Estrogen

William Clearfield, D.O., FAAMA, DABMA, FAARFM

Medical Director, Clearfield Family Medicine, Reno, NV

With some 400 identified functions in the body, estrogen is perhaps the most studied compound in the history of humanity. As an introduction, Dr. Clearfield discusses estrogen in context of maintaining metabolic rate, improving insulin sensitivity, body temperature regulation, muscle maintenance, improved sleep, reduced incidence of cataracts, increased blood flow, decreased accumulation of arterial plaque, reducing visceral fat, memory enhancement, mood enhancement and preserving the amount of collagen in the skin, Estrogen replacement in the peri-and postmenopausal era, however, is not without controversy. The 2002 Women’s Health Initiative identified prescription estrogen as potentially inducing an increased incidence of breast cancer, blood clots, and strokes. This lecture discusses the physiology of estrogen, the indications and contraindications of estrogen as replacement therapy in the menopausal period, the safety of plant-based “natural” estrogens as opposed to equine based synthetic estrogen, the estrogen dominance syndrome, and the use of estrogen replacement therapy in the face of various hormonally related cancers. Lastly, we will review a case study, pointing out the intricacies of estrogen metabolism, its replacement in physiologic doses when indicated and clinical pearls gleamed from Dr. Clearfield’s twenty plus years of hormone replacement.