As a nutritional therapist who specialises in women’s health, I see so many clients in my practise who are struggling with issues such as mood swings, PMS symptoms, low libido, and fertility issues. A lot of women tend to accept symptoms such as painful breasts, cramping before and during a period, mood swings, cyclical headaches as part of the menstrual cycle, but often these are signs that there is an imbalance in the two main hormones involved in the menstrual cycle: estrogen and progesterone. Having too much estrogen – or not enough progesterone – is known as ‘estrogen dominance’, and I am seeing more and more of it in my practise. In this blog post, I am going to explain the role of estrogen and progesterone, as well as outlining some signs and symptoms of estrogen dominance, potential causes and what we can do to address this imbalance. If any of this information resonates with you and you are struggling with any of the symptoms below, we should definitely talk!
What are estrogen and progesterone?
Estrogen is a steroidal/ sex hormone whose main function is growth and proliferation. It is most prominent in the first half of our menstrual cycle, i.e from day 1 of our menstrual bleed up until ovulation. Its role is to thicken the uterine lining as well as triggering ovulation. We usually have a surge of estrogen just before ovulation, which acts as a trigger for our ovary to release a mature egg. Estrogen also has a stimulatory effect, which may contribute to us feeling more energetic and sassy in the follicular phase of our cycle (we also get a little boost of testosterone just before ovulation, which can explain why we may feel more in the mood mid-cycle!).
Progesterone is also a steroidal hormone, whose function is to maintain a pregnancy (pro-gestation), but also has a calming effect on the body. It is the star of the luteal phase of our menstrual cycle (from ovulation to menstruation) and is produced by the corpus luteum (the ovarian follicle which has been released during ovulation). Progesterone has been referred to as ‘the great sedator’, which may explain why often pregnant women feel that ‘pregnancy zen’ (progesterone levels are 200 times higher than normal in pregnancy). It may also explain why in the second half of your cycle you may feel more introverted and wanting to relax rather than go out on adventures! Progesterone is not only involved in pregnancy, however, but also has strong anti-stress effects, as well as other important functions in our body.
“Experiments have shown that progesterone relieves anxiety, improves memory, protects brain cells, and even prevents epileptic seizures. It promotes respiration, and has been used to correct emphysema. In the circulatory system, it prevents bulging veins by increasing the tone of blood vessels, and improves the efficiency of the heart. It reverses many of the signs of aging in the skin, and promotes healthy bone growth. It can relieve many types of arthritis, and helps a variety of immunological problems.” (Ray Peat)
Estrogen is often referred to as the ‘women’s hormone’ because it is produced in our ovaries during our menstrual years – although we now know that we carry on making estrogen even after menopause, in our peripheral tissues, especially our fat tissue. There are 3 types of estrogen: estradiol, estrone and estriol (produced in pregnancy). After menopause, our ovaries stop producing estradiol, but our other tissues carry on producing estrone. Progesterone, on the other hand, is mostly made in the ovaries, and after menopause there is a huge drop in the production of this protective hormone. So often menopause is a time of unopposed estrogen rather than love estrogen. Mind blown yet? Anyways, that is a subject for another day! Let’s get back to estrogen dominance and have a look at symptoms and potential causes, as well as what we can do about it.
Signs and symptoms of estrogen dominance:
- Irregular menstrual cycles
- Mood swings
- Painful periods
- Increase in PMS symptoms
- Spotting before your menstrual bleed
- Fibrocystic lumps in the breast
- Weight gain (especially around the thighs and hips)
- Headaches and migraines
- Low libido
- Varicose veins/ Bulging veins on the back of the hands
- Memory problems
- Fertility issues
- Uterine fibroids
- Uterine polyps
- Low thyroid function
- In men: fertility issues, erectile dysfunction and gynaecomastia (‘man boobs’)
On top of causing a lot of the symptoms listed above, high levels of estrogen increase a person’s risk of ovarian or breast cancer, strokes and blood clots.
Remember, estrogen dominance can happen even when estrogen levels are low – as long as there is not enough progesterone to keep estrogen in check.
What causes estrogen dominance?
Chronic stress is one of the main reasons why you may be estrogen dominant. This is because progesterone is the precursor to our stress hormone cortisol, when we are under chronic stress, our body has to use up progesterone to keep up, causing us to have less available to balance out estrogen. Other stressors which can affect estrogen levels include poor sleep, excessive or intensive exercise as well as undereating, fasting or having imbalance blood sugar levels. Katharina Dalton, who studied and treated PMS extensively, observed that “Progesterone receptors do not bind to molecules of progesterone in the presence of adrenaline, which is released when the blood glucose level is low”.
The oral contraceptive pill
Often women are recommended to take the pill in order to regulate their hormones, but the birth control pill is usually just a big ole dose of estrogen. Not only does it not address the root cause of your hormonal issues, it downregulates your menstrual cycle which means that as soon as you stop taking the pill, you are back at square one. On top of that, you are getting estrogen on top of estrogen, leaving you even more estrogen dominant. Even progesterone only pills may be an issue, as synthetic progestin used in these progesterone only pills can actually bind to other hormone receptors in the body, causing them to effectively have an estrogenic effect.
Exposure to endocrine disruptors in personal and homecare products
Our modern environments contain a lot of man made chemicals which act as estrogens in the body. These can range from chemical laden personal products we use on our bodies, to cleaning products and fragrances used in our home, plastic containers, furniture and even clothing.
Poor liver and gut health
When estrogens are used in our body, they need to be detoxified and excreted. Our liver is our main detoxification organ and the one responsible for detoxifying estrogen once it’s used and getting it ready to be excreted by the colon. If our liver is not functioning properly, this process is impaired, and our estrogen levels are increased. Once the liver has detoxified estrogen and packaged it up in a lovely parcel to be excreted from the body, it is sent to the colon to get excreted. If our gut health is not optimal, it may not be excreted fast enough, and that lovely little package can be opened and sent back into circulation in the body.
Excess body fat
Our fat tissue not only stores estrogen, but it can also convert other hormones to estrogen through a process called aromatisation. This can become a vicious cycle, as the more fat cells you have, the more estrogen you produce, which in turn can cause our weight to increase.
So what can we do to improve this estrogen/ progesterone balance? Here are my top tips!
- Reduce stress: identify sources of stress in your life and find out how to reduce these. Although we cannot always control external stressors, there are plenty of stresses we do have control over, i.e. how well we sleep, how often we eat, the type of exercise we do and the people we surround ourselves with.
- Optimise digestion: ensure you are having daily bowel movements and address any gut dysbiosis issues. Eating a raw carrot salad every day is a great way to help do both.
- Love your liver: your liver is the main organ in charge of removing excess estrogen, so if liver function is not optimal, chances are you are not getting rid of excess estrogen efficiently. Include liver loving foods as well as avoiding substance which tax your liver (I’m looking at you, glass of wine!).
- Look at reducing endocrine disruptors in your environment (chemicals in the home and personal products) – switch to more natural products or learn how to make your own!
- Eat regular, nutrient dense meals which balance blood sugar. Ensure you are not skipping meals and always balancing blood sugar by combining protein and carbohydrates with each meal, as well as a little fat for hormonal health and satiety.
- Optimise sleep. If you are not sleeping well, find the root cause and work on optimising sleep. I work with plenty of clients who struggle to sleep and often some simple nutrition and lifestyle adjustments can make a big difference. You can find out more about sleep and hormonal health in my blog post about sleep.
- Consider changing your birth control method.
If you are struggling with any of the symptoms above and would like to delve deeper into hormonal balance, testing can be a helpful tool. If you feel like you could use some more personalised investigations and nutrition and lifestyle plan, I would love to chat to you! Click here to book a free discovery call and let’s chat about how some bespoke diet and lifestyle changes can help your hormones flourish.
Progesterone Pregnenolone & DHEA – Three Youth-Associated Hormones: http://raypeat.com/articles/articles/three-hormones.shtml
Katharina Dalton ‘Once a Month’
The estrogenic activity of synthetic progestins used in oral contraceptives: https://pubmed.ncbi.nlm.nih.gov/8431886/#:~:text=Conclusions%3A%20These%20studies%20provided%20direct,to%20stimulate%20or%20differentiate%20cells