Oestrogen Dominance

Estrogen is a fat-soluble steroid hormone that is made in your body.  In women, their ovaries make the majority of estrogen but many other tissues can make estrogen such as fat tissue, adrenal glands and the skin.

A hormone is like a messenger; it goes to cells inside your body and informs the cell to do something.

Estrogen was originally thought to be only involved in women’s reproductive system. But it is now known to be involved in both men and women and it acts throughout your whole body, such as in the brain, liver and heart.

 

WHAT DOES ESTROGEN DOMINANCE MEAN?

Estrogen has some important functions in maintaining balance in your body.  But estrogen needs to be restrained, otherwise its biological effects can cause problems.                                                    

Estrogen has a complimentary sex hormone in your body, called progesterone.  Progesterone and estrogen have balancing roles in your body and generally progesterone curbs the activity of estrogen.

Ideally, we want controlled amounts of estrogen and abundant amounts of progesterone to achieve hormonal balance.  However, it is common for this balance to tip, favouring too much estrogen.   This is known as estrogen dominance.

It is described as a condition where a woman can have deficient, normal or excessive estrogen, but has little or no progesterone to balance its effects in the body. Even a woman with low estrogen levels can have estrogen dominance symptoms if she doesn’t have any progesterone.

What are the signs and symptoms of estrogen dominance?

• Acceleration of the ageing process                                 
• Allergies, including asthma, hives, rashes, sinus congestion                                         
• Autoimmune disorders such as lupus,      
• thyroiditis and possibly Sjorgen’s disease                                                                           
• Breast cancer                                                            
• Breast tenderness                                                     
• Cervical dysplasia                                                      
• Cold hands and feet as a symptom of thyroid dysfunction                                                  
• Copper excess                                                            
• Decreased sex drive                                    
• Depression with anxiety or agitation                       
• Dry eyes                                                                       
• Early onset of menstruation                                     
• Endometrial (uterine) cancer                     
• Fat gain, especially around the abdomen, hips and thighs                                            
• Fatigue                                                                          
• Fibrocystic breasts                                                      
• Foggy thinking                                                           
• Gallbladder disease  
• Zinc deficiency                                                 
• Water retention and bloating
• Uterine fibroids
• Uterine Cancer
• Thyroid conditions mimicking hypothyroidism
• Sluggish metabolism
• Prostate Cancer
• PMS
• Premenopausal bone loss or even osteoporosis
• Polycystic ovaries
• Mood Swings
• Insomnia
• Irritability
• Magnesium Deficiency
• Irregular menstrual periods
• Hair loss
• Headaches
• Increase blood clotting
• Infertility
• Memory loss

 

Your doctor may have tested your blood for estrogen and progesterone and probably found them in the normal range.  However, research suggests that this does not mean that your hormone levels in your entire body are in balance.

There are a number of reasons why a blood test can be misleading when it comes to estrogen and progesterone.

1. Blood levels do not reflect tissue levels – the amount of estrogen or progesterone in the blood does not correlate to the amount and activity in the tissues.

Firstly, a blood test for hormones is a poor medium to choose because we are trying to measure a fatty substance in a watery environment.  A fat-soluble hormone, such as extrogen, doesn’t mix into a water solution, such as your blood.  Estrogen is often bound to molecules such as red blood cells, albumin and lipoproteins in the blood, which may be discarded in a blood test.

Ratio – it is the relative difference between estrogen and progesterone, rather than the absolute level of estrogen that is important for hormone balance.  If your doctor has tested your blood estrogen (if we pretend blood tests are valuable) and it is low, you still need to know the level of progesterone. Perhaps the progesterone is even lower than the estrogen; still resulting in estrogen dominance.

Time of cycle – hormones fluctuate during a menstrual cycle and at different times the same level of hormone may be high or low.  It is important to test menstruating women at certain times of their cycle to get a good understanding of her hormone balance (day 21 of a woman’s cycle is often a good reference point).

Estrone and estriol; the other estrogens – doctors commonly measure estradiol in women.  However, estrogen is a collective noun for a number of estrogenic hormones, all which have biological importance. Women (and men) make estrone (E1), estradiol (E2) and estriol (E3), While estradiol is thought to be the most active hormone, estrone and estriol also have biological actions.  Standard hormone blood tests do not measure E1 and E3, assuming only E2 is important. But research dating back to 1958 has found that estriol is not to be ignored.

“estriol itself is a potent estrogen, contrary to the usual conception of its being just a metabolite of the more potent estrone and estradiol.”                              R.C. Merrill, “Estriol: A review,” Physiol.Revs 38(3), 463-480, 1958

Estradiol (E2) is converted into estriol in your body, which may give you misleading information on your estrogen levels if you only had estradiol measured.  You may have a normal E2 level but your E3 level could be high still making you estrogen dominant.  Another study back in the 1950’s found that men who had suffered a heart attack had higher estriol (E3) levels compared to health men.

So in summary:

If you are getting hormones measured, ensure that you are getting all estrogens tested.

SALIVA HORMONE TESTS

Compared to standard blood tests, a salivary hormone test is a reliable way to measure estrogen dominance. A salivary hormone test is:

• Accurate – Salivary hormone tests measure the ‘free’ hormone in the saliva and better reflects hormone profiles than the blood. The tests have been used since the 1960’s and are backed by research.
• Comprehensive – The tests look at all 3 estrogens, progesterone, DHEA and testosterone.  This is very important to observe the ‘other’ estrogens; estrone (E1) and estriol (E3), to gauge estrogen dominance.  And, the addition of DHEA and testosterone is also useful, particularly in cases such as acne, PCOS, menopause, polymyalgia rheumatic, lupus and loss of libido.
• Relative – This test will also look at the ratios of estrogen to progesterone.  As mentioned before, it is the difference between estrogen and progesterone, not their absolute levels that contribute to estrogen dominance.
• Non-invasive – a saliva test is painless and simple.
• Easy – You do the saliva test from the comfort of your home.  You get sent the test kit, you do it at home and put it in the reply paid envelope. Easy! Also, it is convenient when needing to do it on a specific day of your cycle (e.g. Day 21). Simply order the kit early, wait for the required day to arrive and perform the test.

 

Research over the past 30 years has shown that many perimenopausal and menopausal women are in a state of estrogen excess.

The researchers found that despite menopausal women having low blood levels of estrogen, the content in the tissue (uterus) was the same as younger menstruating women. The estrogen levels inside the organs of menopausal women are high.

The follicular phase is the part of a menstruating woman’s cycle from the last day of her period, to ovulation.  The follicular phase is when progesterone is at its lowest – a time when estrogen dominance is at its peak.

From this research we can see that the only difference between the tissue concentrations of estrogen in menopausal women compared to menstruating women is that menstruating women get regular protection from estrogen dominance during the luteal phase.  Menopausal women don’t ovulate therefore don’t get the luteal surge of progesterone to offset their estrogen dominance.  You can see that menopause can be a time of worse estrogen dominance for many women.

The hormone most consistently absent after menopause is progesterone.  (A lack of progesterone means estrogen is unopposed – estrogen dominance)

There are many ways to improve hormone balance regardless of age or even sex.  Here are some important factors that help improve hormone balance.

ESTROGEN DETOXIFICATION

Your body removes estrogen via your liver and then into your bowels.  Research has proven by optimising liver and bowel function you can lower your estrogen load.

Liver – estrogen can become inactivated in the liver and then disposed of through the bowels and kidneys.  There is a system in the liver that inactivates estrogen and the main component of that system is the estrogen detoxification enzymes known as the p450 enzyme.

Improving the activity of the p450 enzyme is a major target for improving estrogen dominance.  And nature has a great tool to fire up this enzyme!  A compound has been isolated from green leafy vegetables call Indole 3 Carbinol (I3C), which is known to powerfully increase p450 activity.  This results in lower estrogen levels and it is thought to be the reason why eating green leafy vegetables protects women against estrogen dependant cancers, such as breast cancer.  Using I3C in supplemental form can give very impressive improvements in estrogen levels.

In an experiment of bowel function and estrogen levels, scientist gave people various fibre supplements to see how this affected the amount of estrogen in their body.  It was found that if you speed up your transit time with certain fibres you can lower your estrogen levels.  Transit time is the time it takes for food to go through you; faster transit means estrogen sits in your bowels for less time to be re-absorbed.  The use of fibre, diet, herbs and probiotics can help improved estrogen clearance from the bowels.

Maintaining a healthy level of body fat is important in combating estrogen dominance for both male and female.  This is especially important for the women who have the “tummy, hips and thighs” weight gain.

STRESS REDUCTION

The pioneer of estrogen dominance, Ray Peat said:

“The avoidance of stress is the basic principle for preventing the development of the estrogen dominant state”

Progesterone is the natural counterpart to estrogen but it is also the hormonal precursor to your stress hormones, such as cortisol.  When you are stressed your body makes cortisol to help combat the effects of stress.  Progesterone is the precursor molecule to cortisol, therefore an increase need for cortisol leads to a decline of progesterone.  A lack of progesterone can then allow estrogen to ‘dominant’.

                                                                                                                                                                        

DIET MODULATION

As if human hormones are not complex and confusing enough – there is a whole plant kingdom full of hormone like compounds!  These compounds are similar in function to our own hormones and can be found in many common foods.                                                                                                                                                                           

“Whether weak or strong, the estrogenic response of a chemical, if not overcome, will add extra estrogenic burden to the system”

Foods high in phytoestrogens include: flax seed, tofu, soybeans, multigrain bread, soy milk, hummus, garlic, beans, sunflower and sesame seeds.

Soy foods are often touted as good for you but they rate as one of the highest foods in phytoestrogens.  Some health “experts” suggest soy for women, claiming it to be helpful especially approaching menopause.  But there has been some research finding soy to increase levels of estradiol in women and creating unwanted changes in breast tissue.  The best eating plan for estrogen dominance is a high protein, low carb approach.

ENVIRONMENTAL ESTROGENS

There are a large amount of environmental chemicals that also have an estrogenic action in our body.  The evidence is growing and alarming.  Xenoestrogens is the term used to describe these environmental estrogens.  Research is only now discovering the impact senoestrogens are having on the body, although many of these synthetic chemicals have been used for many years.

Some common xenoestrogens are:

• Bisphenol A – this is a chemical used to make plastics softer and is used for drink bottles, to line food cans, children’s toys and water pipes
• Phthalates – another chemical found in commonly used plastics and poses a major risk to health
• Heavy Metals – such as cobalt, copper, nickel, chromium and lead all act in an estrogen like manner in the body
• PVC – again, like bisphenol A, used in food containers
• Parabens – a common ingredient in cosmetics
• Pesticides – such as dichlor-diphenyl-trichlorethylane (DDT) and endosulfane, both commonly found in the food supply
• Alkilphenols – used in dental appliances

The net results of recent studies create some major concerns of bisphenol A.  The levels found today in humans are greater than the tissue concentrations used to cause cancer in test animals.  This means that ‘pound for pound’ we are getting a higher dose than what experimenters need to induce cancer in animals.

 

PROMOTE PROGESTERONE

To combat the adverse effects of estrogen dominance it is important to promote progesterone production.  Similar to phytoestrogens, nature offers some phytoprogesterones, although far fewer in number.

One plant that science has found to have a progesterogenic effect in the body is a Traditional Chinese Medicine herb called Ligusticum chuanxiong.  Studies done in 2006 found Ligusticum chuanxiong to stimulate the progesterone receptor.

Another herb that can be used to promote progesterone is Vitex Agnus Castus.  Vitex is helpful in menstruating women who have a progesterone deficiency due to luteal phase defect (late ovulation or early onset of period).

There are a number of other herbs that although do not directly increase progesterone, they can help with hormonal imbalances.  The Peruvian root vegetable Maca is known to be a potent aphrodisiac, has high levels of I3C and is suggested to help progesterone production.  The herbs Burpleurum and Rehmannia are both Traditional Chinese Medicine herbs that have been proven to help with hormonal symptoms such as PMS and menopause.

 

In some cases, women may need a supplement of progesterone to offset their estrogen dominance.  Progesterone supplements come in capsules, creams or oils and is a very safe and effective measure to combat estrogen dominance.

Cases that require supplemental progesterone is usually peri-menopausal and menopausal women.  Younger women generally don’t need supplemental progesterone if you can correct the estrogen dominance using natural remedies.  Younger women should be able to make adequate amounts of progesterone if their system is in balance.  Occasionally, a younger woman (e.g. younger thatn 35 y.o.) may need extra progesterone if it is a serious case of estrogen dominance, such as breast cancer, severe endometriosis, or chronic infertility.

Middle age women (hormonally speaking, greater than 35-40 y.o.) sometimes need supplemental progesterone to fight the often many years of estrogen dominance.  Also, as we have seen, peri-menopausal and post-menopausal women make very little progesterone and sometimes (but not always) need extra progesterone.

Natural progesterone therapy has been used for many years and is safe and effective.  Natural progesterone therapy is giving your body the exact same hormone that your body makes – progesterone.  HRT (Hormone Replacement Therapy) is nothing like natural progesterone because:

1. It contains synthetic progestins which are supposed to act like progesterone in the body but research shows it can often act like estrogen.
2. It contains estrogen, supposedly because the woman is estrogen deficient.  As we have also seen women don’t become relatively estrogen deficient, and actually they are in estrogen excess – more estrogen is the last thing they need.

Some natural progesterone is made from the herb wild yam.  Some women find relief with wild yam creams and supplements, however women do not convert wild yam into progesterone.

In Australia, unlike other countries such as America, naturopaths cannot dispense progesterone (progesterone is available over the counter in the U.S.).  However, that does not mean it is illegal for personal use in Australia.  If you need extra natural progesterone you either see a wholistic GP for a prescription or purchase it yourself online for personal use.

 

Progesterone needs to be used from day 14 to day 28 during reproductive years and 20 days on, 5 days after menopause.  I find it easier to suggest using progesterone from 7^th to 28^th of the month.

 

Copyright 2010