If you are going through menopause and experiencing the symptoms of low estrogen then this article is for you. I am going to explain why all women who have low estrogen symptoms will benefit by using an estrogen cream. All menopausal women who are no longer producing estrogen on their own require estrogen cream for the rest of their life in order to protect their bones, heart and brain. Estrogen protects women against heart attacks and strokes, osteoporosis, alzheimer’s disease and early cognitive decline, vaginal atrophy, urinary incontinence, colon cancer, cataracts and macular degeneration. In other words, not taking estrogen predisposes you to all of these diseases.
What are the symptoms of low estrogen?
When estrogen levels start declining in women they will experience one or all of the following symptoms: anxiety, depression, mood swings, sagging skin and breasts, increased wrinkles on the face, night sweats, hot flashes, fatigue, dizziness, vaginal dryness and itching, headaches, urinary incontinence and decreased memory. What I have found in my practice is that the main symptoms that women come to see me for are hot flashes, night sweats, vaginal dryness and painful intercourse.
By the time women are in my office I have their blood work in front of me that normally show estradiol levels <6. Prior to entering menopause their average level was 120-200 and could peak as high as 500. Estrogen levels <6 mean your ovaries are no longer making any and you will need to supplement in order to feel better.
Here is a link to a great article on the benefit of estrogen (and in this article they were referring to premarin which is not bio-identical but even prevented chronic disease): http://www.lifeextension.com//Magazine/2013/11/Surprise-Findings-in-Estrogen-Debate/Page-02
Should you use an estrogen cream to treat the symptoms of low estrogen?
In my practice about 65% of women who present with low estrogen symptoms I start them on an estradiol capsule. The reason for this (and this goes against what many doctors write online) is that oral estradiol actually provides a better protective effect on the heart. Since 90% of women will die of heart disease I want to maximize the protective effects of estradiol on the heart.
So the question becomes why don’t I put every women on estradiol capsules. It is a very complex question but I will do my best so simplify it. Premarin (horse estrogen) caused some women to develop blood clots and because of that it is assumed that bio-identical estradiol in a capsule form will do the same thing.
The fact is that when bio-identical estradiol has been studied and given to women in a capsule form it does not cause blood clots. However, much of the medical community misunderstands the science and if a patient who has risk factors for heart disease (high blood pressure, obese, smokes or has a lot of inflammation) has a heart attack or blood clot and is on oral estrogen they will blame the estrogen. So in cases where women have risk factors for heart disease I will use topical estrogen either in a cream form or many times a topical patch.
Topical estrogen in creams or patch has never been shown to increase the risk of blood clots so it is considered the safest form of estrogen to take. Out of the women I use topical estrogen in, 50% get a prescription for the vivelle dot patch (bio-identical estradiol in a simple patch that is placed on the lower abdomen) which delivers a 24 hour continuous dose of estradiol to the women. The other 50% I use a estrogen cream (estradiol lipoderm cream) which is compounded by the pharmacist and made to order. The dose will vary depending on how symptomatic they are and what their labs look like.
How is estrogen cream applied and what will I feel?
Generally I have women apply 1/2 gram of cream to the upper inner thighs or upper inner arms each morning and evening. This provides a steady dose of estrogen day and night. For women who have insurance that will cover the vivelle dot patch, they simply take one dime sized patch and apply it to the lower abdomen and leave it there for 3.5 days.
They then take it off and replace it with a new one on the opposite side (rotate the site). If you get the dose correct immediately the hot flashes, night sweats, vaginal dryness and the rest of their symptoms will resolve very quickly (within a week). Many times we have to adjust the dose up or down because every women absorbs and metabolizes estrogen differently. With more women within a few months we get the dose perfect.
Here is a link to information about the minivelle which is a smaller version of the vivelle dot patch http://minivelle.com/?utm_source=psearch&utm_medium=GOOGLE&utm_term=minivelle+estrogen+patch&utm_campaign=Minivelle+Brand+-+Patient&utm_content=Dosing
The bottom line all women benefit from estrogen once they hit menopause. It reduces their risks of heart disease and cancer (which is opposite of what most women and doctors believe) and eliminates the symptoms of menopause. The safest form of estrogen to take is an estrogen cream or patch.
If you would like to schedule a consult with Dr. Sean Breen simply give us a call at 877-721-0047 and visit us on the web at www.DoctorBreen.com