ESTROGEN, PROGESTERONE AND YOUR MENSTRUAL CYCLE

 

 

Dr Steven R. Goldstein MD, a hormone specialist in NYC, is the co-author of the books “The Estrogen Alternative” and “Could it be….Perimenopause?”. A past President of the International Menopause Society and a Certified Menopause Practitioner, Dr Goldstein has worked alongside thousands of his patients in over 2 decades of private practice using hormone replacement therapy (HRT) to help them cope with the symptoms of menopause and hormone imbalances that may result in gynecological conditions such as bleeding.

 

Let’s take a closer look at the hormones estrogen and progesterone. Estrogen is made from follicles that develop each month in the ovaries. A follicle is a saclike structure inside the ovary that contains an egg. At the end of a cycle, if pregnancy does not ensue, the menstrual lining of the uterus is shed. The first day of the period begins day one of a new cycle. At that point, both ovaries recruit about a half dozen follicles under the influence of the follicle stimulating hormone (FSH) from the pituitary gland in the brain. Around day nine, one follicle takes off geometrically and becomes the dominant follicle. It is a small 2.5 cm cystic structure prior to it bursting. This is ovulation.

At midcycle, (day fourteen), a surge of luteinizing hormone (LH) from the pituitary causes the follicle to rupture, releasing the ovum to be picked up by the fallopian tube.

 

The follicle is now known as the Corpus Luteum (CL), and it begins to produce large amounts of Progesterone.

 

Progesterone causes the glands of endometrium (lining of the uterus), to become lush in preparation for receiving the fertilized egg. If no pregnancy ensues, estrogen and progesterone levels decrease and the woman gets her period fourteen days after ovulation. Recall that the beginning of bleeding day one of the new cycle. Thus, in an idealized twenty eight day cycle, a woman ovulates on day fourteen and fourteen days later she gets a menses.

 

Dr Goldstein, one of the top hormone doctors in NYC, says that it is important to remember that a menses (or a period) is a bleed that is preceded by ovulation. Not all bleeding is a menses. Without progesterone to trigger menstruation, the endometrium can keep building up and eventually be shed, giving the woman the impression she has had her period.

 

These hormonal imbalances can lead to irregular bleeding, where there is estrogen but no progesterone. Irregular bleeding and a host of other symptoms can follow. Unopposed estrogen (estrogen without progesterone) for long periods of time can lead to pre cancer.

 

Dr Steven R. Goldstein MD is a leading hormone specialist in NYC who uses HRT such as Selective Estrogen Receptor Modulators to help women cope with symptoms of menopause. Women who are experiencing excessive bleeding should also see Dr Goldstein as it may be due to a hormonal imbalance that gives rise to a thick uterine lining. If you are experiencing those symptoms or irregular periods then a consultation with Dr Steven R. Goldstein may be appropriate.