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Estrogen: The Essential Hormone You Don’t Understand

Dr. Michael Cutler, May 21, 2012

Estrogen is an important female hormone many people often discuss but rarely understand. Many women who could benefit from estrogen supplementation don’t appreciate its impressive health benefits. It can even make you happier!

Estrogen Function

There are about 400 known functions of estrogen in the female body. I’ll mention just the major ones. Estrogen is known to be responsible for:

The shape of a female’s breasts, hips, pelvis and face. Smooth and unwrinkled skin without excessive hair growth. Enhancement of sexual desire and vaginal lubrication. Increased physical stamina. Positive mood and enthusiasm. Reduced heart disease risk. Prevention or slowed osteoporosis (bone thinning). Control of the menstrual cycle and ovulation. Supporting the brain, joints and immune system health. From these functions, it’s easy to see that estrogen is not only responsible for much of a woman’s health but also her happiness.

Menstrual Complications

Estrogen deficiency is notorious for causing menstrual problems that most women recognize. Common menstrual-related symptoms include: very short or nonexistent periods, extended irregular bleeding pattern (more than five days), or periods with severe cramps.

This is quite common for women nearing menopause, a time when estrogen levels begin to decline dramatically. Without sufficient estrogen, other symptoms can become noticeable, but usually women do not realize they can be related to estrogen deficiency:

Hot flashes Painful intercourse Hair loss on the top of the head

Night sweats Panic attacks Frequent urination

Anxiety Strange dreams Snoring

Mood swings Urinary tract infections Sore breasts

Irritability Vaginal itching Palpitations

Insomnia Lower back pain Varicose veins

Depression Bloating and flatulence Urinary leakage

Loss of sexual interest Osteoporosis Dizzy spells

Hair growth on face Aching joints Skin feeling crawly

Migraine headaches Memory lapses Weight gain

Wrinkles around eyes Vertical lines above the mouth Dry or irritated eyes

Feeling tired all day long Loss of shapeliness at the waist Vaginal dryness

Feelings of depression or discouragement Breasts that shrink, sag or lose plumpness Indigestion

Symptom Control

Although estrogen cream is used mostly to control symptoms, it provides long-term health benefits, too. If you do an Internet search regarding the use of hormone replacement therapy (HRT), most sites will advise not to use estrogen plus progestin. That’s because they usually don’t tell you that HRT can also mean estrogen cream plus progesterone.

Studies with estrogen applied plus progesterone actually demonstrate beneficial effects: They help protect from breast cancer risk, lower bone thinning (osteoporosis), support heart health, and decrease memory loss in older age if started in the perimenopausal years or before.

Estrogen Can Lower Breast Cancer Risk

Estrogen has three main components: estrone, estradiol and estriol. The estrone component is the one that can be metabolized further into either a breast cancer-producing form (e.g. 4-hydroxyestrone and 16-alphahydroxyestrone) or a form that helps protect from cancer (e.g. 2-hydroxyestrone). These estrone metabolites can be measured with salivary testing if necessary.

You can promote the metabolism to the cancer-protecting estrone (2-hydroxyestrone) in several ways. First, balancing the other hormones is important; when unbalanced, they promote estrone formation. Also helpful is eating plenty of broccoli, soy isoflavones, flaxseed lignans and omega-3 oils. In addition, B vitamins, vitamin D, SAMe (methionine), magnesium, N-aceytyl cysteine (NAC), glutamine, glycine and the herbs rosemary, turmeric or chrysin are known to decrease breast cancer risk by promoting healthy estrone metabolism. In addition, don’t forget the importance of consistent exercise, weight control and not smoking.

Estriol Protection

A number of studies show that estriol protects against breast cancer. When given with estradiol or with progestin, estriol shows clear breast cancer-protecting effects. [1] In a large study of 30,000 women reported in 2004, those who used estriol had no increased rate of breast cancer, while those who used estrogen only did. [2] In a large case-control study of 3,345 women, the risk for breast cancer among estriol users was identical to nonusers. [3]

Estrogen plus progesterone clearly decreases breast cancer risk. This was shown to be true in a double-blind, placebo-controlled trial [4] of women given estrogen plus progesterone prior to breast surgery reported in 1995. This was again indicated in a randomized, double-blind study [5] reported in 1998. And a primate animal study [6] reported the same results in 2007.

Estrogen Treats And Prevents Osteoporosis

It is clearly known that transdermal estrogen supplementation reduces bone fracture rates in postmenopausal women. Subjects using only a low dose of 0.1 mg per day stopped losing bone density and dramatically reduced their fracture rate in two clinical trials. [7] [8]

Estrogen Can Decrease Cardiovascular Disease Risk

We know that estrogen lowers bad cholesterol (LDL) and boosts good cholesterol (HDL). Coronary artery spasm, which precipitates a heart attack by squeezing down areas of the vessel where there is already atherosclerotic plaque, is decreased with the use of estrogen and also estrogen plus progesterone. [9] Estrogen lowers anti-thrombin III levels, thereby lowering recurrent venous thrombosis (vein clotting).

Estrogen For Better Memory

Studies with animals and humans agree that estrogen replacement therapy, when started before menopause, decreases memory loss in older age. [10] In the Italian Longitudinal Study on Aging reported in 1998, researchers found that among the 2,816 women aged 65 to 84 years who were studied, the rate of Alzheimer’s disease was only one-fourth as much among estrogen users compared with the general female population of the same age who shared multiple other risk factors. [11]

A study reported in 1996 found that among 156 women who reported taking estrogen after the onset of menopause, those who eventually developed Alzheimer’s disease did so much later (delayed onset) and significantly less often (60 percent fewer) compared with those who did not. Also, those who had used estrogen longer than a year had even a greater risk reduction for Alzheimer’s disease. [12]

Estrogen Dosing

The usual dose of estrogen cream for menopausal symptoms is 0.25 mg to 1.0 mg per day of “Biest” (estradiol and estriol in a 1:4 ratio or 1:1 ratio). If a woman is still having periods, she can use it during days 5-25 of her cycle. If she is menopausal, she can use it continuously or with a 3-5 day break each month along with progesterone.

Summary

Estrogen can be used to control symptoms of menopause and menstruation. Estrogen cream (but not taken orally) plus progesterone has long-term health benefits without health risks (unlike estrogen plus progestin, as you’ll see quoted so much in the lay press). Estrogen is generally used with progesterone to protect from a few of its potential long-term health risks. Estrogen provides the benefits of stronger bones, a healthier heart and improved memory for the later years of a woman’s life.