In a online forum recently, a woman was seeking advice for the excessive bleeding she experiences every month. There were more than 150 comments and some were beyond extreme. This woman had no idea that she was experiencing estrogen dominance and that there are ways to manage it.
Getting advice from other women is crucial but learning the basics from a doctor helps us all make informed decisions. Our goal is to give you the “low down” on estrogen dominance so you know what to discuss with your doctor.
This article is the second in our series on hormones. The first, Managing Perimenopause Symptoms explained the transition that occurs before menopause. This article deals with the balance of hormones. Most women mistakenly believe that the symptoms they experience at this age are due to a decline in estrogen, when in fact it is the lack of progesterone.
Here, our medical expert, Steven Krems, M.D. explains the ins and outs of estrogen dominance.
What is estrogen dominance?
During a woman’s reproductive years the hormones that control the monthly cycle and pregnancy are progesterone and estradiol. As a woman ages, her progesterone levels become lower in general and during months that she doesn’t ovulate, there is no progesterone at all.
The estradiol level generally stays high during peri-menopause and even for awhile after menopause. Estrogen dominance occurs when a woman has too much estradiol in relation to progesterone. This continues to be a big issue long after menopause due to all the estrogens in our diet.
That sounds so complicated so here it is: If you have too much Estrogen compared to Progesterone, you will feel a bunch of the symptoms below.
What are the symptoms of estrogen dominance?
- Weight gain especially around the middle
- Breast tenderness and enlargement
- Irregular periods and possible heavy bleeding with clots
- Hair loss
- Decreased sex drive
- Trouble sleeping
- Foggy thinking
- Mood swings (irritability and depression)
What is the impact of estrogen dominance?
The symptoms above give you an idea of the impact of estrogen dominance. The lower progesterone levels are why women experience sleep issues starting in the peri-menopausal time. It can also create heavy bleeding during menstruation which can cause low iron and fatigue.
Estrogen dominance is a big reason for the extra pounds. One of the roles of estrogen is fat deposition. One of the roles of progesterone is to help burn fat. When that balance is disrupted, women gain weight, especially around the middle.
As this persists over the years, women who used to be nice and slim, turn round. Gaining weight around the middle is associated with numerous consequences. These include difficulty controlling blood sugar (leading to diabetes), higher cholesterol, and high blood pressure and can increase the risk of cardiovascular disease.
Estrogen dominance also increases women’s risk for breast cancer and endometrial cancer (cancer of the uterine lining).
When a woman finally goes through menopause, will estrogen dominance be over?
At the time of menopause, a woman stops ovulating, and her periods stop occurring. Hormonally there is no more progesterone and in time estradiol levels fall as well. However, there are many other sources of estrogen that will continue to have an impact.
What are the other sources of estrogen?
The adrenal gland, for one, makes a different type of estrogen called Estrone. Perhaps more impactful are the many estrogens we get from out diet.
Most people have heard of the benefits of “phytoestrogens” found in foods like soy, certain vegetables, nuts and grains. These are somewhat protective as they are very weak estrogen. They bind to estrogen receptors in the body’s tissues and prevent stronger estrogens from having an adverse effect.
Stronger estrogens are found in our diet from pesticides, chemicals and even plastics found in our water. We live on a polluted planet. Even if we try our best to eat free-range, hormone-free and organic we cannot completely avoid estrogens in our diet.
What treatment options are available for estrogen dominance?
There is a growing school of thought, based on the available evidence and many years of clinical experience, that hormone supplementation with “Bio-Identical Hormones” is the answer.
A blood test determines hormone levels and a treatment plan is created. In addition to estradiol and progesterone, treatment also incorporates hormones like testosterone, thyroid and DHEA.
Additionally, there are herbs that can be used for hot flashes, vaginal dryness and insomnia. A supplement called Indole-3-carbinol (I3C) helps prevent estradiol and other estrogen from converting to stronger, more “toxic” metabolites. It is also easy to get more of the I3C from your diet by eating lots of kale, broccoli, cabbage, Brussels sprouts and bok choy.
What about cancer survivors? Who cannot take bio-identical hormones?
Generally speaking estradiol is the hormone that is worrisome in women who have had estrogen-related cancers like breast cancer and endometrial cancer. Progesterone is protective for estrogen-related cancers.
Hormones like progesterone, thyroid, testosterone can still be used. We generally avoid DHEA in women who have had breast cancer, as it can be converted into estrogens by the body.
Estrogen Dominance Natural Treatment
While some M.D.s are well versed in this, a Naturopath (N.D.) is a great source to learn which herbs and supplements reduce estrogen dominance. They can also assist with dietary changes that are helpful – both with foods to include and avoid.
Prior to getting professional help from a M.D. or N.D. there are some easy dietary changes you should definitely make.
- Avoid heavily processed foods
- Avoid dietary fats and excessive sugar
- Eat a high fiber diet
- When eating meat, poultry and even grains, choose organic, free-range and hormone free to avoid getting additional hormones (estrogenic) from the food.
A huge thank you to Dr. Steven Krems for shedding light on this subject. In our next article, we will go into more depth on treatment options.