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Estrogen Replacement Therapy: Yes or No?

Posted Apr 03 2013 12:00am

Let’s face it.  The average women does not understand the role of estrogen during perimenopause .  But, when the average OB/GYN doesn’t seem to understand it very well either, is it any surprise then that women looking for help for their symptoms of perimenopause are clueless?

It also doesn’t help that there is a big, wide world out there (the Internet) full of contradicting information.  Hell, if medical researchers can’t decide whether estrogen is good for you or bad for you, or whether it should be part of hormone replacement therapy during perimenopause and menopause or not.  Well, how are we supposed to know?

It’s a conundrum.

I have professional colleagues who make an excellent case against estrogen for women in menopause .  I have other professional colleagues who feel that estrogen therapy can be very beneficial when administered in the right form (transdermal bioidentical as opposed to non-bioidentical) and dose.

There is also the feminist research crowd who believe that the entire notion of hormone replacement therapy in the first place, is rooted in patriarchal, sexist medicine which simply wants to control and define the female experience for women.

I must be honest and say, I believe there is a certain amount to truth to that, though I try not to dwell on it too much.  The last thing you ladies need is for me to turn into a raging Femi-Nazi.  That just wouldn’t be a pretty sight.

When in balance estrogen is a natural antidepressant and mood regulator

All sociological theories, and medical research aside.  At the end of the day, I’m a solutions girl.  I just want answers, and I want to be able to give answers to women like you who come to my blog looking for help.

That’s why I read countless articles, research reports, and text books.  It is also why I have dedicated my entire career to women’s health. I want the best information I can find, which is also useful. Otherwise, it all seems like an exercise in intellectual futility and frankly, at my age, I have no patience for that.

So why am I telling you all this?  Because I have an appointment next week with my gynecologist, and I’m going to discuss a possible prescription for low dose, transdermal, bioidentical estrogen . I’m considering it for a few reasons.

First, I’ve been menopausal for close to two years now.  I’ve also been through hell and back the past two years with my divorce, suffering horribly with depression. I’ve been experiencing short-term memory loss, foggy brain , and just a general mental malaise that makes me feel horribly sluggish between my ears.

Estrogen is a natural anti-depressant and mood stabilizer .  It works in concert with serotonin, one of the fifty neurotransmitters in your brain, which also modulates and stabilizes mood.  When a woman’s estrogen levels are low (as they are for women who are in actual menopause), chances are her serotonin levels are low – hence struggles with depression.

Don’t misunderstand me.  I’m not suggesting that if you struggle with depression that estrogen is all you need.  I’m saying it might be an important part of the puzzle when you are treating it.

Second, I’ve also been diagnosed with Fibromyalgia .  But, truthfully, I’m not so sure what I think about all that. I call it the “non-disease.” I do believe that the symptoms of fibromyalgia are real.  They are very real.  But, it’s such a nebulous term, that I’m not so sure I’m ready to jump on a fibromyalgia bandwagon and call it an actual “medical condition.”

Fibromyalgia sufferers feel free to set the record straight.  But, that is my opinion and I’m sticking to it.

One of the treatment protocols for fibromyalgia is antidepressants .  Why?  Because research has shown that antidepressants help manage chronic pain (a hallmark symptom of fibromyalgia) by raising serotonin levels in the brain.  Higher serotonin levels in the brain creates a chemical firewall if you will (my word), which affects the pain signals sent from your brain.  The result is less “perceived” pain.

So, here’s my logical leap:  If estrogen and serotonin have a direct correlation , that is, when one goes up, the other goes up, and vice versa.  And serotonin plays a direct role in mood regulation and pain management, and I have been struggling with depression and chronic pain issues, and I’m in menopause with naturally low levels of estrogen………..well, then, you get the picture.

I have an appointment one week from today.  I plan to discuss my options for a low dose (very low dose) of bioidentical, transdermal estrogen .  I’m going to give it a try. If I begin to feel better, I will report that back to all of you.  If I don’t feel better, I will report that as well.  Ultimately, my work here is for you and not for me.  If sharing my personal experience will help you, then I’m willing to do that too.

I’ll keep you posted.

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