In recent years we have seen a dramatic rise in female-related illnesses. This may be related to an excess of estrogen and can affect women of all ages. Endometriosis, PMS, uterine fibroids and even anxiety, weight gain and depression are examples of disease processes brought about by abnormal estrogen levels. This imbalance may affect up to 30% of all women. Being a woman in our time is certainly a high-risk profession. Fortunately, scientific evidence is mounting that hormone imbalances such as estrogen dominance are the key cause of these seemingly separate but related diseases.
For too long, the medical field has ignored the importance of hormonal balance. Physicians have ignored the value of maintaining excellent hormonal health. Now, we know that the common denominator in many female hormone diseases such as those mentioned above is related almost exclusively to estrogen dominance. The underlying problem is a relative excess of estrogen and an absolute deficiency in progesterone. The prevalence of estrogen dominance syndrome may even approach 40% in women over 35 years old.
To better understand the consequences of these hormone disturbances must first we must first discuss the normal functions of estrogen and progesterone.
Rising estrogen levels are needed for uterine lining growth during the menstrual cycle and replace and rebuild after the last menses. The vagina and female bladder functions are maintained under the influence of estrogen. It keeps the vagina moist and prevents the bladder from leaking urine. Estrogen is needed to maintain a proper rate of bone breakdown and prevent bone loss.
Estrogen causes the breast to grow and it also stimulates the development of female sexual organs.
Estrogen can decrease the function of thyroid hormone. Estrogen increases the production thyroid binding globulin. This protein binds thyroid hormone and thus makes it inactive thereby decreasing metabolism and increasing fat cell production.
Estrogen effects the brain and our psychological health. At normal levels, estrogen is needed to prevent depression and insomnia. At normal amounts, it increases concentration and maintains normal sex drive. If estrogen is too high, it can lead to depression, anxiety, insomnia, decreased sex drive and decreased concentration. Also estrogen is a hormone that if left unchecked can cause many inflammatory imbalances.
On the other hand, estrogen levels have been found to be much lower in women who perform strenuous physical activity. Exercise plays an important role in how estrogen is metabolized in the body. Studies have shown that women with an increased risk for breast cancer had great improvement in their estrogen metabolism when they were placed on a moderate exercise regimen and calorie restriction. Ultimately, lean body mass means less body fat which means less estrogen is being produced from fat cells. Fewer fat cells mean less fat storage so the high estrogen high fat cycle is broken.
Progesterone is produced in the corpus luteum in the ovaries. It is also produced in smaller quantities by the adrenal glands and the placenta during pregnancy. Progesterone’s major action is to prepare the uterine lining for a possible pregnancy and maintain the pregnancy. Progesterone is produced for fourteen days after ovulation. If there is no pregnancy, progesterone decreases and signals the beginning of menses.
Progesterone decreases breast cell growth. It is involved in the maturation of breast cells and decreases the rate of multiplication. It causes the breast to store fat in preparation for pregnancy. Progesterone also promotes normal cell death in the breast which may be important in the prevention of cancer.
While estrogen decreases the rate of bone breakdown, progesterone stimulates bone osteoblasts. Osteoblasts are responsible for making new bone to replace old bone.
As opposed to estrogen, progesterone decreases thyroid binding globulin thereby increasing the activity of thyroid hormone. This leads to increased metabolism and utilization of the fat stored under estrogen influence for energy. Normal progesterone levels are important for a normal body composition.
Progesterone is a natural diuretic and can reduce bloating and swelling. When estrogen levels are not balanced out by adequate levels of progesterone, women tend to retain more fluid than usual.
In the brain, progesterone binds GABA receptors. These receptors decrease anxiety, insomnia and depression. Anti-depressants and barbiturates bind these same receptors. Progesterone is a natural antidepressant and prevents anxiety.
Progesterone is stops being produced when a woman stops ovulating i.e. menopause. Some progesterone is produced by the adrenal glands, but levels fall much faster than estrogen levels when a woman goes through menopause. Clearly this upends the balance that needs to exist between progesterone and estrogen for optimal health. This imbalance leads to poor sleep, low energy, diminished sexual desire and problems managing stress appropriately.
Estrogen Dominance Symptoms
|Anxiety||Cyclic weight gain|
|Post-Menopausal Bleeding||Hot flashes|
|Fatigue||Fibrocystic breast disease|
|Decreased libido||Breast and Endometrial Cancer Risk|
Many factors increase our estrogen exposure. Consuming processed foods laden with sugar, high fat diet, lack of exercise and exposure to environmental toxins and obesity all lead to excess estrogens. Many of these toxins are referred to as xeno-estrogens. Xeno-estrogens are found in plastics, phthalates, bisphenol A which lines beverage and food containers, BHA, a food preservative also used in certain medications, hormone injected meats, weed killer, pesticides, DDT and PCB’s. Also foaming agents in soaps and detergents and cosmetics can contain significant amounts of absorbable estrogens. These foreign substances bind very strongly to estrogen receptors in the body and therefore strongly mimic the effects of estrogen in the body. Studies have revealed high levels of estrogen in females, low testosterone, low sperm counts and feminization in males in animal models.
Stress, itself, is a major contributor to hormone imbalance. When we are under constant stress our bodies produce cortisol. Over time this repeated stress causes the adrenal glands to fatigue., Progesterone may be shunted toward production of cortisol resulting in lower progesterone levels and estrogen and cortisol imbalance.
In younger women stress effects the ability to ovulate or produce an egg each month Thus no progesterone is produced, therefore it is not available to counteract the effects of the estrogen made during the menstrual cycle. Adolescent girls and peri-menopausal women with irregular menses, mood swings and emotional outbursts may benefit greatly from progesterone therapy and are most likely to be estrogen dominant.
Normal balance of estrogen and progesterone in a woman’s body help prevent excess or abnormal growth in tissues sensitive to the effects of estrogen. Without proper balance, fibroids may grow in the uterus, cysts may grow in the breasts or ovaries and cancer of the uterus and breast may occur.
Progesterone is not produced when a woman stops ovulating as occurs in menopause. Some progesterone is produced by the adrenal glands, but levels can actually fall much greater than estrogen levels when a woman goes through menopause. Clearly this scenario can greatly upset the delicate balance that needs to exist between progesterone and estrogen for optimal hormonal health. Hormone imbalance is responsible for poor sleep, low energy, diminished sexual desire and problems managing stress appropriately.
What Can Be Done
Estrogen can be lowered by regular strenuous physical activity. Exercise plays an important role in how estrogen is metabolized in the body. Studies have shown that women with an increased risk for breast cancer had great improvement in their estrogen metabolism when they were placed on a moderate exercise plan and had sustained weight loss. Ultimately less fat leads to less estrogen being produced by the fat cells- a self-fulfilling cycle.
Next, re-establish hormone harmony with bioidentical hormone replacement. This is a complicated process and should be managed by evaluating subjective symptoms listed above while also testing hormone levels in the blood. This marriage of subjective symptom evaluation and objective evidence is the key to excellent hormone therapy. This may take time with several evaluations to establish a trend thus establishing the best possible hormone level for an individual. Also this should be done by a practitioner with extensive knowledge and experience managing and treating this condition.
Complicating the treatment plan further, progesterone replacement at times is an excellent choice and in other scenarios is not the right option.
I do not believe supplements are the best choice for this management. Not in today’s era when we can simply measure estrogen and progesterone and balance them with bio-identical supplemental natural hormones. We can replace what the body should be making with natural hormones and restore balance. Supplements have too many variations and quality is not strictly maintained at this time. However, they may be an adjunct if the routine measures fail.
We can attempt to decrease our exposure to xeno-estrogens. This is possible to some degree, but many exogenous estrogens are being placed in our path which are unavoidable.
Lowering stress and diet management are the last two available options. Both of these are mentioned last because they are the most difficult to change. But if you understand the clear cut benefits then it is easier to stick with a plan that achieves the results you desire.