What is Estrogen Dominance and Who May be Affected?
Estrogen dominance is the excess estrogen that is present throughout follicular (the first 14 days of menstrual cycle, including menses) and luteal phases (the second 10-14 day of a cycle within the 28-day cycle). It is accompanied by progesterone deficiency during the second part of the menstrual cycle. Hormone estrogen works hard on growing the inner lining of the uterus, preparing it to accept a fertilized ovum. Hormone progesterone works hard on differentiating the cells within the grown uterine lining, as well as growing a perfect blood vessel network that will provide the implanted egg with oxygen and nutrients. Unfortunately, when there is too much estrogen, the uterine lining grows uncontrollably and causes heavy bleeding when the fertilization and the implantation of the egg did not happen and the menses start.
Unfortunately, estrogen dominance is very common among young women, as well as for women who experience the first signs of perimenopause. Mood swings, bloating, and irritability are just a few signs that the woman’s body experiences. The women of childbearing age are usually offered birth control pills to “regulate the periods” and to alleviate heavy bleeding, cramps, etc. The women in perimenopause are sometimes offered HRT (hormone-replacement therapy).
Aren’t men lucky that they do not have to deal with all these things and symptoms? This is a very premature conclusion though. We see estrogen dominance in men too! You wonder why? Because with increased adipose (fat) tissue around the waist comes a deficiency in testosterone and dominance in estrogen. In such cases, if a doctor prescribes extra testosterone to his patient, there is a high probability that the testosterone will be converted into estrogen in the abdominal fat tissue via the special aromatase enzymes. For example, this research points to a possible link between estrogen dominance in men and the risk of esophageal adenocarcinoma. I do not mean to divert too far talking about men here, but the men may grow not just a belly, but also “breasts” too! The men may also develop breast cancer.
The Symptoms of Estrogen Dominance:
Usually, these symptoms appear 10-14 days before the start of the menses. Some women blame it on PMS (premenstrual syndrome), others on their bad luck. I was blaming my symptoms on both.
- Tenderness and swelling in the breast
- Bloating due to water retention
- Irritability, depressive moods
- A desire to hide under the rock and not to be bothered by anyone
- Weight gain due to water retention
- Tiredness with the lack of motivation to do anything
- Inability to fall asleep or stay asleep
- Carb cravings and cravings for sweet and salty foods at the same time (Have you seen yourself reaching for pickles or potato chips and popcorn after you managed to eat a bag of M&Ms?)
- Irregular or heavy periods
- Brain fog and forgetfulness
- Moderate-severe cramps with the start of the period
- Strands of hair on the chin or above the lips can be a sign of high estrogen and/or high testosterone in women.
- Endometriosis and implantation defects preventing a successful pregnancy
The recent research showed that estrogen dominance also may lead to the later diagnosis of breast cancer in genetically predisposed women. Doctor Zava went into depth of this phenomenon in his book “What Your Doctor May NOT Tell You About Breast Cancer: How Hormone Balance Can Help Save Your Life”. Having a family history of breast cancer myself and seeing so many patients with these symptoms made me look deeper into the root causes of the symptoms. As I mentioned, some women choose to start prescription contraceptive pills “to regulate their period” and some women are told that it is just supposed to be that way and they suffer quietly. Women in their 30s and 40s blame it on getting older.
Causes of Estrogen Dominance
- Stress and imbalance in HPAG-axis (Hypothalamic-Pituitary-Adrenal-Gonadal Axis)
- Impaired Methylation (MTHFR, COMT, etc. mutations)
- Low-fiber high-carbohydrate diets
- Impaired thyroid function (hypothyroidism)
- Toxic exposures to pesticides and fungicides
- “Xenoestrogens” – chemicals that mimic estrogen when ingested or touched. These compounds act like fake estrogens in the body and get attached to estrogen receptors, blocking real estrogens from attaching to their receptors, thus, increasing the circulation of estrogens in the body. My least favorite xenoestrogen is BPA that is present in abundance in cashier receipts and is absorbed via the skin into blood.
- Impaired microbiome that cannot detoxify the estrogens and excrete them in the stool.
What Lab Tests May Help to Show the Estrogen Dominance
First of all, I recommend starting with the evaluation of basic labs including thyroid, liver, kidney function, and other common markers. The estrogen dominance may stem from the imbalance in the thyroid function, impaired liver function, etc. That is why I look for upstream causes, and if any are found, correction may bring long-awaited relief. When everything is balanced and looks great, I get a deeper dive into the hormone detoxification pathways and use DUTCH hormone testing.
DUTCH (Dry Urine Test for Comprehensive Hormones) is my go-to to figure out the pathways via which estrogen hormones are metabolized and excreted. It is not super-expensive, extremely easy to perform, and can be used to establish the baseline before the natural interventions are started and later, to evaluate the progress of these interventions. It also can be used to monitor transdermal estrogen creams, adrenal function, melatonin sufficiency, and now, the health of human’s powerhouse plant mitochondria. I have just done this test myself and cannot wait to see the results after all my hard work of healing my microbiome and improving detoxification pathways.
You can see the sample DUTCH report and what it includes Here:
In addition, regular LabCorp/Sonora Quest hormone labs can be ordered and interpreted too to add to the full hormonal picture.
How to Improve Estrogen Detoxification and Reduce Estrogen Dominance Naturally
- Increase fiber in your diet to maintain regular bowel movements at least once a day. Estrogen is excreted in the stool; if you suffer from constipation, the estrogen (and other toxins) get reabsorbed from the stool in your gut and are brought back into circulation in your body. We do not want that to happen!
- Eat a balanced diet that is high in low-glycemic vegetables, some fruit (the best is organic berries), moderate amounts of proteins including low-mercury fish (Alaskan salmon, sardines, etc.), some grass-fed and finished beef/pork, and healthy fats (coconut oil, grass-fed butter, avocados, some nuts and seeds).
- Eat 1-2 tbsp of ground flaxseed and chia seeds to promote estrogen binding and excretion.
- Meditate for at least 10 mins every day to decrease stress.
- Detoxify your liver with supplements and amino acids that support Phase 1 and Phase 2 of liver detoxification.
- Avoid any xenoestrogens that mimic natural estrogens. These include birth control synthetic estrogens, chemical detergents, cleaning products, makeup and creams with the ingredients you cannot read or pronounce. If you cannot eat it, do not apply it on your body.
- Eat more cabbage, broccoli, cauliflower, Brussel sprouts, spinach, kale, bok choy (cruciferous veggies). If you have underlying digestive issues and you are sensitive to broccoli and cauliflower, you may still do great with bok choy, spinach, and kale. These veggies are great sauteed, baked or broiled.
- Decrease stress and try green matcha tea or latte instead of your morning espresso.
- Avoid alcohol as much as possible. I advise my patients struggling with PMS to limit drinking to 1 drink/week or even less.
Should you need more help with managing the symptoms and finding out the underlying cause of your hormone imbalances, schedule a consultation with Zhanna Tarjeft, FNP Here.
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Useful Resources and References:
- Lee, J. R., Zava, D., Hopkins, V. What Your Doctor May NOT Tell You About Breast Cancer: How Hormone Balance Can Help Save Your Life. 2002, New York
- Lessey, B.A., Young, S.L. Homeostasis Imbalance in the Endometrium of Women with Implantation Defects: The Role of Estrogen and Progesterone. Retrieved on Feb 10, 2018 from https://www.ncbi.nlm.nih.gov/pubmed/24959818
- Muti, P, Bradlow, H.L., Micheli, A., Krogh, V., Freudenheim, J.L., Schunemann, H. J., Stanulla, M., Yang, J. Sepkovic, D.W., Trevisan, M., and Berrino, F. Estrogen Matabolism and Risk of Breast Cancer: A Prospective Study of the 2:16⍶-Hydroxyestrone Ratio in Premenopausal and Postmenopausal Women. Retrieved on February 10, 2018 from http://www.breasthealthproject.com/documents/EstrogenMetabolismandRiskofBreastCancer.pdf
- Shafei, A., Ramzy, M.M., Hegazy, Al., Hysseny, A.K., El-Hadary, U.G., Taha, M.M., Mosa, A.A. The Molecular Mechanisms of Action of the Endocrine Disrupting Chemical Bisphenol A in the Development of Cancer. Retrieved on Feb 10, 2018 from https://www.ncbi.nlm.nih.gov/pubmed/29317319
- Yang, H., Sukocheva, O.A., Hyssey, D.J., Watson, D.I. Estrogen, Male Dominance and Esophageal Adenocarcinoma: Is there a Link? Retrieved on Feb 10, 2018 from https://www.ncbi.nlm.nih.gov/pubmed/22346245