While women urgently need estrogen supplementation to prevent a range of degenerative changes once they enter menopause, estrogen supplementation, as a medical procedure, also has its indications and contraindications. So, under what circumstances can women supplement estrogen, and under what circumstances should they not?
Experts advise that postmenopausal women should consider estrogen supplementation in three situations: First, when experiencing severe menopausal symptoms that significantly impact quality of life, including vasomotor instability, urogenital atrophy, and neuropsychiatric symptoms. Second, those with low bone mass, osteoporosis, or multiple fractures, or those with high-risk factors for osteoporosis such as weight loss, insufficient calcium intake, smoking, excessive alcohol consumption, lack of exercise, early menopause, or a family history of osteoporosis should supplement with estrogen. Estrogen supplementation can reduce excessive bone loss in both the immediate and long term after menopause. After six years of use, the risk of hip fracture can be reduced by 25%, and the incidence of vertebral fracture can be reduced by at least 50%. Third, individuals with high-risk factors for arteriosclerosis and coronary heart disease should also supplement with estrogen to prevent coronary heart disease. High-risk factors for coronary heart disease include hypertension, dyslipidemia, impaired glucose tolerance, smoking, lack of exercise, and a family history of cardiovascular disease. Epidemiological studies show that long-term estrogen supplementation reduces the risk of coronary heart disease by 35%–45%.
Similarly, there are six contraindications for estrogen supplementation: 1. Estrogen-dependent tumors: breast cancer, endometrial cancer, melanoma. 2. Unexplained vaginal bleeding. 3. Severe liver and kidney disease. 4. Thromboembolic diseases within the past 6 months. 5. Systemic lupus erythematosus, otosclerosis. 6. Porphyria.
In addition, there are five other areas where caution should be exercised when supplementing with estrogen: uterine fibroids, endometriosis; severe hypertension and diabetes; a history of thromboembolism or a tendency to form thrombosis; gallbladder disease, migraines, epilepsy, asthma, pituitary PRL tumors, etc.; and a family history of breast cancer.
For middle-aged women, estrogen supplementation is an important way to prevent disease and improve quality of life. However, Professor Lin reminds women that before supplementing, they must first understand their own situation; only by "matching the appropriate supplement" can it be safe and effective.
