By Dr. Justin Marchegiani
Estrogen, one of the two main sex hormones that women have, is responsible for female physical features and reproduction. Today’s talk is going to be on estrogen dominance. Again, anyone that has female hormone symptoms for the most part, it is going to be a contributing factor to 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 tidbits and the factoids of what causes estrogen dominance. Also, how it 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?
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.
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. Now right around day 20, we could be making about 200 micrograms of estrogen. While we’re making 20 to 25 milligrams of estrogen, that 200 or 300 time ratio can be seen.
Now if you add all the plots of progesterone up in blue and all the plots of estrogen in red typically on average, this will be day 18 to 22 roughly. But if we’re looking at an average, typically you’re looking at about the 23 to 25 times ratio for progesterone in relationship to 1 estrogen.
To delineate, typically around Day 20, we’re looking at a 200-300 progesterone:1 estrogen. While over here, a 23-25x progesterone: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
Let’s walk through normal female hormone physiology briefly.
- Drop in hormones: This triggers menstruation or bleeding. That’s important because it’s causing the endometrial lining to slough off.
- Menstruation / Bleeding / Period
- Increase in FSH. This increase in FSH grows that follicle into an egg. That follicle then starts to produce an increase in estrogen.
- Increase in estrogen: Increase in this hormone causes LH or luteneizing hormone to trigger increase in progesterone. It peaks typically around day 12 or 13.
- Increase in Progesterone: It spikes typically around day 18 to 22. That’s where the ratio 200-300 progesterone:one molecule of estrogen can be seen.
- Drop in Progesterone
That’s our normal female hormone cycle and typically we start to see the ratios skewed. Our average Progesterone:Estrogen (P:E) is 23-25x. And at day 18-22, it is about 200-300x.
That is estrogen dominance affecting the female cycle. We start to see these ratios skewed. So estrogen dominance would be occurring when we start dropping below 20. Most women I see are in that 20- 50 to 20-80 around their peak, 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 the ratio may not be great, but it’s the hormone level by itself that is may be even worse. So 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, cramping, fibroids, tissue growth, moodiness, and endometriosis. It is a hormone signal that causes cells to grow.
Progesterone is a hormone signal that causes cells to grow up, ideally mature. So growing is like me lifting weights and just getting big. So that’s the estrogen analogy. The progesterone analogy is like a child growing into an adult. 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 bond 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. 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 can get converted into E1. You can see the estrone–look at the O-N-E. 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 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. 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 imbalance ratio.
The Metabolic Process in relation to Estrogen
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,. Also, we’ll see backed up metabolic processes or pathways to metabolize these hormones. Another is we see something known 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 take 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 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 is so important for fat breakdown. And you 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. If you can’t make bile, you can’t break down fat. And if 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
Bad amount of beta-glucuronidase from this imbalance in bad bacteria and infections 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, estrogen dominance in our cycle. We can see it through our metabolites and then now we can break it down via the environmental causes.
The gut, 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 kind of begots the next.
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 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, kind of like cancer does. 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 their food and their water in plastics all over the place and we’re reabsorbing those chemicals which cause our cells to grow. This is because they have an estrogenic like effect. So environmental estrogens from food and from plastics and then also from phytoestrogens contribute to estrogen dominance.
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 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 important. Also, 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. For so many people, it’s hard for them to wrap their head around the fact that their gut could be a potential hormonal 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.
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.