Interestingly, women are often told that they need more estrogen
when they go through menopause. When a woman in an industrial- ized nation goes through menopause ovarian production of estrogen falls by an estimated forty percent. With estrogen levels double nor- mal in these women, despite this fall, there is still a lot of estrogen around to promote tissue growth, water retention and fat storage. Es- trogen continues to be produced by the adrenal glands and fat cells to maintain those functions of estrogen not related to reproduction, namely bone formation, insulin balance, and fat and protein metabo- lism.
Progesterone is not produced when a woman stops ovulating as occurs in menopause. Some progesterone is produced by the adrenal glands but levels can actually fall much greater than estrogen levels when a woman goes through menopause. Clearly this scenario can greatly upset the delicate balance that needs to exist between proges- terone and estrogen for optimal hormonal health. Hormone imbal- ance is responsible for poor sleep, low energy, diminished sexual desire and problems managing stress appropriately. Stress, itself, is a major contributor to hormone imbalance. We place tremendous demands on our bodies - more than we were de- signed to handle without support. When the body is under physical or emotional stress its response is to produce stress hormones, one of which is cortisol. Over time this repeated stress taxes the adrenal glands and they fatigue. Because cortisol requires progesterone for its production, progesterone may be shunted toward production of corti- sol resulting in less progesterone available to counteract the negative effects of estrogen. Estrogen dominance again results.
Treatment for Menopause
Over the years attempts have been made to address and treat the symptoms associated with menopause. In the early 1900’s aging female nobility in China were given dried young female’s urine to eat. Containing the metabolites of progesterone, estrogen and testoster- one, the dried urine was found to help with menopausal symptoms. In the 1940’s the pharmaceutical company Wyeth decided to pro- duce a drug called Premarin, a conjugated estrogen made from preg- nant mare’s urine to help with menopausal symptoms. This drug was an effective therapy for many women; however, in the 1970’s a causal relationship was found between estrogen and endometrial cancer. In response, Wyeth developed Provera - a synthetic progestin, not equal to progesterone in many of its effects except its ability to protect the uterus from unopposed estrogen. For thirty years these synthetic hor- mones were peddled to unsuspecting menopausal women as the only way to eliminate menopausal symptoms and prevent cancer, heart dis-ease and osteoporosis. In the 1990’s Wyeth partnered with the National Institute of
Health, a government agency, to conduct a long term study of the effects of Premarin and Provera in postmenopausal women. The aim of the study was to prove that women needed hormone replacement therapy to protect them from cancer, heart attack, stroke and bone loss. This study was called the Women’s Health Initiative and was conducted across the United States in multiple academic centers. In 2002 the study was halted because data actually showed an increased incidence of heart attack, stroke and breast cancer in pa- tients taking these hormones. Millions of women stopped taking these hormones after the NIH came out with a public statement declar- ing that hormones were harmful. Although Wyeth was not required to take Premarin and Provera off the market, low dose variations of the drugs continued to be prescribed for shorter duration to women experiencing menopausal symptoms. Were there any other available options to address these symptoms?
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