A Brief Overview
Oestrogen is one of the key female sex hormones and is made mostly in the ovaries, but also via the adrenal glands and fat tissue (as well as the placenta in pregnancy). The adrenal glands and fat tissue become the key producers of oestrogen during peri-menopause and post menopause.
Oestrogen is actually a broad term for a group of 3 Oestrogens known as Oestrone (E1), Oestrodiol (E2, the most potent) and Oestriol (E3).
This is the hormone that gives us our feminine characteristics and plays a role in our menstrual cycle. It affects many tissues throughout the body. Our brains, bones, breasts, heart, lungs, ovaries, vagina, digestive system, bladder and muscles have receptors for oestrogen. It’s key roles include:
- Protecting our brains – and cognitive function
- Protecting our bone mass
- Protecting our heart by ensuring our arteries remain supple
- Protects collagen which keeps our skin supple
- Keeps the vagina lubricated
There are issues with too much and too little Oestrogen. This not only relates to the actual amount, but also (particularly as sex hormones start declining in our 40s) the ratio between Oestrogen and Progesterone. This is termed Oestrogen dominance, and is linked not only to raised Oestrogen (natural and external sources), but to low relative Progesterone, high insulin levels, increased abdominal fat (which produces Oestrogen) and impaired detoxification (think liver function, genetics and sluggish bowels). Symptoms are many and can include:
- Mood fluctuations – anxiety, depression, irritability
- Low libido
- Low thyroid function including fatigue
- Hot flushes and night sweats
- Oestrogen dominant related conditions such as Fibrocystic Breasts, Fibroids and Endometriosis
- Increased risk of Oestrogen related cancers including Breast Cancer
Considered a ‘balancing’ and ‘calming’ hormone. Progesterone plays a role in preparing the body for pregnancy and regulates the luteal phase of the menstrual cycle. It’s produced by our ovaries during our cycle, our placenta in pregnancy and in the adrenal glands in small amounts (the main source post-menopause) It has many roles:
- It balances Oestrogen to reduce Oestrogen dominance
- It protects our our bone health
- It promotes quality sleep
- It’s calming. It touches the GABA (calming) receptors in our brain. Low progesterone is linked to increased mood issues including anxiety and irritability
- It plays a role in breast, cardiovascular, brain and nervous system health.
- We can produce other hormones from it – including Cortisol, Testosterone and Oestrogen.
Our levels naturally decline during the peri-menopause, but there are many other factors that impact on balance, including genetic mutations, luteal phase defects, low thyroid function, and stress, as well as poor diet and lifestyle issues. When we’re stressed, our body can favour the production of cortisol, the stress hormone over the production of sex hormones.
This is one of the family of androgen hormones. Think of this as the ‘oomph’ hormone. Whilst we produce relatively less than men, it’s still important for our vitality. It gets converted into oestrogen in our adrenals, fat tissue, ovaries, placenta and brain, but it’s tightly controlled to make sure we don’t get too much by Sex Hormone Binding Globulin (SHBG)
It gives us oomph, assertiveness, confidence, libido, bone and muscle strength and good memory and cognitive function.
Things that can negatively impact on testosterone balance are many and include:
- High insulin, which results in less SHBG and more free Testosterone. This is linked to weight gain and a diet high in sugars and refined foods. We can see this in PCOS (Polysystic Ovarian Syndrome)
- Stress can lead to low Testosterone as the body favours the production of the stress hormone, Cortisol, rather than sex hormones. How is your sex drive when you’re stressed?
So what affects our hormone balance?
If you are peri-menopausal, or in your 40’s, I recommend that you tackle some of the root causes of hormone imbalances as a priority. These include blood sugar handling issues, adrenal dysfunction, thyroid health issues, exposure to toxins and xenoestrogens, as well as imbalances in sex hormones. And of course our digestive system plays a huge role in hormone balance too. By tackling these underlying health issues, you may find that what you consider to be peri-menopausal symptoms are much improved.
You may want to consider HRT. This can be an absolute godsend. In particular for those of us struggling with debilitating symptoms of hot sweats, cognitive issues and osteoporosis. However, hormone replacement is not the only option or factor in your overall health, and it may not optimise your health in the longer term. So if you still feel less than great if you are taking HRT, or you felt great to start with and have then noticed a dip, please do consider other areas of your health that need attention.
Should you decide to look at HRT, I recommend talking to a clinic or GP who can recommend body-identical hormones which are regulated. If you have a uterus then a combined HRT of a transdermal oestrogen and oral micronised progesterone are considered by many experts to have a better safety profile. Some women also benefit from testosterone. Older style HRT made from pregnant mares urine (Premarin) and old style progestogens are associated with higher health risks. I am not an expert or able to advise on HRT, but I am happy to point you in the direction of those that may help, so that you can make the best decision for you.
Bioidentical hormones are also an option, which are similar to body-identical. These are privately compounded and tailored to suit your individual hormone levels, based on functional hormone testing. Some women feel more comfortable looking at this option. It is essential to work with a reputable expert in this field as they are not as tightly regulated. They are also not available on the NHS. Research is also less widely available in this area.
As a Nutritional Therapist, my approach to supporting women going through hormonal changes is to use a functional medicine approach. This considers biochemical individuality. In my 1:1 consultations, I help you identify which factors in your diet, lifestyle and biochemical make-up could be impacting on hormone balance and contributing to your symptoms. We then work out a plan to address those factors.
Where appropriate I may recommend functional testing to gain further insight into what might be going on. Comprehensive blood testing can indicate underlying nutrient requirements, underlying health issues and hormone levels. DUTCH (Dried Urine Test for Comprehensive Hormones) not only helps us understand your actual hormone levels of sex and adrenal hormones, but gives further insight into how your body processes those hormones, which can help pinpoint why you’re experiencing symptoms.
In my clinic I offer a range of packages from single appointments to packages that offer extra support and cutting edge functional testing. Take a look at my Services and Prices Page for more information.