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Sep 27, 2019

The Benefits of Estrogen Hormone Replacement Therapy

The Benefits of Estrogen Hormone Replacement Therapy

NAMS (the North American Menopause Society) is an organization of physicians, researchers and experts whose mission is “to promote women’s health at midlife and beyond.” To this end, they periodically create a“position statement” summarizing the current body of evidence we have regarding menopausal health concerns. Below are the “cliff notes” of the benefits of estrogen excerpted from the NAMS position statement from 2017.

Benefits of Estrogen Hormone Replacement Therapy:

  • Weight and metabolism: Hormone therapy may decrease abdominal fat accumulation and reduces the risk of Type 2 Diabetes
  • Genitourinary symptoms: Vaginal estrogen may improve incontinence by increasing the number of blood vessels around the peri-urethral and bladder neck region and reduces bladder contractions. Estrogen may also improve synthesis of collagen and improve vaginal epithelium.
  • Sexual function: Transdermal or vaginal estrogen increases vaginal lubrication, blood flow and sensation.
  • Cardiovascular disease: Women with early ovarian failure or surgical menopause have a higher risk of death from heart disease as well as from all causes compared with women who have a normal age of menopause which may be reflective of premature aging. Randomized controlled trials show that women who initiate hormone therapy younger than age 60 or within 10 years of menopause have a reduced risk of coronary heart disease, no increased risk of stroke, and a reduction in all-cause mortality.
  • Eyes: Estrogen may decrease the risk of cataracts and glaucoma.
  • Skin: Estrogen increases epidermal and dermal thickness, increases collagen and elastin content, and improves skin moisture with fewer wrinkles.
  • Neurologic: Estrogen decreases dizziness and vertigo and improves postural balance. Evidence suggests that estrogen is neuro-protective and may reduce production of β-amyloid, the protein associated with Alzheimer’s disease.
  • Bones: Estrogen decreases osteoporosis (thinning of bones) and improves bone elasticity.
  • GI: Estrogen reduces one's risk of colorectal cancer and is suggested to decrease fatty liver.
  • Dementia: Four observational studies provide support for the view that timing of hormone therapy initiation is a significant determinant of Alzheimer disease risk, with early initiation lowering risk and later initiation associated with increased risk. The key is that estrogen must be started very soon after menopause - within 10 years.  

Dr. Leslie Meserve
Chief Medical Officer, CurieMD

References:

https://www.menopause.org/docs/default-source/2017/nams-2017-hormone-therapy-position-statement.pdf

https://www.ncbi.nlm.nih.gov/pubmed/21280086

Photography by Mithi Studio