Estrogen--Not the Wicked Stepsister of Hormones
Estrogen has been given a bad rap by the media and by proponents of progesterone cream, many of whom claim the majority of a woman's hormonal problems can be alleviated by the use of bioidentical progesterone. Bioidentical progesterone IS beneficial and DOES alleviate many problems, However, just as being estrogen dominant is not conducive to good health, being progesterone dominant and/or estrogen deficient isn't going to make for a happy camper, either.
I think estrogen has been vilified so much because few make the distinction between bioidentical estrogen and conjugated estrogen which is made from the urine of pregnant horses. Ever think the brand name Premarin sounded odd? Break it down...PREgant MARe urINe. Premarin isn't good for you, or me, or anyone. It's a Frankenhormone and "kind of" fitting into one's estrogen receptor sites is like forcing a big tire onto a Mazda Miata. It'll run...but not well. Artificial hormones are much more likely to cause blood clots, high blood pressure, fluid retention, etc. than natural ones. The key is knowing how much of each to take and when.
There are 3 forms of estrogen--estradiol, estrone, and estriol. My naturopath gave me bioidentical estradiol when my mid-luteal phase levels came back postmenopausal. I was only 36 when I had them tested. Whether my low estrogen is a product of genetics or years on the BCP (sometimes one's ovaries cannot resume natural hormone production on their own after years on oral contraception, which, after all, does the job for them) or stress is a matter of debate right now.
When I first tried the estradiol cream, I experienced what I refer to as a "high." I've never used drugs in my life; I have never been drunk. But this hormone hit my brain hard and fast. I felt GREAT...for about ten minutes. Then I crashed and felt tremendous anxiety and irritability for the next few hours. I attribute this to a few things. Number one, if you're low in several hormones, anything introduced is going to be a shock to the system. Number two, I was started on too high a dosage. Number 3, a high dose of estrogen all at once means a high dose of serotonin at once in an organ that has been depleted for God knows how long. Any addict will tell you that whenever there is a high, there is an inevitable coming down from it, which they say is uncomfortable (to put it mildly). My advice for hormone supplementation is start low and go slow. I gave up the estrogen for a long while, afraid of the mood altering side effects returning. I finally felt so awful, I tried a pinpoint amount of cream (about .6 mg) and felt a bit better. I'm up to about 2 mg a day right now. My midluteal estrogen level should be around 156 pmol minimum. Mine, at last check, was 60 pmol. That is highly deficient. At day one of your menstrual cycle, estradiol should be about 80-90 pmol. Anything below that is not conducive to feeling well.
Necessity of Estrogen
Having adequate levels of estrogen--actually, I prefer optimal levels...why settle for adequate?--means several areas of your body will benefit. Estrogen maintains skin elasticity and plumpness, creating a more youthful appearance. Many oral surgeons will tell you that you should NOT have surgery done in the last week of your menstrual cycle. Why? Falling estrogen levels. Estrogen increases blood circulation and facilitates clotting. Tooth extraction healing, for example, is reliant upon good clotting lest you wind up with a painful condition called "dry socket." Estrogen given to men mitigates the effects of DHT and helps with acne and male pattern baldness.
Premenopausal and menopausal women often experience vaginal dryness, hot flashes, and in somnia. Estrogen can help with these. Even in young women with low ovarian estradiol output, supplementation can be a boon. Vaginal health in general is aided by estrogen. If you've read my hub on vulvodynia and its devastating effects, you know that estrogen is vital to treating thinning, irritated, inflamed vulvar tissue.
Estrogen helps digestion. Tipping the scales in favor of progesterone (see my hub on Heartburn and GERD) loosens the LES (lower esophageal sphincter) causing stomach acid to flow backwards from the stomach into the esophagus. A more balanced hormonal picture can correct this. Likewise, estrogen helps the body absorb nutrients, most notably calcium. This is why women after menopause may develop osteoporosis. Without adequate estrogen to increase bone density, bones may become brittle and weak.
Estrogen improves insulin sensitivity. Progesterone causes blood sugar levels to rise, creating slight insulin resistance. It is important for these two hormones to be in balance to ensure proper glucose metabolism. If you've ever experienced PMS and felt ravenous hunger, this is because progesterone dominates in the second half of the menstrual cycle, causing your body to become slightly more insulin resistant. Your pancreas responds by pumping out more insulin to usher glucose into your cells. Higher than normal levels of insulin cause hunger and weight gain. A better overall hormonal cascade and balanced levels of estrogen and progesterone can combat this.
My hub on OCD also mentions estrogen as a powerful antidepressant. Estrogen inhibits MAO (monoamine oxidase) which breaks down serotonin and norepinephrine. Without these neurotransmitters, one is predisposed to anxiety, depression, and a host of other mental illnesses.Low estrogen means low serotonin and low serotonin can lead to depression, anxiety, paranoia, etc. Low estrogen also means more body aches and pains, as serotonin not only influences mood, but also joint health.
While estradiol is the most potent form of the 3 estrogens, it seems to be the most beneficial. One can also supplement with the weaker estriol, but the effects will be milder and perhaps not as quickly noticed. I understand that reports of estrogen causing breast cancer cell proliferation are a very real concern, however, in my case the benefits outweighed the risks, and they may in yours as well. If you're feeling subpar and think you might benefit from bioidentical hormone supplementation, ask your doctor for a hormone panel of bloodwork. As I was, you might be surprised at the results, and what a little estrogen can do for you.
I wish you good luck and good health.