The problem could be due to “estrogen dominance”, a common condition that occurs if you have a relative deficiency of progesterone in relation to estrogen. Without progesterone supplementation, most women will experience estrogen dominance at some point in their lifetime, the extent of which will vary based on genetics, nutrition, emotional stressors and exposure to environmental toxins.
Depending on a woman’s age, there can be various causes of Estrogen Dominance: Most of the times it can be attributed to loss in Progesterone because of stress (physical, emotional, work, etc) or increase in Estrogen due to exposure of environmental toxins, Xenoestrogens which are “foreign” estrogens often widely used industrial compounds such as PCB, BPA and Phthalates. Here is a short look at how Estrogen Dominance develops during different stages of women’s life.
- Pre-menopause(15-40s): Lack of ovulation and/or reduction of ovarian production of progesterone. In younger women, estrogen dominance is likely a result of a cycle when she fails to ovulate. Even while women are still menstruating relatively regularly, anovulatory cycles become more common with age and without ovulation no corpus luteum is formed and therefore, very little progesterone is produced.
- Peri-menopause (40s-mid-50s): Lack of ovulation or erratic cycles, when estrogen levels fluctuate rapidly from high to low in the absence of adequate progesterone. As a woman reaches menopause and ovulation ceases completely, the production of progesterone will typically have decreased by over 90%. However, estrogen continues to be produced from the conversion of testosterone in her peripheral adipose (fat) tissue, resulting in estrogen Dominance.
- Post-menopause: An imbalance of progesterone to estrogen in waning reproductive years when ovarian production of estrogen can decline by as much as 60% and levels of progesterone can drop to nearly zero with the cessation of ovulation.
- Hormone imbalances triggered by medications like synthetic hormone combinations have also been found to contribute to estrogen dominance problems.
You are probably thinking “What does this have to do with a man? Estrogen and progesterone are female hormones.” Actually, the male body also makes estrogen and progesterone, and these hormones need to be balanced in men, also.
In men, bio-available testosterone (the type that can be used by the body) declines with age. However, an age-related increase in body weight and fat cells can result in increased conversion of testosterone to estrogen (which is measured as estradiol). Therefore, relative levels of free circulating estrogens increase with age and it has been proposed that increased estrogenic stimulation of the prostate in the aging male may lead to reactivation of prostate growth and cancer. In his book “Hormone Balance for Men: What Your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, the late John Lee, MD, stated “Optimal protection against estradiol-induced cancer occurs when the saliva progesterone level is 200-300 times that of saliva estradiol level.” Progesterone has many benefits in the male body beyond prostate protection, including defense against cardiovascular disease, hair loss and many neurodegenerative diseases such as Alzheimer’s.
A person can be estrogen dominant even if estradiol and progesterone levels are within the normal range but the Progesterone to Estrogen (Pg/E2) ratio is low (less than 200). Even someone with low estrogen levels can be estrogen dominant if the person has very low levels of progesterone. Therefore, it is important to determine the Pg/E2 (progesterone to estradiol) ratio and initiate therapy with bioidentical progesterone if needed. It is important to use natural, bio-identical progesterone which is quite different from synthetic derivatives known as progestins. Progestins help protect women from endometrial hyperplasia (overgrowth of the lining of the uterus that can lead to cancer), but progestins can create or exacerbate other problems related to hormone health and contribute to estrogen dominance.
When we are stressed, we produce higher amounts of the hormone cortisol which further reduces progesterone levels. Relatively low progesterone to estrogen (estradiol) ratios can create functional hypothyroidism with reported symptoms of fatigue, weight gain, constipation and thinning hair.
What can you do?
It’s important to know your levels of bio-available (free, unbound) estradiol, progesterone, and testosterone.
Saliva and/or blood spot testing is a simple, reliable means of determining your hormone levels. With this information, we can work together with you and your physician to develop a custom treatment plan to balance your hormones and monitor your progress. Contact our compounding pharmacy about hormone testing today!