Estrogen Replacement Therapy

Throughout life, our bodies undergo various transformations, including hormonal changes. With these hormonal changes comes menopause, characterized by a host of physical and emotional symptoms. Estrogen Replacement Therapy is a good solution to combat menopausal symptoms.

Estrogen Replacement Therapy (ERT) involves supplementing the body with the estrogen hormone. By restoring hormonal balance, ERT can help mitigate bothersome menopausal symptoms. For the best menopausal hormone therapy results, you should consult with a professional in the field.

At Eastshore Healthcare, we understand the intricacies of hormonal changes and their profound impact on your daily life.

What is Estrogen?

Estrogen is a sex hormone produced in female and male bodies. It plays a vital role in developing and regulating the female body and reproductive systems. Although present, estrogen levels in males are significantly lower than in females.

Types of Estrogen

Overall, there are three types of estrogen, and their levels change throughout life. These estrogen types include:

  • Estrone (E1) – The primary hormone produced by the female body during menopause and post-menopause, which is weaker than estradiol (E2).
  • Estradiol (E2) – The primary hormone produced during the reproductive years.
  • Estriol (E3) – The main hormone made during pregnancy.

While the ovaries are the main source of estrogen, some amount is also produced in fat cells and adrenal glands.

The Role of Estrogen

Estrogen has a wide-ranging impact beyond regulating the menstrual cycle. It affects various body parts, including the urinary tract, reproductive tract, blood vessels, heart, bones, skin, breasts, mucous membranes, brain, and pelvic muscles.

Increased estrogen levels also trigger the development of secondary sexual characteristics such as armpit and pubic hair growth and breast development.

What is Progesterone?

Progesterone is responsible for supporting pregnancy and regulating menstruation. It prepares the endometrium for the attachment and growth of a fertilized egg. If pregnancy doesn’t occur, the endometrium sheds, leading to menstruation. In case of a pregnancy, progesterone levels rise to support it.

What Is Considered Low Estrogen Levels?

Normal estrogen levels typically range between 50 and 170 pb/mL. Levels below 22.4 pg/mL are considered low and can result in various bodily changes.

Estrogen levels gradually decline in females during the perimenopause phase, characterized by changing hormone levels and associated symptoms.

Symptoms of Low Estrogen

Some common menopausal symptoms of low estrogen levels are:

  • Pain during sex because of reduced vaginal lubrication
  • Experiencing more UTIs because of the urethra thinning
  • Absent or irregular periods
  • Mood shifts
  • Night sweats and Hot flashes
  • Tender breasts
  • Headaches or existing migraines worsening
  • Difficulty concentrating
  • Depression
  • Fatigue
  • The skin may appear more wrinkled
  • Abdominal weight gain
  • Difficulty sleeping

Low estrogen can also increase health risks of:

  • Osteoporosis – Estrogen plays a role in maintaining strong and healthy bones by preventing calcium loss. Insufficient calcium can increase the risk of bone loss and fractures in the arms, legs, hips, and spine.
  • Heart disease – Estrogen protects against heart disease by elevating good cholesterol levels. After menopause, the baseline risk of heart attacks increases.

Causes of Low Estrogen

Age is the largest cause of a drop in estrogen levels. Other causes include:

  • Excessive exercising
  • Eating disorders, such as bulimia and anorexia, can deprive the body of nutrients it needs to maintain healthy estrogen levels
  • Genetic conditions like Fragile X and Turner syndrome
  • Autoimmune diseases that attack the ovaries can keep them from producing sufficient estrogen
  • Conditions affecting the pituitary gland
  • Chronic kidney disease

Estrogen Replacement Therapy

After getting diagnosed with low estrogen levels, you should get treatment. Estrogen replacement therapy is a great treatment to improve your estrogen levels.

Types of Estrogen Treatment

The ideal type of hormonal replacement therapy depends on your symptoms, personal preference, goals, and overall health. Below are the options available:


Estrogen pills can be taken daily. Women without a uterus can use estrogen alone, while those with a uterus can opt for combination pills containing progestin and estrogen.

Skin Patches

A patch is placed on the skin at the buttocks or abdomen for 3 to 7 days. It’s left on 24/7, even when bathing and swimming. It can be an estrogen patch or a combination of progestin and estrogen delivered to the bloodstream via the skin.

Topical Gels, Creams and Sprays

Like patches, these hormone replacement treatments are absorbed through the skin and are applied once daily. Application areas may vary, with some applied to the arm and others to the legs. When using estrogen topically, avoid skin-to-skin contact to prevent unintentional exposure to the hormone.

Vaginal Suppositories, Creams, and Rings

Vaginal inserts are designed for women experiencing vaginal itchiness, dryness, burning, pain during sex, and other vaginal discomfort. The dosing schedule varies depending on the specific product.

Generally, it involves replacing rings every three months and using vaginal estrogen tablets daily for several weeks, followed by a reduced frequency of twice a week.

What Are the Risks of Estrogen Replacement Therapy?

Estrogen replacement therapy carries certain risks, which may include:

  • Blood clots
  • Stroke
  • Breast cancer
  • Heart disease

The risk level depends on the patient’s age. Women aged 60 and above, or those who have been in menopause for a decade or more, face a higher risk of these conditions. However, if therapy begins within ten years of menopause onset or before turning 60, the benefits often outweigh the risks.

The risk experienced also depends on whether estrogen was delivered alone or combination therapies of estrogen and progestin.

How Long Does Estrogen Replacement Therapy Take to Work?

The therapy takes a couple of weeks before you start feeling its effects. However, it can take up to three months to experience the full benefits. If you do not feel the benefits of hormone replacement therapies after four or six months, you should consult with Eastshore Healthcare to try a different delivery method.

How Long Can You Be on Estrogen Replacement Therapy?

For extreme situations, a patient may be on any type of hormone therapy for five years when their symptoms have stabilized. For individuals closer to their menopausal age, menopausal hormone therapy will start at the lowest dose to manage their symptoms and avoid potential risks.

Contact Eastshore Healthcare

Estrogen therapy will alleviate the menopausal symptoms you’re experiencing due to low levels of estrogen. It will significantly improve your quality of life, depending on the extent of your symptoms. However, Menopausal hormone therapy does come with some potential risks. Because of this, you need to work with an experienced medical professional at East Shore Healthcare.

At Eastshore Healthcare, we’ve had the privilege of working with many patients who have had remarkable success. We understand the health benefits of hormone replacement therapy. Contact us to schedule your complimentary consultation to see if Hormone replacement therapy is right for you!