WHAT IS ESTROGEN?
What exactly is Estrogen and why is it important?
Estrogen is a natural hormone made by your body, along with Progesterone, Testosterone, and many others.
It does many important things, such as keeping your reproductive organs, skin, hair, and bones healthy. Without it, you could not develop into a female!
We worry about using added Estrogen in certain medical conditions, including high blood pressure, extreme diabetes, migraine headaches with “aura” (warning signs that the headache is about to start such as seeing squiggly lines or other vision changes), breast or liver cancer, a previous stroke, heart attack, or blood clot, smoking in women age 35 and older, or even recently pregnant women!
It’s because Estrogen affects your blood vessels, making it easier for blood clots to form. When another medical issue already puts you at higher risk for this to happen, adding any medicine with Estrogen in it is a BAD idea.
Blood clots are when your blood cells clump together. They usually form in the legs but can also form in the lungs. Wherever they are, they are LIFE THREATENING. If it clogs up an important blood vessel, death could be instant.
A clot can also break off into the bloodstream and clog up a vessel somewhere else, like in your heart (heart attack) or brain (stroke).
A previous issue with blood vessels means you’re at higher risk of it happening again. So if you’ve ever had a heart attack, stroke, or blood clot before, or know of blood clots in your family (since there are some genetic blood clotting disorders that run in the family), BE SURE TO TELL YOUR DOCTOR!!
Most women don’t know that immediately after you have a baby, your body’s hormones are re-adjusting and you have a higher risk of blood clots. Thus, it’s UNSAFE to have Estrogen until at least 21 days after your baby was born!!
To decrease your chances of getting a blood clot, it’s important to keep getting out of bed and moving around, even if you delivered with a C-section, a big surgery.
Another common issue with being able to take Estrogen is smoking. It seems silly to set a cut-off age of 35, but as women get older, their chances of developing blood clots increases as well.
The amount you smoke matters a little bit. If it’s less than 12 cigarettes/day, you may be able to convince your doctor to prescribe you Estrogen, but it is still quite dangerous, so many doctors flat out avoid Estrogen, no matter what amount you smoke.
Cancer is another disease that already increases your risk of blood clots. You cannot use Estrogen in cases of certain breast and liver cancers/diseases.
Estrogen is also not safe in severe cases of high blood pressure (measurements of >160/100) or diabetes that has affected the blood vessels.
Many women also have migraine headaches, a severe kind of headache that can come with nausea and vision changes. If your migraines have an “aura” (warning signs that the headache is about to start such as seeing squiggly lines or other vision changes), Estrogen medications would not be safe for you.
The word “migraine” is thrown around a lot and used to mean any kind of headache sometimes, so it’s important to discuss what your headaches are like in DETAIL with your doctor, to figure out if it’s truly a migraine, and if it has an aura.
Doctors use this chart, called the Medical Eligibility Criteria for Contraceptive Use, which is very detailed and can be overwhelming for patients to look at themselves.
If you are curious, the scores range from 1-4. Dark green (score of 1) means “go ahead and use.” Red (score of 4) means “absolutely avoid!” Scores 2-3 advise “use with caution.”
The first column, “CHC” stands for “Combined Hormonal Contraceptives,” the only column that contains Estrogen listed on there. It includes the Pill, the Patch, and the Ring, which contain both Estrogen and Progesterone Combined.
Don’t worry, you don’t need to understand this chart. Just be prepared to talk to your doctor in DETAIL about your medical history before starting any medication with Estrogen in it!!
As you can see, there are SO many things your doctor must consider. Some decisions are not related to Estrogen at all, such as not using an IUD when a woman recently had an infection in the uterus.
It’s really important to keep track of your medical issues, even if they were in the past only, and to not leave anything out!!
If you cannot have Estrogen, don’t worry, there are MANY birth control choices out there that do NOT have Estrogen in them.
Make sure to always keep in close touch with your doctor!! Whatever new medicine you start, you can always contact him/her if you notice any side effects or changes!
Great communication is the key to changing healthcare for the better!