By Dr. Justin Marchegiani
Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani and today’s talk is gonna be on estrogen dominance. Again, anyone that has female hormone symptoms for the most part, estrogen dominance is gonna be a contributing factor and why you’re having those symptoms. So I’m fresh off an interview I did today where we talked about estrogen dominance in one of the local summits that went here and I want to dig in a little bit deeper and give you some of the–the tidbits and the factoids of what causes estrogen dominance, how that actually looks on the lab work, and what are some simple things that you can do to help to start improving it in the right direction.
What is Estrogen Dominance?
So first off estrogen dominance is what it is. We have this ratio of estrogen that’s a little bit higher in relation to what the normal ratio of progesterone should be. So let’s establish what those norms are. So Dr. John Lee talks about the fact that progesterone to estrogen, that amount of progesterone to estrogen can be anywhere between 200 to 300 times. So progesterone can be 200 to 300 times more than 1 molecule of estrogen. Alright, two hundred to three times. Now typically we see this 200 to 300 per ratio right around day 20 of our female cycle. Day 20, so right here is where we typically see this ratio intact. Right in this area. Now right around here, we could be making about 200, I wanna say 200 micrograms of estrogen, while we’re making 20 to 25 milligrams of estrogen, that 200 or 300 time ratio here. Now if you add all the plots of progesterone up in blue. Progesterone’s in blue. All the plots of estrogen in red typically on average–so I’m gonna put here–this is the day 20. This is day 20, 18 to 22 roughly. But if we’re looking at on average–I’ll just put average here–typically you’re looking at about the 23 to 25 times ratio for progesterone in relationship to 1 estrogen. So just to kind of delineate, typically around Day 20, we’re looking at a 200 to 300 to 1 progesterone to estrogen, while over here a 23 to 25 times progesterone to 1 estrogen in general. So this is from a research of what Dr. John Lee. He’s written a couple of books on this topic. So when we do a month-long cycle, we can really delve in and see some of these imbalances.
Female Hormone Cycle Overview
So let’s walk through normal female hormone physiology briefly. So you see here we start off, right? We start off here. I’m gonna start from the end and then work forward. So we have this drop in hormones over here. That drop in hormones does a couple of different things. I’m gonna erase this year. The first thing we see with this drop, that’s drop in hormones, that triggers menstruation. That’s bleeding. Okay? Menstruation. That’s important because that’s causing the endometrial lining to slough off. The next thing we start to see after that is we see an increase in FSH. That increase in FSH grows that follicle into an egg, okay? That follicle then starts to produce an increase in estrogen. Alright, that rise in estrogen, increased estrogen causes an increase in LH, luteinizing hormone. Number six, that LH increases progesterone and the last thing is the progesterone falls, drop in hormones along with estrogen, and that signals menstruation. So it’s 1, 2, 3, 4, 5, 6. So let me walk you through here. So we have basically this drop in hormones here, that then signals bleeding. Women menstruates, that’s the period. Over here FSH is a brain hormones so you don’t see it on this graph. It’s happening in the brain. FSH increases that causes the follicle, the new egg to grow. That follicle then stimulates estrogen to go up. When estrogen peaks typically around day 12 or 13 that causes a rise in progesterone. Progesterone spikes typically around day 18 to 22. That’s where this ratio that was over here comes, that 200 to 300 times progesterone to one molecule of estrogen. And then from there, we have our progesterone spiking and then we have that drop in hormones. So one more time, it’s basically drop in hormones, FSH follicle making estrogen, estrogen then stimulating LH, LH stimulating progesterone, progesterone peaking, progesterone and estrogen falling, bleeding occurring. That’s our normal female hormone cycle and typically we start to see the ratios skewed. And one more time, I’ll write it up on my little Chalk Talk dry erase board, our normal ratio is about 23 to 25 times progesterone to estrogen that’s our average, okay? And then our peak day 18 to 22 is about 200 to 300 times PE. So I hope that makes sense here regarding what estrogen dominance is and how that kind of affects the cycle. So we start to see these ratios skewed. So estrogen dominance would be we start dropping below 20 where on our peak over here where our progesterone tops out, we go below that 200 to 300 times. Most women I see are in that 20 to 50 to 20 to 80 around their peak here where they have significant less progesterone, but they also have a lot less estrogen, too.
Female Hormone Level Imbalance
I see a lot of women whose hormones are very depleted where, yeah, the ratio may be not great, but it’s the hormone level by itself may be even worse. So again estrogen dominance is really just looking at a ratio. You can still have low estrogen and low depleted hormone levels and still be estrogen-dominant. That’s kind of a big myth and depleted hormones make it really hard for you to heal and regenerate. So looking at estrogen dominance symptoms, we have bloating. We have cramping. We have fibroids. We have tissue growth. We have moodiness. We have endometriosis. Estrogen is a hormone signal that causes cells to grow. Progesterone is a hormone signal that causes cells to grow up, ideally mature, right? So growing is like me lifting weights and just getting big while progesterone, right? So that’s the estrogen analogy. The progesterone analogy is like a child growing into an adult, right? One is maturation. One is just bulk. Now estrogen is important because we need that when it comes to certain tissue like in the endometrial lining, but progesterone is important to help that egg kind of bond, right? To the endometrial lining and then essentially maturize into a grown baby. That’s the goal and that’s why these hormones, they’re on a teeter totter and they’re incredibly important. But if we have this imbalance in progesterone and estrogen, all of those estrogen dominance symptoms can happen.
Kinds of Estrogen
So we have a couple of different kinds of estrogen. I’m gonna just break it down. We have DHEA which is a part of the adrenal hormones, but it’s also part of the ovaries, too. That converts to our main estrogen, estradiol. Estradiol, otherwise known as E2–look at that prefix here with the di, E2 gets–can get converted into E1, right? You can see the estrone–look at the O-N-E. The one in there. And this can go either one of two ways. It can go to our 2 which is our more healthy estrogen or it can go to our 16, which is our more anti-healthy, unhealthy, disease-promoting estrogen. And again our–our ratio is we like to have greater than 2 over here to 1. So we like a 2:1 ratio or greater for healthy estrogen balance. And this is–now we’re going like estrogen dominance is kind of the macro view, the telescope view. Now we’re looking at estrogen metabolism. That’s more of the microscope and the microcosm view. These are just how estrogen is being metabolized. But this is important, too, because you can have more bad estrogens on this side of the fence and then you may experience more estrogen dominance symptoms because of the fact you have this un–imbalance ratio. So I hope that makes sense. You may have to rewind it a couple times.
The Metabolic Process
Big picture. Estrogen dominance is estrogen in relationship to progesterone, but we also know that how estrogen is metabolized can also create estrogen dominance symptoms. So a lot of people that we see–we’ll run organic acid testing and we’ll look at these various organic acids like sulfate or pyroglutamate, hippurate, glucarate, and we’ll see backed up metabolic processes or pathways to metabolize these hormones. And we’ll also see something knowns as beta-glucuronidase where we have an inability to metabolize some of these estrogen hormones. So think of beta-glucuronidase as an enzyme and it’s there to basically, it takes the straitjacket–the straitjacket off of our metabolized estrogen. So when our body goes and metabolizes hormones, it conjugates it. It binds a protein to it, in other words, puts a straitjacket around it so it can escort it out to the kidneys and the liver and the stool. Now beta-glucuronidase, this enzyme that occurs when we have dysbiosis, a high amount of bad bacteria in the gut, in relationship to good bacteria, that beta-glucuronidase comes in, it unhooks the straitjacket and now the estrogen can go back and become reabsorbed and create lots of hormonal issues. Again estrogen also makes bile sludgy and this is why people that have estrogen dominance can also have digestive issues because bile so important for fat breakdown and actually need good fats to make your hormones. So you can see how estrogen and digestion actually compound each other and make your hormone issues worse in the future because if you can’t break down fat, you can’t break down–if you can’t make bile and you can’t break down fat because bile is needed to break down fat, then you can’t make the fat into your hormones. So you can see how one problem actually makes the other problem worse and worse as you go on.
Estrogen in the Body and in the Environment
So recapping this. Bad amount of beta-glucuronidase from this imbalance in bad bacteria and infections, that then takes the straitjacket off all these metabolized estrogens. They get reabsorbed into the system and that can create more hormonal havoc. So you can see here estrogen dominance in our cycle. We can see it through our metabolites and then now we can break it down via the environmental causes. So I already talked about some. One is the guts. The gut–I’m just gonna put a G here–through the beta-glucuronidase, through the dysbiosis, through the SIBO, through parasitic and fungal and bacterial issues. All of these things cause low stomach acid and low enzymes, inability to break down food. We can’t break down our food. Our food sits in our tummy. It rancidifies. It putrefies and it makes the problem worse. So one problem kinda begots the next. So the gut. Next would be I’d say the food. So the pesticides, the chemicals, the GMOs. Again, these pesticides are estrogenic-based. So they go into our body and they have an estrogenic load to our body. So pesticides add more estrogens. The plastics contain estrogens as well. And again, estrogen cause cells to grow. The scientists back in the 19–I think late 1990s, Dr. Sotomayor over at Tufts found that when she put her cells into the plastic test tubes, that the cells would grow more vigorously in these test tubes, kinda like cancer does, and she found that it was the plastic test tubes especially the BPA was causing those cells to grow. So now flash forward, people are putting plastics in every–or putting their food and their water in plastics all over the place and we’re reabsorbing those chemicals which cause our cells to grow because they have an estrogenic like effect. So environmental estrogens from food and from plastics and then also from phytoestrogens, things like soy. Soy can be devastating because there’s a lot of gut and enzyme inhibitors in it such phytic acid and oxalic acid and chymotrypsin in various trypsin inhibitors, which affect protein breakdown but they’re also estrogenic. They can add your horm–they can add to your hormone levels of estrogen and for many can be incredibly devastating because estrogen is the opposite of testosterone. And men need testosterone to be healthy and virile. So again we have the gut and we have food. We have phytoestrogens and we have plastics, and again all of these are so, so important and if we don’t have the gut working, we don’t have the building blocks to make the hormones, which then makes the problem even worse. And you can see how the gut–so many people it’s hard for them to wrap their head around the fact that their gut could be a potential hormonal causing–causing factor that could be driving a lot of their hormone issues. People think the gut and the hormones are like two separate things. “Hey, if I don’t have digestive issues, well, there’s no way that’s part of my hormonal issues,” but it can be.
So recapping everything, if you have a hormonal issue or long-term issue, we may want to run a month-long test, if not a test that looks at hormones especially in the sensitive time of your cycle around day 18 to 22. We may also want to do an adrenal test to get a window into how your adrenals are functioning because your adrenals produces a significant amount of DHEA which is depleted in people that are chronically ill. We also want to dig into the environmental and lifestyle causes over here that could be driving the issue. And there’s a lot of natural cyclical augmentation programs and adrenal programs and gut-healing programs that we do on the functional medicine side to address the underlying cause of what’s driving these issues. So click on screen, subscribe to my female hormone balancing video series, and if you’re struggling with this issue and you want to take it to the next level and get to the root cause, reach out on screen or below and I’m always here to help.
Thanks. This is Dr. J. Subscribe to get more info. Thanks. Have a good day!