Understanding the Role of Estrogen and Menopause

Wednesday 14 April 2021
Dr..Jubil Tom

Medically reviewed by

Dr. Jubil Tom, MD

on 1 June 2021

Table of Contents

I. The Process of Menopause

II. Symptoms of Low Estrogen

III. Diagnosing Menopausal Conditions

IV. Estrogen Replacement Therapy

V. Treating Symptoms of Menopause

The Process of Menopause

Menopause is a natural biological process that marks the end of a woman’s menstrual cycle. The average age of menopause in the U.S. is 51, but menopause can happen earlier or later. [1] Menopause is diagnosed if you have gone one year without a menstrual period. Your reproductive hormones naturally decline as you grow older. Around the age of 40, your ovaries start to produce less estrogen and progesterone hormones. These hormones regulate menstruation, and with their decline comes a decline in fertility. 

a group of older women on a scenic hike

As you approach menopause, you may experience variations in your menstrual periods. They can become lighter or heavier, shorter or longer, and vary in frequency until your ovaries stop releasing eggs altogether. The process of menopause can be induced earlier if you undergo an oophorectomy (surgical removal of the ovaries). Chemotherapy and radiation therapy can also induce menopause.

Although rare, one percent of women experience premature menopause due to low levels of reproductive hormone production (primary ovarian insufficiency). This condition can result from genetic factors or autoimmune diseases and is usually treated with estrogen replacement therapy. [1]

During menopause, you may also be at an increased risk of complications related to low estrogen and progesterone levels. To treat symptoms of menopause, your doctor may prescribe Climara (estradiol) or Estraderm (estradiol). Climara patches and Estraderm contain estradiol, a form of estrogen. Your doctor may also prescribe progesterone capsules to supplement low progesterone levels. Read on to learn about menopause symptoms, potential complications, estrogen replacement therapy, and treatment options. 

Symptoms of Low Estrogen

The low levels of estrogen that accompany menopause can cause mild to severe symptoms. Vaginal dryness can often occur due to low estrogen. This is an uncomfortable condition characterized by soreness, recurring urinary tract infections (UTIs), itching, and pain during sex. [2]

Hot flashes may also occur due to decreased estrogen levels. A hot flash occurs when you feel an intense warmth not caused by any external sources. They can occur suddenly or gradually over several minutes. Hot flashes may be accompanied by sweating, redness, and an increased heartbeat. After a hot flash recedes, you may feel cold. Menopause can trigger hot flashes to appear many times a day. Around 75 percent of women going through menopause experience hot flashes. [3] [4]

a distressed woman

One of the more severe complications of low estrogen is osteoporosis. This is a condition that weakens the bones, causing them to lose strength and bone density. Menopause is not the only risk factor for osteoporosis. You may be able to reduce your risk of developing this complication with good nutrition, exercise, and not smoking. [5]

Menopause can cause psychological symptoms in addition to physical symptoms. Low levels of estrogen commonly lead to mood changes, anxiety, memory problems, and depression. These psychological mood conditions actually stem from a very physical root. When your hormones fluctuate, the chemistry in your brain is affected. [6] If you experience sudden emotional changes, let a close partner or family member understand. When these hormonal fluctuations subside, your mood conditions will likely go away as well. However, you can always talk to your doctor about ways to combat mood swings during menopause. 

Diagnosing Menopausal Conditions

If you do not display any symptoms, menopause is diagnosed after 12 months of not having a menstrual cycle. Most of the time, women will know they have started the transition into menopause once they start having hot flashes or irregular periods, so tests aren’t always needed. However, your doctor may conduct tests to check estrogen levels to rule out an underactive thyroid. There are over-the-counter home test kits that check follicle-stimulating hormone (FSH), estrogen, and thyroid-stimulating hormone (TSH) in your urine. These levels fluctuate during menstrual cycles, so home tests may not be definitive. [7] 

Estrogen Replacement Therapy 

If you experience one or more of the above conditions related to low estrogen, your doctor will likely suggest estrogen replacement therapy (ERT) to help relieve symptoms. ERT is considered the most effective treatment for menopause symptoms. Estrogen pills can typically be taken daily, and patches like Climara (estradiol) and Estraderm (estradiol) may be worn for up to a week. Boosting your estrogen levels can also be done through vaginal creams or tablets or with topical gels that are absorbed through the skin. Combination therapies may also be prescribed, which involve combined doses of estrogen and progesterone. [8] 

a woman practicing yoga

Treating Symptoms of Menopause

For mild menopause symptoms, you may be able to rely on home remedies for relief. Many women who have gone through hot flashes say that dressing in layers can help. You may also be able to avoid hot flashes by avoiding triggers such as hot beverages, caffeine, spicy foods, and stress. Getting enough sleep, eating a balanced diet, and exercising regularly can protect you from nutritional deficiencies and osteoporosis. [7]

Consult your doctor before starting any type of estrogen replacement treatment. Depending on the severity of your symptoms, your doctor can adjust your treatment to steer clear of risks and provide you the most benefits. Talk to your doctor if you have concerns about any menopause-related conditions, and ask your doctor if estrogen replacement therapy is right for you. 

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.