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Categories > Menopause > Menopausal hormone therapy

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Unlocking the mystery of estrogen

» Estrogen’s many roles

» When estrogen levels drop

» What to do

Is hormone therapy for you?

Whether you should take hormone supplements to relieve menopausal symptoms is an important decision you need to make with your doctor who will consider your individual risk factors and medical history. Each woman is unique, so don’t opt for hormone replacement therapy (HRT) or decide against it based on what your sister or your neighbor is doing.

HRT may help relieve menopausal symptoms such as severe hot flashes and vaginal discomfort—but lifestyle changes can also help with these. Health experts say that HRT is not considered the therapy of choice for disease prevention in healthy older women. In fact, women with a history of breast cancer are advised to avoid HRT.

Your doctor can help you find alternative ways to fight memory loss, bone loss, heart disease and stroke.

You probably know that the female hormone estrogen has regulated your menstrual cycle and ovulation throughout your childbearing years—and likely had a lot to do with those teary episodes of premenstrual stress you may have experienced. But did you know that fluctuating levels of the hormone are thought to contribute to migraine headaches? Or that decreasing estrogen levels are one reason why pelvic muscles weaken and lead to urinary incontinence?

Estrogen, in fact, affects many aspects of your physical and emotional health. Once you reach menopause, your estrogen production drops, which explains why your body goes through so many physical and emotional changes at the time.

Estrogen’s many roles

Before you reach menopause, estrogen—largely produced in the ovaries by the cells surrounding the developing egg follicles—is responsible for the growth and development of your breasts and uterus. Thanks to estrogen, your uterus builds up a new lining in which a fertilized egg can implant itself and which helps nurture a fetus throughout pregnancy. Additionally, estrogen helps:

  • build and strengthen your bones
  • control your cholesterol levels (and fight heart disease)
  • protect your brain
  • maintain your skin’s elasticity
  • keep your vagina and bladder healthy
  • influence your moods and emotions
  • regulate your body temperature

Estrogen isn’t a single hormone but the name given to a group of three hormones produced by a woman’s body. These three forms of estrogen are estradiol, the primary estrogen in your body until menopause, and two weaker forms called estrone and estriol.

Your body begins producing estrogen at menarche (when you start having periods) and curbs (but doesn’t totally stop) production at menopause (the end of periods).

Lifestyle practices can cause estrogen levels to ebb, too. Women who exercise excessively, maintain a very low body weight or suffer from eating disorders may have very low levels of estrogen if the pituitary gland fails to send signals to the ovaries.

As most women reach their mid-30s, the ovaries gradually produce lower levels of estrogen and progesterone. At menopause, which usually occurs between ages 45 and 55, your body makes considerably less estrogen and progesterone and you stop having periods. By the time menopause is complete and you have not menstruated for a year, your body produces significantly less estrogen and progesterone. However, your adrenal glands and fat cells continue to produce some estrogen in your body—about a tenth of the level found in premenopausal women. When levels of estradiol drop, estrone becomes your predominant estrogen.

When estrogen levels drop

As your ovaries gradually stop producing estrogen, changes occur throughout the body. Hot flashes are a common complaint among women during menopause. Signs that you’re having a hot flash include perspiration, a flushed appearance and feelings of warmth spreading through your upper body to your face. Hot flashes that occur at night are often called night sweats and can disrupt sleep. Experts think hot flashes are triggered by changes in brain chemistry resulting from lower levels of estrogen.

Deprived of estrogen, the breasts gradually become less full, muscles lose tone and skin loses elasticity. The uterus and ovaries shrink and the vaginal wall becomes thinner and drier, potentially making intimacy with your partner difficult and even painful. The vagina may also lose some of its protective acidity, increasing your risk for vaginal infection. Tissues supporting the vagina and the pelvic floor muscles become less elastic, which can lead to pelvic prolapse. Estrogen loss is also thought to result in an increased risk of heart attack, cognitive decline and bone loss.

What to do

If you’re suffering from menopausal symptoms, lifestyle measures can help restore your emotional and physical health. Try some of these measures to make your life a little more pleasant:

  • Prevent hot flashes by avoiding hot or spicy foods that can trigger them.
  • Strengthen your pelvic floor muscles by contracting them (ask your doctor about Kegel exercises).
  • Eat well. Aim for a variety of fruits, vegetables and grains and limit fats and sugars.
  • Exercise regularly to strengthen your bones, boost your mood and protect against disease.
  • Get regular medical checkups and screenings.


© 2014 Dowden Health Media