Estrogens in Menopause

There are 3 types of estrogens: estrone (E1), estradiol (E2) and estriol (E3):

Estrone is the estrogen of menopause, but because it produces a number of undesirable side effects, there is controversy over whether or not to replace estrione. One drug, Triest, is a combination of 80% estriol, 10% estradiol and 10% estrione. However, few anti-aging doctors prescribe this combination of estrogens when treating menopause.

Estradiol is the most abundant estrogen during the reproductive years. In the brain, it affects serotonin levels, pain threshold and fine motor coordination. It also affects your ability to learn and multitask. By inhibiting an enzyme called choline acetyl transferase, estradiol decreases your risk for Alzheimer’s disease. This is yet another reason why women in menopause benefit from estrogen replacement.

Estradiol also has a number of desirable affects on the heart. Transdermal estradiol reduces CRP, an inflammatory marker associated with heart disease. In many studies, it has been shown to be cardio protective, improving the elasticity of your arteries and decreasing the accumulation of plaque. Estradiol is also important for your skin and hair, your bones, energy production, and over all well-being.

Estradiol has a profound effect on a woman’s sexuality. It maintains the integrity of the vaginal wall and the cells lining the vagina. Without estradiol, the cells become thin, and the vaginal lining dries out. Obviously, this diminishes sexual pleasure by making certain activities uncomfortable and even painful.

Most important, without estradiol, the body is thrown into accelerated aging.

Some women will show symptoms of estrogen deficiency a few days before their cycle starts and into the first week of the cycle. They may suddenly feel exhausted, depressed, crying for no particular reason, have difficulty focusing, and may suffer from migraine headaches and joint pain. Often a low dose estradiol gel is beneficial. Estradiol can be best replaced as a Transdermal gel, or patch. (Oral estrogens are not recommended.)

Estriol is the weakest of all three estrogens. Found in the placenta, Estriol appears to protect against breast cancer.

The drug Biest is a combination of both estradiol and estriol, and is most often prescribed by anti-aging doctors.

Benefits of Testosterone in Menopause

Most women experience some change in sexual function during the years just before and after menopause. Usually, sexual complaints include loss of desire, painful intercourse, and diminished sexual responsiveness. Sexual arousal and function can all be influenced by ovarian hormone levels. This is why testosterone replacement often helps to restore sexual function.

Testosterone may be given as a topical cream or gel, while some physicians insert pellets. If using a cream, follow-up testing must be done by examining saliva or urine.. Blood levels may not be accurate when using a cream. If using a gel, either blood, saliva or urine may be used to follow levels.. If a level is too high, changes in doses may take months for the saliva to reflect theses changes. (When pellets are inserted, blood levels can be measured, but nothing can be done about elevated levels, aside from waiting for the pellets to lose their potency.)

Testosterone treatment has a number of other beneficial effects in women. Testosterone has been shown to increase bone density in the hip and arm bones, and also decreases fat while increasing lean muscle. In addition, testosterone helps women overcome excessive worry, since it’s been shown to improve mood and quality of life.

For more information on hormone replacement in menopause and estrogen dominance call our office at (646) 736-7378 or have us  Contact You  for more information and an appointment.