Estrogen is a powerful hormone that does so much good for us, but it’s a misunderstood one as well. There has been media hype and an unjustified fear of estrogen. Once you educate yourself and understand the three levels of estrogen dominance, you’ll be able to make empowered decisions for your health and well-being.
The Fear of Estrogen
There has been an unjustified fear of estrogen starting around 2002 when the WHI trials (a large scale study that looked at the effect of hormone therapy on the prevention of heart disease and osteoporosis, and any associated risk for breast cancer) ended early because of adverse effects of women receiving hormones vs. those receiving placebo. The study’s treatment drug (Prempro, which is a combination of Premarin, an estrogen, and provera, a progestogen) was frequently (and mistakenly) referred to as estrogen. It primarily was the Provera (the progestogen) that was the cause of health problems encountered in that study. But media myths die hard and many women remain fearful of estrogen, even their own body’s estrogen.
What is Estrogen?
I sometimes hear of women wanting to ‘flush estrogen’ out of their body. You don’t want to do that! Estrogen is a wonderful hormone. Women primarily make it in their ovaries during their reproductive years and men make it in their testes, adrenals and via testosterone (through a process called aromatization). There are other estrogen production sites (called extra gonadal production) around the body as well, such as the parietal cells of the stomach. Yes, the even the stomach makes estrogen!
But all hormones are about balance, about being in the Goldilocks position. When not in balance, estrogen can cause heavy bleeding, PMS, fibroids, migraines, and more. These are all symptoms of estrogen dominance. Symptoms of low estrogen are hotflashes, low mood and vaginal dryness.
In a bid to get rid of estrogen dominance, women will talk of ‘flushing’ estrogen out of the body. You definitely don’t want to do that. Too little estrogen is just as troubling as too much estrogen.
The main question to ask when you have symptoms of estrogen dominance is: “What is my body doing with estrogen? This is called estrogen metabolism.
How Are You Metabolizing Estrogen?
Estrogen is a ‘use it and lose it’ hormone. It is NOT just about the amount of estrogen in the body. It is not even just the ratio of estrogen to progesterone in the body (although that is the most well known determinant of estrogen dominance).
In order to see how you are metabolizing estrogen, you need to do a urine test. Urine shows metabolites of estrogen. Blood and saliva do not.
I use the DUTCH complete hormone test to determine if there is estrogen dominance and at what level. The DUTCH test is considsered by many to be the gold standard of hormone testing.
There are 3 places to look on a DUTCH test to see if estrogen dominance is present.
Sex Hormone Summary
This is the sex hormone summary on the very first page of a DUTCH complete test. Here, we are simply comparing the dial positions of estrogen to progesterone. When the estrogen dial is more turned to the right than the progesterone dial, it is considered estrogen dominance.
This example of estrogen dominance is quite extreme, as I am sure you can see!
This is extreme estrogen dominance. The estrogen is sky high and the progesterone is super low.
By way of comparison, here is an example that is NOT estrogen dominant because the progesterone dial is more turned to the right than the estrogen dial.
At first glance, this is NOT estrogen dominance. But remember, this person could be estrogen dominant at the second and third level. Keep reading!
The second place I look to determine estrogen dominance is the levels of 2-OH, 4-OH and 16-OH metabolites. Think of metabolites like ‘daughter compounds’ of estrogen. These ‘daughters’ can either behave good or bad. If you create too much 4-OH or 16-OH, you may have symptoms of estrogen dominance. This person makes too little 2-OH (you want at least 70% of that because it is considered protective) and too much 4-OH (which is considered more potentially carcinogenic).
The third place I look to estrogen dominance on the DUTCH test is the methylation dial.
If methylation is low, it indicates that estrogen is having a hard time getting out of the body. We get a peek at methylation of estrogen on the DUTCH test by looking at the methylation dial. Here is an example of low methylation.
The fan dial on this methylation gauge is low. This means that this person is having a hard time at properly detoxing estrogen.
There are other phases of estrogen detox such as sulfation and glucoronidation that are beyond the scope of this article. However, the main takeaway is that you can be estrogen dominant on several levels. It is not as simple as your ratio of estrogen to progesterone.
Want to do a DUTCH test with me to find out how your 3 levels of estrogen detox are? You can sign up for that right here.
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