Hormone replacement is prescription medication for menopausal and postmenopausal women that generates low levels of estrogen, estrogen and progesterone combined, or progesterone alone.
Estrogen Replacement Therapy (ERT)
generates low levels of estrogen.
Hormone Replacement Therapy (HRT)
generates low levels of both estrogen and progesterone hormones.
According to the American College of Obstetricians and Gynecologists, the average time a woman uses hormone therapy to relieve menopausal symptoms is four years.
Estrogen Replacement Therapy
Estrogen replacement therapy helps alleviate symptoms experienced during and after menopause. Estrogen receptors are similar to open windows which allow the hormone estrogen to flow to specific organs and tissues. If a tissue/organ does not have a specific estrogen receptor, the hormone estrogen will not flow to or affect that particular tissue/organ. Estrogen receptors are located in the brain, breast, heart, blood vessels, uterus, vagina, bladder, liver, bones, skin and gastrointestinal tract. Estrogen replacement therapy can effect any of these estrogen sensitive tissue.
Estrogen replacement is effective with postmenopausal uro-genital symptoms such as vaginal dryness (atrophy), recurrent cystitis (inflammation of the urinary bladder) and incontinence (inability to control urination).
Vaginal estrogen replacement such as vaginal creams, and the vaginal ring help with vaginal dryness, and bladder weakness. However, since very little vaginal estrogen enters the circulation, these products do not help with hot flashes or prevent osteoporosis. Vaginal estrogen cream and the vaginal estrogen ring bring significant relief for women who experience only localized uro-genital menopausal symptoms. For an overview regarding options to relieve menopausal vaginal dryness click here.
In addition to help alleviate menopausal hot flashes and night sweats, estrogen replacement is also a primary therapy for osteoporosis prevention and management. Diminished estrogen production due to menopause causes a decrease in bone repair and renewal. Estrogen replacement in postmenopausal women helps direct bone repair and renewal cells which helps prevent bone loss.
The use of unopposed estrogen replacement (estrogen alone, without progesterone) for postmenopausal women with a uterus is associated with a slight increased risk of endometrial cancer (cancer of the lining of the uterus). However, by taking a progestin for 14 days every six to twelve months along with estrogen replacement, the risk of endometrial cancer is reduced substantially. The hormone progesterone protects the uterus by keeping the cells of the endometrium from overstimulating.
Estrogen replacement is available by prescription in the form of pills, skin patches or skin creams/gels.
An overview regarding the postmenopausal estrogen replacement skin patch is presented a few sections below.
Hormone replacement is highly effective for
the treatment of vasomotor symptoms.
Low dose oral contraceptives
or hormone replacement result
in prompt resolution
of vasomotor symptoms
(hot flashes and night sweats)
within 1 to 2 weeks in 80% of women.
Hormone Replacement Therapy
Hormone replacement therapy combines estrogen and progesterone to alleviate symptoms experienced during perimenopause and menopause. Hormone replacement pills or skin patches are available by prescription.
Talk to Your Health Practitioner:
There are important differences in the effects of various hormone replacement therapies on cholesterol (lipoprotein) metabolism, coagulation (clotting of blood), and fibrinolysis (breakdown of blood clots). When considering hormone replacement therapy it is important to find a healthcare practitioner with formidable knowledge regarding how hormone replacement effects lipoprotein metabolism and other cardiovascular risk factors.
For a more indepth overview regarding the effects of hormone replacement and estrogen replacement on cholesterol metabolism view this topic listing on the site map.
Low Dose Birth Control Pills
Help with Perimenopausal Symptoms.
Low dose birth control pills contain 20 micrograms of ethinyl estradiol and a progestin. In addition to preventing pregnancy, low dose birth control pills are used to treat perimenopausal symptoms such as irregular menstrual periods, heavy menstrual bleeding, anxiety and heart palpitations. Low dose birth control pills provide a consistant level of hormones throughout the month which helps regulate menstrual bleeding and other symptoms of perimenopause.
Low dose birth control pills provide higher levels of hormones than estrogen replacement and hormone replacement. Low dose birth control pills to help regulate menstrual bleeding during perimenopause are most effective when taken on the first day of menstrual bleeding, as opposed to starting the pill on a Sunday. Starting the pill at day one of the menstrual cycle (first day of your period) will prevent an ovarian follicle from developing, which lessens estrogen production, which lessens endometrial thickening, which reduces menstrual bleeding.
How Birth Control Pills Prevent Pregnancy
Follicle stimulating hormone and luteinizing hormone are produced by the pituitary gland which is located at the base of the brain. These two hormones coordinate the development and release of an egg from the ovary. A surge in both of these hormones ordinarily occurs in the middle of a woman's menstrual cycle. Follicle stimulating hormone stimulates ovarian egg production. Luteinizing hormone triggers egg released from the ovary: ovulation. Oral contraceptive pills inhibit the production of both follicle stimulating hormone and luteinizing hormone; as such oral contraceptive pills prevent ovulation.
Another contraceptive mechanism of (combined) birth control pills is to prevent fertilization. Combined oral contraceptives effect cervical secretions. The progestin contained in the birth control pill causes the cervical secretion to thicken which impedes sperm, little or no sperm enter the uterine cavity; as such fertilization cannot occur.
Oral contraceptives do not terminate a pregnancy, they prevent the ability to become pregnant.
Oral contraceptives cause suppression of the hypothalamic-pituitary-ovarian axis, however after seven days without oral contraceptive use, pituitary function and basal estrogen (estradiol) secretion often returns to normal.
Regarding Ovarian Cancer
The results of a study completed by the John Hopkins School of Hygiene and Public Health concluded that when compared with women who never used oral contraceptives, the adjusted risk of ovarian cancer was reduced by forty percent for oral contraceptive users overall, with longer duration of use affording greater protection.
Source:
Americal Journal of Epidemiology
Risk of Ovarian Cancer in Relation to Estrogen and Progestin Dose
and Use Characteristics of Oral Contraceptives.
Vol 152. No 3: 233-241
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Are Their Side Effects
when taking Hormone Replacement Therapy?
Some women experience side effects such as headache, nausea and breast pain when starting estrogen replacement or hormone replacement. These side effects usually diminish as the body adjusts to the hormone level. However, if side effects are consistent or troublesome, your healthcare practitioner can prescribe a lower dose of estrogen replacement a different estrogen replacement or hormone replacement product.
Postmenopausal estrogen replacement in the form of an estrogen patch (transdermal) is available in .025 mg .0375 mg .05 mg .075 mg and 1 mg dosages. These slight variations in hormone dosage allow for a more individualized estrogen replacement. Such dosages of estrogen replacement are considerably lower doses than the prescription hormone replacement products that were available fifteen years ago and result is less side effects.
Hormone replacement therapy is a prescription medication of estrogen and progesterone. Hormone replacement therapy can cause side effects in some women. These side effects are due to either the estrogen or progestin content in the hormone replacement product. If side effects persist, a different dose or different product of hormone replacement can be prescribed.
For example some hormone replacement regimens contain the same amount of estrogen/progesterone throught out the month. This is a monophasic product. Another hormone replacement regimen contains estrogen and then a progestin every third day for three days. Some hormone replacement regimens contain progestins (norethindrone) that have androgenic activity. Other hormone replacement regimens contain progestins (drospirenone, norgestimate) that having anti-androgenic (anti-male hormone) properties.
When hormone replacement therapy is started some women may experience irregular bleeding/spotting. This is common and usually lessens over time. However, it is important to discuss any unusual vaginal bleeding with your health practitioner when you are taking hormone replacement.
Hormone Therapy and Weight Gain
Research confirms that women who take hormone therapy are no more likely to gain weight than women not taking hormone therapy.
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Weight Gain and Menopause
Although influenced by calorie intake to a certain extent, visceral fat (belly fat) accumulation also results from estrogen deficiency due to menopause. During the menopausal transition many women experience an imbalance of sympathetic and parasympathetic activity. Elevated sympathetic activity effects vascular and cardiac contractile function and can result in symptoms such as hot flashes and heart palpitations.
Sympathetic overstimulation and catecholamines can oppose the effects of insulin. The role of insulin is to transport and regulate glucose. Insulin lowers blood sugar by enhancing membrane transport of glucose into muscle cells, white blood cells, and connective tissue. An absence of, insufficiency of, or decreased sensitivity of cells to insulin results in an altered pattern of glucose and fat metabolism. High insulin levels prevent the body from being able to burn or utilize body fat for energy. Fat is then stored which is recognized as weight gain.
Keep in mind, muscle is metabolically active tissue and burns more calories at rest than fat does, as such, when muscle is lost, metabolism slows.
Sources:
Ascorbic Acid Selectively Improves Large Elastic Artery Compliance in Postmenopausal Women
Kerrie L. Moreau; Kathleen M. Gavin; Angela E. Plum; Douglas R. Seals
Hypertension. 2005;45:1107.
Dysregulation of the Autonomic Nervous System Can Be a Link between
Visceral Adiposity and Insulin Resistance
Stina Lindmark, Lars Lönn, Urban Wiklund
Obesity Research 13:717-728 (2005)
Eleveated Sympathetic Activity may Promote insulin Resistance Syndrome by Activating Alpha 1 Adrenergic Receptors on Adipocytes.
McCarty MF/ Pantox Laboratories, San Diego,CA 20109
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What is an Estrogen Patch ?
An estrogen patch is a skin patch about one inch square.The patch contains plant-based estrogen. Estrogen patches are flat, translucent and stay in place when taking a shower or swimming. The patch is replaced once a week or bi weekly.
The patch delivery system delivers estrogen more steadily, maintaining more stable blood levels of estrogen.
Estrogen patches are available in .025 mg .0375 mg .05 mg .075 mg and 1 mg dosages. Such dosages can help individualize estrogen replacement and provide the lowest dose of estrogen needed to treat postmenopausal symptoms.
The estrogen in the patch is absorbed through the skin, and by passes the liver. As such, the patch does not have a negative effect on HDL and LDL cholesterol concentrations, increase the risk of gallbladder disease or increase C-reactive protein. Elevated levels of C-reactive protein, a systemic marker of inflammation, have been shown to predict the presence of endothelial dysfunction, atherosclerosis, and the risk of future cardiovascular events. Additionally, the patch does not increase triglyceride levels (fats in the blood).
The average cost for estrogen only skin patches range from $34 (generic) to $63 per month.