In the past 40 years, we have seen a dramatic rise in female-related illnesses never seen before in history. Today, we see the age of puberty (menarche) dropping precipitously to as low as 10 years of age, endometriosis afflicting 10% of all perimenopausal women; Premenstrual Syndrome (PMS), rising and afflicting close to 30% of perimenopausal women, uterine fibroids affecting close to 25 % of women from age 35 to 50, and breast cancer afflicting close to 10% of all women.
Being a woman in the 21st century is certainly a high risk profession. Navigating through this hazardous profession is not easy. Imagine having endometriosis, PMS and fibrocystic breasts when you were young, progressing to uterine fibroids, hysterectomy, misguided hormone replacement and ultimately breast cancer as your menopause approaches. The very thought of this journey can send chills up through anyone's spine. Fortunately, scientific evidence is mounting that hormone disruption is the key cause of all these seemingly separate but related diseases.
For too long, we have ignored the importance of hormone balance. For too long, physicians have been misguided on the real truth on hormonal balance. Now, we know that the common thread in many female hormone diseases such as those mentioned above is a little known condition known as estrogen dominance. The underlying problem is a relative excess of estrogen and an absolute deficiency in progesterone. In the west, the prevalence of estrogen dominance syndrome approaches 50 percent in women over 35 years old.
Here are some typical complaints from patients having estrogen dominance:
"My breasts are swollen and getting bigger" "I can't put on my rings on my fingers."
"I am more impatient now than ever."
"People tell me I am too bossy." "I am getting cramps again like when I was younger."
"I just cannot have my period."
"I miss my periods regularly." "My periods come irregularly."
"I get scared when I see large clots during my period." "I have Pre-Menstrual Syndrome (PMS)." "When I get a hug, my breast hurts." "I have fibroids." "I have endometriosis. "I cannot fit into my shoes." "I have a cyst in my breast."
"I feel tired all the time."
Let's first understand....
First, at look at Estrogen!
Estrogen is produced in the ovaries. It regulates the menstrual cycle, promotes cell division and is largely responsible for the development of secondary female characteristics during puberty, including the growth and development of the breast and pubic hair. Estrogen therefore affects all female sexual organs, including the ovaries, cervix, fallopian tubes, vagina, and breast. As a general rule, estrogen promotes cell growth, including signaling the growth of the blood-rich tissue of the uterus during the first part of the menstrual cycle and stimulates the maturation of the egg-containing follicle in the ovary. It softens the cervix and produces the right quality of vaginal secretion to allow the sperm to swim and to lubricate us during intercourse. Furthermore, it lifts our mood and gives us a feeling of well-being.
In non-pregnant, pre-menopausal women, only 100-200 micrograms (mcg) of estrogen are secreted daily. But during pregnancy, much more is secreted.
Estrogen in our body actually is not a single hormone but a trio of hormones working together. The three components of estrogen are: estrone (E1), estradiol (E2), and estriol (E3). In addition, there are at least 24 other identified types of estrogen produced in the woman's body, and more will be discovered. In healthy young women, the typical mix approximates 15/15/70% respectively. This is the combination worked out by Mother Nature as optimum for human females. Today, we use the word estrogen loosely to include also a family of hormones, including animal estrogens, synthetic estrogens, phytoestrogens (plant estrogens), and xenoestrogens (environmental estrogens, usually from toxins such as pesticides).
Estrogen is a hormone that is pro-growth. Since too much of anything is generally not good, the body has another hormone to offset and counterbalance the effects of estrogen. It is called progesterone.
Next, a look at Progesterone!
As its name implies, Progesterone is a hormone that is pro-gestation. In other words, it favors the growth and well-being of the fetus. Without a proper amount of progesterone, there can be no successful pregnancy. It protects us against the "growth effect" of estrogen. When progesterone is secreted, further ovulation is prevented from taking place in the second half of the menstrual cycle, and a thick mucous that is hostile to sperm is produced that prevents its passage into the womb.
Progesterone is made from pregnenolone, which in turn comes from cholesterol. Production occurs at several places. In the women, it is primarily made in the ovaries just before ovulation and increasing rapidly after ovulation. It is also made in the adrenal glands in both sexes and in the testes in males. In women its level is highest during the luteal period (especially from day 19-22 of the menstrual cycle). If fertilization does not take place, the secretion of progesterone decreases and menstruation occurs 12 to 14 days later under normal conditions. If fertilization does occur, progesterone is secreted during pregnancy by the placenta and acts to prevent spontaneous abortion. About 20-25 mg of progesterone is produced per day during a woman's monthly cycle. Up to 300-400 mg are produced daily during pregnancy.
As mentioned earlier, progesterone acts as an antagonist to estrogen. For example, estrogen stimulates breast cysts while progesterone protects against breast cysts. Estrogen enhances salt and water retention while progesterone is a natural diuretic. Estrogen has been associated with breast and endometrial cancers, while progesterone has a cancer preventive effect. Studies have shown that pre-menopausal women who were deficient in progesterone had 5.4 times the risk of breast cancer compared to healthy women.
The following lists clearly shows how progesterone and estrogen balances each other. It is very important to note that both hormones are necessary for optimum function. Progesterone will not work without some estrogen in the body to "prime the pump", for example.
Now that we understand the difference between the two......
Estrogen and progesterone work in synchronization with each other as checks and balances to achieve hormonal harmony in both sexes. It is not the absolute deficiency of estrogen or progesterone but rather the relative dominance of estrogen and relative deficiency of progesterone that is main cause of health problems when they are off balance.
While sex hormones such as estrogen and progesterone decline with age gradually, there is a drastic change in the rate of decline during the perimenopausal and menopausal years for the women in these two hormones as mentioned earlier.
From age 35 to 50, there is a 75% reduction in production of progesterone in the body. Estrogen, during the same period, only declines about 35%. By menopause, the total amount of progesterone made is extremely low, while estrogen is still present in the body at about half its pre-menopausal level.
With the gradual drop in estrogen but severe drop in progesterone, there is insufficient progesterone to counteract the amount of estrogen in our body. This state is called estrogen dominance. Many women in their mid-thirties, most women during peri-menopause (mid-forties), and essentially all women during menopause (age 50 and beyond) are overloaded with estrogen and at the same time suffering from progesterone deficiency because of the severe drop in physiological production during this period. The end result - excessive estrogen relative to progesterone, a condition we called estrogen dominance.
According to Dr. John Lee, the world's authority on natural hormone therapy, the key to hormonal balance is the modulation of progesterone to estrogen ratio. For optimum health, the progesterone to estrogen ratio should be between 200 and 300 to 1.
There are two periods in a women's life that her progesterone level is low - at puberty and again at peri-menopause ( the few years right before menopause). Between puberty and peri-menopause, the production of progesterone can go astray, leading to estrogen dominance as mentioned earlier. Between this period, estrogen dominance can also be the result of excessive external estrogen intake (from diet and environment) or internal estrogen production ( from obesity, birth control pills, or ovarian tumor).
Two Common Causes are:
A. Anovulation (lack of ovulation). Ovulation is the time of the month where an ovarian follicle releases an ovum (egg). Under normal condition, the released egg makes it way from the ovary to the uterus in preparation for fertilization. This usually happens from day 12 to day 14 of the menstrual cycle. After the egg is released, the empty follicle becomes the corpus luteum. This is the main factory where the production of progesterone takes place.
When the follicles become dysfunctional, no eggs are released. This is called anovulation. If a woman is not ovulating, there would not be a corpus luteum and therefore no increased progesterone production. Laboratory measurement would show both a low estrogen and a low progesterone level. Many still have a seemingly normal menstrual cycle even if there is no ovulation. The lack of progesterone, however, leads to relative estrogen dominance and symptoms like PMS, mood swings, cramps, and tender breast. Anovulation is commonly caused by exposure of female embryos to environmental estrogen (also called xenobiotic or xenoestrogen) such as pesticides, plastic, and pollution. It is often related to a poor diet and stress.
B. Luteal insufficiency. More frequent than anovulation, the egg is produced but the corpus luteum malfunctions. It just does not make enough progesterone. Laboratory measurements would show a high estrogen but low progesterone, and typical symptoms of estrogen dominance would arise. Without adequate progesterone, the chance of achieving pregnancy is reduced. Don't forget that progesterone is what keeps the womb going and it nourishes the fetus.
The predominant reason why menopausal women developed estrogen dominance is because they are being prescribed unopposed estrogen such as Premarin as part of their hormone replacement therapy (HRT) program. Despite decades of research clearly showing that HRT significantly increased breast cancer, millions of women worldwide are on unopposed estrogen for treatment of menopausal symptoms.
Obesity is another cause. During menopause, the amount of estrogen produced from the ovaries decreases, but not as drastic when it comes to another hormone that the ovaries produce called androstenedione (a male hormone). Fat cells can convert androstenedione into estrogen. The amount of conversion in some people is enough to maintain a reasonable estrogen level in the body well into the 70s. The result of excessive estrogen and absolute deficiency in progesterone is clear - estrogen dominance.
We mentioned above our body is essentially soaked in a sea of estrogen. Where does the estrogen comes from? Let us take a closer look.
Click Link For More Causes Below
12 Most Common Causes of Estrogen Dominance
It is the root cause of a myriad of illnesses. Conditions associated with this include fibrocystic breast disease, PMS, uterine fibroids, breast cancer, endometriosis, infertility problem, endometrial polyps, PCOS, auto-immune disorders, low blood sugar problems, and menstrual pain, among many others.
Now Lets Offer Some Solutions...
1. Estrogen Metabolism
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Often when a person is estrogen dominance progesterone levels are low. Supplementing with a bio-identical progesterone product helps to balance the ratio between estrogen and progesterone, thereby assisting in promoting proper hormone balance. Progesterone can be safely used by menstruating women, pre- and peri-menopausal women, and menopausal women. Men with estrogen dominance can also benefit from progesterone. Additionally, women who may not be highly estrogen dominant but struggle with severe PMS often find that if a progesterone cream is used on a regular basis, their menses and PMS are less difficult.
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Estrogen Dominance is the result of excessive estrogen and progesterone deficiency. It affects about 50% of Western women. It is an epidemic of gigantic proportion. The primary causes are excessive environmental estrogen , obesity, stress, poor diet, lack of exercise, and unopposed estrogen given as part of a hormone replacement therapy. Estrogen dominance is a major root cause of a myriad of conditions including PMS, endometriosis, cystic breast disease, PCOS, uterine fibroid, and breast cancer. Fortunately, the level of estrogen in our body can be reduced. Following the estrogen reduction protocol will go a long way to reduce the amount of estrogen in our body and curing women from the dreaded illness mentioned above.
In the female, a large part of the hormonal balance is controlled by the three major glands: the adrenal gland, the thyroid gland, and the ovaries. Maintaining a proper balance among these three glands is of critical importance in any estrogen dominance recovery program. Excessive estrogen affects both thyroid and adrenal function, and in turn, dysfunctional thyroid and adrenal fatigue makes estrogen dominance worse. They all go hand in hand. When not functioning properly, these three glands , controlling the majority of the hormones in the body, can lead to a viscous downward cycle of hormonal imbalance. Worse yet is that conventional medicine often times are mislead into treating symptoms after symptoms without addressing the root cause. A wide variety of prescription from sleeping pills to anti-depressants are dispensed. Unfortunately, such symptom-based protocol will often make things worse instead of better.
As a result , many following the advice of well-trained but misguided doctors may not find relief with conventional medicine or even with natural compounds unless special attention is paid to make sure that the thyroid and adrenal glands are functioning properly during the recovery. Any attempt to overcome one without paying attention to the others will more likely than not result in failure and discouragement on both the physician and the patient.
Michael Lam, M.D., M.P.H., A.B.A.A.M. is a specialist in Preventive and Anti-Aging Medicine. He is currently the Director of Medical Education at the Academy of Anti-Aging Research, U.S.A. He received his Bachelor of Science degree from Oregon State University, and his Doctor of Medicine degree from Loma Linda University School of Medicine, California. He also holds a Masters of Public Health degree and is Board Certification in Anti-aging Medicine by the American Board of Anti-Aging Medicine. Dr. Lam pioneered the formulation of the three clinical phases of aging as well as the concept of diagnosis and treatment of sub-clinical age related degenerative diseases to deter the aging process. Dr. Lam has been published extensively in this field. He is the author of The Five Proven Secrets to Longevity (available on-line). He also serves as editor of the Journal of Anti-Aging Research