The Estrogen Equation: Benefits and Risks for Women Ages 40-65

I have had a week! I went out to a wine jazz event last Friday in Dallas, and noticed my arm and back were hurting something fierce. I have been feeling like someone had stuck a hot knife in me and twisted… I’m so dramatic but the pain was real. Coupled with my night sweats, I couldn’t take it ya’ll. I went to the clinic and found out it was shingles! Get your vaccine people, I’ve been dragging my feet and this is what I get. Worse when you read about it online and the possibility of long lasting symptoms? I can’t even.

On a better note, this all triggered me to see an HRT Specialist. I saw the best HRT Specialist, she was so awesome. I felt seen and heard. I told her that I write a blog and she gave me so much material on and around midlife and menopause. She corrected some misinformation I had, on having a pap smear exam when I do not have a uterus. I got one done that day, it had been since 2008. That’s a whole other story for another day. But, and cue the drums here, I got a prescription for Estrodiol 0.05 mg, basically an estrogen patch. I didn’t need progestin. I chose the patch simply because I have enough supplements that I take, it would be a bit much to do one more.

It’s been a couple of days and I still have some hot flashes maybe one or two a day, and they are less intense, but the brain fog which was a huge factor lifted. I feel like I’m firing with at least 90% of my cylinders. I’m so happy because that was a doozy.

Estrogen, plays a pivotal role in a woman’s health and well-being. From regulating menstrual cycles to maintaining bone density and supporting cognitive function, estrogen influences virtually every aspect of a woman’s physiology. However, as women transition through midlife, estrogen levels fluctuate, leading to a myriad of changes and potential health concerns.

1. The Benefits of Estrogen:

 Here are some of the key advantages:

   – Bone Health: Estrogen plays a crucial role in maintaining bone density and preventing osteoporosis. Studies have shown that declining estrogen levels during menopause can lead to an increased risk of fractures and bone loss.

   – Heart Health: Estrogen helps regulate cholesterol levels and supports cardiovascular health. Research suggests that estrogen may have cardioprotective effects, reducing the risk of heart disease in premenopausal women.

   – Cognitive Function: Estrogen is involved in various aspects of brain function, including memory, mood regulation, and cognitive performance. Some studies have suggested that estrogen therapy may help improve cognitive function and reduce the risk of cognitive decline in postmenopausal women.

   – Menopausal Symptoms: Estrogen therapy can effectively alleviate common menopausal symptoms like hot flashes, night sweats, vaginal dryness, and mood swings, improving overall quality of life for women experiencing these symptoms.

2. The Downside of Estrogen:

 While estrogen offers many benefits, it’s not without its risks and potential downsides. Here are some considerations to keep in mind:

   – Breast Cancer Risk: Estrogen has been linked to an increased risk of breast cancer, particularly when used in combination with progestin in hormone replacement therapy (HRT). Studies have shown that long-term use of estrogen plus progestin may elevate breast cancer risk.

   – Cardiovascular Risks: Although estrogen is thought to have cardioprotective effects in younger women, its impact on cardiovascular health in postmenopausal women is less clear. Some studies have suggested that estrogen therapy may increase the risk of stroke, blood clots, and heart disease in certain women.

   – Endometrial Cancer Risk: Estrogen therapy without progestin may increase the risk of endometrial cancer in women who have not undergone a hysterectomy. Progestin is often prescribed alongside estrogen therapy to protect the uterine lining and reduce the risk of endometrial hyperplasia, a precancerous condition that can lead to endometrial cancer. However, for women who have had a hysterectomy and no longer have a uterus, the risk of endometrial cancer is eliminated, and estrogen therapy alone may be prescribed without the need for progestin.

  – Other Side Effects: Estrogen therapy may be associated with other side effects such as bloating, breast tenderness, headaches, nausea, and vaginal bleeding.

I have always been very in-tune with my body, so while the side effects are kind of crazy, I’ll continue to pay attention to my body and get regular health check-ups. Be gentle with your body.

3. Studies and Evidence:

 Here are some notable findings:

   – The Women’s Health Initiative (WHI) study, one of the largest clinical trials on hormone therapy, found that combined estrogen plus progestin therapy increased the risk of breast cancer, stroke, blood clots, and heart disease in postmenopausal women.

   – The WHI estrogen-alone trial, which studied women who had undergone hysterectomy, found that estrogen therapy alone did not increase breast cancer risk but did increase the risk of stroke and blood clots.

   – Other studies have suggested that estrogen therapy may have favorable effects on bone density, cognitive function, and menopausal symptoms when used at the appropriate dose and duration.

4. Do the Benefits Outweigh the Downsides?

 The question of whether the benefits of estrogen therapy outweigh the risks is complex and highly individualized. It depends on factors such as a woman’s age, health history, menopausal symptoms, and personal preferences. For some women, the relief of debilitating menopausal symptoms and the potential benefits for bone and heart health may justify the risks associated with estrogen therapy. However, for others, concerns about breast cancer risk or other potential side effects may outweigh the perceived benefits.

Ultimately, the decision to use estrogen therapy should be made in consultation with a healthcare provider who can assess individual risk factors, discuss treatment options, and help women make informed decisions about their health and well-being.