August 2, 2011
Not all women, even those who are menopausal or who have had a hysterectomy, need estrogen. As I hope I’ve made clear, many of the symptoms attributed to estrogen deficiency are actually caused by a relative excess of estrogen and are best treated with natural progesterone to restore the proper balance. In addition, even after menopause or a hysterectomy, a woman’s body continues to make estrogen in her fat cells. However, for women who are experiencing hot flashes, night sweats, or vaginal dryness, bioidentical estrogen can be beneficial.
When used in conjunction with progesterone, bioidentical estrogen also may be useful for women at risk of osteoporosis. While it will not help build bone, which is the function of progesterone, the use of bioidentical estrogen can help slow bone breakdown.
Bioidentical estrogen is available only by prescription. Recall that “estrogen” is actually the name for a class of hormones. The form of bioidentical estrogen that I recommend is oral micronized bi-estrogen, called Bi-Est. Bi-Est is composed of 80 percent estriol, the least stimulating of the estrogens and the one that seems most beneficial to the vagina, cervix, and vulva, and 20 percent estradiol, the most stimulative of the estrogens. The ratio of estriol to estradiol may be varied to control symptoms.
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