Cardiogenic shock (CS) is a medical emergency resulting from inadequate blood flow due to the dysfunction of the ventricles of the heart. Signs of inadequate blood flow include low urine production (<30 mL/hour), cool arms and legs, and altered level of consciousness. People may also have a severely low blood pressure and heart rate. Causes of cardiogenic shock include cardiomyopathic, arrhythmic, and mechanical. CS is most commonly precipitated by acute myocardial infarction. People can have combined types of shock. Treatment of cardiogenic shock depends on the cause with the initial goals to improve blood flow to the body. This can be  done in a number of ways—fluid resuscitation, blood transfusions, vasopressors, and ionotropes. If cardiogenic shock is due to a heart attack, attempts to open the hearts arteries may help. An intra-aortic balloon pump or left ventricular assist device may improve matters until this can be done. Medications that improve the hearts ability to contract (positive inotropes) may help; however, it is unclear which is best and at present there is no convincing evidence supporting inotropic or vasodilating therapy to reduce mortality in hemodynamically unstable patients. Norepinephrine may be better if the blood pressure is very low whereas dopamine or dobutamine may be more useful if only slightly low. Cardiogenic shock is a condition that is difficult to fully reverse even with an early diagnosis. With that being said, early initiation of mechanical circulatory support, early percutaneous coronary intervention, inotropes, and heart transplantation may improve outcomes.
Other causes of hypoestrogenism are excessive exercise, restrictive diet, underactive pituitary gland, ovarian failure, Turner Syndrome, and kidney disease. Symptoms of hypoestrogenism may include pain during sex, irregular periods, mood swings, hot flashes, breast tenderness, headache, depression, fatigue, weak bones, and an increase risk of urinary tract infections. Estrogen therapies, including the use of an estrogen patch, can be used to alleviate these symptoms by increasing estrogen levels to a normal state. Premenopausal women may be recommended to take progestin with estrogen therapy. Prevention of osteoporosis
Estrogen patches may be effective in preventing osteoporosis in postmenopausal women. Research suggests that estrogen patches can significantly increases bone mineral density and reduce risks of fractures in postmenopausal women by raising estrogen levels and avoiding first-pass metabolism.There is evidence that the combination of an estrogen patch with a progestin pill can improve bone mineral density in young, premenopausal amenorrheic athletes, and may be more effective than an oral estrogen with progestin. Hormonal birth control
Contraceptive patches such as norelgestromin/ethinylestradiol are a form of estrogen patch which are used for hormonal birth control. Patches with progestogens
Taking a progestogen in addition to an estrogen patch should be considered for women who have not undergone a hysterectomy to regulate the thickness of the endometrial lining and reduce the risk of endometrial cancer. Hysterectomized women rarely need a progestogen, however it may be considered if a history of endometriosis exists.