Most of us are all too familiar with the symptoms that come along with Premenstrual Syndrome (PMS). However, our hormones can have an impact on us throughout the whole menstrual cycle as well, not just before our period, and even once we have reached menopause and beyond. I’m going to talk about excess estrogen in particular and the issues this can cause.
In this post, I’m going to explain:
- What is estrogen dominance and what causes it?
- How is estrogen metabolised by the body?
- How to improve estrogen detoxification to avoid estrogen dominance and improve our overall health.
What is Estrogen Dominance?
Estrogen is an essential hormone involved in the development of the reproductive system, as well as playing a role in brain signalling, skin elasticity, bone mass and heart health. Progesterone works alongside estrogen in the function of reproduction and fertility. Progesterone plays a role in brain health, insulin sensitivity, fat metabolism and blood pressure regulation. The balance of progesterone and estrogen is an important modulator of our health.
If not metabolised and removed from the body properly, estrogen can become damaging and harmful. If there is an excess of estrogen in relation to progesterone, this is known as “estrogen dominance”, as estrogen dominates over progesterone.
Symptoms of estrogen dominance
Estrogen dominance can cause symptoms commonly associated with PMS such as headaches, nausea, bloating, decreased libido, mood swings, breakthrough bleeding, fatigue and breast tenderness, as well as being a potential trigger for polycystic ovary syndrome, infertility, ovarian and breast cancer, endometriosis, migraines and can increase the risk of auto-immune conditions (1). Therefore, we want to maintain a healthy hormone balance and reduce our risk of these conditions by avoiding estrogen dominance. Many of us have experienced at least one of these health issues or know someone who has.
Causes of Excess Estrogen
What can cause excess estrogen? There are a wide range of different lifestyle, dietary and environmental factors (plus our genetics) that can disrupt hormone balance, resulting in excess estrogen and low progesterone such as:
- Insulin resistance: high levels of insulin caused by insulin resistance or poor blood sugar balance can increase estrogen (2)
- High levels of stress: cortisol (the main stress hormone) produced as a result of chronic stress can reduce progesterone (3), causing an imbalance between estrogen and progesterone.
- Exposure to xeno-estrogens: substances found in the environment which can mimic estrogen in the body such as pesticides, BPA-lined tins and cans, plastics, flame retardants found on furniture and upholstery, synthetic fragrances and ingredients in cosmetics and body care, and charred food (4)
- Smoking, alcohol and caffeine: all impair estrogen detoxification and removal from the body (5) (15)
- Obesity: visceral (abdominal) fat can increase estrogen levels (6)
- Thyroid problems: impaired thyroid function can impair estrogen detoxification and vice versa (7)
- Gallbladder problems: the gallbladder releases bile, which carries estrogen out of the body (11), therefore gallbladder problems can interfere with estrogen detoxification and removal. High levels of estrogen can also increase your risk of gallstones (19)
- Gut dysbiosis (an increase in “bad” bacteria or other organisms living in the gut): an enzyme produced by pathogenic bacteria in the gut can increase estrogen levels by essentially “undoing” the detoxification of estrogen (8)
- Poor elimination (i.e. constipation): regular bowel movements are needed to remove detoxified estrogen from the body (9)
- Taking the oral contraceptive pill (OCP): synthetic hormones can increase estrogen. They can also decrease insulin sensitivity. The OCP can deplete the body of key nutrients needed to detoxify estrogen as mentioned in this post (10).
“Stress, xeno-estrogens, high levels of insulin, gut problems and constipation are some of the key factors that can result in excess estrogen in the body”
Estrogen is detoxified by the liver and requires a wide range of nutrients to metabolise it effectively, for example, the B vitamins and anti-oxidants such as vitamins A, C and E, minerals such as selenium, zinc and magnesium, as well as glutathione, and CoQ10 (11). Once detoxified by the liver, bile (a substance produced by the liver that is more commonly known for its role in fat digestion) carries estrogen metabolites out of the body via the bowels.
Our gut bacteria impact estrogen detoxification. Pathogenic bacteria in the gut can produce an enzyme called beta-glucuronidase which essentially reverses the detoxification process so that estrogen can re-enter circulation again – which is exactly what we don’t want! Friendly bacteria such as Lactobacillus and Bifidobacterium are needed to inhibit or reduce beta-glucuronidase. So keeping our gut bacteria healthy is also important for hormonal health (11).
Estrogen is broken down into 3 different metabolites:
- 2-OH (2-hydroxyestrone): considered to be less harmful
- 4-OH (4-hydroxyestrone): considered harmful and damaging to DNA
- 16-alpha (16-alpha-hydroxyestrone): considered harmful and damaging to DNA
Higher levels of the 4-OH and 16-alpha-OH estrogen metabolites are linked with increased risk of breast cancer.
So how can we improve estrogen metabolism to make sure we aren’t estrogen dominant and we aren’t producing high levels of the damaging estrogen metabolites? Our diet, lifestyle, exposure to toxins, choice of medication and nutrient intake all impact on the detoxification of estrogen. These different factors provide opportunities for us to improve detoxification for the better so we can improve our health.
Steps to take to improve estrogen detoxification
Some initial steps to take to improve estrogen metabolism and reduce the risk of estrogen dominance include:
- Reducing or eliminating refined sugar and refined carbohydrates in the diet, which otherwise increase insulin, reduce bile flow and impair estrogen metabolism (12)
- Making sure your diet is high in fibre, which supports healthy gut bacteria and helps to detoxify and eliminates estrogen (13) Soluble fibre, in particular, is the most beneficial which is found in vegetables (including the peel), fruit, nuts, seeds, beans, lentils and oats
- Eating cruciferous vegetables (broccoli, cabbage, Brussel sprouts, cauliflower and kale) support estrogen metabolism as they contain a compound called 3-indole-carbinol. This promotes the breakdown of estrogen to the less harmful metabolite 2-OH (14)
- Avoiding xenobiotics from toxic skin care which further impairs detoxification as mentioned in this post.
- Replenishing nutrients needed to support detoxification of estrogen (see above). This is especially important if you have been taking the oral contraceptive pill which depletes these key nutrients. Check out this post which explains all
- Reduce or eliminate caffeine. Instead of your usual tea and coffee switch to herbal teas such as peppermint, chamomile, Rooibos, nettle tea or a turmeric latte
- Managing and reducing stress levels in a way that works for you, such as exercise, walking, listening to music, creativity, nature, massage, and breathing techniques etc.
“A diet high in fibre, low in sugar and refined carbs along with avoiding xeno-estrogens and reducing stress can improve estrogen metabolism”
Supporting estrogen detoxification by following the above steps can help to avoid estrogen dominance, which can help to reduce symptoms of PMS and our risk for serious diseases or health issues.
Supporting healthy gut bacteria, a healthy insulin response, replenishing nutrients needed for detoxification and reducing toxins and stress will all go a long way in reducing the “bad” estrogen and supporting balanced hormones.
I recommend you to take just one step at a time, especially if the above recommendations are new to you. Pick one recommendation and work on that for a week or two and then progress onto another step. Which step will you take this week to improve your hormonal health?
- Patel, S., Homaei, A., Raju, A.B. and Meher, B.R., 2018. Estrogen: The necessary evil for human health, and ways to tame it. Biomedicine and Pharmacotherapy, [online] 102(October 2017), pp.403–411. Available at: <https://doi.org/10.1016/j.biopha.2018.03.078>.
- Wallace, I.R., McKinley, M.C., Bell, P.M. and Hunter, S.J., 2013. Sex hormone binding globulin and insulin resistance. Clinical Endocrinology, 78(3), pp.321–329.
- Wellwood, C. and Rardin, S., 2014. Adrenal and Thyroid Supplementation Outperforms Nutritional Supplementation and Medications for Autoimmune Thyroiditis. Integrative Medicine: A Clinician’s Journal, [online] 13(3), pp.41–47. Available at: <http://eds.b.ebscohost.com.ezproxy.endeavour.edu.au/eds/pdfviewer/pdfviewer?sid=1cf960ef-32a1-4eca-8cb5-4d7b8207f7c2@sessionmgr113&vid=79&hid=122>.
- Fucic, A., Gamulin, M., Ferencic, Z., Katic, J., Krayer Von Krauss, M., Bartonova, A. and Merlo, D.F., 2012. Environmental exposure to xenoestrogens and oestrogen related cancers: Reproductive system, breast, lung, kidney, pancreas, and brain. Environmental Health: A Global Access Science Source, [online] 11(SUPPL.1), p.S8. Available at: <http://www.ehjournal.net/content/11/S1/S8>.
- Windham, G.C., Mitchell, P., Anderson, M. and Lasley, B.L., 2005. Cigarette smoking and effects on hormone function in premenopausal women. Environmental Health Perspectives, 113(10), pp.1285–1290.
- Cleary, M.P. and Grossmann, M.E., 2009. Minireview: Obesity and breast cancer: The estrogen connection. Endocrinology, 150(6), pp.2537–2542.
- Santin, A.P. and Furlanetto, T.W., 2011. Role of Estrogen in Thyroid Function and Growth Regulation. Journal of Thyroid Research, [online] 2011, pp.1–7. Available at: <http://www.hindawi.com/journals/jtr/2011/875125/>.
- Kwa, M., Plottel, C.S., Blaser, M.J. and Adams, S., 2016. The intestinal microbiome and estrogen receptor-positive female breast cancer. Journal of the National Cancer Institute, 108(8), pp.1–10.
- Maruti, S.S., Lampe, W.W., Potter, J.D., Ready, A. and White, E., 2013. A Prospective Study of Bowel Motility and Related Factors on Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev, 6(8), pp.1746–1750.
- Campagnoli, C., Clavel-Chapelon, F., Kaaks, R., Peris, C. and Berrino, F., 2005. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. Journal of Steroid Biochemistry and Molecular Biology, 96(2), pp.95–108.
- Hall, D., 2001. Nutritional Influences on Estrogen Metabolism. Applied Nutritional Science Reports, pp.7–9.
- Jessri, M. and Rashidkhani, B., 2015. Dietary Patterns and Risk of Gallbladder Disease: A Hospital-based Case-Control Study in Adult Women – ProQuest. Journal of Health, Population and Nutrition, [online] 33(1), pp.39–49. Available at: <http://search.proquest.com.ezproxy.slv.vic.gov.au/docview/1672598794/9B919886838F4485PQ/5?accountid=13905>.
- Yang, J., 2012. Effect of dietary fiber on constipation: A meta analysis. World Journal of Gastroenterology, [online] 18(48), p.7378. Available at: <http://www.wjgnet.com/1007-9327/full/v18/i48/7378.htm>.
- Hodges, R.E. and Minich, D.M., 2015. Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application. Journal of Nutrition and Metabolism.
- Zhu, B.T., Wang, P., Nagai, M., Wen, Y. and Bai, H.W., 2009. Inhibition of human catechol-O-methyltransferase (COMT)-mediated O-methylation of catechol estrogens by major polyphenolic components present in coffee. Journal of Steroid Biochemistry and Molecular Biology, 113(1–2), pp.65–74