Estrogen Hormone. What You Need To Know.
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The Estrogen hormone gets a really bad wrap, but is that rightfully so? We always hear the term estrogen dominance, but what does that really mean? Can estrogen be good for us too? Let’s explore some of these questions together with a Toronto Naturopathic Doctor.
What is Estrogen?
Estrogen is a female sex hormone made primarily in the ovaries of cycling women. Estrogen hormone can also be made through a process called aromatization from testosterone. The latter process increases as women go through menopause, and is also the process for which men produce estrogen. The main star of show is called Estradiol (E2), and is considered the most potent form of estrogen. Estradiol is made primarily in the ovaries, but is also produced by adipose tissue, liver, and adrenal glands. Estrone, also known as E1, is also made in the ovaries and to a lesser extent adipose tissue. Estrone is less potent than Estradiol, but becomes the predominant form of estrogen a women’s body makes after menopause. A third type of estrogen exists as well, Estriol (E3) and is the main estrogen during pregnancy.
The Benefits of Estrogen
One of the most widely known functions of the estrogen hormone is its role in regulating the menstrual cycle, pregnancy, and for setting off puberty in young females. It also very well known for the array of symptoms women experience as they begin to experience both perimenopause and menopause as estrogen levels begin to fall (is it hot in here, or is it just my menopause?). Although sometimes demonized, estrogen has a wide array of benefits and is required (in appropriate amounts) for optimal functioning.
Brain Health: Estrogen hormones helps to maintain body temperature, aids in cognitive health and prevents memory loss, and helps to regulate parts of the brain responsible for sexual and reproductive development.
Cardiovascular Health: Estrogen helps to regulate the liver’s production of cholesterol, and plays a role in decreasing plaque build-up within the artery walls.
Bone Health: Estrogen plays a role in both the growth and maturation of bone. In adults, it is involved in the regulation of bone turnover as it promotes the activity of osteoblasts, cells which produce bone.
Reproductive Health: The Estrogen hormone has many benefits and roles within reproductive health. It stimulates the maturation of the uterus, and aids in preparing the uterus to nourish and support a growing fetus. It stimulates the maturation of the vagina, and maintains a thick vaginal wall and lubrication. In addition, it also stimulates the maturation of the ovaries, and the onset of a woman’s menstrual cycle. Furthermore, estrogen also stimulates the development of the breast tissue at puberty, and prepares the breast glands for future milk production.
Symptoms of Low Estrogen:
A low estrogen hormone predominantly occurs as women transition through perimenopause and menopause. Other causes of low estrogen may be due to premature ovarian failure, surgical removal of the ovaries, excessive exercise, eating disorders and other hormonal issues. In women of child bearing years, or those wishing to conceive low estrogen can be a serious cause for concern and must be investigated thoroughly by your Naturopathic Doctor.
Symptoms may include:
- Menstrual periods that become less frequent, or stop altogether
- Hot Flashes
- Night sweats
- Difficulty sleeping
- Dryness or thinning of the vagina
- Lowered libido
- Mood swings
- Breast tenderness
- Brain Fog and impaired brain functioning (notably memory)
- Decreased bone mineral density and increased risk of fractures
- Abnormal lipid profiles
Symptoms of High Estrogen:
The term estrogen dominance speaks to higher levels of estrogen, relative to progesterone. A hyper-estrogenic state occurs when levels of estrogen are high, regardless of progesterone levels. This could be because your body is producing too much estrogen, you are not detoxifying and eliminating it properly, or a combination of both. High estrogen levels may also occur during perimenopause, in which estrogen can spike up to three time higher than what it was in your younger self, sometimes referred to the ovaries’ “last hoorah”. It should be noted that these estrogen spikes during perimenopause can be intertwined with symptoms of low estrogen which can feel like hormonal chaos to women (think a combination of heavy periods, breast pain, irritable mood, and night sweats).
Symptoms may include:
- Heavy menstrual bleeding
- Irregular menstrual cycles
- Worsening PMS symptoms (breast tenderness, headaches, mood changes, acne-flare ups)
- Increased vaginal discharge
- Weight gain, especially around the hips, thighs and mid-section
- Depression/ Anxiety
- Lowered libido
How to assess Estrogen Levels:
If you’re experiencing any of the symptoms for either low or high estrogen hormones, it is critical that you investigate further. Prolonged elevation, or depression of hormones can lead to various health conditions, some potentially being life threatening. Your Toronto Naturopathic Doctor can investigate the cause of your estrogen imbalance, and determine a proper course of action and next steps. These are some of the tests they may discuss with you. They also may look at a more complete picture of your hormones, as often times hormonal imbalances influence each other.
Blood Test: Estrogen levels can be assessed through serum with a blood test; this is the most validated test for diagnosing disease and conditions.
The DUTCH test stands for the Dried Urine Test for Comprehensive Hormones. It measures several different hormones, their metabolites, and certain neurotransmitters. Specifically for estrogen, it looks at the different estrogens and how your body is metabolizing it. Our livers are our master detoxification system, and during phase one detoxification estrone (E1) and estradiol (E2) are converted into three different metabolites; 2-OH-E1, 4-OH-E1 and 16-OH-E1. The second phase of detoxification prepares these metabolites to be secreted out of the body and involves methylation. Basically, this phase 2 is responsible for neutralizing the phase 1 metabolites, and preparing for elimination.
If an individual’s phase 2 methylation detoxification is not functioning optimally, this can increase the amount of circulating estrogen metabolites, instead of being able to properly excrete them. This can become an issue because the estrogen metabolites can exhibit estrogen like effects causing estrogen dominant symptoms, increasing cell proliferation, and may increase the risk of certain cancers. It should be noted that the 4-OH-E1 metabolite is considered the safer, and more desired metabolite in this pathway, and that increased volumes of the other metabolites may indicate that your estrogen detoxification pathways require support. Your Naturopathic Doctor is trained to be able to look and interpret the results of your DUTCH Test to determine if your liver, and detoxication pathways require support to optimize both estrogen levels, and its detoxification.
How Naturopathic Medicine can help:
A Toronto Naturopath can help support you in many ways when its come to estrogen. You will want to look at Xenoestrogens: Xenoestrogens are exogenous molecules that imitate the actions of estrogen in the body. They can either be “natural” or “synthetic”. Natural xenoestrogens include phytoestrogens (soy, flax seed) and synthetic xenoestrogens include environmental toxins and synthetic hormones (oral contraceptives etc.). It is important to note that xenoestrogen is an umbrella term, and that there is a difference between natural and synthetic xenoestrogens.
Synthetic xenoestrogens include things like BPA found in plastics and on receipts, phthalates commonly found in personal care products and cosmetics, and dioxin and DDT found in pesticides and herbicides. Synthetic xenoestrogens have the ability to strongly bind to estrogen receptors and can negatively alter its activity.
Natural xenoestrogens, also known as phytoestrogens, are things like flax-seed and soy that can weakly bind to estrogen receptors to help modulate and balance estrogen levels without overstimulating the production of estrogen.
Your Toronto Naturopath will want you to look at how you can reduce and when possible eliminate these from your life.
The EWG has an interesting article speaking about the Dirty Dozen Hormone Disruptors in further detail, and identifying ways to reduce our exposure to synthetic xenoestrogens and endocrine disruptors. Your Naturopathic Doctor will also assess the impact synthetic xenoestrogens may be having, and discuss strategies to reduce or minimize your exposure.
Liver and Detoxification support: As was discussed, the liver is the primary organ responsible for the detoxification of estrogen. Working alongside the liver, our digestion system is responsible for the excretion of estrogen. Both systems need be functioning optimally in order to help estrogen levels balance. Your Naturopathic Doctor will ask you specific questions to determine whether any support is needed for both your liver and gut. In addition, the results of your DUTCH test may provide objective evidence to help support these pathways.
Replenishing micronutrients: Our minerals are like spark plugs that kick off essential reactions in the body to get things going. The cells in our body require minerals to make energy and hormones. In order to assess hormonal health, your Naturopathic Doctor will first look at your mineral status and assess for any micronutrient deficiencies. This is the foundation before tackling your hormones.
Bio-identical hormone therapy: Bioidentical hormones have a molecular structure that are identical to that of our human hormones, but are made from plant based extracts. Bio-identical hormone therapy may be a helpful adjunct to your treatment plan to help support your hormonal health and changes, and alleviate perimenopause and menopausal symptoms.
Supplementation: Certain botanicals have been research and studied to help support the levels of estrogen and certain hormones in the body. Herbal discussions may include Tribulus, Black Cohosh, and Rhodiola for examples. At Higher Health, we take an individualistic approach to your health care and will develop a supplementation protocol that is unique for your needs. No two individuals or their hormone support will be the same. When you want to talk more about health with a Toronto Naturopath, you can book a free intro call by clicking here.