Women’s Hormonal Health: Estrogen Dominance, What Are The Causes?

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My last post covered the phases of the monthly menstrual cycle and the endocrine system to understand the term estrogen dominance. Estrogen dominance was introduced by Dr. John Lee, a pioneer in women’s hormonal health, to explain how estrogen levels, even if they are low, normal or in excess can become too high in relation to progesterone.

The idea behind it has evolved over the years, and it is only one part of a complex puzzle in hormonal balance. It is a condition that creates different outcomes in women when the ratio of estrogen levels are higher to progesterone to such an extent that causes imbalance.
From age 35 to 50, progesterone can drop up to 75%, and estrogen only by around 35 %.
The decrease in estrogen and progesterone is a natural outcome from fewer ovulations and reduction of eggs remaining in the ovaries. These are changes that prepare the body for the winding down of the menstrual cycle until it no longer takes place. This is what menopause is supposed to be, a relatively easy and natural transition.

In non-industrialized countries, most women experience menopause with very few symptoms, and in some languages the term hot flash does not even exist.

What is not natural are the factors present in our Western industrial environment which account for estrogen to become disproportionately higher to progesterone even years before menopause.

Ovary releasing mature egg, corpus luteum formation

What can cause estrogen dominance?

  • environmental and industrial xenoestrogen exposure
  • anovularory cycles
  • stress
  • diet and weight
  • synthetic hormones
  • hysterectomy

What are xenoestrogens? 
Xenoestrogens are substances not made by our body, that mimic estrogen in
their molecular structure.

Because they look like estrogen, when ingested, applied on the skin, or inhaled they can fit into the estrogen receptors in our cells and cause estrogen-like effects or disrupt the effects.They can interfere with the communication and  responses of our endogenous hormones with the endocrine system.

Think of a receptor as a lock which opens with a specific key. In our cells we have receptors and molecules which fit into them to cause an effect.

There is a characteristic which our estrogens have in their structure which is called a phenolic A ring. Other hormones made in our body do not have this characteristic phenolic A ring.
Xenoestrogens have this phenolic A ring in their structure which they share with our body’s estrogens.

Women by the way are not alone in the long term effects from xenoestrogen exposure. Sperm count in men can be affected as well.

Because xenoestrogens are fat soluble, they are absorbed and inhaled easily through the skin.

phenolic A ring
Estrone (estrogen) note phenolic A ring on the left side
Bisphenol -A , plastic xenoestrogen used in water bottles note the phenolic A rings on both sides 

 

Sources of xenoestrogens include:
– most plastics, and substances called phthalates that make plastic products softer and longer lasting
– pesticides, herbicides
– growth hormone and estrogenic compounds given to livestock and chicken
– surfactants used in detergents and dish washing liquid
– flame retardant products found in carpets, furniture, matresses, etc
– solvents found in paint remover, glue
– teflon coating in cookware
– waxes, emulsifiers, and phthalates used in soaps, nail polish and remover, shampoos, hair spray and cosmetics
– industrial products:
PCB, PVC ( plasticizers) widely used in construction materials. PCB has been banned since 1976 but exposure still exists. PVC is also used in vinyl clothes.
dioxin (by product from processes which utilize chlorine: waste disposal burning, production  of chemicals and pesticides, etc).

Livestock and poultry are fed estrogenic compounds to fatten them up and accelerate their growth. They also eat grains and grass that have been exposed to pesticides and herbicides.
These xenoestrogens are also present in milk from cows injected with these compounds.
Because our exposure to xenoestrogens is rampant, we have to take matters into our own hands to diminish it.
Not drinking or eating from plastics, and eating certified organic meat, poulty, produce, and milk is a start.
Finding cosmetics, detergents, personal care, household products  and pesticides that are safe in websites such as Organic Consumers Association, Non-Gmo ProjectNatural Products  Association, etc are also critical steps.

Another factor causing estrogen dominance are anovulatory cycles which is when ovulation does not take place in the menstrual cycle. This can happen years before menopause.
When ovulation does not happen, the egg is not released into the fallopian tubes which means no corpus luteum from the empty follicle manifests.
 If  there is no corpus luteum, then progesterone is not made and estrogen dominates the luteal phase which is the second half of the menstrual cycle.
In other words, you still get your period, but you do not ovulate. Xenogen exposure is the main reason why anovulatory cycles are happenning in women years before menopause, because they interfere with the communication and interactions between the hormones in the endocrine system.
Next on the list of estrogen dominance causes is stress.
High cortisol levels are made in the adrenal glands in response to stress. When we are under high levels of stress, the adrenal glands start to release in higher than usual levels, cortisol and other responders like epinephrine (adrenaline) to help us cope. Progesterone made in the adrenals is also compromised during chronic stress, because it is utilized to make more cortisol.
The adrenal glands are part of the endocrine hormonal network, and the ovaries respond to its signals of chronic stress response by shutting down. Times of extreme stress are not prime times for pregnancy, and the body is protecting itself by conserving this energy.
With this response from the adrenals, the ovaries are underactive, and ovulation may not take place.
If ovulation does take place, and the follicle is released, then the corpus luteum may malfunction.  Remember that the corpus luteum is in the follicle that released the egg, and progesterone is made there and secreted during the luteal phase. A malfunction in the corpus luteum means that it does not make progesterone.
As a consequence of the ovaries shutting down from stress,  progesterone gets depleted either from lack of ovulation or corpus luteum malfunction. This makes estrogen dominate over progesterone during the second half of the menstrual cycle.

Diet and weight are also factors that contribute to estrogen dominance.
A diet consisting of hormonally fed meats and pesticides from produce adds to the levels of xenoestrogens that we already are inhaling and absorbing through our skin.
Processed food, fast food and junk food deplete us of minerals like magnesium, zinc and vitamins like B6 which are needed to metabolize estrogen.
Low fiber in the diet also accumulates estrogen because fiber flushes excess estrogen out.
High refined carbohydrate intake combined with little exercise contributes to excess calories and weight gain especially because of its effect on insulin levels
When calorie intake exceeds our body’s energy needs, estrogen levels increase.
The more weight you have correlates with your estrogen storage. Estrogen is made in the fat cells especially in the abdomen, stomach and thighs.
Estrogen itself increases the size of adipose tissue’s (fat) cells. This design is meant to protect us during menopause when the ovaries slow down estrogen production, so that we have another estrogen producing source.
But, when estrogen is dominant, more fat cells enlarge and produce more estrogen. This promotes even more fat cells to enlarge creating more weight gain.
Women in industrialized Western countries have the highest levels of estrogen from xenoestrogen exposure, diet and lifestyle.

Synthetic hormones are chemically altered hormones that look like our natural hormones in their chemical structure. They can fit in the cellular receptors meant for our natural hormones. The message delivered at the cellular receptor even though the chemical fits in the receptor, may be altered from the original message that is sent from our natural hormones.
Synthetic hormones are found in birth control pills which are chemical versions of  both estrogen and of progesterone. The chemical versions of progesterone are called progestins. Some birth control pills contain progestins alone. It is important to know that progestins are not progesterone.
Birth control pills contain an excessive estrogen component, and by suppressing ovulation, natural progesterone production is decreased.
Conventional hormonal replacement therapy given at menopause or after a hysterectomy also contain potent synthetic estrogens used in combination with progestins.
Again, the potent synthetic estrogens and the progestins that do not replace natural progesterone account for estrogen to dominate.

Lastly, a hysterectomy which is surgical removal of the uterus, causes estrogen levels to gradually fall about two years after, but progesterone levels begin to drop in one to two months. The fast drop in progesterone compared to estrogen causes estrogen dominance.

Now that we know what estrogen dominance is, and what the common causes are, we can begin to understand its symptoms.
In my next post I will cover the many symptoms that result from estrogen dominance before and during menopause.

Camille Medina, RPh
Natural Pharmacy C.l.i.n.i.c., llc

The information provided here is not intended to diagnose, treat, cure, or prevent any disease. Suggestions and ideas presented in this document are for information only and should not be interpreted as medical advice, or for diagnosing illness. Seek advice from a health care professional before administering any dietary supplements.

References:

Alternatine Medicine Rev 16(1): 5-13 (2011) Polychlorinated biphenyls: persistent pollutants with immunological, neurological, and endocrinological consequences. Walter J Crinnion

Lee, John, M.D. , with Hopkins, Virginia. What Your Doctor May Not Tell You About Menopause. New York: Wellness Central, revised edition 2004

Martin, Raquel, with Gerstung, Judi, D.C. The Estrogen Alternative. Vermont: Healing Arts Press, 2000.

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