How to increase estrogen at menopause: drugs, herbs, products

In the development of climacteric syndrome, the main method of treatment and prevention of disorders caused by a lack of estrogens in the woman's body is HRT using analogues of these sex hormones. Estrogens during menopause are a very effective medicine, helping well with severe climacteric symptoms. But it should be taken into account that when treating with such drugs, it is necessary to regularly see a doctor, as well as undergo periodic examinations.

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Indications estrogen in menopause

Estrogens are indicated as a component of HRT during menopause. Also, during menopause, medications containing only estrogens are prescribed for continuous use to women after hysterectomy.

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Release form

Estrogens during menopause can be used not only orally - to reduce the negative impact on the body, some drugs are available in the form of vaginal suppositories, as well as creams, and in addition, gels.

Most often, tablets are used - they are more effective both as a treatment and in the prevention of climacteric manifestations. Gels are used for transdermal use (they are prescribed if the patient has liver pathologies, because with this method of administration, the drug enters the blood directly, without passing through the liver). Vaginal suppositories and creams contain estriol, which is a weak estrogen.

Natural estrogens during menopause

Natural estrogens (or phytoestrogens) are plant-based medicinal compounds that are similar in their chemical structure to natural female hormones, which means they can function in the body as an estrogen substitute.

Hormone-like chemical compounds contained in certain plants can significantly help the process of restoring hormonal balance in the body. Since many of the discomforts of menopause arise precisely as a result of a decrease in estrogen levels, these plant substances are one of the most popular treatment options for this syndrome.

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Herbs for menopause with estrogens

Plant estrogen is found in record quantities in the following medicinal herbs: shepherd's purse, Siberian ginseng, and also orthilia secunda.

Herbs that contain smaller amounts of this hormone: chamomile flowers, sage, licorice root, parsley, linden flowers, sweet clover and flax seeds, as well as alfalfa and clover.

There are 300 plant species in 16 different families that contain some amount of estrogens. Among them, the most studied are lignans, followed by isoflavones.

Isoflavone glabridin is found in licorice root. Large amounts of this substance can inhibit the processes of cancer cell reproduction, but a small amount, on the contrary, provokes the growth of these cells.

Lignans extracted from flax seeds acquire a steroid nature exclusively in the human intestine. Their biological properties are similar to those of isoflavones.

Estrogen suppositories during menopause

Hormonal suppositories during menopause are used to relieve symptoms of burning and itching in the vagina.

Ovestin suppositories are one of the most effective and popular products containing estrogen – in the form of estriol. Estriol is a hormone with a short-term effect, which eliminates the risk of new cells forming in the endometrium.

The medicine promotes the regeneration of the epithelial layer on the vaginal mucosa, and in addition, restores its natural microflora and acid balance - thereby preventing the development of pathogenic microbes. At the same time, the level of local immunity increases.

Estrogens in tablets during menopause

Among the most popular and effective estrogenic drugs produced in tablet form, which are used during menopause, are the following:

• Premarin, which contains conjugated estrogens. It is used as part of hormonal therapy – for climacteric syndrome, uterine bleeding, and osteoporosis that develops during menopause;
• Estradiol, which contains components that are closest in composition to natural female hormones. It is used to stabilize the hormonal balance in the blood;
• Presomen, which is often used in HRT. Its medicinal properties help maintain the functionality of a woman's reproductive system;
• Tefestrol – it helps restore the condition of the vaginal mucosa and also stimulates uterine function;
• Estrofem is used to replenish the deficiency of endogenous estrogens in the female body.

The properties of estrogens during menopause will be discussed using the example of the drugs Estrofem and Ovestin.

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Pharmacodynamics

Estrofem is created on the basis of the substance 17-β-estadiol, which in its composition corresponds to the natural estrogen produced by the ovaries. It helps to restore the normal functioning of the female genital organs - the uterus with fallopian tubes, vagina, milk ducts, and stroma. At the same time, it affects the pigmentation of the area near the nipples and genitals.

The medicine also affects the function of female 2-nd sexual characteristics, suppresses lactation processes, stabilizes the menstrual cycle, and along with these processes of fat and protein metabolism with carbohydrates.

Thanks to LS, it is possible to lower the cholesterol level in the blood, and also to increase the libido and emotional state of the patient. Its effect helps to strengthen bone mass, as well as their density - this helps to prevent the occurrence of osteoporosis and makes bones stronger, as a result of which the risk of fractures of the vertebrae and joints in the hip area is reduced.

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Pharmacokinetics

After intravaginal use, the active substance provides optimal local bioavailability for the medicinal effect. At the same time, it is quickly absorbed, penetrating into the general hematopoietic system. As a result, the plasma concentration of unbound estriol quickly increases. This indicator reaches its peak 1-2 hours after use.

Almost the entire active component in plasma binds to albumin (unlike other estrogens, it almost does not interact with globulin, which provides a connection with sex hormones).

During metabolism, estriol is mainly converted into the conjugated and unconjugated state due to circulation in the intestine and liver. It is the final product of decay and is usually excreted from the body in a bound form along with urine. Only a small part of it (about 2%) is excreted along with feces (usually this is unbound estriol). The half-life lasts about 6-9 hours.

When 0.5 mg of the active substance is administered vaginally, the peak concentration is approximately 100 pg/ml. The minimum level is approximately 25 pg/ml, and the average concentration is approximately 70 pg/ml. With three weeks of daily administration of estriol at this dosage, the average value decreases to 40 pg/ml.

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Dosing and administration

Divigel is used transdermally. It is prescribed for cyclic or continuous long-term treatment. The gel is applied to the skin in the lower abdomen or buttocks. The area of treatment with one packet of the drug should be equal to the size of 1-2 palms. After completing the treatment, wash your hands thoroughly and wait 1-2 minutes for the gel to dry. It is prohibited to treat the areas of the face, chest or genitals with the medicine, as well as damaged skin. The gel must not get into the eyes.

If a scheduled treatment with the medicine was missed, it should be applied earlier - no more than 12 hours should pass from the scheduled time of the procedure. If this period has passed, the missed treatment should not be carried out, and the next one should be carried out at the appointed time. In case of frequent missed treatments, uterine bleeding (similar to menstruation) may develop.

The duration of the treatment course, as well as the dosage of Divigel, is prescribed by the attending physician.

At the initial stage of treatment, 1 g of gel per day is usually prescribed. After 2-3 cycles from the start of treatment, the dose is adjusted, taking into account the woman's condition, as well as the effectiveness of the drug. On average, the therapeutic dosage is 0.5-1.5 mg of estradiol (or 0.5-1.5 g of the drug).

Estrofem is taken orally, and this must be done each time at the same time of day. Treatment begins with a minimum dosage - 1 tablet once a day. The dose can be adjusted at least 3 months after the start of the treatment course. During menopause (or with a removed uterus), a woman can start the course on any day.

If you miss a dose, you should take the pill as soon as possible, but if you miss a dose for a whole day, do not use the missed pill – a double dose of the medicine is strictly prohibited.

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Contraindications

Contraindications to the use of drugs containing hormones include the presence of the following diseases or conditions in the patient:

• history of thrombosis or thromboembolism;
• severe diabetes mellitus;
• oncological pathology of the endometrium or mammary gland;
• estrogen-dependent malignant tumors;
• pathologies of the kidneys or liver, in which there is a disorder in the functioning of these organs;
• having vaginal bleeding of unknown etiology;
• suspicion that the patient is pregnant.

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Side effects estrogen in menopause

Anti-climacteric drugs containing hormones are known to cause a large number of side effects - in short, this list includes the possible occurrence of such problems:

• weight gain;
• headaches
• the appearance of edema due to fluid retention in the body;
• coarsening of the mammary glands;
• development of cholestasis, which leads to disruption of the digestive process.

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Overdose

In case of a severe overdose of Divigel, painful sensations in the mammary glands, a feeling of irritability or anxiety, and flatulence may occur. There is no specific antidote - a reduction in dosage or complete discontinuation of the drug is required.

If the dosage of Estrofem is exceeded, symptoms characteristic of indigestion may develop, such as vomiting with nausea.

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Interactions with other drugs

Estrofem significantly enhances the medicinal effect of hypolipidemic drugs on the body.

When combined with Estrofem, the effect of anticoagulants, diuretics, antihypertensives, as well as hypoglycemic drugs and male hormones is weakened.

The process of Estrofem metabolism becomes much more intense when combined with barbiturates, anticonvulsants, tranquilizers, opioid analgesics, anesthetic drugs, and inducers of microsomal liver enzymes.

Rifampicin, phenylbutazone, and ampicillin alter the balance of intestinal microflora, as a result of which the absorption of Estrofem is weakened.

The therapeutic effect of estradiol is enhanced by its combination with folic acid and thyroid medications.

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Storage conditions

Menopause medications must be stored under standard conditions for medicinal products. They must not be frozen, and the temperature must not exceed 25°C.

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Shelf life

Estrogens during menopause are permitted to be used for 3-4 years from the date of manufacture of the drug.

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