Estrogen dominance

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Estrogen dominance (ED) is a theory about a metabolic state where the level of estrogen outweighs the level of progesterone in the body. This is said to be caused by a decrease in progesterone without a subsequent decrease in estrogen.

Contents

The theory was proposed by John R. Lee and Virginia Hopkins in their 1996 book, What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone. [1] In their book Lee and Hopkins assert that ED causes fatigue, depression, anxiety, low libido, weight gain specifically in the midsection, water retention, headaches, mood swings and white spots on fingernails fibrocystic breasts. [1] The book criticizes estrogen replacement therapy and proposes the use of "natural progesterone" for menopausal women in order to alleviate a variety of complaints. Lee's theories have been criticized for being inadequately supported through science, being primarily based on anecdotal evidence with no rigorous research to support them. [2] Estrogen dominance can affect both men and women.

Proponents

Estrogen dominance is widely discussed by many proponents and on many alternative medicine websites, including:

Christiane Northrup, former obstetrics and gynaecology physician, believes that estrogen dominance is linked to "allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, and increased blood clotting, and is also associated with acceleration of the aging process." She believes that ED can be reduced by several methods including taking multi-vitamins, using progesterone cream, decreasing stress and detoxifying the liver. [3]

Nisha Chellam, an internal medicine and holistic and integrative health physician, admits that "estrogen dominance isn't an official medical diagnosis" but believes that it is "an under-diagnosed condition." The list of symptoms Chellam attributes to ED include "unexplained weight gain, difficulty losing weight, breast tenderness, subcutaneous fat, heavy periods, missing periods, prolonged cycles, painful periods, premenstrual dysmorphic disorder [ sic?], infertility, mood swings, insomnia, headaches and migraines." [4]

Bob Wood, R.Ph., lists the symptoms of estrogen dominance as "fibrocystic and tender breasts, heavy menstrual bleeding, irregular menstrual cycles, mood swings, vasomotor symptoms, weight gain and uterine fibroids" and believes that testing and "balancing hormones is of benefit to women of all ages". [5]

Research

Extensive research has been conducted on all aspects of estrogen including its mechanism of action, contraindications to estrogen supplementation and estrogen toxicity. [6] Research on hormone replacement therapies have indicated that hormone replacement did not help prevent heart disease and it increased risk for some medical conditions. [7] [8] Research conducted by Alfred Plechner points to cortisol as a possible cause of naturally elevated estrogen. "The cortisol abnormality creates a domino effect on feedback loops involving the hypothalamus–pituitary–adrenal axis. In this scenario, estrogen becomes elevated..." [9]

Related Research Articles

<span class="mw-page-title-main">Estrogen</span> Primary female sex hormone

Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal activity: estrone (E1), estradiol (E2), and estriol (E3). Estradiol, an estrane, is the most potent and prevalent. Another estrogen called estetrol (E4) is produced only during pregnancy.

<span class="mw-page-title-main">Menstruation</span> Shedding of the uterine lining

Menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hormones. Menstruation is triggered by falling progesterone levels and is a sign that pregnancy has not occurred.

<span class="mw-page-title-main">Progesterone</span> Sex hormone

Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the major progestogen in the body. Progesterone has a variety of important functions in the body. It is also a crucial metabolic intermediate in the production of other endogenous steroids, including the sex hormones and the corticosteroids, and plays an important role in brain function as a neurosteroid.

<span class="mw-page-title-main">Menstrual cycle</span> Natural changes in the human female reproductive system

The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone. The uterine cycle governs the preparation and maintenance of the lining of the uterus (womb) to receive an embryo. These cycles are concurrent and coordinated, normally last between 21 and 35 days, with a median length of 28 days, and continue for about 30–45 years.

<span class="mw-page-title-main">Estradiol</span> Chemical compound

Estradiol (E2), also spelled oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is responsible for the development of female secondary sexual characteristics such as the breasts, widening of the hips and a female-associated pattern of fat distribution. It is also important in the development and maintenance of female reproductive tissues such as the mammary glands, uterus and vagina during puberty, adulthood and pregnancy. It also has important effects in many other tissues including bone, fat, skin, liver, and the brain.

<span class="mw-page-title-main">Progestogen (medication)</span> Medication producing effects similar to progesterone

A progestogen, also referred to as a progestagen, gestagen, or gestogen, is a type of medication which produces effects similar to those of the natural female sex hormone progesterone in the body. A progestin is a synthetic progestogen. Progestogens are used most commonly in hormonal birth control and menopausal hormone therapy. They can also be used in the treatment of gynecological conditions, to support fertility and pregnancy, to lower sex hormone levels for various purposes, and for other indications. Progestogens are used alone or in combination with estrogens. They are available in a wide variety of formulations and for use by many different routes of administration. Examples of progestogens include natural or bioidentical progesterone as well as progestins such as medroxyprogesterone acetate and norethisterone.

Hormone therapy or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also be referred to as hormonal therapy or antihormone therapy. The most general classes of hormone therapy are oncologic hormone therapy, hormone replacement therapy, androgen replacement therapy (ART), oral contraceptive pills, and transgender hormone therapy.

Hot flashes are a form of flushing, often caused by the changing hormone levels that are characteristic of menopause. They are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and may typically last from two to 30 minutes for each occurrence.

Hypogonadism means diminished functional activity of the gonads—the testes or the ovaries—that may result in diminished production of sex hormones. Low androgen levels are referred to as hypoandrogenism and low estrogen as hypoestrogenism. These are responsible for the observed signs and symptoms in both males and females.

Abnormal uterine bleeding (AUB), also known as (AVB) or as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. The term dysfunctional uterine bleeding was used when no underlying cause was present. Vaginal bleeding during pregnancy is excluded. Iron deficiency anemia may occur and quality of life may be negatively affected.

Bioidentical hormone replacement therapy (BHRT), also known as bioidentical hormone therapy(BHT) or natural hormone therapy, is the use of hormones that are identical on a molecular level with endogenous hormones in hormone replacement therapy. It may also be combined with blood and saliva testing of hormone levels, and the use of pharmacy compounding to obtain hormones in an effort to reach a targeted level of hormones in the body. A number of claims by some proponents of BHT have not been confirmed through scientific testing. Specific hormones used in BHT include estrone, estradiol, progesterone, testosterone, dehydroepiandrosterone (DHEA), and estriol.

Breast pain is the symptom of discomfort in either one or both breasts. Pain in both breasts is often described as breast tenderness, is usually associated with the menstrual period and is not serious. Pain that involves only one part of a breast is more concerning, particularly if a hard mass or nipple discharge is also present.

<span class="mw-page-title-main">Luteal phase</span> The latter part of the menstrual cycle associated with ovulation and an increase in progesterone

The menstrual cycle is on average 28 days in length. It begins with menses during the follicular phase and followed by ovulation and ending with the luteal phase. Unlike the follicular phase which can vary in length among individuals, the luteal phase is typically fixed at approximately 14 days and is characterized by changes to hormone levels, such as an increase in progesterone and estrogen levels, decrease in gonadotropins such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), changes to the endometrial lining to promote implantation of the fertilized egg, and development of the corpus luteum. In the absence of fertilization by sperm, the corpus luteum atrophies leading to a decrease in progesterone and estrogen, an increase in FSH and LH, and shedding of the endometrial lining (menses) to begin the menstrual cycle again.

<span class="mw-page-title-main">Menstrual disorder</span> Medical condition affecting menstrual cycle

A menstrual disorder is characterized as any abnormal condition with regards to a person's menstrual cycle. There are many different types of menstrual disorders that vary with signs and symptoms, including pain during menstruation, heavy bleeding, or absence of menstruation. Normal variations can occur in menstrual patterns but generally menstrual disorders can also include periods that come sooner than 21 days apart, more than 3 months apart, or last more than 10 days in duration. Variations of the menstrual cycle are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian (HPO) axis, and early detection and management is required in order to minimize the possibility of complications regarding future reproductive ability.

<span class="mw-page-title-main">Dydrogesterone</span> Chemical compound

Dydrogesterone, sold under the brand name Duphaston among others, is a progestin medication which is used for a variety of indications, including threatened or recurrent miscarriage during pregnancy, dysfunctional bleeding, infertility due to luteal insufficiency, dysmenorrhea, endometriosis, secondary amenorrhea, irregular cycles, premenstrual syndrome, and as a component of menopausal hormone therapy. It is taken by mouth.

<span class="mw-page-title-main">Fibrocystic breast changes</span> Medical condition

Fibrocystic breast changes is a condition of the breasts where there may be pain, breast cysts, and breast masses. The breasts may be described as "lumpy" or "doughy". Symptoms may worsen during certain parts of the menstrual cycle due to hormonal stimulation. These are normal breast changes, not associated with cancer.

Antihormone therapy is a type of hormone therapy that suppresses selected hormones or their effects, in contrast with hormone replacement therapy, which encourages hormone activity.

Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal atrophy, accelerated skin aging, vaginal dryness, decreased muscle mass, sexual dysfunction, and bone loss or osteoporosis. They are in large part related to the diminished levels of sex hormones that occur during menopause.

An estrogen-dependent condition can be that relating to the differentiation in the steroid sex hormone that is associated with the female reproductive system and sex characteristics. These conditions can fall under the umbrella of hypoestrogenism, hyperestrogenim, or any sensitivity to the presence of estrogen in the body.

Sleep problems in women can occur across the life cycle. Subjective and objective data confirms women's increased risk to suffer from sleeping problems of various kinds at different life stages. Subjective and objective evidence supports the notion that various factors such as hormonal changes, ageing, psycho-social, physical and psychological as well as the presence of sleeping disorders may disturb women's sleep. Evidence from both subjective and objective measurements support the presence of disturbed sleep during the menstrual cycle, pregnancy, the postpartum period and the menopausal transition. The relationship between sleep and women's psychological well‐being suggests that underlying causes of sleep disturbances across a woman's lifespan are often multi‐factorial.

References

  1. 1 2 Lee, J.R.; Hopkins, V. (2004). What Your Doctor May Not Tell You About(TM): Menopause: The Breakthrough Book on Natural Progesterone. Grand Central Publishing. ISBN   978-0-7595-1004-3. Stated differently, it is clear that many of estrogen's undesirable side effects are effectively prevented by the presence of progesterone. I would propose that a new syndrome be recognized: estrogen dominance.
  2. Watt PJ, Hughes RB, Rettew LB, Adams R (2003). "A holistic programmatic approach to natural hormone replacement". Fam Community Health. 26 (1): 53–63. doi:10.1097/00003727-200301000-00007. PMID   12802128. S2CID   34859665.
  3. Northrup, Christiane (6 February 2007). "What Are the Symptoms of Estrogen Dominance?". Christiane Northrup, M.D. Archived from the original on 19 October 2021. Retrieved 10 March 2022.
  4. "Estrogen Dominance: What It Is and Why You Can and Should Treat It". Nutritious Life. 13 December 2021. Retrieved 10 March 2022.
  5. "Estrogen Dominance – Integrative Hormone Consulting". Integrative Hormone Consulting. 30 October 2017. Retrieved 10 March 2022.
  6. Delgado, Benjamin J.; Lopez-Ojeda, Wilfredo (20 December 2021). "Estrogen". NCBI Bookshelf. PMID   30855848 . Retrieved 10 March 2022.
  7. "Estrogen's Effects on the Female Body". Johns Hopkins Medicine. 19 November 2019. Retrieved 10 March 2022.
  8. "Estrogen & The Heart: Risks, Benefits & Side Effects". Cleveland Clinic. Retrieved 10 March 2022.
  9. Plechner, Alfred J (2004). "Cortisol abnormality as a cause of elevated estrogen and immune destabilization: insights for human medicine from a veterinary perspective". Medical Hypotheses. Elsevier BV. 62 (4): 575–581. doi:10.1016/j.mehy.2003.12.005. ISSN   0306-9877. PMID   15050110.