implantation in the uterus , and the way in which the lining of the womb thickens to accept a fertilized egg. The monthly period happens because no implantation has taken place there is no pregnancy and the lining of the womb is shed.

    At around the age of 50-55 years, the monthly cycle stops completely so no more ovulations, no more periods and no more pregnancies. This is the menopause.

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    Mood And Memory Disorders

    Oestrogen facilitates synaptogenesis, induces growth factor production, protects against oxidative stress and regulates neurotransmission in brain systems associated with cognition and mood .

    Although oestrogens affect brain tissues and brain processes in ways expected to reduce dementia risk and improve the course of cognitive ageing, this is not supported by clinical findings. Many observational studies imply that oestrogens reduce the rate of AD, however it now seems that there is no benefit to be had by starting hormones, and there may even be an increased risk when started in women over the age of 65 .

    Data from the HERS trial suggested that for symptomatic postmenopausal women, HT was associated with lower depressive symptoms. Two small RCTs demonstrated that transdermal oestradiol had antidepressant efficacy , however, compelling evidence is lacking regarding the antidepressant efficacy of HT alone.

    Isolating the effects of ageing from the effects of the menopause is difficult, but there is currently no evidence to support the use of HT for improvement or prevention of cognitive decline. Any beneficial effects of HT in mood disorders may be more likely to occur in women with concurrent vasomotor symptoms .

    Hrt Does Not Cause Weight Gain

    Weight gain at the menopause is related to age and lifestyle factors. An increase in body fat, especially around the abdomen, can occur during menopause because of hormonal changes, although exactly why this happens is not clear. Normal age-related decrease in muscle tissue, and a decrease in exercise levels, can also contribute to weight gain.

    Most studies do not show a link between weight gain and HRT use. If a woman is prone to weight gain during her middle years, she will put on weight whether or not she uses HRT.

    Some women may experience symptoms at the start of treatment, including bloating, fluid retention and breast fullness, which may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are changed to suit the individual.

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    Vaginal Symptoms And Sexual Dysfunction

    Vaginal symptoms become apparent 45 years after the menopause and objective changes as well as subjective complaints are present in 2550% of all postmenopausal women . Symptoms may include vaginal dryness , dyspareunia , vaginal itching, burning and pain . Dyspareunia can adversely affect a postmenopausal woman’s sexual quality of life or intensify pre-existing sexual disorders .

    Locally administered vaginal oestrogens are effective in the treatment of menopause-related vulval and vaginal symptoms and a Cochane review reported equal efficacy across all products tested creams, pessaries, tablets and vaginal rings . Local oestrogen therapy will lower vaginal pH, thicken the epithelium, increase blood flow and improve vaginal lubrication .

    A 2009 review of topical oestrogen concluded that no studies show evidence of endometrial proliferation after 624 months of use, therefore it does not support the concomitant use of progestins with topical oestrogens and is endorsed by the International Menopause Society .

    Vaginal oestrogen is controversial in women with a history of hormone-dependent cancer such as breast cancer, in whom vulval and vaginal symptoms are common, particularly those on endocrine therapy and although an increase in recurrence has not been reported, some oestrogen is absorbed into the systemic circulation .

    Non-hormonal treatment options include lubricants and moisturisers both of which can be effective although usually only in the short term .

    How Estrogen Is Related To Breast Cancer

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    According to the American Cancer Society, approximately two out of three breast cancers are hormone receptor-positive. This means that the cancer cells have receptors for either or both of the hormones estrogen and progesterone.

    Estrogen stimulates the growth of breast cancers that are estrogen receptor-positive. This is why menopausal hormone therapy is contraindicated in women with breast cancer or a history of breast cancer, so as to not increase a woman’s risk of breast cancer recurrence.

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    Weighing The Hormone Replacement Therapy Pros And Cons

    When it comes to getting HRT after surgical menopause, deciding what to do isnt easy. The contradictory headlines in the media in recent years havent helped. Its easy for women to feel like they are making the wrong choice, no matter what they do.

    When youre deciding, you have to consider a lot of different factors, including your age, your family history, and your habits. Just take it slowly and dont allow yourself to be rushed into a decision youre not ready to make. Check the latest research into HRT. Remember that both the potential long-term benefits and risks of hormone therapy are really quite small for any individual person.

    Finally, dont discount your gut feelings. The decision to get hormone therapy after surgical menopause is personal. The right answer depends as much on your preferences as it does on the facts in your medical chart.

    What Happens And How Does It Feel

    For some women this loss of reproductive ability may be deeply felt, and for all women the menopause is a personal experience, not just a medical condition. However, the diminishing release of oestrogen from the ovary as women advance into their 40s is often the cause of symptoms which can be distressing and may need medical attention.

    Hot flushes are the most common symptom of the menopause, occurring in three in every four menopausal women. Other common symptoms include night sweats, sleeplessness, vaginal dryness, irritated skin, more frequent urinary incontinence and urinary tract infections, low mood and a reduced interest in sex. Symptoms vary hugely in duration, severity and what impact they have on women.

    All the common symptoms of the menopause are associated with a decrease in the bodys production of oestrogen. Oestrogen lack can affect many parts of the body, including the brain, causing changes in emotional well-being, and the skin, influencing its elasticity and thickness.

    There is also some evidence that oestrogen deficiency is the cause of some chemical changes in the body which make women after the menopause especially vulnerable to heart disease and stroke.

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    How Will I Know When I Am Postmenopausal

    Women are considered to be postmenopausal when they have not had their period for an entire year. Having your doctor measure your follicle stimulating hormone level is another way to see if you are near menopause. FSH is a hormone produced by the pituitary gland . Your FSH levels will dramatically rise as your ovaries begin to shut down these levels are easily checked through one blood test. FSH levels can fluctuate during perimenopause, so the only way to know you are definitely postmenopausal is when you have had no period for a year.

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    Menopause Symptoms And Hrt

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    Menopause symptoms that may be relieved by HRT include:

    • hot flushes and night sweats
    • vaginal dryness
    • hair loss or abnormal hair growth
    • dry and itchy eyes.

    Other therapies, including vaginal oestrogen products, antidepressants or other medications, may be used depending on the symptoms and risk factors. Seek advice from your doctor.

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    What Are The Risks Of Hrt

    The health risks of HRT include:

    • Increased risk of endometrial cancer For women who have had a hysterectomy , this is not a problem
    • Increased risk of breast cancer with long-term use
    • Increased risk of cardiovascular disease
    • Increase in inflammatory markers
    • Increased risk of blood clots and stroke, especially during the first year of use in susceptible women

    All women taking hormone replacement therapy should have regular gynecological exams . The American Cancer Society also recommends that women over age 50 should:

  • Perform breast self-examination once a month
  • Have a breast physical examination by her health care provider once a year
  • Have a mammogram once a year
  • What Is The Role Of Estrogen In Female Reproductive Process

    Female reproductive system In females, estrogens affect the ovaries, vagina, fallopian tubes, uterus, and mammary glands. In the ovaries, estrogens help to stimulate the growth of the egg follicle they also stimulate the pituitary gland in the brain to release hormones that assist in follicular development.

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    What Hormones Are Involved In The Menopause

    There is a plethora of hormones at play in the menopause, all of which have a significant role in bringing about physical and psychological change.

    The main hormones are oestrogen, progesterone, and testosterone, but others such as the control hormones follicle-stimulating hormone and luteinising hormone also play a part.

    As women enter the perimenopause phase to menopause, the ovaries produce less oestrogen and progesterone. The ovaries become less responsive to the control hormones released by the pituitary gland in the brain – FSH and LH – resulting in higher levels of these control hormones.

    What Are The Types Of Hormone Therapy

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    There are two main types of hormone therapy :

    • Estrogen Therapy: Estrogen is taken alone. Doctors most often prescribe a low dose of estrogen to be taken as a pill or patch every day. Estrogen may also be prescribed as a cream, vaginal ring, gel or spray. You should take the lowest dose of estrogen needed to relieve menopause symptoms and/or to prevent osteoporosis.
    • Estrogen Progesterone/Progestin Hormone Therapy : Also called combination therapy, this form of HT combines doses of estrogen and progesterone .

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    Actions For This Page

    • Menopausal symptoms can be managed with education, lifestyle changes, support and hormone replacement therapy , also known as menopausal hormone therapy .
    • In the early postmenopausal years, HRT is an effective therapy for menopausal symptoms. In most women with moderate to severe symptoms, the benefits outweigh the small increases in risk.
    • The long-term use of HRT has some benefits, but also has some risks.
    • The current role of HRT is for menopausal symptom relief, at the lowest effective dose and for the shortest duration required for the control of bothersome menopausal symptoms.
    • The decision to use HRT, and for how long it should be used, must be based on individual assessment and needs.

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