Throughout a woman’s fertile period the two hormones estrogen and progesterone (produced by the ovaries), work together to control the menstrual cycle. Estrogen stimulates ovulation and progesterone prepares the endometrium or lining of the uterus for implantation of a fertilised egg. If pregnancy occurs progesterone continues to be produced by the placenta to maintain the pregnancy, if not levels of progesterone falls, which initiates menstruation. The production of estrogen and progesterone is regulated by hormones produced by the pituitary gland - Follicle Stimulating Hormone (FSH) and Luteunising Hormone (LH), which in turn are under the control of Gonadotropin Releasing Hormones (GnRH) produced by the hypothalamus in the brain.
Androgens are generally considered to be male hormones but they also have several functions in the female body, including puberty related changes like pubic hair growth, preventing bone loss, libido and for the production of oestrogen.
Conditions caused by hormonal imbalance
An hormonal imbalance in women can cause a range of hormonal disorders:
- Lack of progesterone can result in menstrual disorders like, secondary amenorrhoea (menstrual periods that have stopped, are absent or irregular), dysmenorrhoea or painful periods, premenstrual syndrome and abnormal uterine bleeding, which occurs during the menstrual cycle instead of at the end. Medication containing a form of progesterone can help treat these menstrual disorders. Endometriosis, a condition where the endometrium grows outside the uterus and causes pain and bleeding can also be treated with progesterone.
- Overproduction of androgen or androgenisation causes hirsutism or production of unwanted hair, androgenic alopecia (hair loss) and polycystic ovary syndrome (PCOS), which is usually accompanied by acne and hirsutism and is related to insulin resistance and type-2 diabetes. These conditions can be treated using anti-androgen drugs.
Treating symptoms of menopause
As menopause approaches, the production of the female hormones estrogen and progesterone ceases, which brings to an end to the regular cycle of ovulation and menstruation. A lack of estrogen causes the of symptoms including, hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy. Estrogen also has several other actions in various metabolic processes including maintaining bone mass, which is why a lack of estrogen at menopause increases risk of osteoporosis.
Hormone replacement therapy (HRT) is used to help relieve symptoms of menopause by replacing female hormones that the body has stopped making naturally. HRT is generally in the form of an estrogen and can be delivered systemically as oral tablets or patches, or as topical creams for local vaginal symptoms like atrophic vaginitis. Combination HRT includes a form of progesterone to reduce the risk of developing endometrial cancer due to estrogen alone.
Other menopausal symptom relief medications available include clonidine, an alpha blocker and some dietary supplements that help reduce hot flushes.
Hormone based treatments for other conditions
This category also provides hormone based treatment for other women’s conditions, including:
- Some breast cancers and endometrial cancer, which are both estrogen-dependent tumours and can be treated with anti-estrogen drugs.
- Infertility due to lack of ovulation using an estrogen receptor modulator
- Osteoporosis or loss of bone mass is a common problem in postmenopausal women, which can be treated with medications that regulate bone turnover.