Who can benefit from estrogen treatment?

Estrogen is a hormone that’s naturally produced by your body. It’s found in both men and women. Estrogen plays an important role in managing your reproductive system, but it also protects your bones and helps your skin heal from bruises and injury.

Sometimes, your body doesn’t make enough estrogen. This can happen for various reasons. For example, your estrogen production slows down as you get older. Some conditions can also affect your estrogen levels.

If your estrogen levels are low, your doctor may prescribe hormone therapy to help replace your estrogen levels and ease symptoms. Some research suggests that long-term hormone therapy use may increase your risk for complications, however, including severe ones like cancer. Talk with your doctor about this before you begin using hormone therapy.

Learn more: What are the symptoms of low estrogen? »

Keep reading to learn more about the benefits and risks of estrogen, and which conditions may be treated with hormone therapy.

Your natural estrogen production changes over time. As you begin puberty, you will create more estrogen. You’ll continue to have higher levels through your childbearing years. As menopause approaches, your estrogen levels will begin falling.

As estrogen levels fall, you will start having symptoms of menopause. Most commonly, these symptoms include:

  • hot flashes
  • vaginal dryness
  • chills
  • difficulty sleeping
  • excessive sweating

For menopause, many doctors will prescribe an estrogen-containing medication. Replacing the declining estrogen with hormone therapy may help ease menopause symptoms.

Estrogen can help maintain vaginal health. When estrogen levels decline, you may experience changes to the tissue, lining, and pH balance of your vagina. That can cause several vaginal health issues, including:

  • vaginal dryness
  • vulvar atrophy, a condition that causes dryness, soreness, and urinary incontinence
  • atrophic vaginitis, or inflammation of vaginal tissues that is frequently caused by dryness and irritation

Estrogen may be able to help treat these conditions.

The ovaries are responsible for producing estrogen. If they fail to produce the hormone or if they are affected by any other condition, hormone therapy may be necessary.

These issues may require supplemental estrogen:

  • female hypogonadism, or decreased function of the ovaries
  • failure of both ovaries
  • removal of both ovaries, or an oophorectomy

If you’ve had your ovaries removed, hormone therapy may be used to help ease symptoms of premature menopause. Sometimes, both the uterus and ovaries are removed. This is called a total hysterectomy.

Estrogen may help decrease bone loss after menopause. However, new medications are better able to stop and reverse bone loss, so most doctors rely on those now. Those medications aren’t always effective or their side effects may be too severe. In those cases, your doctor may recommend using estrogen to treat bone loss, or osteoporosis.

Learn more about osteoporosis treatments »

Hormone therapy is not without its risks. In fact, hormone therapy is not used as widely as it once was because research began revealing complications with long-term use, such as cancer and heart risks.

However, thanks to these studies, doctors and medical researchers have a better understanding of who will benefit most from estrogen therapy and who should try other treatments.

The risk factors and side effects associated with estrogen use include:

  • Blood clots: Estrogen increases your risk of blood clots, which can cause stroke, heart attack, and even death.
  • Cancer: Estrogen may increase your risk of certain cancers, specifically breast cancer. Talk with your doctor about your personal health history, your family history, and your risk of breast cancer.
  • Birth defects: If you’re using estrogen or hormone therapy and become pregnant, your pregnancy may end prematurely. If you’re able to carry a pregnancy to full term, birth defects are common for babies born to women using estrogen.
  • Dense breast tissue: Women who take estrogen may develop dense breast tissue. Dense tissue makes reading mammograms harder, so detecting breast cancer in its early stages may be difficult.

Doctors typically prescribe estrogen-only medication to women who have had a hysterectomy but still have their ovaries. Women who have not had a hysterectomy usually receive a combination estrogen-progesterone medicine. That’s because estrogen-only treatments increase a woman’s risk of endometrial cancer. The endometrium is the lining of the uterus. Removing the uterus during a hysterectomy removes the risk of endometrial cancer.

What’s been approved by the U.S. Food and Drug Administration?

The U.S. Food and Drug Administration (FDA) approves all estrogen therapy medications. Some hormones are sold as “bio-identical hormones” and are not FDA-approved. They are available without a prescription, and they are not held to the same safety standards as prescription medications. Despite marketing claims, these hormones are also not more natural than the FDA-approved treatments.

The short-term benefits of estrogen therapy can help ease symptoms of several conditions and reduce your risk of other diseases. However, health concerns related to hormone therapy are valid. Before you begin using estrogen, weigh the pros and cons of the treatment with your doctor. Use estrogen at the lowest dosage you can, and use it for as short a time as possible to reduce complications.

While you can’t prevent your body’s natural hormone fluctuations, you can help ease the symptoms of estrogen loss. You can also take measures to prevent some of the complications of estrogen loss.

These lifestyle changes for managing estrogen loss include:

  • Eat a balanced diet. Foods rich in calcium and vitamin D can boost bone health and help prevent osteoporosis.
  • Consider a calcium supplement. Estrogen and calcium need each other to help build bone strength. Eat plenty of calcium-rich foods to give your body natural building blocks for your bones.
  • Lift weights. Strength training is a highly effective way to build bone strength and reduce your risk of osteoporosis. If you’ve never done strength training, work with a certified physical trainer to create a routine.