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Estrogen: Imbalances, Sources & Uses

Doctor with medical card

Last week we discussed estrogen types, functions & levels. This week we will discuss estrogen imbalances, sources, and uses (including estrogen replacement therapy and birth control.)

Estrogen Imbalance

Estrogen imbalance can lead to:

● fatigue

● dry skin

● low sex drive

● mood swings

● difficulty falling asleep

● irregular or no menstruation

● feeling depressed or anxious

● hot flashes, night sweats, or both

● vaginal dryness and/or vaginal atrophy

● light or heavy bleeding during menstruation

● more intense premenstrual or menopausal symptoms

● weight gain (predominantly in the hips, thighs, and waist)

● benign (noncancerous) lumps in the uterus and/or breasts

● Some of these symptoms are prevalent during menopause.

Some hereditary and other conditions can lead to high levels of estrogen in men, which can result in:

● infertility

● erectile dysfunction

● (gynecomastia) enlargement or swelling of male breasts

Men with low estrogen levels can have excessive abdominal fat and low libido.

Estrogen Sources and Uses

If a person has low concentrations of estrogen, their doctor may prescribe them supplements or medication.

Estrogen medications include:

● synthetic estrogen

● bioidentical estrogen

● Premarin (animal estrogen)

Estrogen Replacement Therapy

Estrogen therapy is a part of hormone replacement therapy that can help mitigate menopausal symptoms and improve the patient’s quality of life.

This therapy can consist solely of estrogen (estrogen replacement therapy), or it may involve a combination of estrogen and progestin (a synthetic form of progesterone.)

Hormone replacement therapy is offered in many forms including a pill, nasal spray, patch, skin gel, injection, vaginal cream, or ring.

This therapy can help manage:

● anxiety

● hot flashes

● mood changes

● sleep disorders

● vaginal dryness

decreased sexual drive

● dyspareunia (pain with sex)

It can also help reduce the risk of osteoporosis (this risk increases as women enter menopause.)

Side effects can include:

● nausea

● bloating

● headaches

● leg cramps

● indigestion

● vaginal bleeding

breast soreness

● fluid retention, leading to swelling

Certain types of hormone therapy can also increase a patient’s risk of a stroke, blood clots, and certain types of cancer. The patient’s doctor will consult a person on whether or not this therapy is right for them.

Beyond menopause, estrogen therapy can also help with:

● delayed puberty

● other ovarian issues

● certain types of acne

● primary ovarian insufficiency

● some cases of prostate cancer

High concentrations of estrogen can increase a patient’s risk as well as the progression of certain varieties of breast cancer. Specific types of hormone treatments block estrogen in order to slow or stop cancer progression.

Hormone replacement therapy is not for everybody. For example, if a patient has an increased risk of developing breast cancer or thyroid issues they may be advised against using hormonal therapy. Patients who are unsure whether or not hormone therapy is right for them should discuss the pros and cons with their doctor.

Birth control

Birth control pills can either contain progestin or a combination of synthetic estrogen and synthetic progesterone (progestin.)

Certain types of birth control prevent pregnancy by stabilizing hormone levels, therefore preventing ovulation, as well as thickening the cervix mucus so sperm cannot access the egg. 

Birth control pills aren’t just used to prevent pregnancy, they can also decrease premenstrual symptoms and reduce the severity of hormonal acne. 

However, birth control pills can increase a patient’s risk of:

● stroke

● blood clots

● headaches

● heart attack

● irregular bleeding

● changes in weight

● pulmonary embolism

● nausea and vomiting

● breast tenderness and swelling

Side effects of oral birth control bills are more likely in women who smoke, are over 35, or both. Long-term use of birth control has also been linked to higher rates of breast cancer.

Patients who are interested in discussing hormone replacement therapy can contact Mangrove Women’s Health at (530) 345-0064, extension 281 to set up an appointment with Dr. Davis.

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