Estrogens and Progesterone Overview
Two types of sex (steroid) hormones are estrogens and progesterone. There are three estrogens: B-estradiol, estrone and estriol. B-estradiol is by far the most potent. It is 12 times more potent than estrone and 80 times more potent than estriol. Any over exposure to B-estradiol can increase a person’s risk of disease. Estriol is considered the “good estrogen.” There is only one type of progesterone, and it considered a very safe hormone. Progesterone is called progestin when it is in a synthetic form.
Estrogen and progesterone work in synchronization with each other as checks and balances to achieve hormonal harmony in both sexes. Estrogen and progesterone need the presence of each other in order to perform their individual functions.
Maintaining estrogen balance can be difficult for many. For many decades of a woman’s life circulating estrogens are fluctuating and cause both good and bad influences. The primary role of estrogen is to maintain the growth and function of the uterus so that the sex organs can become adult sized, and prepares the uterine lining to accept an egg. Additionally, estrogen affects skeletal growth, skin, fat and protein deposition, and electrolyte balance. Men also produce a certain amount of estrogen.
Progesterone is the building block for many other major hormones. Other sex hormones are formed from progesterone, including the corticosteroids, which are essential for stress response, electrolyte balance, blood pressure, and lastly, survival. Cortisol, DHEA, testosterone and estrogen are all made from progesterone in a process that begins with cholesterol. Progesterone is the primary hormone of fertility and pregnancy. It is essential to the survival of the fertilized egg, then the embryo, then the fetus. In pregnancy, it prevents the shedding of the uterine lining. A drop in progesterone can result in a miscarriage.
Causes of Estrogen Dominance
Estrogen dominance is generally not caused by one factor, but often many factors, including:
- Hormonal imbalance
- Hormone therapy
- Environmental estrogens
- Stressful lifestyle
- Glandular dysfunction
- Hormonal Imbalance
From the time menses begins until menopause, levels of estrogen and progesterone ebb and flow in a manner which promotes reproduction. At about age 35 to 40, women reach the time of pre-menopause, which is when their levels of progesterone and estrogen begin to reduce.
Normal Hormone Progression
During this time through age 50, there is a 35% drop in estrogen, but a 75% reduction in progesterone occurring simultaneously. This is normal, and does create many pre-menopausal symptoms that we accept as part of the aging process.
Many pre-menopausal women in their mid to late thirties, as well as many women in the menopausal stage are overloaded with estrogen. At the same time they are suffering from progesterone deficiency because of the severe drop in physiological production during this period. There is then insufficient progesterone to counteract the amount of estrogen in our body. It is most noticeable among peri-menopausal women who do not ovulate, which is quite common. You may have a fairly normal cycle, but no egg is released and very little progesterone is produced.
It is not the absolute deficiency of estrogen or progesterone, but rather the relative dominance of estrogen and possible deficiency of progesterone that is the main cause of health problems when they are not in balance. The end result: excessive estrogen relative to progesterone, add up to a condition Dr. John Lee has termed “estrogen dominance.” Dr. Lee’s books, What Your Doctor May NOT Tell You About Pre-menopause and What Your Doctor May NOT Tell You About Menopause explain this and more in-depth. These books are available on our website.
Hormone Replacement Therapy (HRT)
A woman reaches menopause naturally around the age of 50, or as a result of having her ovaries surgically removed. Until recently, doctors routinely prescribed hormone replacement therapy (HRT) for menopausal symptoms. These prescription drugs are comprised of synthetic estrogen or an estrogen-progestin combination. HRT is also used to protect against the loss of bone after menopause.
But, there are risks. Concerns about hormone therapy arose from the Women's Health Initiative (WHI) clinical trial, whose purpose was to address the most common causes of death, disability and impaired quality of life in postmenopausal women. The hormone replacement therapy (HRT) component of the WHI trial looked at the long-term use of oral HRT in older women in the USA for the prevention of disease. The WHI study was stopped in 2002 because the incidence of invasive breast cancer exceeded the safety level set by the WHI. Many doctors are no longer prescribing synthetic HRT.
For women taking the combination of estrogen-progestin (Prempro) used in the study, researchers found an increased risk of:
- Heart disease
- Breast cancer
- Blood clots
In addition, not only did hormone therapy increase the women's risk of breast cancer, it also made tumors harder to detect, leading to potentially dangerous delays in diagnosis.
For women taking estrogen alone (Premarin), preliminary results showed no increased risk of breast cancer or heart disease but did find a slightly increased risk of stroke.
Women and their doctors are discovering that conventional HRT does not give them the overall health and well-being they had hoped for, and they are seeking out healthier alternatives, such as natural bio-identical hormone replacement, lifestyle changes, and diet changes. What everyone will hopefully soon realize is that menopausal and sexual reproductive problems are actually symptoms of overall hormonal imbalances. Women need to get a complete picture of their hormonal status and find appropriate therapeutic steps to maintaining balance.
Birth Control Pills
Birth control pills contain estrogen, and contribute to the development or worsening of estrogen dominance. Depending on dosage, they can be very potent, and linger for a long period of time in the body. Dr. Joseph Mercola’s webpage “Just Say No to Birth Control Pills” states the following about birth control pills:
A woman's natural cycle is composed of rising and falling levels of estrogen and progesterone. Birth control pills work by keeping estrogen at a sufficiently high level that they fool the body into thinking it is pregnant, therefore another pregnancy cannot occur.
Cramping, painful and irregular periods are often due to a deficiency of progesterone and an excess of estrogen. Estrogen-alone birth control pills --the most commonly prescribed pills on the market now --often compound the problem. That's why some women have intolerable estrogen-induced side effects when they are on birth control pills such as weight gain, mood swings, and breast tenderness.
What is not usually mentioned, or even known, is the metabolism of birth control pills by the liver requires extra amounts of the B-complex vitamins, vitamin C, magnesium, and zinc. That means if you're taking birth control pills for years at a time, as are most American women, you're creating nutrient deficiencies. Weight gain, fluid retention, mood changes, depression and even heart disease can all arise from nutrient imbalance.
We are constantly assaulted by estrogens in our environment from the food we eat and the chemicals we use. Estrogen mimickers in the form of chemicals (xenoestrogens), and foods and plants (phytoestrogens), mimic the action of estrogen produced in cells and can alter hormonal activity.
Evidence is steadily growing that xenoestrogens and other hormone mimicking substances are implicated in a wide range of human and wildlife health problems. Estrogen dominance from these environmental hormone disrupters are causing an imbalance of female hormones, creating a host of estrogen dominance symptoms (see chart below). Girls and boys are reaching puberty too early as a result of these disrupters. Additionally, xenoestrogens produce hormonal stimuli that contributes to inappropriate growth of mammary tissue cells, resulting in a problem society is calling “man boobs.” Some theorize that estrogen dominance in men is contributing to hair loss, atherosclerosis, prostrate problems, lowered libido, and impotency.
Xeno literally means foreign, therefore xenoestrogens means foreign estrogens. Some of the 70,000 registered chemicals for use in the United States have hormonal effects in addition to toxic effects. The synergistic effects of exposure to many xenoestrogens are well documented, but largely unknown.
Xenoestrogens found in certain pesticides, plastics, fuels and drugs are usually synthetic and difficult for the body to break down, and can amplify the effects of estrogen. These substances can increase the estrogen load in the body over time, and are difficult to detoxify through the liver. Exposure to xenoestrogens is a concern for everyone. Those with an estrogen dominance condition should be particularly concerned about avoiding xenoestrogens.
Xenoestrogens can be found in many of our meats and dairy products in the form of chemicals and growth hormones that are given to the animals. These can be quite powerful, and should be avoided where possible. Choosing meat and dairy items that do not contain Rbst can help decrease xenoestrogen exposure.
Sources of Xenoestrogens
- Commercially raised meat • Plant estrogens (soy, flaxseeds)
- Canned foods • Car exhaust and indoor toxins
- Plastics, plastic food wraps • Cosmetics
- Styrofoam cups • Birth control pills and spermicide
- Industrial wastes • Detergents
- Personal care products • All artificial scents
- Pesticides and herbicides • Air fresheners, perfumes, etc)
- Paints, lacquers and solvents
For a more extensive list of xenoestrogens, see our Environmental Estrogens page.
Phytoestrogens (phyto meaning plant) are naturally occurring estrogenic compounds that are found in a variety of foods, herbs, spices. Their chemical structure resembles estrogen. These compounds are generally weak estrogens, in comparison to real estrogen and xenoestrogens, but in a body that is already experiencing too much estrogen, adding more will contribute to the problem.
Some of the strongest phytoestrogen containing substances are soy, the lignans found in flax seed products, red clover, black cohosh, chasteberry, and dong quai. Soy includes soybeans, soy milk, tofu, tempeh, textured vegetable protein, roasted soybeans, soy granules, soy protein powders, miso, and edamames.
Over consumption of phytoestrogenic foods or herbs on a long term basis may actually increase the risk of estrogen dominance significantly. Furthermore, phytoestrogens have been shown to inhibit the conversion of T4 to the active T3 thyroid hormone, and can trigger hypothyroidism. It is suggested that those with a history of thyroid imbalance, or suffering from estrogen dominance, should consume a minimum amount of phytoestrogens.
Stressful Lifestyle and Glandular Dysfunction
Stress causes adrenal gland exhaustion and reduced progesterone output. This tilts the estrogen to progesterone ratios in favor of estrogen. Excessive estrogen in turn causes insomnia and anxiety, which further taxes the adrenal gland. This leads to a further reduction in progesterone output and even more estrogen dominance. After a few years in this type of vicious cycle, the adrenal glands become exhausted. This dysfunction leads to blood sugar imbalance, hormonal imbalances, and chronic fatigue.
In the female, a large part of hormonal balance is controlled by the three major glands: the adrenal gland, the thyroid gland, and the ovaries. Maintaining a proper balance among these three glands is of critical importance in any estrogen dominance recovery program. Excessive estrogen affects both thyroid and adrenal function, and in turn, dysfunctional thyroid and adrenal fatigue makes estrogen dominance worse. They all go hand in hand. When not functioning properly, these three glands, controlling the majority of the hormones in the body, can lead to a viscous downward cycle of hormonal imbalance. Worse yet is that conventional medicine often times are misled into treating symptom after symptom without addressing the root cause. A wide variety of prescriptions from sleeping pills to anti-depressants are dispensed. Unfortunately, such symptom-based protocol will often make things worse instead of better.
Estrogen Dominance Symptoms
The following symptoms are common among those with excess estrogen. What begins with mild symptoms in younger years often becomes moderate in the mid to late 30s, and severe by the time a woman reaches her mid 40s. If you are experiencing as few as 6 of these symptoms, you probably have some level of estrogen dominance.
|Premenstrual breast tenderness||Irregular menstruation||Uterine fibroid tumors|
|Premenstrual mood swings||Weight gain||Endometriosis|
|Premenstrual fluid retention, weight gain||Hair loss||Fibrocystic breasts|
|Premenstrual headaches||Depression||Polycystic ovary syndrome|
|Menstrual cramps||Fatigue||Breast tumors|
|Adrenal gland fatigue||Thickened uterine lining|
|Headaches, migraines||Accelerated aging|
|Severe menstrual cramps||Miscarriage|
|Heavy periods with clotting||Anxiety and panic attacks|
|Joint and muscle pain||Autoimmune disorders|
|Insomnia and restless sleep|
Health Consequences of Estrogen Dominance
Estrogen dominance can lead to many different related health conditions. For example, in women, over-stimulation from estrogen of the breast tissue can cause tenderness, swelling, and fibrocystic breasts. In the uterus, excess estrogen stimulation may lead to endometriosis, hyperplasia, heavy or irregular menses, menstrual cramping and uterine fibroid tumors. If estrogen over-stimulation occurs in the liver, we see weight gain, constipation, cyclical headaches and migraines, depression, mood swings, fluid retention, and low libido among many other symptoms. Review the following link for a more complete list of symptoms http://www.johnleemd.com/store/estrogen_dom.html
- Not only has it been well established that estrogen dominance encourages the development of breast cancer…it also stimulates breast tissue that can trigger fibrocystic breast disease.
- Estrogen dominance can cause weight gain, headaches, bad temper, chronic fatigue and loss of interest in sex…among other symptoms.
- Excess estrogen can lead to a decrease in the rate of new bone formation…Although most doctors are not yet aware of it, this is the prime cause of osteoporosis.
- Estrogen dominance increases the risk of fibroids...
- In estrogen-dominant menstruating women where progesterone is not peaking and falling in a normal way each month, the ordered shedding of the womb lining doesn't take place.
- Menstruation becomes irregular.
- Water logging of the cells and an increase in intercellular sodium, which predispose a woman to high blood pressure or hypertension, frequently occur with estrogen dominance.
- The risk of stroke and heart disease is increased dramatically when a woman is estrogen-dominant.
-Source: Leslie Kenton, Passage to Power, Random House, UK, 1995
Correcting Estrogen Dominance
What assists in correcting estrogen dominance? Alternative health care makes the following suggestions:
- Hormonal support with a natural progesterone cream
- Nutritional supplements to ensure your body has the nutrients it needs to make and balance its hormones. These nutrients tend to be low when estrogen is high:
- Vitamin B Complex
- Vitamin E 400 IU for breast tenderness and fibroid inflammation
- DIM and/or Myomin to metabolize excess estrogen
- Dietary and environmental changes to rid yourself of phytoestrogens and xenoestrogens (environmental estrogens)
- Lifestyle changes to manage the stresses in your life
Natural progesterone cream supplements low progesterone levels and balances the ratio between estrogen and progesterone, thereby assisting in promoting proper hormone balance. It can be safely used by menstruating women, pre-and peri-menopausal women, and menopausal women. Men with estrogen dominance can also benefit from progesterone. Additionally, women who may not be highly estrogen dominant find that if a progesterone cream is used on a regular basis, their menses and PMS are less difficult.
Diindolylmethane (DIM) is a powerful metabolizer of estrogen, assisting in removing excess estrogen and benefiting conditions associated with estrogen dominance. Supplementation with DIM can help promote proper estrogen levels through the pre-and peri-menopausal years, and in men experiencing higher estrogen levels. These conditions include uterine fibroid tumors, fibrocystic breasts, glandular dysfunction, and more. It can also benefit men by improving estrogen-dominance related health issues such as hair loss, atherosclerosis, prostrate problems, lowered libido, and impotency. DIM also promotes testosterone action, which improves mood, fights depression, boosts libido, improves cardiovascular health, improves memory, and supports muscular development.
Myomin is a formula of four Chinese herbs that promote proper hormonal balance. Like DIM, Myomin also metabolizes excess estrogens. Myomin inhibits aromatase, which can reduce levels of bad estrogens (estradiol and estrone), and promotes production of the good estrogen (estriol). For men and women, this action prevents the conversion of testosterone into bad estrogens, and leads to the unhindered production of more estriol from progesterone, DHEA and other hormones. Additionally, some of the herbs help promote shrinkage of tumors and cysts. Of the two, DIM is the stronger metabolizer of estrogen.
It is very important to understand that what may be true for one woman is not necessarily true for another. The journey of hormonal changes is an individual one. What this also implies is that the treatment for one individual can be quite different from that of another.
You can reduce your exposure to xenoestrogens by choosing body care products without chemicals, using chemical-free cleaning products, limiting daily intake of phytoestrogens, as well as reducing exposure to exhaust fumes and indoor pollutants.
Choosing lean, organic meat and dairy products is best. Purchase organic fruits and vegetables as much as possible. If they are not available, thoroughly wash or peel all produce to remove at least some of the pesticides.
Heat food in metal or porcelain container, not plastic, and definitely not in the microwave with plastic wrap. Using glass containers to drink from rather than plastic, previously used water bottles, or Styrofoam cups can also help reduce xenoestrogen exposure.
Key points to reducing estrogen dominance:
- Avoid chemical sources of estrogen (xenoestrogen)
- Avoid food sources of estrogen (phytoestrogens)
- Cleanse the liver
- Reduce stress
- Balance hormones
- Metabolize excess estrogen (DIM, Calcium D-Glucarate)
- Do not heat food in plastic
- Drink out of glass containers, not plastic or Styrofoam