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In our last post we talked about the different hormones that are involved in the female cycle (estrogen, progesterone, LH and FSH) and really focused in on the main sex hormone in women, estrogen. We also talked about what estrogen dominance is, the symptoms associated with estrogen dominance and how it develops in women. Today’s post will be a piggy back from last week’s article and the discussion will revolve around natural treatment options for estrogen dominance and overall hormone balance.
Recap Of Last Week’s Post:
First let's quickly recap what happened last week. Estrogen is made in the ovaries, adrenal glands and adipose tissue and is the main sex hormone in women. Estrogen dominance is defined as, a relative excess of estrogen to a relative deficiency of progesterone. Estrogen dominance isn’t necessarily a surge in estrogen, but in imbalance between both of these hormones. So estrogen dominance happens when there is too much estrogen and not enough progesterone to balance out the estrogen. The causes of developing estrogen dominance range from physiology, environmental factors, diet and lifestyle choices.
Testing for estrogen dominance is challenging because there is no one diagnostic test. However, blood work assessing both estrogen AND progesterone levels can help to decipher if estrogen dominance is present. It is important to note that progesterone is best measured in the luteal phase, when progesterone dominates and estrogen is best measured in the follicular phase.
Before we get into treatment for estrogen dominance, let's discuss how estrogen is eliminated from the body. Estrogen is metabolized by the liver in 3 different pathways. Depending on the pathway, estrogen will be converted into good or bad metabolites. When your body converts too much estrogen into the ‘bad estrogen’, this is when you can experience estrogen dominant symptoms like, irritability, PMS, painful periods, headaches and also puts you at a higher risk for developing certain types of cancer.
Natural Treatment For Too Much Estrogen
As discussed before, there are many possible reasons for why women can develop estrogen dominance. As a result of the many possible causes, treatment needs to also focus on a multi-systems approach. Naturopathically, treatment is focused around nutrition, sleep optimization and nutritional supplementation. This can help to alleviate some of the symptoms of excess estrogen and potentially reduce the risk of developing hormonal cancers.
Nutrition
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Increase Fiber in the diet to support the gut - Excess estrogen is eliminated via the digestive tract through daily bowel movements. When bowels are not being eliminated in a timely fashion, they hang around in the digestive tract longer than they should. If you do not have bowel movements everyday, or they are hard to pass, then you are likely constipated. This causes estrogen to be reabsorbed into the bloodstream, contributing to higher estrogen levels. This can be prevented by eating fibrous foods in the diet, like flax seeds, oat bran and lots of fruits and veggies. Don’t forget to also increase water intake as this soaks up the fiber and allows for smoother bowel movements.
- Aim for about 20-30 grams of fiber a day.
- Limit Caffeine - Studies have shown that women who drink more than 500 mg of caffeine a day which is about 5 cups of coffee are more likely to have higher levels of estrogen. So ensure to keep your daily caffeine intake to <100 mg/day which is about 1 cup a day.
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Increase fruits and veggies - Fruits and vegetables are a great source of fiber, vitamins and minerals that help to support estrogen breakdown in the body, and can help prevent cancer. Particular, cruciferous veggies have been shown to protect against cancer. These veggies contain high amounts of sulforaphane and indole-3-carbinol which can promote healthy estrogen breakdown and support liver detoxification pathways. Examples include: broccoli, cabbage, cauliflower, kale, bok choy, collard greens and brussel sprouts.
- Aim for about 6-7 servings of fruits and veggies a day.
Avoid Synthetic Chemicals
- Decrease exposure to Xenoestrogens through choosing your beauty products wisely - Xenoestrogens are synthetic chemicals that mimic estrogen in the body that can lead to potentially dangerous outcomes. Xenoestrogens can evoke estrogen responses in the body and interfere with endogenous estrogen actions. They put a higher burden on the liver and are carcinogenic in general. Chemicals that have been linked to cancer include: aluminum salts, parabens, cyclosiloxanes, triclosan and phthalates. These are often found in cosmetic products, household cleaners and plastics. So, be sure to read all labels before using anything on your skin. Read my previous post on the dirty dozen of cosmetics or refer to the Environmental Working Guide’s (EWG’s) Database.
Lifestyle Changes
- Stress Management - Chronic stress can ramp up your stress hormone, cortisol, lower progesterone and thus, raise estrogen levels! Lowering stress can help to balance these three hormones. Try activities like yoga, guided meditations or breathing exercises.
- Sleep Quality - Prioritizing sleep and getting good quality sleep can help to balance hormones and can regulate appetite as well.
- Get Moving - Exercise will help to reduce stress but also can help to reduce body fat, as mentioned in the previous article estrogen can also be formed in adipose tissue.
Supplementation
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Vitamin B6 and Magnesium - These nutrients are both involved in estrogen metabolism and can be very helpful for PMS symptoms. These nutrients are also essential in progesterone production.
- Magnesium: 250 mg/day
- Vitamin B6: 40 mg/day
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Vitex agnus-castus (chasteberry) - One of the most powerful ways to counteract estrogen dominance is by raising progesterone levels and lowering estrogen levels simultaneously. Vitex acts on the pituitary and inhibits the production of FSH which prevents an increase in estrogen. It also promotes LH secretion which support progesterone production, resulting in hormone balance between estrogen and progesterone.
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Indole-3-carbinol (I3C) and diindolymethane (DIM), which is I3C’s metabolite can help to decrease circulating excess estrogen. DIM also supports liver detox pathways which in turn helps to promote healthy metabolism of estrogen.
- Probiotics (Lactobacillus acidophilus & Bifidobacterium spp.) - Probiotics help with detoxification by binding to harmful estrogens in the digestive tract and eliminating them from the body. So supplementing with probiotics can help to achieve balance in the gut which can then lead to balanced hormones.
If you feel that you suffer from a hormonal imbalance, specifically estrogen excess it is important to get tested! Mainstream approach for estrogen dominance involves birth control more often than not. The causes of estrogen dominance are so multifactorial that treatment needs to also be multifactorial. A 360 approach to estrogen dominance involves dietary changes, lifestyle modification and supplementation to help promote healthy estrogen levels. This can help to reduce symptoms of PMS and potentially lower risks of hormone-related cancers.
** Disclaimer: The advice is in this article is for informational purposes only. It does not replace the care of a Naturopathic physician.
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