The science
The female body can synthesize three types of estrogens: estrone (E1), estradiol (E2), and estriol (E3)
The ovaries synthesize E2, the most biologically active estrogen. E2 accounts for most of sex specific changes that begin during puberty like monthly ovulation & menstruation and the development of secondary sex characteristics.
E2 production begins in the brain
The hypothalamus secretes gonadotropin-releasing hormone (GnRH) stimulating the pituitary gland to secrete follicle stimulating hormone (FSH) and luteinizing hormone (LH). Once puberty hits, the hypothalamus secrets GnRH in pulses creating peaks and valleys. FSH and LH stimulate ovarian follicles to develop and secret hormones. As the ovarian follicles develop, the follicular cells develop into theca cells and granulosa cells. Theca cells synthesize progesterone; granulosa cells synthesize estrogen. How much of each hormone is secreted is directly related to the phases of the menstrual cycle.
The 3 medications used in BHRT treatment
Bioidentical estrogen
Estrogen is the hormone that controls your menstrual cycle. Estrogen is a powerful hormone responsible for the development of female anatomy during puberty. It's responsible for the growth of women's breasts and much more.
During menopause, the ovaries produce less estrogen which causes uncomfortable symptoms in women. Optimizing your estrogen levels relieves menopause symptoms and develops healthier, stronger women.
Progesterone
Compounded testosterone
Hormone secretion is based on your menstrual cycle
On average, menstrual cycles last 28 days. The cycle is centered around a surge of LH and FSH on day 14, which makes ovulation possible. Variations in FSH and LH levels result in variations of estrogen and progesterone levels. The follicular phase is the two weeks leading up to ovulation where mostly estrogen is produced. The luteal phase is the two weeks after ovulation where mostly progesterone is produced.
Follicular phase
- Estrogen makes the endometrium, the superficial layer of the uterus, thicker and sprout progesterone receptors.
- Estrogen acts as a negative feedback signal, making the pituitary secret less FSH as estrogen levels rise.
- Right before ovulation, the high estrogen levels make the pituitary much more sensitive to the actions of hypothalamic GnRH which creates a positive feedback signal leading to a massive surge of FSH and LH that allows ovulation to occur.
Luteal phase
- Progesterone binds to receptors in the endometrium and stimulates endometrial glands to produce more secretions that prepare the uterus for a potential pregnancy.
- Progesterone acts as a negative feedback signal, making the pituitary secret less LH. Progesterone levels decrease and menstruation follows.
The ovaries eventually run out of functional ovarian follicles
There are no more theta or granulose cells to secret any more hormones. E2 levels decrease and cause many symptoms leading up to menopause like hot flashes and night sweats. Some estrogen is still being synthesized by the adrenal glands and the fat cells in the body, but this estrogen is not E2, it's E1 (estrone).
HormoneMD can treat menopause symptoms
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