Estrogen is a hormone made by the ovaries. It helps prepare the body for pregnancy every month. We make less of it during perimenopause and stop almost completely once we reach menopause. This decrease in estrogen may explain some menopause symptoms.

Taking estrogen to replace some of what is no longer made in our body can offer relief from some menopause symptoms. Women with a uterus need to take a progestin with the estrogen. This is because estrogen makes the uterine lining grow. Adding a progestin stops this growth and prevents the estrogen from causing uterine cancer.

Estrogen comes in many forms. These include pills, a skin patch, gels and sprays applied to the arms or thighs, and vaginal rings, vaginal tablets, and vaginal creams. Information about vaginal products can be found here: [link to vaginal cream, ring, tablets]

The estrogen in pills is either manufactured (estradiol, esterified estrogens) or taken from the urine of pregnant horses (Premarin, conjugated estrogen). Their effectiveness and safety are the same. Skin patches, creams, gels and estrogen products used in the vagina contain estradiol.

Some women prefer “bioidentical” or “natural hormones.” Bioidentical means they are the same as those made by the body (estradiol and micronized progesterone). There is no difference in how the synthetic and natural hormones work.

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