Dr. Jocelyn Craparo gives a complete overview of the functions of
estrogen and progesterone. This is important background in understanding
the changes that come with menopause and some of the therapies directed
at their treatment. — Beverly
Vaughn, MD, Medical Coordinator, Menopause and You Program
The female hormones estrogen and progesterone are crucial components of
a woman’s health. Not only do they contribute to a woman’s menstrual
cycle and ability to bear children, but they have an impact on other
areas of the body. As most women know, menopause—when the body no longer
produces estrogen—introduces physiological changes. In this article, we
want to inform you about the role of estrogen and progesterone in
Estrogen and Progesterone
Estrogen is produced by the ovarian follicle (ovary), and estrogen
levels rise through the early part of the menstrual cycle. Progesterone
begins to be produced upon ovulation, and levels elevate through
the remainder of the cycle until dropping just prior to the
menstrual flow. Although most of the estrogen and progesterone we make
comes from our ovaries, small amounts are produced in other organs.
While estrogen and progesterone are the hormones associated with
ovulation and menstruation, it is extremely important to understand the
greater scope of their effects on the female body. We begin to
experience the influence of these hormones in fetal life and continue to
be significantly affected by them until well after menopause.
Many organs of the human body have estrogen and progesterone receptors.
These receptors are prominent in skin, bone, breast tissue, the uterine
lining, and blood vessels. The dominant hormone is estrogen, accounting
for women’s secondary sexual characteristics. Estrogen is a factor in
the changes that occur in tissues of the breast, vagina, uterus, and
Progesterone is important mainly for the preparation of the endometrium
for implantation of the egg during pregnancy and the maintenance of
pregnancy. Progesterone has characteristics that balance and counteract
the adverse effects that estrogen can have. For example, some women
produce too much estrogen, thus standing a risk of cancer of the uterus
Supplemental progesterone has been known to aid in managing abnormal
uterine bleeding, as well as recurrent pregnancy loss or premature
While progesterone is important, health care providers concentrate
largely on the effect of estrogen. Let’s review what estrogen
contributes to a woman’s physiology, and how the loss of estrogen at
menopause affects the body.
Estrogen and Menopause
Estrogen during the premenopausal, childbearing years is responsible for
the following in a woman’s body:
Normal skin thickness and elasticity
Relaxation of blood vessels in the heart, thus protecting a
woman from heart attack
Enhanced calcium absorption, leading to bone strength
Bladder and urethral health
When a woman’s ovaries cease to produce estrogen, however, the receptors
in various organs are deprived. This can occur as a result of natural
menopause, premature menopause, or surgical removal of the ovaries
prior to menopause. The following are some of the effects from loss of
Skin dryness and wrinkles
Bone loss and osteoporosis
Dryness of the vagina and decreased sexual sensation
Treatment options are available if you experience or are at risk for any
of these effects, as discussed next.
Over the past 50 years, the use of estrogen replacement therapy has been
the mainstay in the treatment of hot flashes and in the prevention of
osteoporosis. Recent controversies over the long-term use of estrogen,
however, have led many doctors to recommend alternative therapies for
changes associated with menopause and estrogen loss.
For example, supplements, such as calcium and vitamins, can be taken for
maintenance of bone health. Medications, such as Fosamax and Actonel,
are being used to treat osteoporosis. Weight-bearing exercise is
recommended for its impact on maintaining bone mass. Some
antidepressants, such as Paxil and Effexor, have been found helpful in
relieving hot flashes. Topical estrogen in a variety of forms can be
used vaginally to alleviate dryness and restore sexual sensation.
Because estrogen and progesterone are naturally reduced in a
postmenopausal woman’s body, continued exposure to synthetic hormone
replacements is of questionable safety. Hopefully, investigators will
continue to study and define the complex roles of these hormones. In the
meantime, women can work with their doctors to determine the best ways
of gaining relief and benefit from medication, lifestyle, and exercise
This article is part of the Menopause and Youlibrary,
a web-based program sponsored by Women’s Health Source.
It is intended as an information resource providing guidelines for
women. As always, check with your own health care practitioner with your
specific concerns and questions.
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