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How to Support Estrogen Dominance




Welcome to the Gut Honest Truth blog where a Certified Functional Medicine Practitioner gives you digestible information to tackle your chronic health concerns.


That’s me, Katie Morra;


As always, working one-on-one for your specific needs is always our top recommendation, check out our appointment options to get started with one of our licensed health care professionals today.


On to the post...


What is estrogen dominance?

In order to accurately answer this, let’s back up and review estrogen for 1 second.


Estrogen, also known as oestrogen, comprises a group of hormones responsible for initiating the development of secondary sexual characteristics such as hips, breasts, and pubic hair during puberty. While estrogen is often associated with female hormones, it is important to note that men also have estrogen, albeit in smaller quantities.




What are the 3 Types of Estrogen?

In women, there are three primary types of estrogen, and the levels fluctuate during different stages of life:


Estrone (E1):

Estrone is the estrogen of menopause. When the ovaries don’t make estrogen anymore, then we rely on the androgens converting to the estrogens via the aromatization pathway.


Estradiol (E2):

Estradiol is the most potent in the cycling years and can convert into estrone and estriol. Some of the main roles of estradiol include:

  1. Important for uterine thickness & reproductive, heart, bone, skin and brain health

  2. Increases cervical mucus and stretchiness

  3. Maintains the vaginal microflora

  4. Increases blood flow

  5. Has receptors on all immune cells

Estriol (E3):

The body increases estriol production during pregnancy.


Estrogen Throughout the Menstrual Cycle:

During menstruation (the bleeding phase), estrogen levels are low. They gradually rise during the follicular phase as the body prepares to release an egg, peak just before ovulation, and then decline as the luteal phase (the period between ovulation and menstruation) begins. More information on the menstrual cycle phases can be found here.


The moral of the story is that the body requires estrogen in appropriate amounts, at the appropriate times and this blog's focus is to emphasize the problems that arise when there is an excessive production of estrogen.


How does estrogen dominance happen?

Estrogen dominance is indeed a term used to describe a hormone imbalance where there is an excessive amount of estrogen in relation to other hormones, particularly progesterone. However, it's important to note that the terminology and understanding of this condition can vary among healthcare professionals and researchers.


Frank estrogen dominance:

In this case, the body is producing an excessive amount of estrogen or excessively converting androgens to estrogen, which can occur due to various factors such as obesity, environmental exposures to estrogen-like compounds (xenoestrogens), certain medications, or certain medical conditions like polycystic ovary syndrome (PCOS).


Relative estrogen dominance:

This occurs when you have an imbalance between estrogen and progesterone, with estrogen levels being too high in comparison to progesterone levels during the luteal phase (ovulation to the start of your first day of bleeding). It can also occur in perimenopause or menopause when progesterone production declines, leading to an imbalance with estrogen.

Excess body weight: Adipose tissue (fat cells) can produce and store estrogen. Having a higher percentage of body fat can lead to higher estrogen levels. This is particularly relevant in postmenopausal women when the ovaries produce less estrogen, and fat cells become a more significant source of the hormone.


Medications:

Some medications, including certain birth control pills and hormone replacement therapy, contain synthetic hormones that can increase estrogen levels in the body. It's essential to discuss the potential side effects and risks of these medications with a healthcare provider.


Stress:

Chronic stress can lead to an overproduction of cortisol, a stress hormone. High cortisol levels can disrupt the balance between estrogen and progesterone by interfering with the production of progesterone, which can contribute to estrogen dominance.


Xenoestrogens:

Xenoestrogens are synthetic chemicals that mimic estrogen and can be found in various everyday products, including plastics, pesticides, and some personal care items. Exposure to xenoestrogens can lead to increased estrogen levels in the body and disrupt hormonal balance.


Liver dysfunction:

The liver plays a crucial role in metabolizing and detoxifying hormones, including estrogen. If the liver is not functioning optimally due to factors like alcohol abuse, liver disease, or a poor diet, it may not effectively break down and eliminate excess estrogen from the body, leading to its accumulation.


It's true that simply having high estrogen levels alone doesn't necessarily mean you will experience symptoms or negative health effects. The balance between estrogen and progesterone is crucial for overall hormonal health and well-being. Symptoms of estrogen dominance can vary widely and may include menstrual irregularities, mood swings, breast tenderness, weight gain, and more.


Balancing hormones and addressing estrogen dominance often involves lifestyle modifications, dietary changes, and sometimes hormone replacement therapy or other medical interventions, depending on the underlying cause and severity of the imbalance. It's essential for individuals experiencing symptoms of hormonal imbalance to consult with a healthcare provider for proper evaluation and personalized treatment recommendations.


Supporting Estrogen Dominance Through Lifestyle:


Lifestyle and adjustments:

  • Aim for a daily bowel movement aka a great way to clear out excess hormones

  • Commit to stress reduction techniques

  • Lean into better sleep hygiene

  • Aim for a minimum of 25 g of fiber per day

  • Support your liver

    • Eat enough protein

    • Consider taking B vitamins

    • Focus on cruciferous vegetables

    • Consider a castor oil pack for additional support

Foods to support hormone balance include:

  • Broccoli and broccoli sprouts

  • Cabbage

  • Kale

  • Flaxseeds and seed cycling

  • Protein like grass-fed beef, lentils, eggs

  • Shiitake mushrooms

  • Carrots

  • Jicama

  • Avocado

  • Blackberries

  • Beets

  • Burdock root

  • Dandelion root

  • Dark chocolate

  • Aim for a daily bowel movement aka a great way to clear out excess hormones

  • Commit to stress reduction techniques

  • Lean into better sleep hygiene

  • Aim for a minimum of 25 g of fiber per day

  • Support your liver

  • Eat enough protein

  • Consider taking B vitamins

  • Focus on cruciferous vegetables

  • Consider a castor oil pack for additional support

Supporting Estrogen Dominance Through Supplements:

Numerous supplements are often touted or recommended for supporting estrogen dominance, but it's crucial to keep in mind that the key factor may lie in your progesterone levels and the balance between estrogen and progesterone. Therefore, taking supplements aimed at reducing estrogen might not necessarily be the most suitable choice for your specific needs.


Products targeting supplementation raising progesterone may be just the ticket for you in this case. Herbs like chaste tree, shatavari, maca, fenugreek, tribulus, evening primrose oil, vitamin C, & B6 may be advantageous options.


Understanding estrogen detox pathways is important to really understand which supplement may be best suited for you in the moment but that is a conversation for another blog. We strongly advise working with a practitioner and using a comprehensive hormone test like the DUTCH test that can provide insights into hormone pathways and detoxification phases before attempting hormone manipulation via supplements on your own. But as promised, here is more information on supplemental support for actual high levels of estrogen in the body.


Sulforaphane vs. I3c vs. DIM vs. Calcium-d-Glucarate


Sulforaphane acts as an antioxidant. It functions by accelerating the activity of phase 2 detoxification enzymes, facilitating the more rapid transition of metabolites from phase 1 to phase 2. It does not directly lower estrogen levels in the body but rather opens the detox doors and windows, so to speak. Tip: best food choice here would be including broccoli sprouts to your diet.


When you consume broccoli, brussels sprouts, and cabbage, you’re consuming something called. Indole-3-carbinol (I3C) Once I3C enters the stomach's acidic environment, many I3C molecules combine to form 3,3’-diindolylmethane (DIM). Key point being that we need healthy levels of stomach acid to create this!


Pro tip: chop broccoli, Brussels sprouts, and cabbage before cooking with them or eating them in order to release an enzyme called myrosinase This enzyme reacts with the food to create compounds known as sulforaphane and Indole-3-carbinol (I3C).


DIM is supportive for phase 1 estrogen detox and can redirect estrogen down a healthier pathway, which we love. However, it is important to note that DIM can also lead to a decrease in circulating estrogen levels so we do not recommend it be used if you have low estrogen, amenorrhea, menopause or if your phase 2 and 3 detox pathways are sluggish. We also do not recommend that it be used for long periods of time without testing your hormone levels.


Calcium-d-Glucarate (CDG) helps support our phase 3 estrogen detox. When we have bad bacterial overgrowths in the gut, we can increase an enzyme called beta-glucuronidase. This enzyme essentially takes figurative scissors and snips off all the hard work your body did to package up extra estrogen in your stool for elimination and lets it go freely back into the body. CDG essentially acts like a hand slapping away those figurative scissors, allowing your body to move forward with what it was trying to do- clear estrogen out through stool. Key point: work on your gut health, clear infections, improve constipation and always start with phase 3 on the road to estrogen detox.


How Do I Find a Practitioner That Orders Comprehensive Hormone Testing?

We most frequently recommend starting with a comprehensive hormone test such as the DUTCH test from Precision Analytical. This is a dried urine test for comprehensive hormone assessment. This test assesses sex and adrenal hormones and their metabolites. It also includes the daily free cortisol pattern, organic acids, melatonin (6-OHMS), and 8-OHdG. Patient’s collect the urine from the comfort of their own home, non-invasive, easy to complete. We love the DUTCH test because urinary hormone testing provides the ability to measure hormone metabolites along the steroidogenic pathway. This allows us to see how our hormones are impacted by enzymes and cofactors as well as elimination.


If you need more support getting a comprehensive sex hormone panel done and support along your healing journey, schedule a consultation today with our Institute for Functional Medicine trained and certified health care practitioners.



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