I say feeble attempt because for over 60 years, while millions of women have suffered ovarian failure, the primary remedy given to ease the ill health and poor quality of life resulting from hypogonadism (menopause) has been Premarin. Premarin is a pill that contains a very large amount of estrogen. The ovaries never produced such large amounts. So what should we expect from giving a person more than their bodies require? Giving Premarin for hypogonadism is like giving chocolate to a starving person, it's good at first but it lacks the nourishment your body needs to stay healthy as time goes on. As with any hormonal deficiency we simply want to put back what the body is no longer making. This is called physiologic replacement and it really isn't that hard to do.
Estrogen, like every other hormone in our body has a function. Too much or too little and you could get sick. Like every other hormone in the body, estrogen works with other hormones to create and maintain good health. If you experience side effects it means you have too much or too little because replacement means just that. You know you have replacement when your health has been restored.
Estrogen is a human hormone, important to both women and men. In fact, the level of estradiol in a man's body is nearly identical to the amount in a woman's body in the early part of her menstrual cycle. After ovarian failure a man has 5-10 times more estrogen than a woman. Even more interesting, estradiol is the hormone that the ovaries make in the smallest quantity. It is interesting that estrogen alone is often referred to as HRT and considered full treatment when it is the hormone that the ovaries make the least of and other ovarian hormones are made in much larger amounts!
Something to keep in mind. Premarin is not interchangeable with transdermal estradiol. For instance, Instrinsa, the testosterone patch that eventually will be approved for use in the United States (it is currently approved in Europe) specifically states on its package insert not to use Premarin with it.
This graph makes it easy to see what the physiologic window is and what isn't based on blood serum levels. Physiologic is any dose inside both of the blue windows. Start out low on your estradiol dosage and see how you feel. As long as you stay in the physiologic window you are maintaining your health. Outside of the window and side effects begin to occur. It really is that simple.
Your doctor is accustomed to using physiologic replacement for other ailments (hypothyroid, diabetes, etc). So when you are ready to seek treatment, ask your doctor for physiologic replacement of all of your ovarian hormones.
Next time I am going to blog about melatonin, a very interesting hormone.