Estrogen Dominance – What is the Reality?
Most traditional medical practitioners still propose that menopause is caused by a decline in the production of estrogen and they believe in estrogen supplementation or HRT (Hormone Replacement Therapy), often with synthetic hormones. On the other hand, several alternative practitioners are of opinion that women have too much of estrogen, which results in a condition called “Estrogen Dominance”. This was a groundbreaking invention by Dr. John Lee who proposed that it’s the estrogen dominance which actually causes symptoms of premenopause and menopause, particularly in younger women. According to Dr. Lee the problem can be corrected by rebalancing the estrogen to progesterone ratio through progesterone supplementation.
What is Estrogen Dominance?
Let’s first understand that estrogen and progesterone are two primary female sex hormones. In a typical menstrual cycle, estrogen level increases in the first half and achieves a peak level at ovulation (formation of an egg or ovum); then it drops in the second half and progesterone level rises. Release of progesterone takes place upon rupture of egg follicle during ovulation. At this time, testosterone is also released in “surges” and increases an interest in sex. It is also secreted before menses. If pregnancy doesn’t occur, menstruation takes place and the entire cycle starts again.
All these hormones do their jobs well; but whether they should be released more or less depends on a complex system of feedback between hypothalamus, ovaries, adrenal glands and pituitary gland that secretes luteinizing hormone (LH) and follicle stimulating hormone (FSH). Diet and stress affect this feedback system and thus influence hormonal balance directly.
Here the role of progesterone is critical. It opposes estrogen by assisting the body to break it into metabolites which are then removed. Estrogen promotes tissue growth and progesterone orders the body to shed it off.
The original concept of Dr. Lee was quite simple. It argued that during menopause, the first sign is a decline in progesterone and not estrogen. Without having the opposition by progesterone, levels of estrogen remain abnormally high in the second half of menstrual cycle. This leads to discomfort in several women and over time can give rise to some serious health issues.
The HRT experiments have shown tragic examples of elevated estrogen and absence of opposing progesterone. The synthetic estrogen (Premarin) was given to women for many years after its formulation, without progesterone, as a result of which there was an outbreak of uterine cancer. This led to Premarin being prescribed along with synthetic progesterone (brand name Provera) to safeguard the uterine lining. Today a combination of Premarin and Provera is widely prescribed as a synthetic HRT.
Further, the concept of estrogen dominance by Dr. Lee was evolved to another argument that overall estrogen levels in both women and men are too high due to xenoestrogens which are manmade chemicals present in the environment that imitate our natural estrogen and disrupt our endocrine system even if they are present in slight amounts. This has been proved by the effects seen in wildlife, especially frog and fish. These environmental estrogens have been proved to cause reproductive defects in smaller forms of life; so, they are suspected to be affecting humans negatively too, adding to the estrogen dominance and infertility issues.
Where do You Fit In?
The estrogen dominance theory is very true, but you should remember that its significance lies in the estrogen to progesterone ratio which is individualized. So, among all women showing symptoms of estrogen dominance, some may have low progesterone levels and can respond very well to progesterone supplementation, while some others may have normal levels of progesterone and can do well by observing changes that can make their levels of estrogen or testosterone normal. So, how will you find where you fit in? You can find that only by checking your hormone levels and taking appropriate measures.
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