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What is Estrogen Replacement Therapy?

Madeleine A.
Madeleine A.

Estrogen replacement therapy refers to the replacement of the hormone estrogen when the ovaries no longer are able to produce it. While providing relief from menopausal symptoms such as hot flashes, night sweats, and vaginal dryness, estrogen replacement therapy may also include the use of hormones called progestins. When a woman goes through menopause, either natural or surgical, her ovaries stop producing adequate amounts of estrogen. Surgical menopause refers to the removal of the ovaries.

Generally, estrogen replacement therapy no longer is recommended for long-term use. Women taking estrogen replacement therapy for short-term relief of symptoms from menopause, however, may garner some protection from osteoporosis, heart disease, and colorectal cancer. Estrogen replacement therapy may prevent bone loss that could occur after menopause, thereby decreasing the risk of bone fracture.

Tofu is a natural soy product that contains plant estrogens.
Tofu is a natural soy product that contains plant estrogens.

Typical mild side effects that can occur during treatment with estrogen replacement therapy include, but are not limited to, headaches, nausea, mild vaginal bleeding, and breast pain. More ominous estrogen replacement therapy side effects may include blood clots, uterine cancer, breast cancer, heart disease, and stroke. Certain gynecological cancers can be fueled by estrogen, such as breast cancer and uterine cancer.

Researchers recommend eating whole soy products, rather than supplements, to mitigate hot flashes.
Researchers recommend eating whole soy products, rather than supplements, to mitigate hot flashes.

Usually, estrogen replacement therapy is prescribed as a combination of hormones that include not only estrogen, but progesterone. Long-term estrogen use without progesterone may increase the risk of endometrial or uterine cancer. Progesterone typically counteracts the risk of uterine cancer. Hormone replacement therapy may be delivered via pills, patches, creams, or vaginal preparations. Generally, pills and patches are reserved to ease hot flashes, and vaginal preparations are used to treat vaginal dryness.

Mild vaginal bleeding is a typical side effect of estrogen replacement therapy.
Mild vaginal bleeding is a typical side effect of estrogen replacement therapy.

Women who are receiving hormone replacement therapy usually undergo a physical examination every year. During the physical examination, the doctor may perform a breast exam or order a mammogram. Estrogen typically causes breast tissue to become denser, which may cause breast lumpiness. Lumpy or cystic breasts may make it more difficult for a woman to examine her breasts; therefore, she should receive regular mammograms. A pap smear and pelvic examination may also be performed to check for abnormalities.

Natural alternatives to estrogen replacement may include the incorporation of soy products into the diet. Soy contains isoflavones, or plant estrogens, that mimic the effects of estrogen in the human body. Natural soy products include soy milk, tofu, and soybeans. Although soy products may help alleviate some menopausal symptoms in certain patients, they may not be effective for all patients.

Although hormone replacement therapy carries risks and side effects, it typically is very effective in relieving severe menopausal symptoms that may be disruptive to the life of a patient. Typically, hormonal therapy temporarily is used only until a woman is past menopause. During treatment, the physician may change or experiment with different estrogen treatments to find the most effective method.

Discussion Comments

burcinc

@donasmrs-- Actually, I think estrogen replacement therapy is given more often to women in surgical menopause rather than natural menopause. Some women have their ovaries removed at a very young age for various reasons and they experience more problems then older women who enter menopause naturally.

This therapy is also used for women with an estrogen deficiency and who are unable to get pregnant. So it's not exclusively for menopausal women.

fify

@donasmrs-- Tumors or growths in the breasts can have estrogen receptors. So estrogen encourages these tumors to grow and sometimes turn cancerous. That's why women with breast cancer in their family or a growth in their breast should not receive estrogen replacement therapy. And those that do must receive a mammogram periodically like the article said.

Estrogen replacement therapy resolves menopause symptoms that are really severe for some women. But it's not meant to be a long-term treatment. Most doctors put their patients on this therapy for a temporary period, to relieve their menopausal issues.

I think it's important for women to learn about all of the possible risks associated with this therapy. Your doctor should have talked to you about this.

donasmrs

How does estrogen replacement therapy lead to cancer? And why do doctors recommend this therapy to menopausal women if there is a risk of cancer?

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    • Tofu is a natural soy product that contains plant estrogens.
      By: Jiri Hera
      Tofu is a natural soy product that contains plant estrogens.
    • Researchers recommend eating whole soy products, rather than supplements, to mitigate hot flashes.
      By: roboriginal
      Researchers recommend eating whole soy products, rather than supplements, to mitigate hot flashes.
    • Mild vaginal bleeding is a typical side effect of estrogen replacement therapy.
      By: Marin Conic
      Mild vaginal bleeding is a typical side effect of estrogen replacement therapy.