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Dear Doctor,
I recently read about a hormone imbalance called estrogen dominance.
This sounds a lot like me. Can you
tell me more about this, and is there anything that can be done to help?
CF, Billings
Dear Reader,
The hormone imbalance resulting in estrogen dominance is a
significant health issue for many women.
Estrogen, progesterone and testosterone are the main reproductive
hormones. These hormones exist in a
balance, contributing to normal puberty, pregnancy, peri-menopause
and menopause. However, when these hormones are out of balance, symptoms
occur for which many people seek treatment.
In women, the most common of these imbalances is between estrogen
and progesterone, resulting in a relative excess of estrogen as compared to
progesterone: estrogen dominance.
The symptoms of estrogen dominance will be familiar to many
women. These are: pre-menstrual and peri-menopausal irritability, moodiness, sadness,
anxiety, bloating, breast tenderness, migraine headaches, concentration
problems. Menstrual symptoms include
heavy bleeding, short menstrual cycle and irregular menses. Conditions associated with estrogen
dominance in women are: breast cysts, uterine fibroid tumors,
endometriosis, breast cancer, and systemic lupus erythmatosis. In men, benign prostate hypertrophy is
exacerbated by an excess of estrogen.
How, then, does estrogen dominance occur? There are three main ways: You are making
or getting too much estrogen, your body is not making enough progesterone
to balance estrogen, or your body is not metabolizing and eliminating
estrogen adequately. In the first, if you are taking estrogen hormones and
experience the above symptoms, then you are probably getting more estrogen
than your body needs. There are also
xeno-estrogens (outside estrogens) that we can
pick up from plastics, foods, or water.
Avoiding sources of xeno-estrogens can
lower estrogen levels in the blood.
Progesterone is important because it helps to counteract the
negative effects of excess estrogen. Progesterone levels often go down as
we near menopause. During this peri-menopausal time, our bodies make estrogen in an
attempt to ovulate. However, if ovulation does not occur (because of
ovarian aging) no progesterone is made resulting in a relative excess of
estrogen to progesterone. The third
reason for excess estrogen, inefficient metabolism and elimination of
estrogen is the most interesting, and is discussed below.
When I see a problem with estrogen dominance, the first issue I
address is estrogen metabolism. When estrogen is broken down by the liver,
it is metabolized down two main pathways, the 2-hydroxyestrone and the
16-hydroxy estrone pathways. The 2-hydroxy metabolite confers weak
estrogenic activity and is termed the “good” estrogen. The 16-hydroxy metabolite shows stronger
estrogen activity and promotes tissue proliferation. It has been found that women who
metabolize a larger portion of estrogen to the 16-hydroxy metabolite are at
a higher risk for breast cancer and it has been found that shifting
estrogen balance toward a less estrogenic state through promotion of the
2-hydroxy pathway improves a variety of conditions related to estrogen
dominance.
Estrogen metabolism is strongly influenced by nutrition and
lifestyle. Lifestyle considerations that improve estrogen metabolism to the
2-hydroxy pathway are adequate exercise, stop smoking, and weight loss (if
overweight). Nutritional influences to improve estrogen metabolism include
lower fat and higher protein diet; low sugar; intake of cruciferous
vegetables like broccoli, cauliflower, kale, and brussel sprouts; moderate
intake of soybean; and omega 3-containing fish. Some people benefit from supplementing
with indole-3-carbinole (the active ingredient in broccoli), fish or flax
oil, whey protein, turmeric, magnesium, and selenium. The type and amounts of dietary changes
and supplements required will be individual. It is important to note that
some estrogen metabolism occurs in the gastrointestinal tract. Therefore, making sure the GI tract
functions well is very important.
Supplements of acidophilus (especially if there is a history of
antibiotic use or high sugar intake) along with ground flax seeds and high
fiber diet are extremely beneficial.
In summary, many women will benefit from improving the hormone
balance between estrogen and progesterone. This might be achieved through
improving estrogen metabolism pathways, supplementing with progesterone, or
decreasing estrogen exposure.
Yellowstone Naturopathic
Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655
ync@180com.net
Dispensary
406·254·9682
dispensary@yncnaturally.com
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