Estrogen is normally produced within the body in both men and women. But for those who are born with a genetic disorder or have an acquired condition that affects the production of hormones, there is a need for them to undergo therapy. And among the types of therapy involves the taking of estrogen pills.
Before deciding on which treatment is best for you, you have to first understand the basic types of therapy. You must first verify if it is safe to take estrogen pills or not. And how will each type of therapy affect your body?
Let us define and explore what Estrogen Replacement Therapy (ERT) is and how it works. With ERT or Estrogen Replacement Therapy, you are given treatment to increase the level of estrogen in the body. This is often given to women who have gone through menopause or those who are experiencing early menopause brought about by cancer treatment or surgical removal of ovaries.
Estrogen replacement therapy aids in relieving menopausal symptoms such as night sweats, vaginal dryness, sleep problems, and most especially, hot flashes. And along with the normal transition of aging, estrogen replacement therapy can also be useful in protecting you from osteoporosis or the thinning of bones. It may also help lower your risk of having breast cancer for postmenopausal women.
Everyone can definitely benefit from estrogen therapy. Especially that there are four major benefits that ERT can provide to its users:
- As stated earlier, it helps mainly to relieve menopausal symptoms.
- Estrogen replacement therapy also helps improve vaginal issues.
- Another condition that can be treated with ERT is ovarian problems.
- Undergoing therapy to replace your estrogen hormone helps in protecting your bones from degeneration.
But along with the advantages that you can gain from estrogen replacement therapy, you may need to consider your options such as taking an estrogen pill. Because there are certain disadvantages and risks that may affect your overall health and wellbeing.
For this reason, we need to have an in-depth understanding of the different types of estrogen therapy, and in what mode they can be administered to our body. Deciding on the perfect type of hormone replacement therapy is dependent on factors such as –
- your current health status
- the symptoms that you manifest
- your personal preference
- And what you need to get from the treatment
Let us get into detail as to what are the specific types of estrogen therapy:
Estrogen Pills – the most common type of ERT where people take in oral medication such as Premarin (conjugated estrogen), Estrace, or Estratab. Seek doctor’s orders for proper dosage and timing of taking in your medication. The usual dosing schedule is once a day and must be taken without food.
ADVANTAGES: Helps in resolving various symptoms of menopause and lower the risk of osteoporosis. It is known as the best type of estrogen therapy, according to studies.
DRAWBACKS: With estrogen, it is more commonly associated with a higher risk for blood clots or stroke. If oral estrogen is combined with another hormone called progestin, the risk of getting breast cancer and heart attack may also increase. Side effects of estrogen pills include headache, nausea, vaginal discharge, and painful or swollen breasts. Since estrogen has an impact on the liver, people with liver damage are advised to utilize a different type of therapy.
Skin Patches – Another type of estrogen replacement therapy. Some examples are Alora, Climara, Estraderm, and Vivelle-Dot. There are also combination patches such as Combipatch and Climara Pro. Menostar is a patch that contains a low dose of estrogen and is used to help lower the risk of osteoporosis. The patch is often worn on the lower stomach area or below the waistline. You may change the patch either once or twice a week depending on the directions for usage.
ADVANTAGES: Aside from the advantages that you get from oral therapy, skin patches offer additional benefits that you may opt into. One advantage is the convenience it offers as you only need to stick it on and leave it for a few days to a week. Patches are a great option for people having liver problems since estrogen directly enters the bloodstream without passing through the liver. Basing on a study in 2007, patches are not linked with blood clot formation in postmenopausal women, unlike estrogen pills.
DRAWBACKS: It is still too early to conclude that patches may be safer than estrogen pills. They may have a slight possibility of causing cancer or stroke. The patch may also irritate the skin upon application. You must not expose estrogen to direct sunlight or high heat as they may release estrogen too quickly making you receive high doses initially and lower doses after. It is recommended that you must not wear your estrogen patch when you are in saunas or tanning beds.
Creams, Gels, and Sprays with Estrogen – Another route for estrogen to enter your body is through gels such as Estrogel and Divigell, creams (Estrasorb), and sprays like Evamist. Similar to the skin patch, estrogen is absorbed through the skin directly into the blood. Although they have a similar entry point and often used once daily, the mode of application varies according to prescription. You may apply Estrogel from the wrist to the shoulder in one arm. Estrasorb goes to the leg area, while Evamist should be on your arm.
ADVANTAGES: Since they are similar to patches that are absorbed through the skin and enter the bloodstream directly, they are safer than estrogen pills. This is a good option for people with cholesterol and liver problems.
DRAWBACKS: The only concern with gels, creams, and sprays is that they have not been well-studied yet. They might be safer the estrogen pills but the experts are not exactly sure for now. Just like the risks posted above, they may put you at risk for cancer or stroke. Another concern that you may experience with this type of therapy is that it can be rubbed off or wash out before it can be fully absorbed. Always make sure that the cream is totally dry before putting on clothes. Always apply after a shower and never let anyone touch you since they may get a dose of estrogen themselves.
Estrogen Vaginal Creams, Rings, and Suppositories – This is recommended for women who have vaginal dryness, itchiness, and a burning or feeling of pain during intercourse. Directly applied to the vaginal area, these vaginal tablets, creams, and insertable rings help relieve the discomfort that women feel down below. The exact timing and dosing vary depending on the product. Vaginal rings are replaced every three months but are often used daily for a few weeks then shift to twice per week. Creams can be used daily for several times per week or as prescribed.
ADVANTAGES: For menopausal symptoms such as dryness, this treatment is more effective as compared to the other forms of therapy. Much like patches, they are more convenient than taking a pill daily. Some suppositories and rings have a low dose that can only affect the area. A great advantage that they possess is the fact that they are able to relieve vaginal symptoms without affecting the entire body to high doses of estrogen.
DRAWBACKS: Vaginal suppositories and rings are only effective for surgically induced menopause. They cannot help with hot flashes and just like the precaution above, more studies needed to be conducted in order to verify their safety levels. They are also considered for risks in having a stroke or cancer. Doctors do not often recommend long term use of vaginal estrogen treatments for women who still have their uterus since they could be at risk for endometrial cancer.
Since there is still a need for further studies about the effectiveness of estrogen pills and the other forms of estrogen replacement therapy, we need to be cautious in deciding which therapy to take. One thing is for certain, whichever form of treatment we follow, we must make sure that it is the one that our physician recommends.
