How Important is Estrogen?

The impact of estrogen levels falling as women enter the menopausal transition is well known. At the International Menopause Society Meeting, the full extent of the impact on the body was discussed. Here are some of the changes that occur throughout the body when estrogen falls:

  • Memory: a decrease in neuronal protection (nerves die off faster in the brain without estrogen) leading to a decrease in cognitive speed and verbal memory of 4.9% over the first 10 years from menopause
  • Mood: increase in depressive symptoms especially in the 2 years before the last period and 2 years after
  • Sleep: Decreased sleep quality (not only due to night sweats) is seen in 80% of women
  • Body Temperature: temperature dysregulation resulting in hot flashes and night sweats along with greater cold intolerance
  • Bone Quality: decreased bone density beginning with the vertebrae in early menopause with greater loss in cortical bone (hip) later in menopause
  • Pain: joint inflammation is increased leading to greater osteoarthritis and reduced subchondral bone repair.
  • Vaginal Dryness: the vaginal lining atrophy leading to dryness in 43% of women by age 61 and 32% of women abstaining from intercourse
  • Bladder Control: 67% of women having a change in bladder routine and 47% having stress incontinence (laughing or coughing and leaking). ¾ of women have some degree of urinary incontinence.
  • Cardiovascular Disease: blood vessels become less reactive and and dilate less. In addition, LDL (bad cholesterol) begins to increase in perimenopause and HDL (good cholesterol) begins to decline. In fact the lower the estrogen level and the higher the FSH, the greater the risk for atherosclerosis (cardiovascular disease).

It is because of these health risks that estrogen supplementation is recommended for many women. Of particular interest is our many patients who suffer from autoimmune diseases where their inflammation is already high, leading to greater cardiovascular risk. Transitioning into menopause can be very difficult as inflammation can be further increased, leading to greater pain and stiffness. The concern many women have is regarding estrogen stimulating breast tissue and when the appropriate time is to start treatment. Our next blog will look at estrogen’s impact on the breast.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

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