Estrogens were first introduced as drugs in 1933, DES (diethylstil bestrol) being one of the first estrogen drugs. Subsequently a combination estrogen-progestin birth control pill was developed and by the mid 1960s the first wave of postmenopausal estrogen replacement use was gaining momentum.
In 1966, gynaecologist Robert Wilson passionately declared that the pharmaceutical industry now offered Woman's precious gift, the elimination of menopause, women's physical, mental, and final emancipation. By the 1970s estrogen became one of the top five prescription drugs.
Women taking estrogen found that they had fewer hot flashes and no vaginal atrophy.
Their moods were better, their breasts firmer, and they had more energy.
However, studies soon showed that taking estrogen for longer than one year increased the risk of endometrial cancer. Estrogens?popularity plummeted when the Food and Drug Administration issued a warning that the dose should be one-quarter of the amount used at that time, but admitted that this still might not be protective enough to negate the increased risk of cancer. The type of estrogen is another factor to consider.
The three types of active human estrogens
Estradiol, estrone, and estriol, can be prescribed alone or in combination. Estriol, although little-studied to date, may be as effective as and safer than standard ERT; however, it is less potent and must be given in higher doses than the other two estrogens.
Some investigators have found that unopposed estriol (that is, without progesterone) does not cause endometrial hyperplasia (increase in the number of cells), However, it is believes that estriol, as with other forms of estrogen, should be given along with progesterone in postmenopausal women with or without a uterus.
The balancing effect of progesterone with estrogen likely affects other tissues besides the uterus. Because of the experience we have with estradiol and estrone, doctors often prescribes an estrogen formula developed by an expert in nutritional medicine. It consists of all three naturally occurring forms of estrogen: estradiol, estrone, and estriol. This "tri-estrogen" preparation includes these hormones in what he calculated to be the same proportion as they are found in premenopausal women and appears to minimize the risks of estrogen and maximize their benefits. It may be used along with natural progesterone and other hormones.
In getting the most out of our healthcare dollar, many of us have begun to voice concerns about the remedy most recommended by Western medicine for menopause and the years after: hormone replacement therapy (HRT).