Doctorweblog. About Health & Medicine

This is a hormone, a chemical substance secreted into the bloodstream by the endocrine glands to direct the body’s functions and development. Oestrogen is one of the two female hormones which alter in balance with one another to control the reproductive cycle and the sexual characteristics in women.

Oestrogen is secreted by the follicles in the ovaries, one of which develops each month in sexually mature women to contain an unfertilised egg. Under direction itself from hormones released by the pituitary gland at the base of the brain, the follicle bursts and releases the egg into the woman’s fallopian tube for fertilisation by the male sperm. Throughout the egg’s development, the follicle has secreted oestrogen to direct the uterus to prepare a blood enriched lining ready for the egg to implant in once fertilised. If fertilisation does not take place, the follicle, now emptied of the egg and known as the corpus luteum, secretes a second hormone, progesterone, which will cause the uterus to shed its lining, a process familiar to most people as the monthly or menstrual period.

The enormous influence of oestrogen on many aspects of women’s health is often only fully appreciated after menopause, when the menstrual cycle ceases and the body’s production of oestrogen reduces dramatically. All kinds of side effects can result. The hot flushes, insomnia and mood swings experienced by many women during menopause are related to the fall in oestrogen levels, as are the more permanent conditions such as thinning hair and loss of skin elasticity. Similar side effects can accompany the surgical removal of the ovaries in younger women.

More serious is the increase in the risk of coronary heart disease experienced by post-menopausal women: an increase up to ten times greater than that of women just prior to menopause. Oestrogen, it seems, helps to limit fatty deposits in the arteries and relaxes the blood vessel walls to increase blood flow.

Receiving particular attention in the 1990s is the role oestrogen plays in the maintenance of bone mass and bone strength. Osteoporosis is caused when calcium leaches from the bone, leaving it porous and brittle. The condition is known to be accelerated by decreasing levels of oestrogen in the body, suggesting that oestrogen helps the cells maintain their calcium content.

To avoid this and other unpleasant and even dangerous conditions associated with aging, many women are turning to Hormone Replacement Therapy, a program whereby synthesised, plant or animal oestrogens and some progesterone supplements are taken regularly from the onset of menopause onward. While many women find that HRT removes all unwanted symptoms of the change of

life, it makes other women sick and may have serious side effects.

Oestrogens are powerful substances, particularly many of the synthesised forms, and they are far from fully understood. Oestrogen is now thought to play a significant role in the development of several kinds of cancer in women, including breast cancer, and in triggering conditions like thrombosis or blood clots in the veins. It is also believed that synthetic oestrogen given to women in the 1950s and 1960s to prevent miscarriage is responsible for a higher than normal incidence of rare cancers in their offspring. Naturopaths may suggest herbal alternatives to hormone replacement therapy. For example, the Chinese herb Dong quai contains plant oestrogens and can actually help to balance the body’s oestrogen levels by adding oestrogen to the system when concentrations are low and inhibiting oestrogen action when the levels are too high, competing as it does with the oestrogen molecule for binding sites. In China it has been used for centuries to treat menopausal symptoms and menstrual problems in women and dong quai is now gaining respect in the West.

*25\69\2*

Although a common maxim holds that ‘seeing is believing,’ this statement is actually not always true. Seeing can be quite deceptive, as anyone knows who has witnessed the tricks of a competent magician. Conversely, we believe many things that we do not actually see, for example that the earth revolves around the sun. But in some ways the maxim carries the weight of truth: Those things that we cannot see are hard to believe, which is one reason why they gave poor Galileo such a hard time when he maintained that the sun and not the earth was the centre of the solar system. Similarly, controlled treatment studies can appear quite unconvincing if one doesn’t believe in the treatment and the studies are performed by someone else. I encountered this phenomenon after conducting numerous light treatment studies in patients with seasonal affective disorder (SAD), or winter depression. The studies from my group at the National Institute of Mental Health, as well as those of numerous colleagues, told a clear story. Light therapy worked. Yet many psychiatrists who had never treated a single patient with light therapy remained sceptical. On the other hand, the successful treatment of a single patient with this modality was in certain instances more persuasive than all the published data on the topic. So, after studying SAD for several years and treating many hundreds of patients with light therapy, I was amused when an old colleague approached me at a meeting and said to me with an air of discovery, ‘You know that light therapy that you have been talking about all this time? I treated a patient with it and the damn thing works.’

In truth, though, it is wonderful to discover a phenomenon for oneself even if it has been described a thousand times before. And so it was for me with the use of St John’s Wort in depression. I had read about controlled studies performed in Europe and had actually seen some of the data. Yet it was only when I saw some of my own patients benefit from the herbal remedy that I felt the excitement that might be expected to greet the arrival of a novel form of treatment for an old and nasty adversary – depression.

*1\75\2*