6 Steps to Help You Make a Decision about Estrogen
Are you struggling with your decision to use an estrogen supplement? Do you hesitate because you think it is too riskybut don’t know what
else to use for your hot flashes?
There are so many choices, that you might get hot flashes just from trying to sort it all out.
Here you will find information about:
- Finding out if an estrogen supplement is a good fit for your symptoms
- Making a choice about the best kind of treatment (hormone or natural) for your symptoms
- Benefits, side effects and risks
Let’s take this step by step so you can make the right decision for your situation.
Step 1: Is Estrogen a Good Fit?
Undoubtedly, estrogen has many benefits for women in menopause. For example, the feeling that I was loosing my mind and my memory finally drove me to using estrogen supplements for a while after everything else failed.
But not every menopause symptom benefits from hormone therapy.
Often women think their symptoms come from estrogen levels that are too low, when the opposite is the case. This happens often during perimenopause and if your symptoms fall into this category other treatments might be better for you.
How do you know which symptoms are related to low or high levels? There is a long list related to each of the two conditions (see links in the right column).
If you have low estrogen symptoms, a hormone supplement will help you get better.
But on the other hand, if you suffer from estrogen dominance, adding additional hormone into the mix can make your symptoms much worse.
Step 2: What Estrogen Supplement Choices Do I Have?
Hormone therapy is still the only FDA approved treatment for hot flashes and night sweats (both called vasomotor symptoms). They workwell but are not without risks no matter what you see on billboards or read in popular books. (Such as Suzanne Sumers’ book: Ageless: The Naked Truth About Bioidentical Hormones.)- Yes, natural hormones are now available and you don’t even have to go to the individually compounded bioidenticals to get them.
- Yes, in our opinion they are better than the synthetic hormones (such as Premarin etc.). But in any case they are powerful chemicals and carry risks and side effects.
One big distinction needs to be made between estrogen pills and other methods (patches, cream, under the tongue etc) of getting this hormone into your bloodstream. There is some indication that oral estrogen has more side effects because it is metabolized by the liver. This process changes its chemical structure which can cause problems for some women.
If your symptoms are debilitating enough that they influence your life, an estrogen supplement might just be the thing to get you back on track. Especially after you have tried the natural remedies for your hot flashes and other symptoms, this may be your best option. (Aside from some otherpharmacological options which carry different risks).
But only you, with the help of your doctor, can decide if the risks outweigh the benefits.
Step 3: When Should I Start With Hormones?
Another consideration is how close you are to menopause. The best time to start taking the hormone is around the time when your periods stop permanently.
The longer you wait after menopause before you start hormone therapy, the more risk you will accumulate. These risks include heart disease, stroke and cancer.
Step 4: Which Form is the Best for Me?
Estrogen
There are 3 forms of estrogen in the body:estrone, estradiol and estriol
Tri-est is a combination of all 3 of these estrogens
Bi-est is a combination of estriol and estradiol – which is more common than tri-est
Now which form of estrogen (tri-est, bi-est, estradiol) is best for you is tricky to decide. Every version has its passionate advocates and critics.Based on everything we have read, (and remember we are not doctors) it makes sense to use something that:
- is quality controlled, (which excludes hormones that are imported from China and compounded in your local pharmacy),
- is not in pill form
- is easy to use.
One example for this is the Vivelle Patch. It contains a natural estrogen, is available at your regular pharmacy and comes in different standard prescriptions. Your insurance may even pay for it, which is unlikely if you use compounded prescriptions.
But there are certainly many other choices you should discuss with your doctor.
Step 5: What are the benefits, risks and side effects of Hormone Supplements?
No dobt, the main benefit of estrogen therapy is the relief it provides for many menopause symptoms. The good news is that women today have a lot more options for different kinds of treatments ranging from traditional hormone therapy to bioidenticals.
Because estrogen affects so many functions in your body – over 300 have been identified – it can help you feel better overall, either by adding an hormone supplement or through a natural remedy.
Most women are very concerned about the side effects and risks of estrogenor hormone therapy. There is plenty of information in the media that scares women into believing that using estrogen therapy is too risky. This is one of the reasons that natural remedies for menopause have become so popular.
Yes, adding hormones to your body either in the natural or synthetic form has some risks. What these risks are is hotly debated, especially since newer hormone treatments have been developed for which long term data are not yet available. This leaves women very confused.
Make sure you understand why your doctor is prescribing a specific estrogen supplement and become an active partner in your treatment.
Step 6: Other Choices – Herbal Estrogen Supplements
If your symptoms are not extreme and you are still in perimenopause, you might want to consider some herbal options.
This category alone includes several groups of natural remedies:
- Supplements that contain estrogen-like chemicals (phytoestrogen)
- Supplements that influence how your body uses hormones
- Supplements that support a healthy estrogen balance
These groups overlap to a certain extend, but let’s look at some of the distinctions.
Phytoestrogens are a group of herbs that have chemicals with a structure that is similar to estrogen. They work on the estrogen receptors in your body and act like weak versions of the hormone.
Examples of these herbs are Red Clover, Dong Quai, Soy and Hops (Life Extension Natural Female Support is a menopause supplement with hops, a very powerful phytoestrogen).
The second group includes herbs likeEvening Primrose and Chaste Tree Berry (Vitex). Both of these herbs influence the pituitary gland which is involved in the hormone regulation and production.
You might be surprised that Black Cohosh is not in this list.
Recently researchers found that Black Cohosh has NO estrogenic effect. It works on the chemicals that influence how your brain regulates certain processes in the body (especially neurotransmitters).
The third group contains supplements with a mix of substances and herbs that help to balance the natural estrogen levels. Many women report good results from these remedies.
Examples include Estrobalance and Estrosense, and herbs like Maca Root and Ashwagandha. This group is especially beneficial for women in perimenopause when hormone levels fluctuate.(Check the article about Natural Supplements for Menopause for more information.)
A Final Word
You may find all of this information slightly overwhelming because“hormones” are such a complicated issue.
So make sure you read the main article about hormone therapy to get all the links and information.
Having said all this: If your symptoms are severe and you have tried the natural remedies, using a hormonal estrogen supplement can be a good option.