Female Estrogen Dominance
If you scored high in the ‘Female Estrogen Dominance’ section of the Health Score Quiz, please read this article as it contains some useful information and resources to help you.
This page is designed to help you understand why you might be experiencing symptoms relating to estrogen dominance. In this section we look at what estrogens are, where they are made, why they might become dominant, how estrogen dominance can impact the body, what tests you might consider and any initial tips to help rebalance sex hormones and reduce the possibility of estrogen dominance.
What are estrogens and where are they made?
Estrogen is most commonly known as the female hormone, albeit, males also have estrogen as well. Equally, there is not just one estrogen hormone either, estrogens are made up of estrone (E1), estradiol (E2) and estriol (E3), with estradiol (E2) being the most potent of the three naturally occurring estrogens.
In females, estrogen helps to initiate sexual development. In addition to progesterone, estrogen helps to regulate the menstrual cycle and reproductive health and supports cognitive health, bone health, cardiovascular health and various other essential bodily roles.
The different types of estrogen
A weaker form of estrogen that the body can convert to other forms of estrogen if required.
This is the most common and most potent form of estrogen and hence, this is the most commonly assessed estrogen.
Excessive levels of estradiol are what typically cause estrogen dominant symptoms due to the level of potency.
This estrogen typically rises during pregnancy as it plays a role in helping the uterus to grow and prepares the body for delivery as it peaks just before giving birth.
The ovaries are one of the main sites for estrogen production, however fat tissue and the adrenal glands also produce estrogen as well. Levels will vary considerably from one individual to another with factors such as age, genetics, body fat levels, diet, exercise levels, pregnancy, medications and more all have an impact on estrogen levels.
What are the conditions and symptoms associated with estrogen dominance in females?
Estrogen has a number of functions in the body, some of these functions include:
- In the ovaries estrogen helps to stimulate the growth of the egg follicle
- In the vagina it helps to maintain the thickness of the vaginal wall and promotes vaginal lubrication
- In the breasts, estrogen is used to help with the formation of breast tissue and stopping the flow of milk after weaning
- In the uterus estrogen supports the health of the mucous membrane and regulates the flow and thickness of the uterine mucus secretions
Estrogen related conditions are on the rise, here are some statistics relating to estrogen dominance:
- Endometriosis impacts around 10% of all women, this is growing and those with infertility, it has been shown that up to 50% of those have endometriosis. Endometriosis is an estrogen dependant disease.
- PMS has become the “norm”, estrogen dominance can be a significant factor in PMS.
- Uterine fibroids impact around 25% of women aged 35-50.
- Breast cancer affects around 10% of women.
- Early puberty, with many females now entering puberty well below the age of 10, correlating significantly with the higher levels of environmental estrogens.
In general, elevated estrogen, especially estradiol, is related to an increased risk of uterine and breast cancer.
Some of the classic symptoms of estrogen dominance include:
- Water retention
- Breast swelling and tenderness
- Fibrocystic breasts
- Ovarian cysts
- Heavy or irregular periods
- Reduced libido
- Weight gain
- Low thyroid symptoms
- Sweet food cravings
Testing considerations for suspected estrogen dominance
When we suspect estrogen dominance, based upon symptoms or a condition, the next step is to consider testing. This involves a combination of initial blood tests as well as a more advanced hormone assessment, often performed using dried urine samples. I believe assessing both the bloods and urine hormone metabolites provides the most effective overview:
Day 1-3 of the menstrual cycle:
- Estradiol (E2) – UK spelling is actually oestradiol
Day 21 of cycle if a 28-day cycle or 7 days after ovulation:
- Estradiol (E2)
- Sex Hormone Binding Globulin (SHBG)
- Free testosterone (or calculate the free androgen index using total testosterone and SHBG)
- Haematology and Biochemistry
- Fasting Insulin/C-Peptide & Fasting Glucose
Urine Metabolite assessments
At the moment I use a dried urine hormone assessment to review the following, around 7 days after ovulation:
- Estrone, Estradiol and Estriol (E1, E2 & E3)
- 2-OH-E1, 4-OH-E1, 16-OH-E1, 2-methoxy-E1 – Helps to understand estrogen metabolism and clearance
- Progesterone metabolites
- Androgens – Testosterone, DHEA-S, DHEA, 5a DHT, androsterone
The above test also includes some other interesting assessments looking at adrenal function, such as cortisol and cortisone levels, along with assessments for melatonin (sleep hormone), and indirect assessments for B12, B6, glutathione which can be important for hormone clearance.
For those with fertility issues, or symptoms at certain points during the menstrual cycle, we may also do a month-long assessment of estradiol, estrone and progesterone metabolites in the urine, to see what the levels are like every few days throughout the cycle.
In some cases, we may also look at genetic testing relating to estrogen clearance/detoxification, as this may help to provide reasoning for the cause and guide the therapeutic support we provide.
If you are looking to work with a professional to help you understand more about the levels and interactions between your hormones, then please feel free to get in touch to enquire about working with us on a 1-2-1 basis, using the enquiry form at the end of this page. Following or sometimes before an initial consultation we can guide you with appropriate laboratory tests.
It’s not just levels, it’s balance too
Estrogen dominance can come about from increased levels of estrogens. Perhaps there is excess production, poor excretion or perhaps there is over conversion occurring from androgens (excess aromatisation). It is also possible that the estrogen dominance is not caused by high estrogens at all, perhaps it is caused by low levels of other hormones such as progesterone and androgens. This is why an assessment of all the hormones is important to help determine the type and cause of the imbalance.
What causes estrogen dominance in females?
So why might we be having all these estrogen issues? Below are some of the possible factors that might be contributing to an estrogen dominant picture:
- Increased amount of overweight and obese females
- Lack of exercise
- Increased consumption of sugar and processed foods and general caloric surplus, resulting in fat gain and increased inflammation
- Exposure to excessive levels of herbicides, pesticides, fungicides that have an estrogenic affect
- Other xenoestrogens found in plastics, body lotions etc
- Poor hormone clearance – Detoxification/genetic factors/gut health
- Nutrient insufficiencies
- Hormone therapies
Nutrition & Lifestyle considerations for androgen dominance in females
Some of the areas that you can consider if you have symptoms of estrogen dominance include:
Excessive levels of aromatisation, the conversion of androgens like testosterone to estrogens may contribute to estrogen dominance. Causes of excessive aromatisation include:
- Inflammation – Look at inflammatory markers
- Levels of body fat, especially visceral fat, the fat that accumulates within our core on a deep level and surrounds the organs
- Poor blood glucose and insulin management. This can be helped through a wholefood diet with the appropriate levels of calories and carbs for that individual, as well as appropriate levels of exercise
Control environmental exposure to estrogens
- Many synthetically produced chemicals found in lotions, cleaning products and more – Look out for products containing things like phthalates, parabens, triclosan, 1, 3-butadiene, PAHs etc
Manage sleep, wake and stress hormones
Changes in hormones involved in regulating the sleep-wake cycle as well as stress, appear to be associated with hormonal imbalances such as estrogen dominance. Shift workers and those travelling regularly across time zones are at higher risk of estrogen related cancers.
Look after your gut
Bacteria in our gut can influence enzymes found in the gut that influence the clearance of estrogens from the body. Maintaining a diet rich in colourful foods and therefore phytonutrients and antioxidants as well as a diet rich in fibre, can support a healthy digestive system in most individuals.
Manage sex hormone binding globulin (SHBG)
This protein helps to bind up sex hormones like estrogen, meaning that less can be available to act upon the cell. If levels of SHBG are low, this can result in high levels of free available sex hormones like estrogen.
High levels of body fat and insulin can cause SHBG to reduce, thus managing body composition and food intake, (amount, balance and type) is crucial for sex hormone balance.
A largely plant-based diet seems to be good for levels of SHBG, however managing and understanding appropriate calorie and macro intake is still critical.
Decrease alcohol consumption
Alcohol is positively associated with estrogen dominance and estrogen dominant cancers, like breast cancer. There is a 10% increased risk for every drink consumed each day.
Alcohol alters the metabolism of estrogen, meaning it can lead to increased levels of estrogen and decreased levels of progesterone.
Decrease dairy consumption
Levels of free estradiol (E2), the most potent estrogen are around 15% higher in women that consumed the highest amounts of dairy, compared to those consuming the lowest amounts.
I hope you have found this content useful. If you feel that you could benefit from additional support in this area, don’t hesitate to get in touch using the enquiry form below.
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