Estrogen Replacement Therapy

Estrogen Replacement Therap

What is estrogen replacement therapy?

Estrogen is the female sex hormone, and it plays a significant role in the menstrual cycle and reproduction. Estrogen replacement therapy (ERT) is a medical procedure wherein the hormone is externally administered in women to elevate the estrogen levels inside the body.

Why is estrogen replacement therapy advised?

Estrogen replacement therapy is advised explicitly to post-menopausal women who are devoid of the uterus.

The therapy controls vasomotor symptoms like night sweats, hot flushes, irritability, fatigue, vaginal dryness, stress incontinence, dizziness, etc. usually prominent during perimenopause and menopause.

One of the primary reasons behind doctors advising estrogen replacement therapy is to prevent osteoporosis in menopausal women.

Estrogen replacement therapy is also applicable to women of any age group who have undergone ovary removal and have become naturally prone to bone loss.

How is estrogen replacement therapy done?

Estrogen replacement therapy can be carried out in various ways.

Point to Note: The doctor gives progestin and estrogen together for women with a uterus because estrogen alone, leads to the overgrowth of the uterine lining, making one susceptible to uterine cancer. 

Estrogen Pills: 

The dosage of the pills could be every day or 25 days each month. Women who had undergone hysterectomy can take estrogen alone, while others take a combination of estrogen and progestin pill.

Cyclic Method: 

In this method, estrogen (every day or daily for 25 days of the month) and progestin (10-14 days of the month) are taken separately.

Transdermal patch method:

A patch is applied to the abdomen's skin or buttocks for three and a half days or seven days, which is then discarded, and a new one is applied. The patch can be left at all times but cannot be exposed to direct sunlight. You can wear on while swimming or bathing but avoid while on the hot tub, sauna, or on the tanning bed. In this technique, the estrogen or estrogen-progestin combination is administered through the skin directly into the bloodstream.

Other methods: 

Estrogen cream, vaginal ring, intramuscular injections, subcutaneous implantation, and transdermal gels are used mainly to heal vaginal dryness. These methods also deliver estrogen into the bloodstream without accessing the liver.

Limitations for estrogen replacement therapy

Who should avoid it?

• Estrogen replacement therapy is strongly not allowed for
  Pregnant women

• Women with phospholipid antibodies
  

• Men/women with a history of heart stroke or high blood pressure
  

• Women with abnormal vaginal bleeding
  

• Men/women with liver problems and diseases
  

• Women with ovarian, uterine and breast cancer
  

• Men/women with blood clots
  

• Smokers
  

• Women with deep vein thrombosis

Side Effects of estrogen replacement therapy 

No doubt, there are side effects of the pills and other methods. They include nausea, dizziness, weight gain, fluid retention, bloating, breast tenderness, cramping, indigestion, vaginal discharge, etc. However, the symptoms disappear within a few days and with a change in lifestyle as suggested by doctors.

Risks for estrogen replacement therapy 

Risks and health hazards of undergoing estrogen replacement therapy depend on your age and health problems. Some common risks include an increase in chances of stroke, ovarian cancer, blood clots, gall stones, breast cancer, and dementia.

Advantages of estrogen replacement therapy

The advantages outweigh the risks of estrogen replacement therapy if you choose the appropriate doctor for the treatment.

It has been successful in many women globally, and the results are:

• Fractures in hips, wrist, and spine decrease by 50–70%, i.e., prevention of osteoporosis.
  

• The therapy reduces all the post-menopausal symptoms as explained above.
  

• Spinal bone density increases by ~5% within three years of the onset of menopause.
  

• Estrogen replacement therapy decreases the risk of heart disease when initiated early in post-menopausal years.

We suggest you consult the right doctor and explain your health conditions to him/her before he/she prescribes the therapy. Your health condition will considerably improve with a year only if you are taking the dose correctly.