Estrogen Dominance: How to Support Estrogen Metabolism
The term “estrogen dominance” is frequently thrown around these days, and is likely the reason estrogen has gotten a bad rep. But estrogen in and of itself is not bad. No single hormone is, but they need to be in balance for us to be feeling our best. If you’re a menstruating female and have been struggling with symptoms like PMS, painful periods, cyclical breast tenderness, mood swings, etc. you may have a hormonal imbalance, where estrogen levels/ratios are not ideal.
Let’s unpack “estrogen dominance”, why it can happen, and some natural ways to tackle it!
Estrogen 101
Estrogen is so much more than a reproductive hormone. Estrogen plays a major role in the development and function of the female reproductive system from puberty through menopause, and beyond, as well as other areas of our health (see more below).
Estrogen levels naturally fluctuate throughout the month, and lifespan. For a cycling female, during menstruation estrogen levels are low and slowly start to rise and peak right before ovulation. Estrogen begins to drop again in the luteal phase, where progesterone should be the predominant hormone.
And guess what? There isn’t just one type of estrogen! We actually produce three different types, mainly in our ovaries, but also in fat cells and the adrenals by way of DHEA - this is why adrenal health is so important when we transition into menopause as the ovaries tap out.
Estrone (E1): Considered the weakest form. Predominant estrogen in postmenopausal women
Estradiol (E2): Predominant estrogen in premenopausal women. Most biologically active estrogen in women. It's also the form of estrogen that plays a role in conditions including endometriosis, uterine fibroids, breast and endometrial cancers, as well as in cyclic menstrual cycle symptoms.
Estriol (E3): Predominant estrogen in pregnant women
What Does Estrogen Do?
Many cells in the body have estrogen receptors. So it’s no surprise that abnormal fluctuations in estrogen throughout the month/lifespan can lead to a whole host of symptoms from mood swings, breast tenderness, and heavy periods to full-on hormonal chaos and even estrogen-driven gynecological conditions.
These are just some of estrogen’s roles in our health and well-being as women:
Heart health
Influences the development of the female body shape and physical female characteristics
Prepares the uterus for pregnancy
Maintains bone and muscular health
Supports cognitive health, memory and executive function
Maintains skin health
As you can see, there are both immediate reasons (hello, symptoms of high estrogen) and long-term reasons to get estrogen levels to a healthy place.
The Liver and Estrogen Metabolism
In the liver, there are two steps to estrogen metabolism known as phase 1 and phase 2 detoxification. During phase 1, Detoxification enzymes convert estrogen to three metabolites- 2OHE1, 4OHE1, and 16OHE1. But, not all pathways are created equal. 2OHE is the safest/most beneficial. Whereas the 4OH and 16OH metabolites are associated with unfavorable growths/are more proliferative.
In Phase 2 detox these metabolites are methylated and prepared for excretion via the kidneys and bowels. Many people mistakenly think that the liver is the only organ involved in estrogen metabolism and while it is very important, so is the health of your gut! This is why drinking ample water, eating fiber, supporting microbiome health, and ensuring regular bowel movements is so important to your hormone health.
What is Estrogen Dominance
Estrogen dominance is one of the most ubiquitous hormone imbalances. There are many ways in which our environment, food, stress, and other lifestyle factors can mess with our hormones and drive this chronically elevated estrogen picture. See my other post for a list of symptoms that could be indicative of an estrogen-dominant state.
When we’re assessing high levels of estrogen, it’s important to differentiate if we have too much material to start with, if the issue is sluggish clearance of the estrogen from the body, or a combination of the two.
Factors that may contribute to estrogen dominance include:
Exposure to endocrine disruptors. Personal care items, plastics, cleaning products, and external sources of estrogen from hormonal birth control or consuming animal products treated with hormones.
Impaired Liver Detoxification. The liver is the primary location for estrogen metabolism. So if it isn’t functioning optimally, the result could be an imbalance of estrogen and estrogen metabolites.
Dysbiosis. The gut microbiome significantly impacts estrogen levels through the activity of the estrobolome - the collection of bacteria capable of metabolizing estrogens in the intestines. Dysbiosis can influence the gut's ability to detoxify estrogen effectively. Overgrowth of certain gut bacteria increases an enzyme called beta-glucuronidase, preventing estrogen excretion and allowing reabsorption into circulation.
Anovulatory cycles. months where you don’t release an egg could also lead to estrogen dominance. When you don't ovulate, progesterone will not be created in sufficient amounts to balance out estrogen. This can happen to anyone but commonly in those with PCOS, chronic stress, and during the perimenopause transition.
Genetic Factors. certain genetic alterations (like COMT and MTHFR) could hinder the body’s ability to detoxify efficiently.
How to Support Healthy Estrogen Levels
The best thing you can do to foster balanced estrogen levels is to support your detoxification pathways - aka the liver and gut!
So taking a look back into contributing factors to high estrogen, some key areas to focus in on could include:
Love your Liver. Food first! These foods contain the essential nutrients needed to support your natural detox pathways, and hormones, and are rich in DIM (diindoylmethane) and sulfur, which assist with the processing of estrogen. Beets, dark leafy greens, cruciferous vegetables (cauliflower, kale, cabbage, broccoli etc), garlic, onion, artichokes, grapefruit, turmeric, and dandelion root tea are great choices. Reducing alcohol intake is also strongly advised.
Gut Health. Daily bowel movements are a non-negotiable as well as ensuring adequate fiber intake (25g + /day), staying well hydrated, and incorporating fermented foods like kimchi, sauerkraut, yogurt, kefir, tempeh, coconut yogurt and miso. Pay extra attention to diversifying and rotating in different fruits and vegetables. Some foods high in fiber include avocados, raspberries, artichokes, almonds, broccoli, and oatmeal.
Practice Stress Management. Anything that brings you comfort, ease and relaxation. This will be different for everyone but could look like; meditation, talking a walk, breathwork, journaling, yoga etc.
Seed Cycling. While there isn’t clinical data to support this, newer correlation studies have shown some benefits for women with PCOS. It is a great way to get in essential nutrients that are supportive of the different phases of your cycle. I’ll do a separate post on this.
Reduce Exposure. we are exposed to hundreds of endocrine disruptors daily. It can take time to make changes in this area since they are ubiquitous, so I recommend swapping out personal care and cleaning products once they are empty. Opting for glass and stainless steel containers in place of plastic, and buying organic, high-quality grass-fed proteins whenever possible.
Supplements. If you feel like you’ve nailed the foundations and things still aren’t moving in the right direction, this would be the ideal time to bring in support with supplements and herbs. NOTE: You should not start any supplements without first talking to your practitioner and working with someone who can provide you with a protocol tailored to your specific needs. Some studies have shown DIM, Vitex, Broccoli seed extract, Calcium D glucarate, Magnesium and B vitamins work well to rebalance estrogen levels.
The Bottom Line
We <3 estrogen, but our modern-day lifestyle and exposures have made us especially susceptible to hormonal imbalances like estrogen dominance and subsequently, developing hormone-related conditions.
Hormonal imbalances can be complex and multifaceted so it’s important to not go at it alone - if this post resonated with you I advise you work with someone who specializes in this area (like me!) so they can help you drill down and figure out your unique root cause.
The good news is that diet and lifestyle modifications can support healthy hormone synthesis and estrogen detoxification, to bring hormones back into healthy ranges.
Click here to schedule a 15-minute discovery call to start your hormone-healing journey today!
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