Restoring Estrogen Levels: Why It Matters Which Estrogen You Replace

How much do you know about the hormones your body makes? When it comes time for hormone replacement, many women are left bewildered as to the choices and whether it makes a difference which estrogen gets replaced or what kind of therapy is employed.
Let’s just say it makes a very big difference. You cannot randomly replace any hormone or every hormone and return to the hormonal balance of earlier years.
Hormone Harmony: The Delicate Balancing Act

Your body needs hormones. And it needs them in specific amounts. These vital substances work together in regulating most major body functions ranging from heart rate, bone density and blood sugar to your immune system, metabolism, sex drive and more. Due to a very sensitive feedback system it is possible for hormone concentrations in the blood stream to remain relatively stable in precise amounts, depending on the body’s needs. This is important because your hormones must exist in physiologic levels in order to perform properly. Too much or too little of a hormone can create internal havoc.

Each Estrogen Plays a Different Role

Your body specifically needs estrogen. It’s what makes you a woman and helps keep you healthy. In pre-menopause, there are three primary estrogens: estrone (E1), estradiol (E2), and estriol (E3). Each becomes predominant at different times in a woman’s life.

Estrone is produced primarily in the ovaries and fat cells in pre-menopause. It is considered a weak estrogen. Estrone becomes the main estrogen in post-menopause after the ovaries stop working. Fat cells are the primary source of estrone at this point.
Estradiol is the key estrogen during a woman’s reproductive years. It exists in a beneficial ratio of 2:1 with estrone (E2:E1). Estradiol is considered the strongest and most important estrogen, achieving higher levels in the blood stream and providing greater estrogenic activity. In fact, there are receptor cells for estradiol throughout the body, not just in the uterus and breast.
Estriol becomes the primary estrogen during pregnancy when it is synthesized in very high amounts in the placenta. It’s almost undetectable when you’re not pregnant.

Menopause: The Great Hormone Disrupter

The production of estradiol begins to slow in your mid-thirties. Likewise, testosterone and progesterone levels drop. Sometime after age 40, hormone loss becomes so pronounced that disruptive symptoms start to appear. You may at this point suffer from mood swings, hot flashes, fatigue, anxiety, depression or other issues.

Unfortunately, this is only the tip of the iceberg. Once menopause fully arrives, your ovaries stop manufacturing these three hormones altogether, making you more susceptible to a variety of health issues. Research has shown that low serum levels of hormones are linked to a variety of maladies. For instance, low testosterone in men can lead to osteoporosis,1 type 2 diabetes,2 and cardiovascular disease.3 Low estradiol in women has likewise been associated with the risk of osteoarthritis,4 Alzheimer disease,5 and cardiovascular disease.6

Bioidentical Estradiol Replacement: The Wise Choice

Your need for physiologic hormone levels never goes away. Every hormone in your body is intricately tied to others in helping you maintain good health and well-being as you age. It makes a huge difference which estrogen gets replaced and what kind of hormones (bioidentical vs. synthetic or conjugated) are used.

Those who suggest replacing estrone or estriol or combinations of estrogens don’t understand the importance of reestablishing proper estrogen ratios. Restoring estradiol in a 2:1 relationship with estrone is paramount. It’s important to note that Premarin and other pharmaceuticals that use conjugated estrogens in oral form reverse the healthy ratio of 2:1 to an unhealthy 1:2. Likewise oral estradiol drugs such as Estrace create an incorrect ratio of 1:1, as do all estradiol patches. The only estrogen replacement therapy that reproduces the beneficial 2:1 ratio are bioidentical estradiol pellet implants, such as those used by SottoPelle®.7

Also, it is essential to use hormones that are molecularly identical to those your body once made. Bioidentical hormones, when properly administered, can actually return hormonal balance at a cellular level. You likewise need a therapy that can address other hormone deficiencies such as testosterone, progesterone and thyroid.

The SottoPelle® Method

SottoPelle’s proprietary method allows us to tailor your hormone therapy according to your unique needs. Our goal is to provide hormonal balance—something other methods or even other pellet therapies cannot deliver.

SottoPelle® employs a proprietary bioidentical pellet implant method that sends a steady, low dose of hormone directly into the blood stream. Precisely dosed hormones are delivered around-the-clock, seven days a week for up to six months. The body recognizes and can work with this type of delivery method. In fact, it is the only system that allows more hormone to be delivered when the body needs it.

You will find that our SottoPelle® method is not only more convenient and better attuned to the way your body works naturally, but it is also far more cost-effective than other hormone treatments.

SottoPelle® BHRT Pellet Experts

SottoPelle® has specialized in bioidentical hormone replacement using the pellet method longer than most. Our founder, Dr. Gino Tutera, developed the proprietary method that makes us a leader in our field. We have a long history of success when it comes to balancing hormones and helping people take control of their health. In fact, we are honored to say that, according to Ranking Arizona, an annual consumer publication by AZ Big Media, our patients have voted us Arizona’s #1 Hormone Therapy Clinic for two years in a row.

Call Us Today!

Consulting with an expert in SottoPelle’s science-based BHRT can go a long way in creating a healthier future for you. Discover what our remarkably simple, hassle-free method can do for you.

Learn more about SottoPelle® at and then give us a call at (877) 473-5538 to schedule a consultation.

1Dupree K, Dobs A. Osteopenia and Male Hypogonadism. Rev Urol. 2004; 6(Suppl 6): S30-S34.
2 Al Hayek AA et al. Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study. J Family Community Med. 2013 Sep-Dec; 20(3): 170-186.
3 Jones TH. Testosterone deficiency: a risk factor for cardiovascular disease? Trends Endocrinol Metab. 2010 Aug; 21(8): 496-503.
4 Roman-Blas JA, Castaneda S, Largo R, Herrero-Beaumont G. Osteoarthritis associated with estrogen deficiency. Arthritis Research & Therapy. 2009 Sep; 11:241.
5 Janicki SC, Schupf N. Hormonal Influences on Cognition and Risk for Alzheimer Disease. CurrNeurol Neurosci Rep. 2010 Sep; 10(5): 359-366.
6 Rossi R, Grimaldi T, Origliani G, Fantini G, Coppi F, Modena MG. Menopause and cardiovascular risk. Pathphysiol Haemost Thromb. 2002 Sep-Dec; 32(5-6): 325-8.
7 Thom M et al. Hormone profiles in post menopausal women after therapy with subcutaneous implants. Br J Obstet Gynaecol. 1981; 88:426-433.