Estrogen Deficiency In Menopause

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Menopause is a natural process that marks the end of a woman’s reproductive years. It typically occurs between 45 and 55, although the exact timing can differ from person to person. During this stage, the ovaries gradually stop producing eggs, leading to a decline in hormone levels, especially estrogen and progesterone. This hormonal transition can cause various physical and emotional changes, often resulting in various symptoms that affect women’s quality of life. We explore the connection between menopause and hormone deficiency, its impact on women’s health, and available treatment options.

Hormones and their Role

Hormones are crucial in regulating various bodily functions, including reproductive health. In menopause, estrogen and progesterone are the primary hormones affected. These hormones regulate the menstrual cycle and maintain the health of the reproductive system. Estrogen also plays a function in bone health, heart health, and brain function.

Menopause and Hormone Deficiency

As women approach menopause, their hormone levels fluctuate and eventually decline. The transition typically occurs in three stages: perimenopause, menopause, and postmenopause. During perimenopause, which can last several years before menopause, hormone levels can become erratic, leading to irregular periods and signs & symptoms such as hot flashes, mood swings, and sleep disturbances.

Once menopause is reached, defined as 12 consecutive months without a menstrual period, estrogen and progesterone levels remain consistently low. This hormone deficiency can cause various symptoms, including hot flashes, night sweats, vaginal dryness, decreased libido, mood changes, weight gain, and sleep problems. Additionally, long-term hormone deficiency can increase the risk of osteoporosis, cardiovascular disease, and cognitive decline.

Understanding Estrogen Deficiency

During menopause, the ovaries gradually produce fewer hormones, primarily estrogen and progesterone. These hormones play a vital role in regulating various bodily functions, including the menstrual cycle, bone health, and mood stabilization. The reduction in hormone levels can lead to several physiological and psychological changes.

  1. Physical Symptoms: a) Hot flashes and night sweats: Sudden feelings of extreme heat, often accompanied by sweating and flushing, are common symptoms of hormone deficiency. b) Vaginal dryness and discomfort: Decreased estrogen levels can induce thinning and drying of the vaginal tissues, leading to discomfort during sexual intercourse and an increased risk of urinary tract infections. c) Sleep disturbances: Hormonal imbalances can disrupt sleep patterns, causing insomnia or frequent waking during the night. d) Changes in the skin and hair: Reduced estrogen levels can contribute to dry skin, thinning hair, and brittle nails. e) Bone loss: Estrogen plays a vital role in maintaining bone density. Estrogen deficiency is a risk factor for loss of bone mineral density and osteoporosis. Bone loss in the jaw further complicates the impact of periodontal disease. Hormone deficiency can accelerate bone loss, increasing the risk of osteoporosis and fractures.
  2. Emotional and Cognitive Symptoms: a) Mood swings and irritability: Hormonal fluctuations can lead to mood swings, irritability, and increased susceptibility to stress. b) Memory lapses and difficulty concentrating: Some women may experience cognitive changes during menopause, such as forgetfulness and difficulty concentrating. c) Depression and anxiety: Hormonal imbalances can contribute to feelings of sadness, anxiety, and a decreased sense of well-being.

Treatment Options

Managing hormone deficiency during menopause involves a variety of treatment options aimed at alleviating symptoms and improving overall well-being. The preference for treatment depends on the severity of symptoms, medical history, and individual preferences. Some common options include:

  1. Hormone Replacement Therapy (HRT): This treatment involves using estrogen and progesterone (for women with a uterus) to supplement declining hormone levels. HRT can effectively relieve hot flashes, vaginal dryness, and bone loss. However, it carries certain risks, such as blood clots and breast cancer, which should be discussed with a healthcare expert.
  2. Non-hormonal Medications: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), originally prescribed for depression and anxiety, have shown effectiveness in managing hot flashes and mood swings during menopause.
  3. Lifestyle modifications and self-care: A healthy lifestyle can significantly improve menopausal symptoms. Regular exercise, a balanced diet rich in calcium and vitamin D, stress reduction techniques (e.g., yoga, meditation), and avoiding triggers like caffeine and spicy foods can all relieve symptoms.

In addition to medical interventions, lifestyle modifications, and self-care practices can help alleviate menopausal symptoms and promote overall well-being. These include:

Regular exercise: Physical activity can help reduce hot flashes, improve mood, promote better sleep, and maintain bone health.

Balanced diet: A healthy diet rich in whole grains, vegetables, fruits, and lean proteins can support hormonal balance and overall health.

Stress management: Practicing relaxation methods such as deep breathing, meditation, yoga, or engaging in activities that bring joy and relaxation can help manage stress and improve overall well-being.

Sleep hygiene: Establishing a constant sleep routine and creating a conducive sleep environment can help alleviate sleep disturbances commonly experienced during menopause.

4. Complementary Therapies: Alternative therapies like acupuncture, herbal remedies (e.g., black cohosh, red clover), and mindfulness-based practices have shown promise in reducing menopausal symptoms. However, more research is needed to prove their efficacy and safety.

5. Supportive Measures: Seeking support from friends, family, or support groups can help women cope with the emotional and psychological challenges associated with menopause. Open communication with healthcare professionals is essential for personalized guidance and treatment adjustments.

Menopause marks a significant milestone in a woman’s life, and the hormonal changes that occur during this transition can profoundly impact her overall health and well-being. Hormone deficiency, particularly the decline in estrogen and progesterone levels, can lead to various physical and emotional symptoms. However, with the help of medical interventions such as hormone replacement therapy and lifestyle modifications, women can effectively manage these symptoms and maintain a good quality of life during and after menopause. Women need to consult with healthcare professionals to discuss treatment options tailored to their needs and make informed decisions regarding their health.

Here we discuss this with Catherine Harland, a menopause coach, to get her thoughts on this topic.

Is Menopause Hormonal Deficiency?

NourishDoc: Is menopause a hormonal deficiency?

Menopause Coach Catherine: Menopause is not a hormone deficiency. It’s simply not. So it’s the equivalent of saying a girl the word pre-pubescent girl is estrogen deficient. It’s the same. No, we receive. We have estrogen in our fertile years to enable us to have children. It is Mother’s nature. It’s her way of, you know, saying you can’t have any more children. This is a natural cycle; not saying it’s easy. It’s not. It can be very challenging. We know that. But it is not a hormone deficiency. It’s not a disease. And it’s being treated that way. A lot of the time in the UK. And this narrative review needs to stop. It isn’t very comforting. It’s, you know, people are women are vulnerable anyway. And they don’t need the scaremongering narrative. 

Lifestyle changes

NourishDoc: Lifestyle changes for women through the menopausal journey?

Menopause coach Catherine: I think what so many cogs to the wheel. There are so many well-being issues that we need to address. So, lifestyle. So we’re looking at stress; many people are very stressed. Some things seem quite big, reducing caffeine and doing a little more exercise than some weight-bearing exercises.

Women need to understand we’re not taught first, but secondly, think we can keep doing the same as in our 20s and 30s. And unfortunately, we can’t. We have to address it. We forgot how just to be to live healthily, you know, like our grandparents that go to the local store, and they would buy the bread the god next door and buy them meat, they’ll go next door by the fruit and vegetables. Now we go to supermarkets. And we’ve become conditioned to this being normal of putting things in our baskets covered in plastic that has been injected with pesticides and sprayed with pesticides to make them last longer.

Hormone replacement therapy

NourishDoc: Is HRT recommended for women?

Menopause coach Catherine: Nearly that was about 21 years ago. So that study thrashed out the water, which was incorrect. And that’s why so many doctors stopped prescribing HRT, and many women were scared to take it. So for a long time, it’s been dead in the water. No one wants to touch it. Speculation isn’t science, and we just have to follow evidence-based information. So that’s been thrashed totally out of the water. By drinking one or two glasses of wine several times a week, you’ve got more chance of developing breast cancer than taking HRT. So that is a fact. 

Advice for menopause women

NourishDoc: Any further advice for women?

Menopause coach Catherine: This is a lot of it is down to lifestyle, diet, and stress. So I would say to any woman, Asian, white, black, whoever’s listening, please follow the correct people. And they will say, Well, how do I know the correct information? Who do I know? Mean? We have the British menopause society; we’ve also got meno clarity. I know we’ve got a lot of them because I’m in the menopause world. 

You know, women. I was one of those several years ago; I didn’t know who to trust and who to believe. So research, you know, follow trusted people like yourself, myself, meno clarity, etc. Do your research. One size doesn’t fit all. It doesn’t. That’s to do your yes lifestyle and not saying, Oh, well, one lady can drink five bottles of wine a week, and one can’t? No, we must reduce it and stop smoking, caffeine, etc. But it’s so worth it to feel better. You know, just research and make your informed choice based on trustworthy information.


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