What is the role of oestrogen in menopause and why is it so important?

Oestrogen plays an important role in every stage of a woman's life. During the menopausal transition, the ovaries gradually produce less of the female sex hormones oestrogen and progesterone. This process can start as early as from the age of 35. Progesterone drops faster than oestrogen. This creates an imbalance, which can result in various symptoms. What is the function of oestrogen in the body? And what symptoms can a drop in oestrogen cause?

What does oestrogen do?

Oestrogen is one of the main female sex hormones. Your ovaries make most of your oestrogen during your reproductive years. Oestrogen contributes to the development of female characteristics during puberty, regulates the menstrual cycle and stimulates the development of the vagina and Fallopian tubes during pregnancy. 

Oestrogen also has other functions: 

• Oestrogen promotes bone health 
• Oestrogen stimulates collagen production, keeping the skin firm  
• Oestrogen protects the cardiovascular system by keeping blood vessels elastic. 

In short, oestrogen plays a major role in women's health, including mental health. As oestrogen levels decline during menopause this protective effect is lost, resulting in changes in the body. We’ll get back to this later.

How do progesterone and oestrogen work together?

Progesterone and oestrogen are the two most important sex hormones in the female body. Both play a role in women's menstrual cycles. 

In the first half of your menstrual cycle, oestrogen triggers ovulation and stimulates the lining of your uterus to thicken. In the second half of your cycle, progesterone prepares your uterus for pregnancy by stabilising the uterine lining. Read more about progesterone and menopause. 

Oestrogen during the stages of menopause

The process of menopause can be divided into three distinct stages: perimenopause, menopause (technically, menopause is not a stage but marks the official end of the menstrual cycle) and postmenopause. What happens to oestrogen during these stages? 

1. During perimenopause, which most women experience in their 40s, the ovaries gradually produce less oestrogen and progesterone. In this stage, the level of oestrogen in your body is still relatively high compared to progesterone. In some women, this can lead to oestrogen dominance. This is where the balance between oestrogen and progesterone gets out of balance, causing various symptoms. 
2. As perimenopause progresses, decreases in oestrogen and progesterone become more pronounced. You're officially in menopause when you haven't had a period for 12 consecutive months. 
3. In the subsequent stage, postmenopause, oestrogen stabilises at low levels. Oestrogen and progesterone stop being made in the ovaries and instead come from the conversion of androgens (produced in the adrenal glands) and in fat and muscle cells. Although they are only produced in tiny amounts, these hormones are still essential to various bodily functions. 

What are symptoms of low oestrogen during menopause?

When progesterone drops faster than oestrogen in perimenopause, it creates an imbalance, resulting in oestrogen dominance. Typical signs of oestrogen dominance include mood swings and weight gain, but fluid retention, breast tenderness, headache and migraine, and sleep problems can also be signs that your oestrogen levels are too high relative to progesterone. 

In most women (but not all) symptoms will get better once the ovaries stop producing oestrogen. However, consistently low oestrogen levels during postmenopause can trigger new symptoms. 
 
Common symptoms in postmenopause include increased dryness of skin and mucous membranes (dry eyes and vaginal dryness). Oestrogen supports skin elasticity and moisture, so low levels can lead to these symptoms. In addition, postmenopausal women have a higher risk of osteoporosis, because oestrogen is essential to maintaining bone density. Low oestrogen can also affect cardiovascular health and increase cholesterol levels, which can further increase the risk of developing heart disease. 

What can you do?

Making adjustments to your diet and lifestyle can reduce the intensity of your symptoms or make them go away altogether. Key things to consider are: 

• Eat a healthy and balanced diet. Eat plenty of fruit, vegetables, whole grains, healthy fats (such as avocados, nuts, and seeds) and protein to keep your hormones balanced. 
• Reduce stress. Stress can disrupt hormonal balance, which can make menopausal symptoms worse. Reducing stress, for instance through relaxation techniques like yoga, meditation or breathing exercises, is very important during this stage of life. 
• Exercise regularly. Try to exercise every day. Walking and the gym are both good options. Exercise not only reduces stress, but it also stimulates the production of ‘happy hormones’ called endorphins. 
• Consider supporting your health with supplements. Solgar® Herbal Female Complex can contribute to your health and well-being during menopause*. Solgar® Hyaluronic Acid contains a high dose of hyaluronic acid, collagen and Vitamin C for improved skin structure and firm, hydrated and supple skin*. 

* Health claim(s) pending approval by the European Commission. 

Can hormone therapy help?

If your symptoms are severe and the above tips have not helped enough, then hormone replacement therapy (HRT) could help. HRT is used to treat hot flashes and night sweats in perimenopause and osteoporosis and vaginal dryness in postmenopause. 

Which form of hormone therapy (composition and dosage form) is right for you depends on your symptoms, medical history and what menopause stage you are in. 

Via SeeMe-nopause, you can get medical help from the comfort of your home. Simply choose your preferred medication and a doctor will review your order to ensure the medication you want to order meets your needs. More about hormone therapy. 

FAQ

What causes oestrogen dominance in early perimenopause?

During perimenopause, progesterone levels decline along with oestrogen. When progesterone drops faster than oestrogen, it creates an imbalance, resulting in oestrogen dominance. This may cause symptoms such as hot flashes, mood swings and night sweats. These symptoms are usually temporary and may disappear once your body has adjusted to a new hormonal balance after menopause.

How long does it take for hormone therapy to work?

Typically, noticeable changes begin to emerge after a few weeks, but it can take up to several months to feel the full effects. Remember, the effects of hormone replacement therapy (HRT) can vary from woman to woman.

Does oestrogen-only HRT have any side effects?

Yes, treatment with oestrogen may cause side effects. Oestrogen-only therapy is typically prescribed in women who have had a hysterectomy due to an increased risk of excessive growth of the womb lining (endometrial hyperplasia), which increases the risk of cancer of the lining of the womb (endometrial cancer). If you haven't had your uterus removed, your doctor will typically prescribe oestrogen along with progesterone to protect you from this risk. Before starting HRT, you should always seek medical advice from a doctor.