How to Fix your Progesterone to Estrogen Ratio for the Last Time – Part 3
We covered decreasing your estrogen in part 1 and part 2, but increasing your progesterone is also a way to improve your progesterone to estrogen ratio. In fact, as we have discussed, it is the most common way practitioners choose to alter the ratio.
With progesterone hormone replacement, women often see significant improvement within the first few weeks to months! But what I have found is that simply adding hormones seems to backfire over time. Sometimes its 6 months, sometimes its 2 years, but most women seem to re-develop symptoms that don’t resolve by altering their dosages in their hormone prescription and they end up back where they started.
This leaves them feeling hopeless once again and suffering from unnecessary symptoms.
Transcortin & SHBG
Transcortin is known as the carrier protein for cortisol, progesterone and aldosterone. The catch….it that it is mediated by estrogen. The higher the estrogen, the higher the transcortin, meaning the less available cortisol and progesterone.
If you are tired, worn out, feel like you are running in sand, etc. then you may be someone with low cortisol. A common prescription to raise cortisol is DHEA, pregnenolone and licorice root. While this often raises cortisol, it does not address the underlying issue of high estrogen.
Likewise, if progesterone is bound to transcortin, it is unavailable for the body to use. By decreasing estrogen and allowing progesterone to be “unbound” we are able to address both hormonal symptoms and fatigue at the same time. So if you are interested in killing two birds with one stone estrogen excess is where you should start.
SHBG (sex hormone binding globulin) is the master regulator for estrogen and testosterone. When estrogen is elevated, SHBG increases and it binds to testosterone, making it less available to be used by the body. In women this often results in low desire, low satisfaction, decreased muscle mass and decreased energy. While I think about 5% of women need progesterone, its less than 1% of women that I feel truly need testosterone. If you have felt well taking testosterone and you are a female, then this will continue to raise SHBG and lead to complications down the road.
So, the moral of the story is; decrease estrogen to increase available progesterone and testosterone.
Vitamins & Herbs
Let me first make my case for vitamins. When it comes to female hormones, vitamins are often placed on the shelf in lieu of herbs. While I use a ton of herbs with patients, it is important to be careful that you aren’t just “pushing” a process.
Herbs can act as the gas pedal to make a process go faster, but if you are low on a critical vitamin, then after a while the herb will stop working and no matter what herb you try to push a process it may not work because you are missing a vitamin involved in the process. Just like pushing the gas pedal on a car works great when you have gas but when the gas is gone it doesn’t matter how hard you push the gas pedal.
That being said its important to know how you are using your herbs. Using herbs to address root causes like detoxing estrogen or to supply nutrients needed to create progesterone is a good thing, while using an herb the same way you use a prescription drug to mask symptoms is not the same.
Vitamin E is critical for many female hormones, but especially for progesterone. One study showed that providing 600mg of Vitamin E daily created a 67% increase in progesterone production. In today’s world of high carbs, high caffeine, unhealthy fats and missing gallbladders, absorption of fat soluble vitamins is often low. (For my article on Vitamin E, click here.)
Vitamin C has been shown in some studies to improve progesterone levels as much as 77%.
Vitamin B6 usually in its activated P5P form lowers estrogen and increases progesterone.
High protein and low carb diets produce more progesterone and less estrogen. In fact managing blood sugar can be huge for increasing progesterone.
Artichoke Extract as I mentioned in part 2 can accelerate the process of balancing your progesterone to estrogen ratio, but addressing the estrogen side and improving blood sugar imbalances.
An overly common prescription for fertility these days is metformin. Metformin is a diabetes medication used in cases of type 2 diabetes. A side effect of regulating your blood sugar with metformin is that you can increase your progesterone by over 250%. By now you should know that I don’t recommend taking metformin, but getting your blood sugar under control not only lowers estrogen, but can also increase progesterone.
And lastly increasing your thyroid performance is also a good way to increase your progesterone. Please read my article on thyroid conditions before you run and take a prescription for that also.
(As you can see its easy to just take metformin, thyroid hormones, estrogen, progesterone and testosterone and think things will improve. So be careful not to get stuck on the prescription addiction pathway.)
Lowering estrogen and increasing progesterone is essential for women to feel healthy and vibrant. We have been slightly tricked into believing that there is a quick way out that makes us feel great and there aren’t any side effects.
The truth is, like most health problems, it takes concentrated effort and sometimes guided effort from a physician to determine the most natural and long-lasting way to achieve health, but it is completely doable.
If you are currently taking prescription medications, do not fear, nearly all of my patients are able to wean off or significantly decrease their medications once their health is back on track.
Please schedule a consultation if you have any questions or need guidance on how to feel well again!
- Barbieri R.L. (2014) The Endocrinology of the Menstrual Cycle. In: Rosenwaks Z., Wassarman P. (eds) Human Fertility. Methods in Molecular Biology (Methods and Protocols), vol 1154. Humana Press, New York, NY PMID: 24782009
- Grodin, J.M., et al.(1973). Source of estrogen production in postmenopausal women. J. Clin. Endocrinol. Metab. 36(2): 207-14.