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The Hormone Effect - Every Woman's Health Issue

The Hormone Effect - Every Woman's Health Issue

Introduction
How do you know when your hormones are out of balance?
What symptoms are due to hormonal irregularities?
What influences our hormone health?
Stress, adrenal function and the progesterone connection
Causes of estrogen dominance or deficiency
What everyday products could be disrupting our hormones?
What do these xenoestrogens do in the body?
Other factors that contribute to estrogen dominance
The dangers of estrogen dominance
How do I know if I am estrogen dominant or deficient?
What can you do to balance your body’s hormone activity?
Medicinal and balancing actions of everyday foods
Estrogen inhibiting foods
Estrogen promoters to reduce or avoid
What herbs and nutritional supplements can help?
Vitamins and minerals
References

Introduction

The endocrine system comprises the body's hormone-secreting glands and organs, responsible for regulating every other system of the body. If your hormone activity is out of balance your whole physiology, including your emotions, can be affected.

Modern medical practice has created several anomalies in how we perceive what is 'healthy' and what is 'disease'. On the one hand, natural healthy states like menstruation, pregnancy and menopause are often treated as medical conditions with unnecessary mechanical and drug interventions. In fact, some medical interventions create hormonal imbalances as a 'side effect' of treating a particular medicalised 'symptom'.

On the other hand, some real indicators of an abnormal hormonal imbalance are often dismissed as "normal for your age". Typical examples are extreme mood swings, loss of libido, memory loss, fatigue and 'middle aged spread' weight gain. This attitude normalises these symptoms as acceptable and unimportant.

The naturopathic approach is to identify any lifestyle factors impacting negatively on endocrine function, as part of a holistic view of health. In today's competitive marketplace large scale food production has reduced the nutritional quality of much of what we put into our bodies, while at the same time polluting our living environment. Modern labour saving technologies are another source of harmful toxins, while tempting us to exchange slower work or communication methods for more stressful, fast-paced productivity-driven behaviour.

It's a complex world, and those complexities are mirrored in our health outcomes. Fortunately we can still look to nature to provide balance and restore function to our all-important endocrine system.

How do you know when your hormones are out of balance?

It's normal to have a range of emotional and physical responses to the events we encounter in everyday life. Sometimes life is stressful so feeling upset, shocked, sad, tired or insecure in response to unexpected change is part of the human experience.

When you notice you are reacting to the usual stressors more often, finding it difficult to regain your equilibrium and feeling out of control or overwhelmed, a hormonal imbalance is likely to be an important part of the picture. As primary regulators of all of our functioning, hormones directly influence our emotional state. Conversely, our emotional state also influences hormone secretion.

What symptoms are due to hormonal irregularities?

There are many different ways a hormonal imbalance can manifest in women, and a continuum of affect from mild to severe. The long list of symptoms can commonly include early onset of menstruation, cramping, irregular bleeding, premenstrual mood swings, headaches, depression, anxiety, lowered blood pressure, low libido, memory loss, fatigue, dizziness, insomnia, hypersensitivity, hypoglycaemia, water retention and bloating, weight gain, salt cravings, acne, wrinkles, lowered immune response, facial hair growth, hair loss, temperature dysregulation, vaginal dryness, hot flushes, night sweats, irregular periods, either scanty or heavy and prolonged bleeding, painful uterine cramping, ovarian pain, urinary tract infections, miscarriage, infertility and more.

Premenstrual syndrome, premature menopause, hypo- or hyper-thyroid dysfunction and polycystic ovarian syndrome (PCOS) are all caused by hormonal irregularities.

What influences our hormone health?

Some of the lifestyle factors that affect our endocrine function include physical stress or injury, mental and emotional stress or trauma, deficient and devitalised nutrition, lack of or excessive exercise, medical hormone treatment (e.g. HRT or contraceptive drugs) and toxic environmental chemicals found in a range of products from cling wrap and cosmetics to pesticides and paints. Toxins are a major factor and the effect of xenoestrogens is discussed in more detail below.

Stress, adrenal function and the progesterone connection

Prolonged stress can require ongoing cortisol secretion, causing overactive adrenal function to meet the body's increased need for this important life-sustaining steroid hormone. This eventually leads to fatigued adrenal glands and reduced adrenal hormone output affecting the functioning of your whole system.

Reduced progesterone output is one outcome of exhausted adrenals, making stress an important contributing factor in estrogen dominance. (As well as being a precursor to estrogen production in the body, progesterone is also the hormonal precursor to other important hormones including cortisol and testosterone.)

Causes of estrogen dominance or deficiency

Estrogen deficiency is usually related to a low level of estrogen's precursor, progesterone. A reduction in estrogen production typically occurs in women approaching menopause, when ovarian hormone output decreases. Another cause is surgical intervention such as hysterectomy.

In younger women low estrogen levels may be due to over exercising, eating disorders and/or having very little body fat. These can all delay female development and onset of menstruation.

If low estrogen levels in younger women are not addressed, your ability to conceive and maintain a pregnancy is compromised. Early menopause can result, accompanied by a range of associated cognitive, emotional and physical symptoms of hormonal imbalance.

Estrogen dominance is one of the primary causes of hormonal dysregulation in women. Maintaining the balance of progesterone to estrogen is essential for healthy function. One role of progesterone is to counter the effects of estrogen in the body, protecting against cancers of the reproductive system and other toxic effects of an over abundance of estrogen. Increasingly women are experiencing a ratio of estrogen to progesterone that is excessive. It is in this context that we talk about estrogen dominance.

During peri-menopause when ovulation happens less frequently, ovarian progesterone production declines. Estrogen production also declines, however the relative ratio of estrogen to progesterone in the body often remains high. The main factors influencing this unhealthy ratio are dietary and environmental estrogenic toxins.

What everyday products could be disrupting our hormones?

Xenoestrogens are the chemicals that mimic natural estrogen, and bind to its receptor sites in the body. The body is tricked into responding as if there is estrogen present. The result is an oversupply of estrogens circulating in the body, which can overload the liver as it tries to metabolise and eliminate them. Xenoestrogens occur in the following categories of chemicals found in everyday household products:

Bis phenol A in cellophane, cling wrap, plastic bags, drink bottles, take-away containers, and medications such as the birth control pill, hormone replacement therapy (HRT) and fertility drugs
heavy metals in cigarettes, paints, plastics and cosmetics
parabens in deodorants and cosmetics
dioxins in sanitary products
PCBs (Polychlorinated Biphenyls) in pesticides and cosmetics
organochlorines in insecticides, fungicides and herbicides
isoflavones in unfermented soy products

What do these xenoestrogens do in the body?

Toxic xenoestrogens flood the body's estrogen receptor sites, over-stimulating their estrogen response. This leads to estrogen dominance where the ratio of estrogen to progesterone is too high, a major factor in many women's health issues. Blood tests won't necessarily show elevated estrogen levels, because the excess estrogen may be in the tissues where levels cannot be measured.

If your liver is too overworked to eliminate these excess hormones, they circulate until blood stagnation traps them in the uterus, ovaries or breasts. Fibroids, cysts and cancer can develop due to overstimulation of cell division in these reproductive organs. The liver and brain also have estrogen receptor sites, and estrogens may build up in these vital organs too.

Other factors that contribute to estrogen dominance

Obesity, aging, anabolic steroids, hormones in meat and dairy, and a poor diet are also major contributors to excess estrogen and its related disorders in men and women.

Some cancers (e.g. breast, uterine, ovarian) are hormone dependent and their growth upsets the body's hormone balance. Ovarian cysts also contribute an over-production of estrogen.

The dangers of estrogen dominance

Prolonged exposure to excess estrogen can be detrimental to the pituitary, thyroid and adrenal glands and to liver and kidney function, all leading to further build-up of estrogen in the tissues.

Overburdening the liver with excess estrogen to detoxify can reduce its activation of thyroid hormone, causing low energy and slowing your metabolism. This potentially leads to another common outcome of estrogen toxicity, weight gain due to excess fluid and fat in the tissues. Estrogens bind to sodium, increasing water retention. In addition, estrogen is stored in body fat. Abdominal fat cells, loaded with estrogen receptors, increase with excess estrogen in the system. This of course results in the typical 'middle aged spread' type weight gain, a risk factor in heart disease, diabetes and cancer. Gaining weight exacerbates the cycle of estrogen dominance, and obesity is a leading cause.

Carbohydrate cravings can also be attributed to estrogen dominance, leading not only to weight gain but to hypo- and hyperglycaemic complications. Estrogen dominance has a systemic toxic effect on the body. In addition to symptoms already listed, auto immune disorders, fibrocystic diseases, cardiovascular disease, epilepsy, endometriosis, joint pain, chronic fatigue, incontinence, candidiasis and osteoporosis have all been attributed to an increased estrogen load relative to progesterone.

How do I know if I am estrogen dominant or deficient?

There are specific blood tests and saliva tests you can take, however the results are not always conclusive. It's best to be guided by your individual symptoms, with the aid of a health professional.

Estrogen dominance needs to be considered in cases of early onset menstruation, PMS, heavy and prolonged bleeding, endometriosis, fibroids, increased blood clotting, fibrocystic breast disease, breast & endometrial cancers, PCOS or thyroid dysfunction. Accelerated aging, allergies, autoimmune disorders, magnesium deficiency, copper excess, zinc deficiency and bone loss are further indicators of estrogen dominance.

In contrast, if you are estrogen deficient you may suffer from hot flushes and night sweats, vaginal dryness, bladder control problems, facial hair, dry thinning skin, palpitations, light headedness, and joint or muscle soreness.

In the following cases it may be difficult to differentiate whether your estrogen level is too high or too low in relation to progesterone: irregular periods, infertility, breast tenderness, water retention, bloating, middle aged spread, hair loss, headaches, foggy thinking, poor concentration, memory lapses, low energy and fatigue, depression, anxiety, mood swings, lowered libido, insomnia.

Remember in all cases the key to balancing your hormone output is to increase progesterone production. In addition, if estrogen dominance is your problem, you may need to take a supplement to help clear harmful excess estrogen from your tissues.

Related product: Clinicians Womens Hormone Support

What can you do to balance your body’s hormone activity?

Progesterone is the precursor to estrogen, as well as its antagonist. Whether your estrogen levels are low or too high, increasing progesterone production is the key to hormonal balance. This will in turn increase estrogen if needed, or increase the progesterone to estrogen ratio if estrogen is too high. In addition it can be critical to support the function of the adrenal and thyroid glands to optimise hormonal health.

Eating foods high in natural magnesium, zinc and vitamin B6 will help increase your body's progesterone production. In addition to counter estrogen dominance you need to reduce the burden of xenoestrogens on your body. The first important stage in treating a hormone imbalance is to remove any external factors contributing to the problem. The xenoestrogenic products listed previously is a good place to start. Choose eco-friendly cleaners, eat organic food and reduce your use of plastics, especially for food and drink storage. In this way you significantly reduce the amount of toxins you ingest and absorb from your everyday environment.

Dealing effectively with problematic issues or situations that are stressful for you is important. Reducing the load on your adrenal glands necessitates unburdening yourself (where possible) and improving your quality of life. Regular exercise, meditation or relaxation techniques and self-nurturing practices all positively affect your endocrine function.

Medicinal and balancing actions of everyday foods

The next stage is to focus on your internal physical environment and support your body to normalise hormonal activity. Your liver is responsible for the breakdown of excess hormones in the body, so improving your liver function is central to hormonal health. Reduce your intake of foods that are hard on the liver: animal foods including meat, cheese, cream and ice cream; coffee, alcohol, sugar, chocolate, peanuts and any highly processed foods.

Wheat germ, kelp, walnuts, turmeric, thyme and oregano are good examples of progesterone promoting foods to include in meals. Cruciferous vegetables (a.k.a. brassicas) like broccoli, kale, cress, cabbage, Brussels sprouts, cauliflower and others from this plant family are great estrogen inhibitors and liver detoxifiers. They contain Di-indolylmethane (DIM), which has been shown in biomedical research studies to have significant anti-cancer and immune modulating actions. DIM has a specific role in detoxifying excess estrogens in the body. Maca root is another cruciferous plant known for its hormone regulating action.

For more information see the Maca article or browse the Maca root supplements available at discount prices from healthpost.co.nz.

The cleansing properties of onions and garlic also help to remove excess hormones from the liver. Squeezing lemon juice into your drinking water helps stimulate liver activity. Fibrous nuts and seeds such as linseeds and almonds help bind liver toxins for elimination via the bowel. They're also rich sources of omega 3 essential fatty acids (EFAs) which help stabilise mood swings caused by hormonal dysfunction. Green 'super foods' such as chlorella or spirulina and organic vegetable juices are some other good liver stimulating agents.

Estrogen inhibiting foods

It's best to avoid any foods that are estrogenic promoters, and include those that are estrogen inhibitors. The inhibitors are plant foods containing phytonutrients that have a specific threefold action to protect against excess estrogen by inhibiting production, reducing receptor activity and altering estrogen metabolism in the body.

In addition to the afore-mentioned brassicas and onions, other examples of estrogen inhibiting foods are organic corn, nuts, seeds, avocadoes, green beans, millet and buckwheat. Good fruit options include citrus, berries, figs, grapes, melons, pears and pineapples.

Estrogen promoters to reduce or avoid

Top of the list are animal meats, dairy products, wheat and unfermented soy products. Eat only organically grown fruits and vegetables because the pesticide and herbicide sprays used on commercially grown produce are estrogen promoters, as are hormones in meat and dairy foods.

Modern manufacturing of soy products is very different from the traditional process of slow fermentation used historically in Asian countries. Phytoestrogens in properly fermented organically grown soy products (such as miso, tamari (soy sauce), tempeh, natto, fermented soymilk and fermented tofu) are safe and beneficial to our health, as many studies confirm. Moderate consumption improves vitamin and mineral absorption, reduces cancer, and promotes hormonal health.

Conversely, unfermented soy isoflavones found in many modern products are toxic xenoestrogens that undermine the immune system, disrupt hormone pathways and contribute to a long list of hormone related disorders.

Foods and drinks in plastic packaging, especially if subjected to extreme temperatures (i.e. freezing or cooking) have an increased estrogenic action due to the volatility of plastics. Processing of manufactured foods tends to increase the concentration of existing estrogen promoters. This is particularly true for commercially processed dairy and soy products, which may contain more estrogen promoters than organic unprocessed milk or soy.

The following are foods identified as natural estrogen promoters in the body - and therefore best to eat infrequently in cases of estrogen dominance. Fruits and vegetables in this category include apples, cherries, dates, pomegranates and rhubarb; alfalfa and red clover (other plants from the legume family related to soy); and the culinary herbs anise, fennel and sage.

The imbalance of omega 6 to omega 3 essential fatty acids seen in a typical modern diet is thought to be another factor in estrogen dominance. This is largely due to over-consumption of vegetable oils such as canola, corn, safflower and soy which are high in omega 6 and prevalent in packaged food products.

For more information see the Flaxseed Oil article or view the range of quality Flaxseed Oil supplements which are available at discount prices from healthpost.co.nz.

The medicinal herb black cohosh has an estrogenic action and in cases of estrogen dominance is generally contraindicated. Read more about this herb in the following section.

What herbs and nutritional supplements can help?

The function of herbal medicine is to support and nourish the body to regain harmony and balance. There are many medicinal herbs that have a specific balancing effect on the endocrine system. Some familiar herbs prescribed for women's hormonal health are listed below, and these are generally more effective in combination with other well indicated herbs. Your local herbalist or naturopath can advise you on a combination that suits your individual symptom picture.

Chaste tree has a specific effect on the pituitary gland - the master gland of the endocrine system. It is a progesterone promoter and best known for its hormone regulating and balancing action.

Wild yam is another progesterone promoter when needed, as its action is adaptogenic. Dong Quai, Liquorice, Sarsaparilla root and Ginseng are some more herbal adaptogens, which means they respond to the needs of the individual and influence the endocrine system accordingly. In this way they may either promote or inhibit estrogen activity, as needed.

Passionflower and chamomile are two effective estrogen inhibitors. These herbs may be well indicated in cases of estrogen dominance.

Black cohosh is an estrogen promoter, so only indicated when estrogen levels are low. Studies show favourable results compared to hormone replacement therapy (HRT) in such cases. It is an anti-inflammatory and great for reducing hot flushes and other menstrual or menopausal irregularities. Some studies have linked black cohosh with increased breast cancer risk, because excess estrogen is also a factor in some breast cancers. Do not take this herb if your estrogen is high. Black cohosh is also contraindicated in pregnancy.

Prolonged use of any herbal formula is not recommended without the guidance of a qualified herbalist.

Vitamins and minerals

A good mineral and vitamin combination to supplement a varied vegetable-rich diet could include the following:

Vitamin E promotes progesterone secretion. Zinc is a progesterone-promoting mineral and a copper antagonist. If zinc is low or copper relatively high, hormonal imbalances develop.

Vitamin B6 is well indicated for improving hormonal health, having a direct role in production of many hormones and neurotransmitters. Magnesium is also important for maintaining the right progesterone/estrogen ratio and is usually deficient in cases of estrogen dominance. Both of these nutrients are needed by the liver to metabolise estrogen, and magnesium is critical for calcium to function well in the body.

For more information see the Magnesium article or browse the range of Magnesium supplements available from healthpost.co.nz.

Excess estrogen will also inhibit your vitamin B12 absorption and you may need to supplement it. Vitamin C and bioflavonoids are important factors in adrenal and thyroid function as well as boosting immune health.

If depression, mood swings, fatigue, memory loss and insomnia are your symptoms then vitamin D may be deficient. The active form of vitamin D is actually a hormone so it is an integral component of the endocrine system. Regular exposure to sunlight is your best source, and if you’re missing out on the sun’s rays a vitamin D supplement may be needed.

For more information see the Vitamin D article or browse the Vitamin D supplements available from healthpost.co.nz.

Evening primrose oil can be a useful supplement in controlling PMS symptoms due to estrogen fluctuations, however long term use may contribute to estrogen dominance in some cases. It's always good to take a break from a supplement and review your need for it once your symptoms improve.

Carolyn Simon
ND, DipMedHerb