Hormones comprise a delicately balanced system in the body. People with a healthy hormone balance tend to enjoy long, healthy, and productive lives, but long-term hormone imbalances may take their toll on myriad aspects of health. In women, one or more hormone imbalance may contribute to such common problems as:
- Breast health conditions, including cancer
- Heart disease
- Mood disorders
- Ovarian cysts
- Perimenopausal difficulties
- Premenstrual syndrome (PMS)
While the cessation of hormone production with age is a gradual process, the consequences are noticeable, and some women may find hormone supplementation is key to bringing their bodies back into balance.
The Role of Hormones
The body produces hormones primarily in various glands (such as the thyroid, adrenal, and pituitary glands) as well as in other organs and cells. Hormones circulate in the bloodstream, which distributes them to cells throughout the body. Receptors within these cells are sensitive to particular hormones that cause them to react; the more hormones that are present in the cell or the more sensitized the receptors, the more intense the reaction.
Estrogens are some of the most powerful hormones in the human body. Almost all tissues have receptors that make them responsive to estrogens. In women, estrogens help the urinary tract, breasts, skin, blood vessels, and uterus to stay toned and flexible. The total amount of estrogens significantly declines after menopause.
Three Major Estrogen Types
While the human body produces several types of estrogen, those commonly used in estrogen replacement therapy (ERT) include estrone (E1), estradiol (E2), and estriol (E3). In younger women, estrone is converted primarily from estradiol in the liver. After menopause, it is mainly produced in fat cells, where it is derived from testosterone.
Estrogens through a Woman’s Lifetime
Estrogen levels start to rise in girls before menarche, sometimes as early as eight years old, and continue to rise until they start menstruation, around the age of 11 or 12. The hypothalamus signals the pituitary to release hormones, which then signals the ovaries to produce more estrogen. It also starts the development of breasts and the growth of pubic hair and hair under the arms.
Most women begin to experience decline levels of estrogens and progesterone in their early 30s. With this decline, there is also a decrease in fertility. In their early 40s, most women’s hormone levels rapidly drop leading up to menopause; symptoms of these hormonal changes may include:
- Dryer skin
- Brittle hair
- Sparser pubic and underarm hair
- Loss of libido
- Mood swings
Conjugated estrogens, such as Premarin, are the most commonly used form of estrogen replacement therapy (ERT) prescribed by healthcare providers. However, researchers do not know for sure if conjugated estrogens increase cancer risk, so practitioners may advise women against standard estrogen therapy if they have a family history of cancer. Other potential side effects of estrogen include:
- Vaginal bleeding
- High blood pressure
- Fluid retention
- Impaired glucose tolerance
The Bioidentical Estrogens Alternative
Tri-estrogen, or Tri-est, is a combination formula of bioidentical estrone, estradiol, and estriol. Bi-estrogen usually contains only estradiol and estriol (with the understanding that estradiol rapidly converts to estrone, and estrone to estradiol). Patients may take either combination in a daily or cyclical schedule, depending on the recommendation of their practitioner.
Progesterone’s Role in the Female Reproductive System
Progesterone plays an important role in women’s reproductive health. In menstruating women, progesterone is produced by the ovaries. Progesterone supplementation often may be beneficial for women struggling with infertility or symptoms associated with the menstrual cycle, such as PMS or polycystic ovary syndrome (PCOS).
Before ovulation, the levels of progesterone are about 2 to 3 mg per day; when ovulation begins and the corpus luteum develops, the production of progesterone rapidly rises to an average of 22 mg per day. A week or so after ovulation it reaches peak production as high as 30 mg per day. If fertilization does not occur after 10 or 12 days, then the production of progesterone falls dramatically, triggering the shedding of the lining of the uterus and resulting in menstruation.
Progesterone is also an important hormone during pregnancy. It prepares the lining of the uterus for the fertilized ovum and is necessary for the survival and development of the embryo. Progesterone is produced in the placenta (which maintains pregnancy), and is secreted at a level of 300 to 400 mg a day during the third trimester.
In a woman’s menstrual cycle, estrogen and progesterone levels should rise from the time of ovulation until just before menstruation. If progesterone levels are inadequate, only estrogen rises, potentially causing symptoms such as:
- Low blood sugar levels
- Salt and fluid retention
- Blood clotting
- Fibroid or tumor development
- Increased cholesterol and triglyceride levels
- Allergic reactions
- Reduced oxygen levels in the cells
- Retention of copper
- Loss of zinc
- Interference with thyroid hormone function, which may lead to weight gain and feelings of exhaustion