How To Avoid Oestrogen Overload
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It’s the few days before your period and your PMS is in full swing, with an irritable, snappy and sensitive, cry-at-the-drop-of-a-hat, snap-at-someone-for-saying-hello, whirl wind of crazy emotions. Maybe it's because you haven't been sleeping well? You have tender breasts, you're cravings sweets, you feel puffy and start to dread the upcoming chronic cramping and heavy flow you all to regularly suffer from.
This is a common story I hear as a Naturopath, from women on their hormone balancing journey, either in a preconception phase, between or after babies. This is the story of Oestrogen dominance.
What Is Oestrogen?
Oestrogen refers to three different hormones which allow endometrial cells (cells lining the womb) to multiply, in preparation for pregnancy. Oestrogen is the sex hormone responsible for the development of the breasts, growth of the uterus and as the skeleton matures, the characteristic womanly curves, in a girl who is going through puberty. Together with other hormones, Oestrogen helps to regulate the menstrual cycle. For more on the ins and outs of the brain driven hormonal changes throughout a menstrual cycle, head over to to episode 1.
When your sex hormones, particularly Oestrogen, become imbalanced, cycle regularity and issues associated with your period, develop.
Oestrogen levels in your body can build up due to high production and/or poor metabolism and excretion from the body. Of the three types of oestrogen- oestrone (E1), oestradiol (E2) and oestriol (E3), oestradiol is the more dominant and proliferative type, promoting growth in the tissues of your body.
Symptoms of oestrogen dominance can include:
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Oestrogen dominance leads to a progesterone deficiency in your body. When your body is in a state of oestrogen dominance, the normal progesterone peak at around day 21 of your cycle (in the luteal phase) will be prevented. This contributes to the symptoms of PMS experienced from one - two weeks in the lead up to your period: breast tenderness, fluid retention (swelling), tiredness, moodiness, irritability, lowered tolerance, headaches, migraines, bloating and fluid retention
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Anxiety and nervousness
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Insomnia
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Irregular cycles
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Fatigue
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Facial flushing
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Sweet cravings
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Low thyroid function
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Fibrocystic (lumpy) breasts
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Weight gain, particularly around your midsection
- Painful and/or heavy periods
As oestrogen is a proliferative hormone, excess levels can manifest as abnormal inflammation and growth. An example is the growth of uterine tissue in the inflammatory conditions of fibroids and endometriosis, which can present through symptoms of menstrual pain, heaviness and clotting.1,2,3 According to the American Society for Reproductive Medicine in 2012, endometriosis may be a contributing factor of dysmenorrhea in more than 20% of women with chronic pelvic pain.4
- More chronic levels can contribute to dysplasia’s and cancers of the cervix and breast.5
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Autoimmune conditions, such as rheumatoid arthritis, hashimoto’s thyroiditis, multiple sclerosis and lupus are often accompanied by excess oestrogen levels in the body.
CAUSES OF OESTROGEN EXCESS
Insulin resistance
Oestrogen dominance and the symptoms and conditions that manifest from, are not just about the actual level of oestrogen in the bloodstream but also what receptor the hormone binds to. In the case of oestrogen, the same molecule can cause health issues when bound to an ER-alpha receptor, contributing to increased growth signalling in the body and therefore is strongly linked to cancer.6 In the case of the same oestrogen molecule binding to an ER-beta receptor, anti- proliferative effects on the body tissue occur and this action instead positively encourages oestrogen detoxification.7
Known drivers for the dangerous ER-alpha activity, include insulin resistance and obesity. With insulin resistance, insulin-like growth factor (IGF-1), whose levels mimic those of insulin, has the potential to bind to an ER-alpha receptor and contributes to oestrogen proliferation effects. Surprisingly, this occurs without the oestrogen hormone being present8 and is an important reminder to promote healthy insulin sensitivity, for balanced oestrogen activity in your body.
Inflammation
Inflammation can also drive high oestrogen levels by encouraging oestrogen- producing enzymes which further fuels the inflammation behind conditions such as endometriosis and fibroids. In the presence of inflammation in the tissues of your body, aromatase, sulphataste and 17-beta hydroxysteroid dehydrogenase (17BHSD), convert DHEA into oestrogen. These enzymes also strengthen oestrone, a low potency form of oestrogen, into oestradiol — the oestrogen which promotes rapid tissue growth.
It’s a vicious cycle, as the more inflammation that is produced, the higher your oestrogen production will be. Oestrogen further increases the activation of inflammation in the tissue of the reproductive system, contributing to the discomfort of heavy menstrual bleeding, clotting, increased pain and abnormal tissue growth.
Liver health
The way in which you detoxify from oestrogen also plays an important role in preventing oestrogen dominance.
The enzyme found throughout the body called cytochrome P450, grabs hold of oestrogen, ready for liver metabolism. The metabolism of the hormone in the first phase of liver detoxification can be pushed down 1 of 3 pathways:
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16 hydroxylation, which doesn’t actually detox oestrogen but instead produces oestriol (E1), which can further contribute to oestrogenic activity in the body
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2 hydroxylation, which produces protective, non toxic 2- hydroxy (OH) oestrogen compounds (quinones)
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4 hydroxylation, which manufactures dangerous 4-hydroxy (OH) oestrogen compounds (quinones). These quinones can potentially bind to and damage DNA, therefore contributing to the development of cancer12
Encouraging healthy oestrogen metabolism during this first phase of liver detoxification, is an important step in overcoming oestrogen dominance symptoms and conditions. Phase II detoxification however, is just as important. If the second phase of liver detox is effective, then any dangerous 4-hydroxy oestrogens can be quickly cleared before having a negative impact on hormone health.
Genetics
This efficient phase II detoxification requires healthy function of enzymes catechol-O-methyltransferase (COMT) and quinone reductase, along with efficient glucuronidation and glutathionation pathways. Sounds complicated but in simple terms, the latter two pathways work to metabolise oestrogens into safe water soluble substances, so you can safely eliminate them via the urine or faeces. In the case of endometriosis sufferers, these pathways are often compromised.13 Genetics also play a role, with a variant in the COMT gene, negatively affecting the COMT enzyme function.
A biochemical process called methylation also influences oestrogen metabolism. Healthy methylation in the liver protects against harmful and potentially carcinogenic 4-OH oestrogens. A variant in the MTHFR gene can cause disruption in this important function, leading to a build- up of dangerous oestrogen metabolites.
If you have genetic predisposition towards a hormonal imbalance, it is not necessarily your hormonal destiny. The environment you place your body in ultimately determines whether these genes will be switched on and therefore negatively affect your hormone health. Your nutritional status through dietary choices, your level and resilience toward stress and your toxin exposure are heavy influencers.
Nutritional Factors Influencing Oestrogen Dominance
Low Magnesium Levels
Magnesium deficiency is common among oestrogen dominance symptoms of PMS and menstrual migraines. Taking the oral contraceptive pill can cause magnesium levels to deplete over time and nutritional deficiencies such as magnesium, may contribute to the worsening of symptoms when the pill is eventually stopped.
When magnesium levels are low, oestrogen detoxification through glucuronidation is compromised and oestrogen is encouraged to be recycled. This is due to an increase in an enzyme called beta-glucuronidase9 as well as heightened aromataste activity, contributing to a state of excess oestrogen.10
B Vitamin Deficiency
As they are required for healthy methylation of oestrogen, a nutritional deficiency in vitamin B6, folate and B12 can lead to issues with healthy oestrogen metabolism.
Glutathione deficiency
Glutathione, is a tri-peptide made up of amino acids- cysteine, glycine and glutamate. This life dependent molecule is produced naturally in your body by the action of enzymes and is found in all of your cells.
Glutathione plays a major role in numerous bodily functions:
• The master antioxidant
• Immune strengthening
• Cardiovascular protective
• Promotes peak mental and physical function
• Cellular detoxer
The detoxifying health properties of glutathione (GSH) hail from its sulphur content, allowing glutathione the incredible ability to bind to free radicals and toxins, such as heavy metals. Our body has an in-built mechanism to protect us against the toxins we breathe and consume on a daily basis. Glutathione binds to toxins allowing them to form into water soluble substances, so they can be excreted as waste via the urine or bile.
For a healthy endocrine system, glutathione is required to complete the phase II liver detoxification of hormones and therefore prevent dangerous oestrogen metabolites. For the males, glutathione assists the production and maturation of sperm.
Your body is designed to recycle glutathione but when the toxic load is increased, glutathione becomes deficient. Among hormonal imbalance, low levels of glutathione in your body can contribute to an accumulation of acidic toxins, which will further degrade your natural glutathione status. Low glutathione levels are associated with early ageing and the pathogenesis of many diseases.11
FOODS AFFECTING YOUR OESTROGEN LEVELS
Both lifestyle and dietary toxic exposures can encourage the heightened production and growth stimulating effects of oestrogen in your body. Taking into consideration toxin exposure, inflammation production, oestrogenic effects, insulin disruption and nutritional deficiencies, the following foods can negatively impact your oestrogen levels:
Conventionally farmed produce
Glyphosate, the active ingredient in the widely used herbicide Roundup, has been linked to impairment of liver detoxification pathways. Glyphosate inhibits important cytochrome P450 enzymes in the body and disrupts your gut microbiome, which both play an important role in oestrogen metabolism.
According to Neurologist Dr David Pearlmutter, before its current herbicide use, glyphosate was originally patented as an antibiotic.66 Exposure to glyphosate has shown to alter the balance between pathogens and beneficial bacteria in your gut, along with contributing to a deficiency in a key hormone health mineral, selenium and the detox savvy amino acid, sulphur.14
Alcohol
The level of alcohol consumed has been directly linked with an increase in oestrogen levels. Alcohol disrupts the action of the COMT enzyme to effectively detoxify oestrogen from your body, therefore contributing to higher oestrogen levels.15 Consumption of one to two alcoholic drinks per day has been linked with a 10% increase in breast cancer risk.16
Coffee
Over 1 cup per day may put a greater strain on your liver’s detoxification pathways, encouraging dangerous oestrogen metabolites. Caffeine encourages the production of ex hormone binding globulin, therefore reducing available testosterone and inhibits the enzyme aromatase. For best liver support, try a going completely caffeine free.
Industrial Seed Oils & Trans fats
Industrial seed oils and such as cotton seed, canola, vegetable, soy, grape seed, rice bran, vegetable, corn and safflower and meals and products made using these oils, along with trans fats found in processed food products such as margarine and bakery items, can impact oestrogen, due to their toxicity levels and inflammation production in your body. As I chatted about previously, inflammation is a major driver for oestrogen activity.
High Fructose consumption
A high concentration of fructose is found in high fructose corn syrup, the sweetener ‘agave’, fruit juice and refined sugar. These can both drive inflammation and upset liver health, as a result of increased insulin production.
Unfermented soy
I'll never forget the story of my patient Sally who shared with me that cutting out her 1/2 cup soy milk per day, had lead to a dramatic reduction in her period pain symptoms. This was something she'd experimented with herself, before bringing in any new treatments.
The major isoflavone genestein, which is synthesised by the soybean, has been linked to oestrogenic and goitrogenic activity17 as well as impacting sperm health. Soy isoflavones are able to cross the placenta barrier in pregnancy18 and have been detected in breast milk and the urine of breastfeeding babies, after soy consumption.19 This exposure to soy isoflavones may contribute to immune complications and altered endocrine activity for a developing child.20,21,22,23,24,25,26
Soy consumption is such a conflicting topic, with studies indicate it's use for hormone balancing and others suggesting genestein can be carcinogenic in rodents.27,28
Soy protein isolate is highly processed, which compromises its nutrition, while increasing its toxin load. Soy protein contains aluminium and chemicals such as nitrates, due to a commercial wash procedure involved in the production of soy protein isolate. Tofu is also commonly pressed in aluminium boxes, in place of the traditional wooden boxes. This toxic metal can leach into the soy foods, contribute to an accumulation of accumulation in your body. Aluminum has oestrogen mimicking effects and has been linked to breast cancer29 and neurological issues. Studies shown for example, an increased risk of cognitive impairment, brain atrophy30 and dementia31 with regular tofu consumption.
For the expecting Mumma, aluminium can cross the placenta32 and can lead to impaired neurologic function.33 Avoiding exposure when in your control is highly recommended.
Unless fermented, soy also contains the enzyme inhibitor physic acid, blocking the absorption of important minerals in your intestines, such as calcium magnesium, iron and zinc which are required for healthy hormones. Unfermented soy also contains anti-enzyme trypsin-inhibitors, that impacts your ability for the digestive enzyme trypsin to work and therefore absorb crucial protein. Unfermented soy includes tofu, soy milk and products made with soy protein (think vegan burgers, sausages, cheese, mayo).
Soy intake can also contribute to an under active thyroid when levels of iodine are deficient in the body.34 A healthy functioning thyroid is crucial for sex hormone balance. Head back to episode 8 for more details.
Approximately 93% of soy grown in America is now genetically modified (GMO)35, meaning it can withstand higher amounts of the herbicide glyphosate. In this case, farmers can use greater amounts of this herbicide without killing the soy plant, leading to residues in the 'Roundup-Ready' soy based food you may be consuming.36
If you are thinking about starting a family, or currently pregnant, it is noteworthy that exposure to glyphosate can increase the risk of gestational diabetes37 as well as hormone and placenta complications.38
My exception is occasional consumption of traditionally fermented types of organic soy such as miso, tempeh, natto and tamari (wheat free soy sauce).
Lack of nutritious whole-foods
Nourishing wholefoods containing fibre and nutrients such as vegetables, fruit, nuts and seeds as well as healing fermented foods and homemade broths play an important role in maintaining healthy digestion. Irregular, incomplete bowel movements are a major contributor to oestrogen dominance. When the body cannot eliminate hormones efficiently from the body, oestrogen build up can occur.
LIFESTYLE FACTORS INFLUENCING OESTROGEN DOMINANCE
Endocrine Disrupting Toxins
Environmental and dietary exposure to dangerous endocrine disrupting chemicals can interfere with the normal physiological action of your hormones.
Xenoestrogens are endocrine disruptors, which increase oestrogen activity in your body. As these compounds build up in the environment and enter your body, they have the dangerous ability to bind to an oestrogen receptor and mimic a strong oestrogenic action. This ultimately causes hormonal disturbance and seriously interferes with the natural biochemical changes in your body.
Sources of endocrine disrupting toxins include:
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The oestrogenic plastic byproducts bisphenol-A (BPA) and bisphenol-S (BPS), utilised in the production of polycarbonate plastics for water bottles, toys, containers, tops of take-away coffee cups, tin liners, receipts, dental fillings and plastic wrap.39,40,41,42 BPA can bind to ER-alpha and beta receptors and have a strong oestrogenic effect in your body. Although BPA is being phased out of plastics, an equally oestrogenic byproduct known as BPS is being used in place.
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Commercially available BPA free ‘Tritan’ plastic, used to make plastic bottles, sippy cups and containers to store food and drinks. In one study, these plastics actually leeched more synthetic oestrogens than plastics containing BPA.43
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Phthalates in personal body and hair care products, including makeup, nail polish, hairspray, deodorant, sunscreens, products containing fragrances, processed foods, unfiltered water, furniture, cleaning products, air fresheners, plastics using polyvinyl chloride (PVC) such as shower screens, soft kids toys, dummies, plastic containers and vinyl flooring. Exposure is extremely dangerous in pregnancy and for babies, as these chemicals disrupt the healthy development of the reproductive system, brain and other organs. Phthalates found in air fresheners have also been disturbingly linked to birth defects.44,45
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Parabens in body and hair care products, sunscreens, food additives and pharmaceutical medication. They easily build up in the breast tissue, as indicated in a study from the Journal of Applied Toxicology, where 99% of breast cancer tissue detected levels of paraben esters.46
I know it can be confusing when reading food labels, let alone the products you use on your skin. Anything you place on your skin, will absorb into your bloodstream, so when you think about it like that, you do want to be picky when it comes to your body care products. You can download my go-to list of toxic ingredients to avoid when choosing the brands and products you will use, over here.
- Polystyrene foam used in products such as takeaway cups, trays and containers leach synthetic oestrogens when exposed to intense heat.47 The polystyrene resin used in the production of hard plastic products, such as your plastic toothbrush and kitchen utensils is a suspected carcinogen according to the Environmental Protection Agency.
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Hormone Growth Promotants (HGP’s) given to non-organic cattle, to fatten them up. Although Europe has banned the use of HGP’s and the import of products from cattle that have been exposed to them, 40% of Australia’s cattle are raised using HGP’s.48 Studies have detected levels of these synthetic hormones in the fresh manure of cattle and the soil run off from feedlots, posing concerns for environmental and health impacts.49 Always shop for hormone free meats, and best organic.
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Herbicides (including atrazine and glyphosate),50 pesticides (including insecticides permethrin, DEET and organochlorine DDT),51,52 antibiotics and fertilisers used in conventional farming practices. Studies in fish and amphibians have linked atrazine use, to increased oestrogen production, with some males developing ovaries.53,54,55
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Perfluorinated chemicals, such as perfluoroctanoic acid (PFOA), found in nonstick cookware. Heat used in cooking, causes the nonstick film to breakdown and release toxins into your food.56,57,58,59
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Persistent environmental pollutants (POPs) such as dioxin, are linked to reproductive and developmental challenges.60,61,62 Dioxins may disturbingly be found in sanitary pads and tampons63 and also watch out for propylene glycol (PEG) found in your body care products. Most feminine hygiene products also contain synthetics (rayon and polyester), are a source of 2,3,7,8-tetra-chlorodibenzo-p-dioxin (TCDD) and are made using conventionally farmed cotton and therefore exposed to pesticides.
As Leah Hetchan explains in her text Clinical Naturopathic Medicine "...in utero dioxin exposure has been shown to cause progesterone resistance and a transgenerational risk of endometriosis." 63
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Jet Fuel64
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Flame retardant chemical, polybrominated diphenyl esther (PBDEs) found in clothing, fabric for upholstery, car seats, furniture foam and plastics of electronics.65 These chemicals are not chemically bound to the materials they are added to, therefore easily off gass into your home, car or work environment. Exposure has been linked to fertility66 and thyroid issues.67
These endocrine disruptors are non-biodegradable and accumulate in your fatty tissue which is difficult to detoxify from. Limiting exposure is a must, for long term hormonal health.
Mercury
Heavy metals can also disrupt hormone health. Mercury accumulates in endocrine organs, particularly the pituitary gland, impacting hormone synthesis.68 A major source of mercury is found in amalgam (silver) fillings, which can overwhelm your detoxification organs overtime and leads to various symptoms and conditions in the body.
Cigarette smoke
The toxic exposure through first and second hand smoking exposure, stresses the detoxification pathways of your body. Smoking causes deficiencies in crucial detox nutrients, such as glutathione.
Antibiotics
A course of antibiotic medication disturbs the delicate balance of your beneficial gut bacteria.69 Upsetting this balance contributes to unhealthy elimination of oestrogen, through your bowel movements and creates issues with oestrogen recycling. Just another reason why fermented foods are a must for hormone health.
Synthetic hormones
The oral contraceptive pill (OCP), other hormone secreting contraceptive devices and hormone replacement therapy (HRT) expose your body to synthetic forms of oestrogen. Although giving short term relief to cycle symptoms, overtime OCP use may contribute to nutritional deficiencies,70,71,72,73,74,75,76 gut permeability (leaky gut) and a disruption of your good gut bacteria77 which all impact your overall oestrogen levels.
Stress
Along with insulin resistance, other conditions of hormone imbalance contribute to oestrogen excess. When your vulnerable adrenal glands are under pressure due to emotional, physical or mental stress, imbalances in the thyroid and sex hormones often develop.
Whether it’s stemming from environmental or dietary exposures, when detoxification pathways are overwhelmed with the stress of toxins healthy hormone metabolism is second priority. This contributes to hormonal imbalance, such as oestrogen dominance.
Consider The Multiple Drivers of Oestrogen Dominance
Think of your normal oestrogen load as a big bucket and all the different contributors to either oestrogen sources, mimickers or recycling factors as I've explained, as droplets of water. Eventually these droplets lead to an overflowing bucket, known as oestrogen dominance, which will contribute to symptoms and as it floods out other buckets such as your progesterone and thyroid, will impact their levels and function too, further contributing to more serious conditions in the body. You can head back to episode 8 where I discuss thyroid health and low progesterone in greater detail.
When aiming to balance your hormones, whether its to prevent or overcome symptoms and conditions (such as endometriosis and fibroids) or prepare yourself for conception, consider helping your body holistically. Look out for these oestrogen dominance drivers through the foods you're eating, the products you apply to your skin, what you're using to prepare and store your foods in and what environment you are exposing yourself to day in, day out. This is a big step in becoming aware and making appropriate changes to encourage healthy oestrogen detoxification, levels and activity in your body.
For further guidance, consider my hormone health book, Balanced, The Natural Way To Healthy Hormones and my preconception guide, Glowing Mumma.
References
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