Estrogen is the most common controversial hormone in the human body. What is it? Who should have it? Whys should one take it? When should one start it? What are the pros and cons to taking it? These are the most common questions asked or should be addressed when counseling a woman across a gynecological table.
Estrogen is one of the two hormones produced by the ovary, the other being the progesterone. It reaches its peak of production during the reproductive life of a woman. It is one of the most important hormones of the human body. Its fluctuation from normal level may mean whether a woman is fertile or sterile. The perimenopausal (before menopause), menopausal and postmenopaus woman are the best choices for Estrogen replacement therapy (ERT). The reason for this is it has been proven by studies that at the age of 35 the ovarian function starts waning hence ERT could be safely initiated anytime on or after the age of 35 and even beyond the perimenopausal and menopausal period according to the compliance of the patient and discretion of the doctor. The disadvantage of taking ERT can be summarized in one sentence – “FEAR OF CANCER.” Estrogen has receptor organs primarily in the uterus and breasts. Consequently, cancer of the uterus and breast are most commonly feared sites discussed during counseling prior to starting ERT. Studies, however, have failed to establish the direct relationship of ERT as the cause of cancer of the uterus and or breasts. The only positive link is it could worsen pre-existing and or unsuspected breast cancer. Studies also show that it takes prolonged use of unopposed ERT to cause superficial cancer of the lining of the uterus, seldom the bad penetrating type. Therefore, it is of utmost importance when a woman still has her uterus to take progesterone in combination with estrogen to prevent the thickening effect of the latter on the uterine lining. It behooves the doctor to investigate any unexplained bleeding with a diagnostic D&C before advising ERT. Even after a hysterectomy for early cancer of the uterus it has been advocated by some gynecologists that it is all right to give estrogen in low doses two or more years following surgery in selected cases. So that with regular and diligent monitoring by the primary care physician it is quite safe to be on ERT.
The advantages of taking ERT far outweighs the disadvantages. Here are the most proven advantages to its use:
Prevention of Osteoporosis (Softening of the bones with aging). Estrogen helps in hardening the bones by enhancing the absorption of calcium.
Prevention of Coronary Disease through its effect on rapid metabolism.
Alleviates menopausal women from, and staves off their, developing menopausal symptoms like cold sweating, body weakness, irritability, fainting, paresthesia, loss of libido, etc.
Gives a woman more pep, energy and vitality. In short, a general sense of well-being.
Finally, from a recent study from the University of Southern California, it appears that ERT may lower the risk of developing Alzheimer’s’ Disease. Bruce McEwen, a Rockefeller University neurologist claims that Estrogen coaxes brain cells into forming new connections with one another, thus allowing the cells to transmit messages back and forth. ERT can also activate genes in the brain cells prodding the nerve cells to generate chemicals to send more impulses.