In Part 1 of this series we covered cortisol, progesterone, and their relationship. Though the vast majority of hormones are made of protein, both of these are steroid hormones made of cholesterol. Estrogen is another steroid hormone. It is the main female sex hormone, but it also plays an important role in male bodies.
Estrogen is responsible for most of the physical changes in the female body related to reproduction. It stores fat in certain areas leading to ‘curviness’, plumps skin, and grows the breasts and pubic hair in females. It also has other important functions such as improving immunity and memory, strengthening bones, controlling cholesterol levels, and maintaining a balanced mood.
The body makes three different types of estrogen:
The two main sex hormones (hormones involved in reproduction) in females are progesterone and estrogen. As we discussed before, progesterone dominates the second half of the menstrual cycle, maintaining the thick uterine lining to prepare for pregnancy. That thick uterine lining exists thanks to estrogen, who dominates the first half of the cycle. Here is that visual again to refresh your memory:
One of the most common hormonal imbalances seen in females is between progesterone and estrogen. This imbalance is known as estrogen dominance. In males, this presents as an imbalance between testosterone and estrogen. Even though estrogen does important things like keeping bones strong, the key to balanced health is balanced hormones! One of progesterone’s most important roles is to balance out estrogen after it gets ramped up during the first half of the menstrual cycle. When estrogen levels in the body are too high, you risk developing estrogen-related cancers and experience a range of symptoms.
Because estrogen dominance describes the relationship between estrogen and progesterone, there are a few ways it can present. Estrogen levels could be normal, but if progesterone levels are low, you have estrogen dominance. The opposite can result in the same: If progesterone levels are normal, but estrogen levels are high, you have estrogen dominance.
If you menstruate, you may have experienced some (or all) of these symptoms. Though they are common in our society, they are likely the result of a hormone imbalance that you can get under control with proper nutrition and supplementation and the help of a functional medicine practitioner.
Estrogen is created in the ovaries/testes, adrenal glands, and fat tissue. In normal amounts, it keeps our bodies well balanced. However, high amounts of fat tissue can result in extra production of estrogen, which in turn encourages more fat storage. This cycle can lead to unwanted weight gain. On top of that, estrogen has been shown to discourage the breakdown of fat cells, especially in the midsection (hips and waist).
Estrogen dominance over time can lead to more serious health issues, such as heart attacks, breast or ovarian cancer, blood clots, and stroke.
Estrogen is known to be an immune-enhancer, whereas androgens and progesterone are immune-suppressors. This is an important piece of information for people living with autoimmune diseases such as Hashimoto’s thyroiditis, rheumatoid arthritis, and multiple sclerosis. Autoimmune diseases manifest when one’s immune system is overactive and starts to attack the body’s own tissue. In this case, having estrogen continue to ramp up your immune system is going to cause further damage. This is the reason that about 78% of people with autoimmune diseases are women.
High estrogen levels can be partially hereditary, but it can also be caused (or triggered) by external sources such as hormonal contraceptives, some antibiotics, and other medications, including the popular hormone replacement therapy used to ‘treat’ menopause symptoms. Other factors that contribute are gut dysbiosis, a low fiber diet, and alcohol consumption. The most common mechanism we see in clinical practice is estrogen dominance due to insulin resistance. When insulin is spiking to control blood sugar this creates fat cells and fat cells secrete more estrogen. This in turn alters the ratios of hormones and can increase inflammation which impacts all areas of the body. As this continues it’s almost like a train gaining steam without brakes. The estrogen dominance then facilitates inflammation which in turn causes more insulin resistance (and on and on…).
Another cause of estrogen dominance can be polycystic ovary syndrome (PCOS), which we mentioned in Part 1 as a cause of low progesterone levels. PCOS can be caused by high levels of androgens (male hormones). Symptoms can include acne, facial hair or male pattern baldness in females. PCOS may be manageable through proper nutrition. One group of researchers studied women with PCOS and found that by decreasing the amount of refined carbohydrates in their diets, insulin sensitivity could be induced. Insulin sensitivity, being the opposite of insulin resistance, can help increase levels of progesterone and therefore decrease levels of estrogen.
Insulin resistance promotes the enzyme aromatase, which converts androgens to estrogen. It also inhibits sex-hormone-binding globulin, resulting in more free estrogen. We’ll talk more extensively about insulin resistance in part 3 of this series.
Excess fat, stress, impaired digestion and detoxification pathways, and external estrogen copy-cats such as xeno- and phytoestrogens can also lead to increased levels of estrogen. The body metabolizes hormones and gets rid of them through detoxification pathways. When these processes aren’t functioning properly (or genetic alterations are present), estrogen will remain in the body for long periods of time.
Xenoestrogens are synthetic, man-made chemicals that resemble estrogen and act on estrogen receptors in the body. They are found in things like plastics, cosmetics (we absorb up to 60% of what we put on our skin!), and birth control pills. Phytoestrogens on the other hand, come from plants and have less of an impact (though still an impact!) on the body’s natural estrogen levels. Soy is the most common culprit in this family of estrogen disruptors.
The functional medicine approach to all hormone imbalances is represented in the pneumonic “PTSD”. Let’s apply it to estrogen!
If you suspect you may have estrogen dominance, you should consider meeting with a practitioner who understands how to identify root causes and will work with you to create a personalized plan for balancing your hormones. Contact us using the form below to get started!
Stay tuned for Part 3 of our hormone series, where we will dive deeper into another very common hormone imbalance: insulin resistance.
Ian really knows A LOT about thyroid problems! His knowledge and confidence convinced me to make the lifestyle changes -including no gluten, no sugar, and more exercise-that are essential to healing hormonal imbalances and to staying well. Several months later, I feel stronger, more energetic, and am happier than I have felt in a long time. Many thanks for all your help!
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