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Menopause and Estrogen


Menopause is the permanent end of menstruation and fertility, defined as occurring 12 months after a woman’s last menstrual cycle. Menopause is a natural biological process. The physical and emotional symptoms of menopause often range in severity, most of which can be successfully treated.  Hormonal changes cause the physical symptoms of menopause, however women may often experience emotional symptoms also. Menopause doesn’t mean our quality of life has ended — we still have almost half of our life to live. Menopause does not have to affect our femininity or sexuality. Many women may find it liberating to stop worrying about periods.

Even though menopause is not considered an illness, we encourage women to research bio identical hormone replacement options for any symptoms of menopause. Today treatment options range from lifestyle adjustments to hormone replacement therapy.  Technically, you don’t become menopausal until one year from your final menstrual period. In the United States, this occurs on average at by age 51.

The signs and symptoms of menopause, often appear before the one-year anniversary of your final period. Menopausal symptoms may include the following:

  • Irregular periods

  • Vaginal dryness

  • Hot flashes

  • Sleep disturbances

  • Mood swings

  • Increased abdominal fat

  • Thinning hair

  • Loss of breast fullness

  • Loss of skin elasticity

The signs and symptoms of menopause are usually enough to for most women to determine they have begun going through the menopausal transition.  We encourage women to have a simple blood test done which will check levels of follicle-stimulating hormone (FSH) and estrogen (estradiol).  As menopause occurs, FSH levels increase and estradiol levels decrease. Your doctor may also recommend a blood test to determine your level of thyroid-stimulating hormone, because hypothyroidism can cause symptoms similar to those of menopause.


Menopause itself requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and on preventing or lessening chronic conditions that may occur with aging.  Estrogen, Progesterone and Testosterone replacement therapy remains the most effective treatment option for relieving menopausal symptoms. Depending on lab results, and  personal and family medical history, a bio identical hormone replacement doctor may be the expert for managing your menopausal symptoms.


Estrogen is produced in the ovaries and adrenal glands. There are three types of estrogen found in a female’s body, estrone, estradiol and estriol.  The levels of all of these hormones fall dramatically at the onset of menopause.  Symptoms of menopause include hot flashes, insomnia, vaginal dryness, bladder problems, difficulty concentrating and anxiety.  With time, many of these symptoms may diminish.  Unfortunately, disease processes such as cardiovascular disease, stroke, osteoporosis, and Alzheimer’s  increase in the absence of estrogen.

The rapid bone loss after menopause has been attributed to the decline in the production of estrogen, which is essential for bone growth.  In addition the loss of estrogen results in the development of heart disease, which is the number one killer of both men and women.  Postmenopausal women on estrogen have a 70% decrease in mortality from heart disease.  Estrogen has also been shown to lower total blood cholesterol and raises HDL, the good cholesterol.  Not only does estrogen protect vessels of the heart, it also protects vessels of the brain and may protect against Alzheimer’s disease.

Estrogen can protect women against many of the diseases of aging. Post menopausal women on estrogen typically feel better and stay healthier.  Unfortunately, most of the estrogen prescribed today is still in the form of a synthetic estrogen.  synthetic estrogen is not natural to the human body.  The healthy trend these days is to avoid the synthetic estrogens and prescribe natural bioidentical estrogen.  Human receptor sites were designed to accept natural estrogen and not a synthetic.  A recent article in the New England Journal of Medicine proved by meta analysis that long term use of synthetic estrogen increases the formation of breast cancer.  In recent research trials it has been shown that natural estrogen, when taken in conjunction with natural progesterone, protects against breast cancer similar to the way it protects against uterine cancer. 

Benefits of Estrogen Replacement

  • May protect against heart disease

  • May protect against stroke

  • May decrease cholesterol

  • May prevent and or lower incidence of Alzheimer’s disease

  • May improve memory

  • May decrease symptoms of menopause

  • May prevent osteoporosis by slowing down the process

  • May improve vaginal dryness

  • May eliminate bladder problems

For more information regarding menopause and estrogen replacement, contact our office to schedule a consultation with Heidi Efinger NP-C.

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