In the
past 40 years, we have seen a dramatic rise in female-related illnesses
never seen before in history. Today, we see the age of puberty (menarche)
dropping precipitously to as low as 10 years of age, endometriosis afflicting
10% of all perimenopausal women; Premenstrual Syndrome (PMS), rising and
afflicting close to 30% of perimenopausal women, uterine fibroids affecting
close to 25 % of women from age 35 to 50, and breast cancer afflicting close
to 10% of all women. Being a woman in the 21st century is certainly
a high risk profession. Navigating through this hazardous profession is
not easy. Imagine having endometriosis, PMS and fibrocystic breasts when
you were young, progressing to uterine fibroids, hysterectomy, misguided
hormone replacement and ultimately breast cancer as your menopause approaches.
The very thought of this journey can send chills up through anyone's spine.
Fortunately, scientific evidence is mounting that hormone disruption is
the key cause of all these seemingly separate but related diseases.
For too long, we have ignored the importance of hormone balance. For too
long, physicians have been misguided on the real truth on hormonal balance.
Now, we know that the common thread in many
female hormone diseases such as those mentioned above is a little known
condition known as estrogen dominance. The underlying problem
is a relative excess of estrogen and an absolute deficiency in progesterone.
In the west, the prevalence of estrogen dominance syndrome approaches 50
percent in women over 35 years old.
Here are some typical complaints from patients having estrogen dominance:
- My breasts are swollen and getting bigger.
- I can't put on my rings on my fingers.
- I am more impatient now than ever.
- People tell me I am too bossy.
- I am getting cramps again like when I was younger.
- I just cannot have my period.
- I miss my periods regularly.
- My periods come irregularly.
- I get scared when I see large clots during my period.
- I have Pre-Menstrual Syndrome (PMS).
- When I get a hug, my breast hurts.
- I have fibroids.
- I have endometriosis.
- I cannot fit into my shoes.
- I have a cyst in my breast.
- I feel tired all the time.
Before we look at estrogen dominance in more detail, let us first review
the basic menstrual cycle and the key female hormones
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Modern Menstruation
One hundred years ago, the average woman started her menses at
age 16. She got pregnant earlier and more frequently. She often spent more
time lactating. In total, women back then
experienced the menstrual cycle about 100
to 200 times in their lifetime. Today, the average modern women starts her puberty at age
12, seldom lactates, has less children, and menstruates about 350 to 400 times during a lifetime. Incessant menstruation has been associated
with the increased occurrence of a myriad of pathological conditions including
infertility, cancer, fibroids, anemia, migraines, mood shifts, abdominal
pain, fluid retention, and endometriosis. What a difference a century
makes!
It is apparent that the modern
woman is made to go through a lot more than her counterpart just a century
ago. Could this have any bearing on the epidemic of female related illness
plaguing our society ? To answer that question, let us now take a
closer look at the hormones responsible for regulating the female menstrual
cycle.
Femal Hormones
The two primary female hormones secreted by the ovaries
are estrogen and progesterone.The
properties of one offsets the other and together they are maintained in
optimal balance in our body at all times. Too much of one hormone or the
other can lead to significant medical problems.
Estrogen
Estrogen is produced in the ovaries. It regulates the menstrual cycle, promotes
cell division and is largely responsible for the development of secondary
female characteristics during puberty, including the growth and development
of the breast and pubic hair. Estrogen therefore affects all female sexual
organs, including the ovaries, cervix, fallopian tubes, vagina, and breast.
As a general rule, estrogen promotes cell growth, including signaling the
growth of the blood-rich tissue of the uterus during the first part of the
menstrual cycle and stimulates the maturation of the egg-containing follicle
in the ovary. It softens the cervix and produces the right quality of vaginal
secretion to allow the sperm to swim and to lubricate us during intercourse.
Furthermore, it lifts our mood and gives us a feeling of well-being.
In non-pregnant, pre-menopausal women, only 100-200 micrograms (mcg)
of estrogen are secreted daily. But during pregnancy, much more is secreted.
Estrogen in our body actually is not a single
hormone but a trio of hormones working together. The
three components of estrogen are: estrone (E1), estradiol (E2), and
estriol (E3). In addition, there are at least 24 other
identified types of estrogen produced in the woman's body, and more will
be discovered. In healthy young women, the typical mix approximates
15/15/70% respectively. This is the combination worked out by
Mother Nature as optimum for human females. Today, we use the word estrogen loosely to include
also a family of hormones, including animal estrogens, synthetic estrogens,
phytoestrogens (plant estrogens), and xenoestrogens (environmental estrogens,
usually from toxins such as pesticides).
Estrogen is a hormone that is pro-growth. Since too much of anything is
generally not good, the body has another hormone to offset and counterbalance
the effects of estrogen. It is called progesterone.
Progesterone
As its name implies, progesterone
is a hormone that is pro-gestation. In other words, it favors the growth
and well-being of the fetus. Without a proper amount of progesterone,
there can be no successful pregnancy. It protects us against the "growth effect" of estrogen. When progesterone is secreted, further ovulation is prevented
from taking place in the second half of the menstrual cycle, and a thick
mucous that is hostile to sperm is produced that prevents its passage into
the womb.
Progesterone is made from pregnenolone, which in turn comes from cholesterol.
Production occurs at several places. In the women, it is primarily made
in the ovaries just before ovulation and increasing rapidly after ovulation.
It is also made in the adrenal glands in both sexes and in the testes in
males. In women its level is highest during
the luteal period (especially from day 19-22 of the menstrual cycle).
If fertilization does not take place, the secretion of progesterone decreases
and menstruation occurs 12 to 14 days later under normal conditions. If
fertilization does occur, progesterone is secreted during pregnancy by the
placenta and acts to prevent spontaneous abortion. About 20-25 mg of progesterone is produced per day during a woman's
monthly cycle. Up to 300-400 mg are produced daily during pregnancy.
Estrogen Effect vs. Progesteron Effect
As mentioned earlier, progesterone acts as
an antagonist to estrogen. For example, estrogen stimulates breast
cysts while progesterone protects against breast cysts. Estrogen enhances
salt and water retention while progesterone is a natural diuretic. Estrogen
has been associated with breast and endometrial cancers, while progesterone
has a cancer preventive effect. Studies have shown that pre-menopausal
women who were deficient in progesterone had 5.4 times the risk of breast
cancer compared to healthy women.
The following table clearly shows how progesterone and estrogen balance
each other. It is very important to note that both hormones are necessary
for optimum function. Progesterone will not work without some estrogen in
the body to "prime the pump", for example.
Estrogen
Effect
Progesterone Effect
Causes
endometrium to proliferate
Maintains
secretory endometriu
Causes
breast stimulation that can lead to breast cancer
Protects
against fibrocystic breast and prevents breast cancer
Increases
body fat
Helps
use fat for energy
Increase
endometrial cancer risk
Prevents
endometrial cancer
Increase
gallbladder disease risk
Restrains osteoclast function slightly
Promote osteoblast function, leading to bone growth
Reduces
vascular tone
Restores
vascular tone
Increase
blood clot risk
Normalize
blood clot
Estrogen Dominance
Estrogen and progesterone work
in synchronization with each other as checks and balances to achieve hormonal
harmony in both sexes. It is not the absolute
deficiency of estrogen or progesterone but rather the relative dominance
of estrogen and relative deficiency of progesterone that is main cause of
health problems when they are off balance.
While sex hormones such as estrogen and progesterone decline with age gradually,
there is a drastic change in the rate of decline during the perimenopausal
and menopausal years for the women in these two hormones as mentioned earlier.
From age 35 to 50, there is a 75% reduction in production of progesterone
in the body. Estrogen, during the same period, only declines about 35%.
By menopause, the total amount of progesterone made is extremely low, while
estrogen is still present in the body at about half its pre-menopausal level.
With the gradual drop in estrogen but severe drop in progesterone, there
is insufficient progesterone to counteract the amount of estrogen in our
body.This state is called estrogen dominance. Many women in their mid-thirties, most women
during peri-menopause (mid-forties), and essentially all women during menopause
(age 50 and beyond) are overloaded with estrogen and at the same time suffering
from progesterone deficiency because of the severe drop in physiological
production during this period. The end result - excessive estrogen
relative to progesterone, a condition we called estrogen dominance.
According
to Dr. John Lee, the world's authority on natural hormone therapy, the key
to hormonal balance is the modulation of progesterone to estrogen ratio.
For optimum health, the progesterone to estrogen ratio should be between
200 and 300 to 1.
What is so
bad about estrogen dominance? It is the root cause of a myriad of
illnesses. Conditions associated with this include fibrocystic breast disease,
PMS, uterine fibroids, breast cancer, endometriosis, infertility problem,
endometrial polyps, PCOS, auto-immune disorders, low blood sugar problems,
and menstrual pain, among many others.
There are two periods in a women's life that her progesterone level
is low - at puberty and again at peri-menopause ( the few years
right before menopause). Between puberty and peri-menopause, the production
of progesterone can go astray, leading to estrogen dominance as mentioned
earlier. Between this period, estrogen dominance can also be the result
of excessive external estrogen intake (from diet and environment) or internal
estrogen production ( from obesity, birth control pills, or ovarian tumor).
Two common causes are:
A. Anovulation (lack of ovulation). Ovulation is the time of the
month where an ovarian follicle releases an ovum (egg). Under normal condition,
the released egg makes it way from the ovary to the uterus in preparation
for fertilization. This usually happens from day 12 to day 14 of the menstrual
cycle. After the egg is released, the empty follicle becomes the corpus
luteum. This is the main factory where the production of progesterone takes
place.
When the follicles become dysfunctional, no eggs are released. This is called
anovulation. If a woman is not ovulating, there would not be a corpus luteum
and therefore no increased progesterone production. Laboratory
measurement would show both a low estrogen and a low progesterone level. Many still have a seemingly normal menstrual cycle even if there
is no ovulation. The lack of progesterone, however, leads to relative estrogen
dominance and symptoms like PMS, mood swings, cramps, and tender breast. Anovulation is commonly caused by exposure
of female embryos to environmental estrogen (also called xenobiotic or xenoestrogen)
such as pesticides, plastic, and pollution. It is often related to a poor
diet and stress.
B. Luteal insufficiency. More frequent than anovulation, the egg
is produced but the corpus luteum malfunctions. It just does not make enough
progesterone. Laboratory measurements would show a high estrogen but low progesterone, and typical symptoms of estrogen
dominance would arise. Without adequate progesterone, the chance
of achieving pregnancy is reduced. Don't forget that progesterone is what
keeps the womb going and it nourishes the fetus.
Estrogen Dominance in Menopausal Women
The predominant
reason why menopausal women developed estrogen dominance is because they are being prescribed unopposed estrogen such as Premarin as part
of their hormone replacement therapy (HRT) program. Despite decades
of research clearly showing that HRT significantly increased breast cancer,
millions of women worldwide are on unopposed estrogen for treatment of menopausal
symptoms.
Obesity is another cause. During
menopause, the amount of estrogen produced from the ovaries decreases, but
not as drastic when it comes to another hormone that the ovaries produce
called androstenedione (a male hormone). Fat cells can convert androstenedione
into estrogen. The amount of conversion in some people is enough to maintain
a reasonable estrogen level in the body well into the 70s. The result
of excessive estrogen and absolute deficiency in progesterone is clear -
estrogen dominance.
We mentioned above our body is essentially soaked in a sea of estrogen.
Where does the estrogen comes from? Let us take a closer look.
Causes of Estrogen Dominance
Our body normally functions in perfect homeostasis. With the advent of society
and industrial state in the past 70 years, our body has been subjected to unprecedented insults from environmental estrogen-like hormones. In less than one hundred years, we have managed to turn our diet from whole
fruits and whole food to fast and processed food. In the past, cattle were
raised on grass and natural organic feed and chickens were allowed to run
free. This is in stark contrast to the commercialization of cattle and poultry
farms of today where animals are in cages most of the time. Worse yet, feeds
laced with pesticides and hormones, both of which have estrogen-like activities,
are routinely given to animals, which in turn is passed to humans.
Women in non-industrialized cultures whose diets are whole food based and
are untainted with modern processed foods and pesticides seldom suffer a
deficiency in progesterone and the signs of estrogen dominance manifested
as menopausal symptoms.
12 of the most common reasons: 1. Commercially raised cattle and poultry.These
animals are fed estrogen-like hormones as
well as growth hormone that are passed onto humans. It takes 60 pounds of
grain, feed, and hay to produce one pound of edible beef. On the other hand,
it only takes one pound of feed to produce one pound of edible fish. Deep-sea
fish such as halibut, sardines, cod, and mackerel are good to consume. Young
ones are often less contaminated than older fish, and smaller fish are better
shielded from contamination than larger fish like sharks and swordfish.
Avoid all coastal fish and shellfish, which are high in contaminants. Fish
are far superior to beef or chicken in terms of hormone load. It is interesting
to note that one-half of all antibiotics in the United States are used in
livestock - 25 million pounds a year. These antibiotics
can contribute to hormone disruptor exposure. The use of antibiotics
is especially prevalent in poultry farms. It only takes 6 weeks now to grow
a chicken to full size (down from four months in 1940). Up to 80,000 birds
may be packed into one warehouse. Feeds used contain a myriad of hormone-disrupting
toxins including pesticides, antibiotics, and drugs to combat disease when
so many animals are packed closely together.
2. Commercially grown fruits and vegetables containing pesticides. If you eat in any developed countries, you are taking in pesticides
from fruits and vegetables, many of which are known hormone disruptors.
Approximately 5 billion pounds of pesticides, herbicides, fungicides, and
other biocides are being added to the world each year. In the past 100 years,
several hundred billions pounds of pesticides have been released into the
environment. Pesticides that are banned in the US, such as DDT, are being
used in some other countries freely. Illegal pesticides are being used on
crops that we eat everyday. It is estimated that a person eats illegal pesticides
75 times a year just by following USDA's recommendation of five servings
of fruits and vegetables a day if these are purchased in regular supermarkets.
Vegetables grown in developing foreign countries such as South America and
Africa find their way back to our dinner table in this global community.
Pesticide residues have chemical structures that are similar to estrogen.
These are eventually passed onto humans. Produce with the most
pesticides reported in A Shopper's Guide to Pesticdes in Produce include strawberries (contain vinclozolin, a known endocrine disruptor),
bell peppers, peaches, apples, apricots, and spinach. Foods with the
least amount of pesticides include avocados, corn, onions, sweet potatoes,
bananas, green onions, broccoli, and cauliflower. If you are eating non-organic
fruits and vegetables, peel and wash them well with diluted vinegar. This
will help to reduce pesticides on the surface. Needless to say, this will
not help to rid of the pesticides inside. Discard the outer leaves of leafy
vegetables, and trim fat from meat and skin from poultry and fish that tend
to collect residues.
3. Exposure to xenoestrogen. When a female embryo
develops in the womb, 500,000 to 800,000 follicles are created in the embryo,
each enclosing an immature ovum. These fragile ovarian follicles are
extremely sensitive to the toxicity of environmental pollutants. When
the mother is exposed to toxic chemicals that resemble estrogen in its molecular
structure, she may experience no apparent damage outwardly. However the
baby is more vulnerable to these toxins that may damage its ovarian follicles
and make them dysfunctional. This will not
be apparent until the baby reaches puberty some 10 to 15 years later, when symptoms of incomplete ovulation or insufficient
progesterone production can be noted.
Petrochemical compounds found in general consumer products
such as creams, lotions, soaps, shampoos, perfume, hair spray and room deodorizers. Such compounds often have chemical structures similar to estrogen
and indeed act like estrogen. Other sources of xenoestrogen include car
exhaust, petrochemically derived pesticides, herbicides, and fungicides;
solvents and adhesives such as that those found in nail polish, paint removers,
and glues; dry-cleaning chemicals; practically all plastics, industrial
waste such as PCBs and dioxins, synthetic estrogens from urine of women
taking HRT and birth control pills that is flushed down the toilet and eventually
found its way into the food chain and back into the body. They are fat soluble
and non-biodegradable. 4. Industrial solvents. A common source of industrial
xenoestrogens often overlooked is a family of chemicals called solvents.
These chemicals enter the body through the skin, and accumulated quickly
in the lipid-rich tissues such as myelin (nerve sheath) and adipose (fat). Some common organic solvents include alcohol like methanol, aldehydes like
acetaldehyde, glycol like ethylene glycol, and ketones like acetone. They
are commonly found in cosmetics, fingernail polish and fingernail polish
remover, glues, paints, varnishes, and other types of finishes, cleaning
products, carpet, fiberboard, and other processed woods. Pesticides and
herbicides such as lawn and garden sprays, indoor insect sprays are also
sources of minute amounts of xenoestrogens. While the amount may be small
in each, the additive effect from years of chronic exposure can lead to
estrogen dominance.
5. Hormone Replacement Therapy (HRT). HRT
with estrogen alone without sufficient opposing progesterone such as the
drug Premarin should be banned. This increases the level
of estrogen in the body. Premarin, a estrogen only drug commonly used in
the past 40 years, is the mainstay of estrogen replacement therapy (ERT).
It is a patented, chemicalized hormonal substitute that is not the same
as what you have in your body. It contains 48% estrone and only a small
amount of progesterone which is insufficient to have an opposing effect.
The indiscriminate and over-prescription of Premarin to many who may not
need it is the problem. Symptoms include water retention, breast swelling,
fibrocysts in the breast, depression, headache, gallbladder problems, and
heavy period. The excessive estrogen from ERT also lead to increased chances
of DNA damage, setting a stage for endometrial and breast cancer.
6. Over production of estrogen. Excessive estrogen can
arise from ovarian cysts or tumors.
7. Stress. Stress causes
adrenal gland exhaustion and reduced progesterone output. This
tilts the estrogen to progesterone ratios in favor of estrogen. Excessive
estrogen in turn causes insomnia and anxiety, which further taxes the adrenal
gland. This leads to a further reduction in progesterone output and even
more estrogen dominance. After a few years in this type of vicious cycle,
the adrenal glands become exhausted. This dysfunction leads to blood sugar
imbalance, hormonal imbalances, and chronic fatigue.
8. Obesity. Fat has an enzyme that
converts adrenal steroids to estrogen. The higher the fat intake,
the higher the conversion of fat to estrogen. Overeating is the norm in
developed countries. A population from such countries, especially in the
Western hemisphere where a large part of the dietary calorie is derived
from fat, has a much higher incidence of menopausal symptoms. Studies have
shown that estrogen and progesterone levels fell in women who switched from
a typical high-fat, refined-carbohydrate diet to a low-fat, high-fiber and
plant-based diet even though they did not adjust their total calorie intake.
Plants contain over 5,000 known sterols that have progestogenic effects.
People who eat more wholesome foods have a far lower incidence of menopausal
symptoms because their pre- and post-menopause levels of estrogen do not
drop as significantly. 9. Liver diseases.Liver diseases such as cirrhosis
from excessive alcohol intake reduce the breakdown of estrogen. Taking drugs that can
impair liver function may also contribute to a higher level of estrogen.
10. Deficiency of Vitamin B6 and Magnesium. Both of these are necessary for the neutralization of estrogen
in the liver. Too much estrogen also tends to create deficiency
of zinc, magnesium and the B vitamins. These are all important constituents
of hormonal balance.
11. Increased sugar, fast food and processed food. Intake
of these leads to a depletion of magnesium.
12. Increase in coffee consumption.Caffeine
intake from all sources was linked with higher estrogen levels regardless of age, body mass index (BMI), caloric intake, smoking, alcohol,
and cholesterol intake. Studies have shown that women who consumed at
least 500 milligrams of caffeine daily, the equivalent of four or five cups
of coffee, had nearly 70% more estrogen during the early follicular phase
than women who consume no more than 100 mg of caffeine daily, or less than
one cup of coffee. Tea is not much better as
it contains about half the amount of caffeine as compared to coffee. The
exception is herbal tea like chamomile which contains no caffeine.
In absolute terms, those who live in the developed
world are bathed in a continuous sea of estrogen and do not know it. Yes,
we all have hormonal imbalances, and specifically - estrogen dominance.
Ovarian Adrenal Thyroid (OAT) Axis Imbalance
Three of the most important ones for females are ovaries, adrenals, and the thyroid gland. All three organs of this axis must be in a state of optimum balance for a woman to feel good. Find out more on this state of imbalance here.
OM3 Prevents Macular Degeneration
New research has found that diets rich in omega-3-fatty acids may slow the progression of early age-related macular degeneration to advanced disease.
Zinc Cuts Risk For Diabetes A new study suggests that long-distance running may be even better for high blood pressure, high cholesterol, and even diabetes.
Vitamins Good For Your Eyes Researchers believe that vitamin B and folic acid have serious benefits in AMD prevention.
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In the
past 40 years, we have seen a dramatic rise in female-related illnesses
never seen before in history. Today, we see the age of puberty (menarche)
dropping precipitously to as low as 10 years of age, endometriosis afflicting
10% of all perimenopausal women; Premenstrual Syndrome (PMS), rising and
afflicting close to 30% of perimenopausal women, uterine fibroids affecting
close to 25 % of women from age 35 to 50, and breast cancer afflicting close
to 10% of all women. Being a woman in the 21st century is certainly
a high risk profession. Navigating through this hazardous profession is
not easy. Imagine having endometriosis, PMS and fibrocystic breasts when
you were young, progressing to uterine fibroids, hysterectomy, misguided
hormone replacement and ultimately breast cancer as your menopause approaches.
The very thought of this journey can send chills up through anyone's spine.
Fortunately, scientific evidence is mounting that hormone disruption is
the key cause of all these seemingly separate but related diseases. 
The predominant
reason why menopausal women developed estrogen dominance is because they are being prescribed unopposed estrogen such as Premarin as part
of their hormone replacement therapy (HRT) program. Despite decades
of research clearly showing that HRT significantly increased breast cancer,
millions of women worldwide are on unopposed estrogen for treatment of menopausal
symptoms. 
