Estrogen dominance is the condition that “causes” most female hormonal imbalances and resultant symptoms. I use quotation marks around the word “causes” because there is obviously a cause to the estrogen dominance. Estrogen dominance has many causes and a whole book can be written about it.
The symptoms related to estrogen dominance are vast and can vary among individuals. Some symptoms include (but are not limited to): breast tenderness, low libido, depression, mood swings, anxiety, weight gain, fibrocystic breasts, headaches, infertility, irregular menstrual cycles, insomnia, hot flashes, uterine pain (possibly fibroids), digestive disturbances, bloating and water retention, cancer, etc.. Because there can be so many systems affected (e.g.: adrenal, thyroid, digestive, etc.) there can be even more symptoms.
In this article I’m going to explain two ways intestinal dysbiosis (or gastrointestinal microbial imbalances) can contribute to estrogen dominance.
Estrogen is ultimately detoxified in the liver through the phase II detox pathway called glucuronidation. During this process, estrogen molecules are bound to glucuronic acid. This process enables the estrogen to be inactivated and thus not cause an impact on physiology. After this process occurs in the liver, the newly formed complex is transported to the GI tract via bile (the route for many toxins to be disposed of). In an ideal world/body, the complex gets flushed down the toilet per se. However, when intestinal microbial imbalances exist (e.g.: an overgrowth or infestation of harmful bacteria, viruses, protozoa, and/or fungus), an increase in the activity of the enzyme beta-glucuronidase can occur. This enzyme is known to uncouple, or disconnect estrogen from glucuronic acid. The result is that estrogen can now be reabsorbed back into circulation and increase the total estrogen load of the body; and contribute to (or cause) estrogen dominance.
Another reason intestinal imbalances can contribute to estrogen dominance is in the way estrogen gets metabolized. The first phase of estrogen detoxification by the liver is known as hydroxylation. During this process, an “-OH” group is added to one of the carbon atoms on estrogen. When it’s added to the “2-carbon”, the end-product is known as 2-OH (or 2-hydroxy) estrogen. If the -OH group is added to the “4-carbon”, 4-OH estrogen is yielded, and when added to the “16-carbon”, 16-OH estrogen follows.
2-OH estrogen has a weak estrogenic effect. Meaning, 2-OH estrogen won’t contribute much to the harmful, proliferative [or harmful tissue-growing (as in cancer growth) effects] of estrogen. On the other hand, 4-OH and 16-OH estrogen will in fact contribute to the deleterious effects of estrogen. Intestinal microbial imbalances favor the production of (mostly) 16-OH estrogen and 4-OH estrogen, and away from the benign 2-OH estrogen. As a result, the classic symptoms and diseases of excess estrogens can occur.
Take home message: a healthy GI tract is much more important than simply avoiding GI symptoms. Additionally, simply treating symptoms of estrogen dominance and hormone imbalances with bio-identical hormones may not be the way to go!
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology
Thank you for explaining the Estrogen pathways!
I just found out I am estrogen dominant and will be starting progesterone cream soon. But I also have a history of intestinal dysbiosis. I have modified my diet and taken probiotics and appropriate supplements for years to correct this. But dysbiosis is never COMPLETELY corrected once you have it. So my question is……..is there a supplement to help the liver detox xenoestrogens or any other techniques to over come estrogen dominance in the midst of a history of dysbiosis. Thank you Dr. D’Aquila!
Hi Ginger,
I disagree that you cannot completely correct dysbiosis. It may take more than diet changes and probiotics, but it’s still totally possible. I see it happen all the time with patients.
As far as supplements, I like taurine, methyl donors, I-3-C, milk thistle, glutathione, and calcium D-glucarate. I would, however, start with clearing up the dysbiosis.
Good luck,
Dr. Rob D’Aquila
So, if Bio-identiual hormones may NOT be the way to go….what is?
thanks for the explanation,
DIxie
Hi Dixie,
For proper endocrine balance, it’s necessary to have a healthy digestive tract, healthy blood sugar levels, a healthy immune system, adequate protein, avoidance or tolerance of stress, avoiding food sensitivities, and getting rid of any infections that may be present.
Good luck,
Dr. Rob D’Aquila
Dr. Rob,
Coat-tailing on the above exchange, as it parallels to mine in many ways. When you refer to “”getting rid of any infections” are you referring to microbial infections? For example, I have b. homonis, aremonas, h. pylori. But, am very afraid to go on antibiotics for these, having had a history of UTI infections and feeling a correlation between my dysbiosis and use of AB therapy. In fact my recent episode was triggered (i my perception) by a dose of Monurel for an infection in August. And I am a mess now with digestion. Put myself on GAPS diet, take loads of high quality probiotics, eat fermented foods, take HCL and digestive enzymes with meals and also taking Monolaurin 3 months now.
So i guess the question is do you advocate antibiotics to eliminate these infects, then healing with diet and probiotics and supplement? Or? Really struggling using antibiotics once again, feels like a vicious cycle. However, after 3 months I agree with ginger, it never feels like it ever really goes away. There are good days and bad days at best.
Thank you.
Melanie
Hi Melanie,
Yes, those are the infections I’m referring to. Monolaurin is a great product that I use in my practice, though it is generally intended for viral infections, not bacterial like H. Pylori.
I cannot and do not tell patients to take antibiotics because my license as a DC doesn’t allow me to legally. However, if a patient simply cannot get rid of an infection using natural methods – I suggest a referral to an MD to just take care of it once and for all – and then rebuild the system afterwards. You are right, antibiotics can be very tough on the system and throw things off, but sometimes I find that that’s the only thing that will work…and I’m not alone…
Good luck,
Dr. Rob D’Aquila