The Low Estrogen Myth – Should I Really Add Hormones?
Are you a female over the age of 25 and having hormonal symptoms? Maybe a little more estrogen will do the trick right? Or is it your progesterone that is too low? Essentially every blood hormone test I have reviewed, (I don’t run blood hormones, which I’ll cover later.) shows low estrogen. How is it that every woman has completely stopped producing estrogen? Ever wondered why hormone replacement therapy is all the rage right now?
In this article we won’t go over whether or not HRT is the proper therapy, but instead lets talk about why it seems that everyone is needing them.
What if low estrogen wasn’t really low estrogen?
As a consumer, its not really your job to decide if showing up with low blood estrogen is the root or the symptom, but it is your doctor’s job. What I tell patients in my office is that I don’t chase lab tests. What does that mean? It means that while your estrogen may be low on your labs, it doesn’t tell us why you have low estrogen.
Some doctors may say that they are “just getting old,” but I don’t buy that. Excuses are not causes!
Symptoms of High Estrogen
It is important to know the symptoms of high estrogen or “estrogen dominance” because it will help you to know what you are experiencing and how to differentiate if you need MORE estrogen, if you have estrogen dominance or if you have estrogen feedback dysregulation. (Estrogen feedback dysregulation is often best identified via signs and symptoms, not via lab tests.)
Symptoms of High Estrogen
- Water retention
- Abnormal pap smears
- Heavy bleeding
- Postmenopausal bleeding
- Rapid weight gain
- Increased breast size
- Breast tenderness
- Painful periods
- Mood swings
- Brain fog
- Red flush or rosacea
- Gall bladder problems (especially if removed)
- Any symptom correlating with your monthly menstrual cycle
One of the telltale signs of high estrogen is that is correlates with your monthly or bi-monthly cycle. This is because estrogen spikes dramatically as you approach day 14 of your cycle and can have a second spike near day 21 also. These symptoms are critical to pay attention to as they are the best monthly indicator of how balanced your hormones are. If you have any of these symptoms, then it is wise to not add hormones until you balance the ones you have already.
Functionally low estrogen
Functionally low estrogen is the most common scenario in women over the age of 40. What I mean by functionally low is that estrogen is not truly low, but rather the right type of estrogen (there are many types) is not being produced, there is too much “bad estrogen”, or there is a build-up of toxic environmental estrogens.
The Right Types of Estrogen
One of the misconceptions in hormone testing is that you either have too much estrogen or too little. Unfortunately, it’s not that simple.
There are many forms of estrogens and those estrogens have intermediate forms too. Some of these estrogens you may have heard of include 4-OH a known carcinogen if not detoxified, 16-OH also an active carcinogen if not converted to estriol and 2-OH which is generally regarded as beneficial and protective. A high ratio of 2:16OH estrogens is associated with low breast cancer risk. While all estrogens play a role in the body, excess of any type can be considered an imbalance.
From my experience, the body tries to keep the sum total of all estrogens in a given range. You may for example, have high 4-OH and 16-OH and low 2-OH estrogen. This scenario will often create a picture of “low estrogen” on a blood test while truly having dysregulated estrogen. As a patient you should first focus on balancing your hormones properly.
If you simply add estrogen do the equation, it doesn’t guarantee that the estrogen you add is converted into beneficial forms of estrogen. In fact, depending on the type of estrogen used, it can make things much worse.
Environmental estrogens are chemicals in our environment that can mimic the effects of estrogen in the body. Many times, these are referred to as xenobiotics.
We are exposed to these chemicals daily in items like plastic, makeups and creams, hand sanitizers, herbicides, pesticides, etc. These xenobiotics fight for spaces on your estrogen receptors and bind to them. When they bind to your cells, your real estrogen hormones cannot bind to them and thus you become “functionally estrogen deficient”.
Or in other words, you get to suffer all the ill effects of not having enough estrogen. Adding more estrogen when you have xenobiotics occupying the estrogen receptors isn’t addressing the root problem of xenobiotics.
Can You Even Detox?
Detoxifying all estrogens (including environmental estrogen) is critical in order for your body to feel the need to properly regulate its hormones balance. Most of the detoxification of estrogen happens via the liver. I won’t go in to details here, but key vitamins such as Magnesium, B6, B9 and B12 are required for detoxification. Xenobiotics can require different vitamins vs. native estrogen, but are also detoxified in the liver.
Another key component to detoxify hormones is glucuronidation. glucuronidation is a big word, but the first four letters “gluc-“come from the word glucose. In order for glucuronidation to work properly, your blood sugar must be stable. This means a healthy low to moderate carbohydrate diet comprised of complex carbohydrate. Things like bread, food allergies, stress and too much or little exercise can cause your glucose to become unstable. When your glucose levels are not consistent throughout the day, your body must focus on regulating blood sugar and is unable to adequately address detoxification and also joint repair.
Before you go and add more hormones to an imbalanced system, it is critical to balance the system that you have. If you add estrogen, progesterone or testosterone to an already imbalanced system it can either make your symptoms worse or it can develop in to new symptoms over time. If you add estrogen to an already dysregulated estrogen pattern, you will just have more mess to clean up in the end.