WHAT IS ESTROGEN DOMINANCE ?

Estrogen dominance is the condition of increased estrogen levels relative to progesterone levels in the body. We can also say that it is a metabolic state where the level of estrogen outweighs the level of progesterone in the body, caused by a decrease in progesterone without subsequent decrease in estrogen.

The difference between estrogen & progesterone? Make us understand it clearly so that we can differentiate it by ourselves

Now normally in the menstrual cycle, an interplay of the estrogen and progesterone brings about a normal cycle. Estrogen rises and as it peaks and drops, progesterone also peaks and drops in the second phase of the cycle making ovulation to occur. When there is increase in estrogen and  no corresponding drop leading to absence of rise and fall in progesterone, it can prevent ovulation from occurring

Both are female hormones that regulate a woman’s cycle. Estrogen controls the follicular phase where the eggs mature leading to ovulation while progesterone controls the second phase, luteal phase which enables pregnancy to be established.

*HOW DOES ESTROGEN DOMINANCE OCCUR IN THE BODY ?

▪️Overproduction of estrogen by the body

▪️ Changes in estrogen metabolism and excretion

▪️An imbalance in the estrogen to progesterone ratio.

*WHAT CONDITIONS ARE ASSOCIATED WITH ESTROGEN DOMINANCE*

They include

▪️ Breast and uterine cancers

▪️ Fibroids

▪️ Endometriosis

▪️ Polycystic Ovarian Syndrome (PCOS)

When these conditions are present, their metabolism can bring about Estrogen Dominance if not properly managed

The body makes three main estrogens:

🔹Estrone (E1)

🔹Estradiol (E2)

🔹Estriol (E3)

Estrone (E1) is the main type of estrogen present in the body after menopause, made primarily in adipose tissue (fat cells)

Estradiol (E2) is the strongest estrogen, made by the ovaries and present in the body before menopause. It contributes to the menstrual cycle.

Estriol (E3) is the weakest estrogen, present in the body primarily during pregnancy. It helps in the pregnancy process and is reduced naturally after childbirth.

*WHAT ARE THE SYMPTOMS OF ESTROGEN DOMINANCE ?

▪️Fatigue

▪️Depression

▪️ Low Libido

▪️ Weight Gain

▪️ Water Retention

▪️Headaches

▪️Mood Swings

▪Fibrocystic breasts

When these symptoms are present and associated with any of the above conditions, then Estrogen Dominance can be suspected.

Fibrocystic breasts? How do we know if that is Available in the breast?

Fibrocystic breasts are cellular changes in the breast. A woman who practices self-examination can detect when something is different. The condition can be confirmed with a mammogram

*MANAGEMENT OF ESTROGEN DOMINANCE*

The body has two main receptors to which estrogen binds

• Alpha receptors that promote cell growth and

• Beta receptors that inhibit cell growth.

Each type of estrogen binds to these receptors, resulting in either cell proliferation or cell inhibition. After they have carried out their functions, they are broken down to their metabolites.

Estrogen is broken down along two major pathways:

• 2-hydroxyestrone and •16-hydroxyestrone.

Each of these metabolites has distinct functions in the body. 2-hydroxyestrone has multiple health benefits, working to block stronger estrogens that promote cell proliferation and possible cancer growth. Conversely, 16-hydroxyestrone increases cell proliferation.

Higher levels of 16-hydroxyestrone are associated with

• Inflammation,
• Excess levels of omega-6 fatty acids,
• Obesity,
• Hypothyroidism,

A small amount of estrogen is metabolized to 4-hydroxyestrone, which is thought to promote cancer by damaging DNA.

So we can say that 2-hydroxyestrone is a good estrogen metabolite while 16-hydroxyestrone and 4-hydroxyestrone are bad estrogen metabolites. For these reasons, a healthy estrogen balance leading towards production of 2-hydroxyestrone is important for women’s health.

Although lab testing can determine a women’s estrogen ratio, testing is likely unnecessary for most women. Women with an increased risk of estrogen dominance should be counseled in healthy lifestyle changes.

The following have been shown to shift estrogen metabolism toward the 2-hydroxyestrone production pathway:

▪️Exercise and weight loss

▪️ Soy and flaxseed

▪️Omega-3 fatty acids

▪️Green tea

▪️Green vegetables and broccoli

▪️A healthy lifestyle that allows for a normal weight helps to decrease the risk of insulin resistance.

Insulin resistance results in increased estrogen levels, resulting in greater amounts of free circulating estrogen.

Insulin resistance also causes increased production of inflammatory mediators, which likely contributes to estrogen-sensitive conditions including fibroids.

So Lifestyle habits that also influence estrogen excretion are:

1. Women eating a vegetarian diet have a three-fold increase in fecal estrogen excretion and have lower blood estrogen levels. Eat a diet high in cruciferous vegetables, including cabbage, broccoli, cauliflower, and Brussels sprouts
2. Overgrowth of certain gut bacteria prevents the excretion of estrogen allowing for reabsorption. Therefore, intestinal health should be looked into when considering conditions of estrogen dominance. Certain Foods rich in Probiotics can help maintain health gut flora like the ones mentioned above.
3. Stress can also influence the balance of hormone levels in the body. Cortisol, the body’s stress hormone, is made from precursors that include progesterone. With an increasing need for cortisol production because of high stress, progesterone levels may decrease, disrupting the balance of estrogen and progesterone in the body. For this reason, stress management should be addressed.
4. Engage in moderate exercise daily to maintain a healthy weight.
5. Eat an anti-inflammatory (or vegetarian) diet to avoid hormone exposure. Consume foods high in omega-3 fatty acids from both fish and flaxseed. Consider anti-inflammatory botanicals such as ginger and turmeric in addition to omega-3 supplementation daily if dietary intake is inadequate.
6. Eat a high-fiber diet, as fiber decreases the amount of estrogen absorbed and increases the amount of estrogen excreted.
7. Eat a diet high in whole soy foods which help to shift estrogen metabolism toward increased levels of 2-hydroyestrone.
8. Avoid excessive alcohol intake, which inhibits estrogen detoxification and increases estradiol levels.
9. Avoid xenoestrogens, or environmental compounds that imitate estrogen in the body. Examples include PCBs (polychlorinated biphenyls), BPA (bisphenol A), and phthalates. These are known as EDCs.
10. Promote a healthy intestinal micro biome, addressing possible food intolerances and supplementing with probiotics if necessary.

Note: Please ask your fertility counselor for more information about how to determine whether or not a specific supplement is appropriate for you. Supplements are not regulated with the same degree of oversight as medications, and it is important to keep this in mind. Products vary greatly in terms of accuracy of labeling, presence of adulterants, and the legitimacy of claims made by the manufacturer.

11. Engage in a healthy approach to stress management. Consider coping techniques, relaxation exercises, and mind-body practices.