Oestrogen Essentials: Options to Ease Symptoms & Protect Long-Term Health (Part 2 of 3)
In Part 1, we explored how sex hormones work together to influence your whole body. Today, we zoom in on oestradiol — the hormone that drives many of the changes women notice through perimenopause and menopause.
Building on Part 1, this week we focus on oestradiol: the most potent oestrogen and the one that declines most dramatically in menopause. It plays a role in hot flushes, sleep, mood, joint comfort, bladder health, sexual comfort, brain function, bone strength, cardiovascular health and skin integrity. (click on the arrow to the left to open the full article)
Oestrogen Recap
Oestrogen receptors are found body-wide (quick visual reminder):
Adapted from tissue distribution data in Paterni et al. (2014) Steroids and Australasian Menopause Society guidelines (2025). Illustration by Menopause & Me.
Brain • Heart and blood vessels • Bones and muscles • Skin and collagen • Bladder and vagina • Many more
Oestradiol (E2): The strongest and most active before menopause. Produced mainly by the ovaries. This is the key oestrogen in menopause hormone therapy.
Oestrone (E1): Weaker than oestradiol. Becomes the main oestrogen after menopause (produced in fat tissue).
Oestriol (E3): The weakest. Mainly produced during pregnancy by the placenta.
Oestetrol (E4): Produced only during pregnancy by the fetal liver.
In menopause therapy, we primarily replace oestradiol because it most closely matches what your body made in higher amounts pre-menopause.
Safe, TGA-approved oestrogen options in Australia (2025)
Transdermal routes (patches/gels) generally have the lowest risk profile.
Many are PBS-subsidised.
Common symptom relief (from guidelines)
Many women notice:
Clinical trials show substantial reductions (often in the range of 75-90%) in hot flushes for many women
Improvement in vaginal dryness, painful sex and bladder symptoms
Better sleep, mood and joint comfort
Reduced brain fog
Individual responses vary.
Long-term considerations (when started early: under 60 or within 10 years of menopause)
Guidelines note potential benefits including:
Reduced bone loss and fractures
Neutral to potentially beneficial cardiovascular effects have been observed when started early, particularly with transdermal formulations
At standard doses, risks are considered low in guideline summaries, but decisions are always individualised.
Your helpful 3-step plan
Continue tracking symptoms
Book a longer appointment with your clinician
Ask: “Is oestradiol a safe option for my history and symptoms?”
Non-hormonal helpers that make a real difference
Many women start here for mild to moderate symptoms:
Keep core body temperature lower (layered bedding, cool room, fans, cold drinks)
Identify and reduce personal triggers (caffeine, alcohol, spicy foods)
Practice paced breathing or relaxation during a flush
Regular physical activity (e.g., walking, yoga or strength training 2–3 times/week)
Maintain a healthy weight (evidence shows weight gain can worsen flushes)
Cognitive behavioural therapy (CBT) or clinical hypnosis (some evidence for reducing flush bother and improving sleep/mood)
Next up: Part 3 (Progesterone, Testosterone and DHEA).
If you’d like support or a personalised plan, you can reach me at:
You’re not alone on this journey: knowledge is power!
Warmly, Jenna
Nurse Practitioner
Sources
Australasian Menopause Society | North American Menopause Society Position Statement | Jean Hailes for Women’s Health | Monash University Practitioner Toolkit
Important Disclaimer: The information in this blog/newsletter is general in nature and intended for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your Nurse Practitioner, doctor, or another qualified health practitioner with any questions you may have regarding a medical condition or before commencing any new treatment, exercise program, changing your diet, or taking supplements – particularly if you have existing health conditions, are on medication, or have had fractures or falls in the past. Individual needs and responses vary.
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