Women in menopause experience real estrogen ‘withdrawal’

• Reprints

Updated: February 12, 2012 8:11AM

We’ve all heard about, or perhaps even experienced, the effects of alcohol, tobacco or drug withdrawal. When a woman goes through menopause, the wide-ranging and sometimes drastic changes she feels throughout her body are the effects of another kind of withdrawal — estrogen withdrawal.

The small hormone estrogen is made in the ovaries and has an ultimate child-bearing function, but there are receptors for estrogen all over the body.

The hormone affects cholesterol levels by its actions on the liver, triggers certain breast cells to multiply, prepares the uterus for pregnancy, preserves bone strength, affects fat distribution and water and salt balances and body hair growth, influences skin and blood vessel elasticity, and affects such brain functions as memory and sexual and maternal behavior.

It’s no wonder that when the body stops producing estrogen, the symptoms can be many.

“Most of the tissues in a woman’s body depend on estrogen for maintenance,” explained Silver Cross Hospital obstetrician/gynecologist Dr. Francisco Garcini. “The cells have different types of estrogen receptors, and estrogen affects the brain, the bones, the skin, the vagina and several other tissues. Some of the effects of menopause can be difficulty sleeping, mood swings, hot flashes, and night sweats and chills.”

Whole-body effects

Each cell type in the body that has an estrogen receptor, Garcini said, responds to estrogen in a different way. The bones, for example, use estrogen to maintain a balance of bone-building and bone breakdown. When the levels of estrogen go down, as they do in menopause, that balance is upset and women may have to take calcium and vitamin D supplements.

The symptoms of menopause are a result of the levels of estrogen naturally decreasing in the body around the age of 50, but Garcini said taking estrogen pills is not the recommended way to combat the symptoms. As useful as the hormone is to younger women, it can also have some harmful effects, such as causing cancer, stroke and heart disease.

“In the old days,” Garcini said, “women in menopause were put on hormone replacement therapy. We know now that estrogen replacement or estrogen and progesterone treatment is not the panacea we once thought it was.”

Today, he said, physicians treat the woman’s individual symptoms, such as prescribing SSRIs (selective serotonin reuptake inhibitors) for depression and anxiety.

“At lower levels,” Garcini said, “SSRIs can get rid of a lot of the side effects of menopause, such as hot flashes, insomnia, and chills.”

Treatment options

Garcini recommends women having the mental symptoms of estrogen withdrawal first try exercise. Keeping physically active can combat many of the symptoms, he said. He has also seen improvement of some of the symptoms of menopause when his patients drink smoothies made with powdered soy protein and yogurt. Soy contains a natural estrogen, but Garcini said soy milk does not contain enough of the hormones to make as much of a difference as the soy protein does.

Some women go through menopause without a single symptom, he said, while others suffer. Some may have symptoms for a year or two, while others feel it for 10 or more years. When all else fails, Garcini said he will consider hormone replacement therapy.

“Hormone replacement is always at the end of the list,” he said. “It’s great for the symptoms, but it can potentially have a lot of adverse side effects.”

More information can be obtained at the North American Menopause Society, www.menopause.org, or at Garcini’s medical practice site, www.promotingwomenshealth.com.