In Functional Medicine we often refer to the relationship between estrogen and progesterone as the “dance of the hormones” or the “hormone orchestra.”
Ironically, what sounds like a beautiful evening at the ballet often plays out each month as a real hand-banging, body-slamming cacophony!
So what gives? Why is it that we often feel out of control, and sometimes out of body, for days at a time?
The answer could be Estrogen Dominance.
Here are typical symptoms that can be attributed to a relative excess of estrogen in relationship to progesterone:
- irregular bleeding
- mood swings
- water retention/bloating
- painful breasts
- hot flashes
- heavy periods
- painful periods
- brain fog
- sleep disturbance
How did we get here? Unfortunately, there are many roads that lead to estrogen dominance. Let’s start at the beginning.
The Typical Menstrual Cycle
During a typical menstrual cycle, the first half of the month, known as the estrogen dominant phase, progesterone is relatively low and estrogen levels steadily rise. Due to some nifty feedback loops that involve the brain and other hormones, ovulation occurs at around Day 14, and an egg is released from the ovary. During this second half of the menstrual cycle, estrogen levels fall somewhat and progesterone levels rise significantly. This is when progesterone takes the lead in our hormone tango.
5 Roads that Lead to Estrogen Dominance
- Irregular Ovulation — One road that leads to estrogen dominance is if ovulation doesn’t occur and progesterone doesn’t have the opportunity to take that lead. We see this type of problem in young girls who haven’t started ovulating regularly, and in peri-menopausal women who are close to the end of their ovarian reserve, and also aren’t ovulating normally.
- Any Type of Stress — Often stress can lead to skipped ovulation. Typically we think of extreme episodes of stress such as a severe illness, anorexia/malnutrition, intense athletic training. But commonly, your average woman who goes through a stressful time will notice that her period becomes irregular. Even long standing, chronic stress can take a toll on your female hormones.
- Foods and Food Packaging — In this day and age of genetically-modified, pesticide-laced, prepackaged food to go, we are constantly exposed to xenoestrogens. These are toxic chemicals that act like weak estrogens in your body. These nasty chemicals can be found in pesticides, plastics that our food comes wrapped in, that “to-go” coffee lid, even the lining of your canned goods and drinks.
- Cosmetics and Household Products — Other examples of endocrine disruptors are phthalates and parabens that are used in hygiene products, cosmetics, and fragrances. This is where women are potentially very vulnerable considering how many bath, haircare, cosmetic, nail, feminine hygiene products we use daily. These just add to your total estrogen “load” that your body sees on a regular basis and that your liver has to metabolize and detoxify. It turns out that optimal liver function is very important in estrogen metabolism and clearance.
- Your Gut Flora — The gut microbiome and your gastrointestinal function is another major player in this hormonal dance that is now looking more like a square dance with all its moving parts. It turns out that the bacteria that reside within our GI tract plays a very important role in helping us eliminate our estrogen by-products once the liver has packaged them up nicely for excretion. Sadly, the average American diet, full of high fructose corn syrup and other inflammatory foods often keep our livers working over-time just trying to detoxify lunch, let alone efficiently remove spent hormones from our systems. Obesity itself is a problem since estrogen is stored in fat cells. The fact that 2/3 of Americans are overweight or obese points to how prevalent this form of estrogen exposure is.
As you can see, there are many, many influences that lead to Estrogen Dominance. It’s not just “the way you are.”
The great news is there is something you can do about it.
First, you don’t need to treat Estrogen Dominance with birth control pills!
While birth control pills may help alleviate symptoms, they do not solve the root problem, In fact, taking birth control pills to treat estrogen dominance could possibly lead to more longer-term problems. (There are other excellent uses for birth control pills, such as actual birth control, and it is important to understand a woman’s goals for her health when deciding how to treat her.)
As a fellowship-trained Integrative Medicine and Functional Medicine doctor, I attack this problem of Estrogen Dominance from many angles. The truth is we have so many ways to help women feel better, without the use of medicine and surgery. We can, and should, use food as medicine, weight loss, botanicals, mind-body modalities for stress management so that women can actually heal themselves.
About Dr. Fitz:
Dr. Bronwyn Fitz is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.