Hormones are the chemical messengers of the body, produced by glands in the endocrine system and released into the bloodstream. Balanced hormones are the key to healthy living, and when they are out of balance, they can cause a whole host of undesirable and noticeable issues that impact our day to day activities from appetite and metabolism, to sleep and reproductive cycles.

Two of those hormones found in the ovaries, estrogen and progesterone, play a crucial role in a woman’s menstrual cycle and overall health, as long as they are balanced. Too much estrogen (compared to progesterone) results in estrogen dominance and can have many unpleasant symptoms.

Estrogen dominance is a disruption in hormonal balance in which a woman’s estrogen levels are too high. Estrogen and progesterone work like a seesaw - balancing the levels of each other to encourage smooth communication with our brain, ovaries and adrenal glands. Problems arise when this delicate balance is disrupted with an excessive increase in estrogen levels in face of normal or low progesterone levels. This can present in one of two ways: frank estrogen dominance or relative estrogen dominance. Frank estrogen dominance is when there is an excess level of estrogen on its own and relative estrogen dominance is when the excess of estrogen is relative to other sex hormones, especially progesterone.

Although there are many factors, causes of estrogen dominance can typically be linked to endogenous (from within) and exogenous factors in our environment (from exposure to external sources). While endogenous factors can be impacted by how estrogen is produced, metabolized and eliminated, exogenous estrogen results from exposure to toxins in our environment.

Lifestyle Lifestyle plays a significant role in estrogen dominance. This includes diet, exercise and stress.

Diet: Diets high in processed carbohydrate, sugar and low fiber are major contributors to estrogen dominance. They promote abnormal weight gain which promote increased insulin secretion which in turn promotes increased estrogen secretion. This becomes a vicious cycle in which these two hormones promote production of both hormones.

Exercise: Sedentary lifestyle results in increase in fat mass. Fat is regarded as insulin secretagogue, that means it actively secretes insulin to carry out daily function. Just like diet, increases in insulin products increases estrogen production

Stress: Stress is mediated by production of cortisol from our adrenal gland located on top of the kidneys. Cortisol is synthesized from progesterone. Under normal stress the cortisol produced from the adrenal gland is sufficient. With chronic stress, the cortisol is depleted. This means more cortisol is needed to be synthesized. This process is achieved by turning more progesterone into cortisol resulting in persistently low progesterone levels and persistently high estrogen levels

Elimination: Estrogen has to be metabolized and eliminated from the body once its effect has been exerted in the desired tissues in the body, Estrogen is broken down and eliminated via two pathways, the liver and the gut. The liver is responsible for the breakdown of estrogen once its job in the tissues is complete and the gut is where the metabolized estrogen is packaged up and eliminated via stool. If either or both of these processes is not functioning optimally, estrogen can be reabsorbed into circulation rather than eliminated, contributing to high levels of estrogen.

Once its effect on all tissue is complete, estrogen is broken down, repackaged and eliminated through the stool. This process requires both a healthy liver and gut.

Liver: The breakdown of estrogen in the liver requires several nutrients including B-vitamins, magnesium, glycine and selenium. Deficiency in these nutrients can slow or impair liver breakdown of estrogen and other hormones. Liver function is further impaired by high intake of alcohol, caffeine and pharmaceutical drugs. When the liver function is reduced by these factors, estrogen is not properly metabolized and it is just pushed back into circulation and contributes to continued estrogen dominance

Gut: Estrogen metabolism and elimination requires a healthy unclogged gut with beneficial bacteria that can help in the process. Imbalances in the gut bacteria can also cause estrogen dominance because the uneliminated estrogen can just simply be reabsorbed, contributing to the estrogen excess. Higher levels of bad versus good gut bacteria which are responsible for breaking down estrogen (known as the estrobolome) can cause more estrogen to be reabsorbed, rather than eliminated via the stool.

Exposure: Exposure to exogenous (external sources) of estrogen-like substances can increase estrogen levels in the body. These substances are often referred to as endocrine-disrupting chemicals (EDCs) and act similarly to estrogen in our bodies. These are referred to as ‘xenoestrogens’. ‘Xeno’ means foreign, so this term refers to synthetic substances which mimic natural estrogen in our body, but are slightly different biochemically. Some sources of xenoestrogens includes:

Other causes include:

While things like genetics are obviously out of our control, environmental, dietary, and lifestyle factors are much more addressable and a great place to start when looking at controlling estrogen dominance naturally.

Dominance Estrogen dominance is not insignificant in its impact on wellbeing. The vital role hormones and estrogen in particular play in regulating many bodily processes and wellbeing of the individual can become very evident when there is minimal disruption in the delicate balancing. When your estrogen is not balanced properly in your body, you may experience the following signs and symptoms:

Managing PMDD can be hard. However we take a stepwise approach in my clinic in evaluating and understanding the cause of your PMDD symptoms. If estrogen dominance is implicated in the symptoms we do our best to address those underlying causes at Ovathera, a virtual treatment platform for PMDD. In the meantime I have outlined below easy to follow steps to help you begin your wellness process.

Your liver is the body’s largest internal organ responsible for over 500 vital body functions metabolism and elimination. When functioning optimally, the liver is involved in processing, metabolizing and helping eliminate byproducts of virtually everything you eat, drink, breathe, or put on your skin and that includes hormones too. A sluggish or improperly functioning liver can be a major factor in hormonal imbalances and estrogen is no exception. Liver detoxification is a key step in estrogen dominance treatment. Liver support can be achieved by increasing intake of liver friendly nutrients B-vitamins, magnesium, glycine and selenium. Deficiency in these nutrients can slow or impair liver breakdown and removal of estrogen and other hormones causing those hormones to be recirculated.

Optimizing your gut microbiome is key to keeping hormones balanced. The gut is responsible for taking the hormone breakdown from the liver, repackaging it and eliminating it via feces.It is imperative therefore for the gut to be healthy enough to effectively carry out this process. An unhealthy microbiome (the balance of good and bad bacteria in your gut) can cause estrogen to be “uncoupled” and reabsorbed into circulation instead of being eliminated. This reabsorption contributes to high estrogen levels in the body. If you are suffering from sluggish bowels, constipation or incomplete emptying, metabolised estrogen has more time to be reabsorbed into the body, rather than quickly being eliminated. Promoting gut elimination of estrogen requires a healthy microbiome and regular, daily stools.

To promote a healthy microbiome, eat foods like cultured natural yoghurt, kimchi, sauerkraut and kombucha which are rich in probiotics daily and avoid unnecessary antibiotic use.

Fiber rich diets are beneficial in promoting regular daily bowel movement and avoiding constipation. Fiber is essential to feed the good bacteria in your gut and keep you regular. If you struggle to go to the toilet daily, try 1 teaspoon of psyllium husk in a large glass of water after dinner or add 1-2 Tbsp of ground flax seeds or chia seeds to your breakfast or smoothies.

Here are some strategies for treating estrogen dominance and improve gut health:

Stress reduction is essential in managing estrogen dominance. Cortisol is secreted by the adrenal gland during stress. This is beneficial when stress is short term. Chronic stress results in estrogen dominance state due to reduction of progesterone breakdown to produce more cortisol to deal with the stress. Ways to reduce stress include better sleep, exercise, yoga, meditation and mindfulness practices.

Completely eliminating xenoestrogen from our lives may be impossible but we can do what we can reduce to reduce as much of it. For instance: Consider switching your birth control pill, the ethinylestradiol (synthetic estrogen) in your pill is a form of xenoestrogen that is stronger than natural estradiol. This contributes to poor ability to clear natural estrogen in your body and can damage intestinal bacteria, further impairing your body’s ability to eliminate hormones. Consider using less BPA containing products.

Most of us are deficient in essential nutrients like magnesium, calcium, zinc and B vitamins especially B6 which are necessary in both metabolic processes, elimination and overall healthy wellbeing. They are also essential nutrients for optimal functioning of the liver. Diindolylmethane DIM is another beneficial supplement. It helps in the metabolizing and detoxification of estrogen Detox. DIM is present in cruciferous foods like broccoli and cauliflower. DIM is a compound that helps convert excess estrogen into “good” estrogen in the body. DIM can also be taken supplementally to promote healthy estrogen metabolism. Although research is still limited on these supplements, they have been used to treat a variety of hormonal issues, and the benefits are promising. These strategies may not directly increase progesterone, they go a long way in balancing hormone health.

If you suspect that you might have estrogen dominance, progesterone deficiency, or you’re unsure, book with one of us – we are able to provide a thorough assessment on your hormonal health. We also offer testing to assess estrogen dominance through measuring the different estrogen metabolites (such as 2-OH, 4-OH, 16-OH) through urine testing. Visit us online at www.ovathera.com for more information.