Menopause is a natural stage of life, but many women experience symptoms such as hot flashes, night sweats, mood swings, and abdominal discomfort due to declining estrogen levels. Estrogen therapy can relieve symptoms and support bone health, but the treatment is not without risks. Who can actually benefit from it, and when do the benefits outweigh the potential disadvantages?
What is estrogen therapy?
Estrogen treatment aims to supply the body with the estrogen that it no longer produces in sufficient quantities. The treatment can be administered as tablets, patches, gel, or spray and can be either systemic, affecting the entire body, or local, where the treatment primarily acts in the vagina and urinary tract.
Women who still have their uterus will usually be given a combination of estrogen and progestogen, as this protects the lining of the uterus from overgrowth. Women who have had their uterus removed can usually be treated with estrogen alone. The choice of preparation, dose, and form of administration depends on the individual woman's symptoms, health, age, and preferences.
Read also: 5 signs that you have reached menopause.
Estrogen decline and the body's adaptation
For some women, the hormonal changes during menopause are experienced almost like a withdrawal-like state. For many years, the body has been adapted to a relatively stable level of estrogen, which has influenced a wide range of physiological processes, including temperature regulation, sleep, mood, pain perception, and mucous membrane function.
When estrogen levels drop significantly over a relatively short period of time, the body may have difficulty adjusting to the new hormonal balance. This can trigger both physical and psychological symptoms, which for some women become so pronounced that they affect daily functioning, work capacity, and quality of life.
This condition is not a disease in the classic sense, but in certain cases, estrogen supplements may be relevant as a way to temporarily alleviate the symptoms. The purpose of treatment is not to stop the natural aging process, but to relieve discomfort and support the body in the transition to a new hormonal state.
Benefits of estrogen therapy
- Effective relief from hot flashes and night sweats
Estrogen therapy is the most effective treatment for hot flashes and night sweats. Many women experience a significant reduction in symptoms, which often leads to better sleep, increased energy, and improved daily functioning.
- Improvement of vaginal and urinary tract symptoms
Local estrogen treatment has been shown to be effective against vaginal dryness, burning, and pain during intercourse. The treatment can also reduce the frequency of urinary tract infections and improve quality of life in women with pelvic symptoms.
- Beneficial effect on bone health
Estrogen inhibits bone breakdown and can help maintain bone density. In women at increased risk of osteoporosis, treatment can reduce the risk of bone fractures, especially when given early in menopause.
Disadvantages and risks of estrogen treatment
- Increased risk of blood clots and circulatory complications
Systemic estrogen therapy may cause a slight increase in the risk of blood clots and stroke, especially in older women and in women who begin treatment several years after menopause.
- Possible increased risk of breast cancer with long-term treatment
Long-term combined treatment with estrogen and progestogen is associated with an increased risk of breast cancer. The risk depends, among other things, on the duration of treatment, dose, type of preparation, and individual risk factors.
- Side effects during the initial phase
Some women experience side effects such as breast tenderness, nausea, headaches, or irregular bleeding, especially at the beginning of treatment. The symptoms often subside over time, but require follow-up.
My medical assessment
I do not see estrogen therapy as a standard solution for all women going through menopause, but as an important and well-documented treatment tool for women with moderate to severe symptoms that affect their quality of life.
As a doctor, I emphasize that the decision to undergo estrogen treatment should always be made on the basis of an individual and holistic assessment. This involves reviewing symptoms, age, time since last menstruation, and overall health. For many women, correctly dosed and carefully considered estrogen treatment can provide significant symptom relief and improved quality of life during a phase of life that can be both physically and mentally stressful for some. The treatment should be continuously evaluated and adjusted so that it remains relevant and appropriate for the individual.
