HRT Misconception #2 - There is one type of female estrogen.

We are continuing our series with Tanya Manoni about hormone replacement therapy and the common misconceptions associated with this treatment. Tanya is one of our hormone experts at the pharmacy and you can schedule a consultation to see what HRT options are available specifically for you.

It’s not quite that simple.   Estrogen is actually a name representing a group of hormones.  There are 3 different types of natural estrogen, and they each have distinct differences.  “Estrogen” refers to the combined total of estrone, estradiol, and estriol.  Of the three, estradiol is the star (when not given orally) with over 400 different functions in the body!   Estradiol binds to estrogen receptors in the brain, bone, skin, digestive tract, and more.  Typically, if you hear someone speaking loosely about estrogen, they are referring to estradiol (or “synthetic estrogens” which is a whole other can of worms that I rarely recommend.)  Estradiol is the major estrogen of pre-menopausal women and is produced primarily in the ovaries.  Estrone, on the other hand, is the “estrogen” of menopause, and is made mostly from conversion of estradiol in the liver.  This sounds well and fine, however estrone is my least favorite of the natural estrogens.  Why am I giving this post-menopausal estrogen such a hard time?   Unfortunately, estrone is linked to breast cancer because it preferentially binds to the alpha form of the estrogen receptors in your body.  These alpha receptors can turn on proliferation of cells when they are occupied by estrone.  Do you know what other tissue/organ makes estrone?  Fat!  If you are a post-menopausal woman, with extra weight around your midsection and thighs thinking “How can I get rid of this estrone?!”  We have solutions.  Come see us.  Call me.  For this blog, however, I am on to the estrogen superhero, estriol.  Estriol is the estrogen of pregnancy, and is secreted largely by the placenta, and very minimally by metabolism of the other two estrogens.  This estrogen is the superhero because it is anti-cancer, specifically in the breast and endometrial tissues.  How?  Well, it preferentially binds to beta-type estrogen receptors and blocks the more proliferative estrogens’ effects.  Do you know it has been used for this purpose and for vaginal and urinary health in Europe for over 60 years?  

TANYA MANONI is a Chattanooga-native but earned her BS in chemistry and PharmD at the University of Utah. She brings with her years of experience in compounding and pharmacy corporate management. Tanya's professional interests include not only BHRT, women’s health, and dermatology, but also nutrition and fitness, in which she became interested while playing NCAA Division I college soccer. While living in Utah, Tanya earned her level 1 certification in avalanche search and rescue, and she continues to enjoy snowboarding, hiking, and mountain biking. She lives in Chattanooga with her husband and two kids, so you will find her running between soccer fields and dance studios in her free time.

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