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clear search termsOur Estrogen Emergency
There’s a disturbing trend in the field of health: men are getting breast reduction surgery like never before. No, I’m not joking – or making light of the problem. In fact, male breast reduction has grown more than 2000% in the past five years. You may see this in your clients. What’s behind this growing need? It’s hormones. When we eat too much sugar or flour (sometimes, even if its whole-grain flour), we over-produce insulin, a hormone that in excess will block our production of sex hormones like testosterone, making a man look more like a woman. But there’s a bigger reason that’s even more disturbing: it’s estrogen.
Normally, our bodies make just the right amount of hormones for our wellness. In women, estrogen is more prevalent. Men produce a little estrogen too but make predominantly testosterone. The problem is that the female hormone estrogen is increasingly prevalent in our food and in our environments. And it’s changing the balance of hormones in men, giving them larger breasts, smaller muscles, larger bellies, lower sex drive, and prostate problems. In women, higher estrogen makes for more troublesome PMS, increased depression, higher body fat, and a higher risk of breast cancer. In children, excessive hormones encourage premature sexual development. In everyone, excessive estrogen increases the risk of cancer, heart attack, and stroke. Do a thorough job of understanding your clients’ symptoms, so you can suggest where hormones might be part of their challenge. I recommend using a helpful symptoms checklist as part of your health history and revisit forms.
An external flood of estrogen makes your body reduce or stop producing hormones internally. In women, this is problematic because the body will not only stop making estrogen but will also stop making progesterone. I see many clients who are low in progesterone, what I call the Calm-and-Relaxed hormone, and these women typically struggle with depression, anxiety, low energy, and fatigue. In the ten years or so prior to menopause, this is a particularly key issue because women’s progesterone production drops off dramatically several years before estrogen production begins to drop. Thus, many women begin to suffer with progesterone/estrogen imbalance – or estrogen dominance – in those critical years before menopause. Relatively high estrogen is exacerbated by our overall increased body fat (which might be high even in someone of normal weight) because fat cells produce estrogen all on their own. Low-dose progesterone cream is available over-the-counter and is quite safe for women to use in low (dilute) doses to help with hormone imbalance. Women can monitor their hormones levels via hormone testing (saliva is more accurate than blood but both are useful) and is most helpful to evaluate on Day 22 of a woman’s cycle, where Day 1 is the first day of menstrual bleeding).
So besides body fat, where are we getting all this estrogen? First of all, from our food. Today’s modern “factory farmers” use hormones and other drugs and chemicals to accelerate weight gain in animals and increase profitability. This practice includes chickens, cows, pigs, and even fish farmers. Hormones also keep dairy cows lactating on a constant basis, including while they are pregnant. When we consume these foods, we absorb the hormones. You can avoid this source by always choosing “hormone-free” animal products, ideally also organic and free-range to avoid exposure to other chemicals in animal feed and drugs. Some of your hormone-sensitive clients may benefit from a month-long trial of avoiding all dairy foods which, by definition, are hormone-laden.
We are also absorbing large amounts of “estrogen mimickers” from our environment. These are chemicals that look enough like real estrogen to fool our bodies into making hormonal changes (medically this is called an endocrine disruptor). Bisphenol-A (or BPA) is a potent estrogen mimicker found in some plastic food wraps, plastic cups and containers labeled #7 in the little recycling triangle, and most food can linings (yes, even organic brands!). Ask your client about these types of products. Help them to choose a stainless steel water-bottle or a glass-lined model and filter their home water. Have them look for canned foods brands certified as BPA-free on the label (e.g. Eden organic foods). If they use other canned foods, make sure they rinse the contents thoroughly before use, choose foods in glass or paper cartons instead, or (even better) choose whole, fresh foods. Another major source of BPA is on cash register receipts which can be easily avoided by asking a cashier ahead of time for no receipt where possible.
Another common culprit of hormone disruption is a chemical called triclosan. It’s found in antibacterial soaps, tooth¬paste, mouthwash, deodorants, and first-aid creams. Make sure you encourage your client to read labels to find out what they are putting into their body. Soap and water remain our best weapons against the spread of infection. Explain to your clients: skin is our largest organ and a powerful absorption site that sends ingredients straight to our blood stream. In general, don’t put anything on your skin that you wouldn’t want to eat.
Another major estrogenic chemical category includes pesticides and gardening chemicals. Encourage your clients to practice natural, organic gardening. In particular, help them to understand the impact of putting a regular flood of chemicals on their lawn or flowers (e.g. Chemlawn). Even if they don’t sit on the grass, the chemicals are carried indoors on kids, pets, shoe soles, and even the wind. And it goes without speaking that it’s best to encourage them to eat as much organic food as they can find and afford (or those certified as pesticide-free). Some produce retains more chemicals than others, so use research data to help your clients spend their organic food dollars wisely. The Environmental Working Group publishes an annuallly-updated list of the types of produce with the greatest pesticide retention after harvest, given then-common agricultural practices.
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Hello! I have a client wanting to see me to discuss her estrogen dominance. She recently saw a GYN specialist who told her that the only way to manage this is to take Prozac monthly but only during the week of her menstrual cycle. I’ve heard other women being advised the same type of treatment, but with Zoloft. Why would this be?
Unfortunately, many of the practitioners in our SAFM Family notice the same thing. It is a well-intentioned attempt to boost serotonin levels to calm the nervous system that sadly misses the opportunity to address the true root cause of the challenges. This treatment often does bring rapid relief of symptoms and it also quickly becomes a ‘bandaid’ with long-term use consequences, as withdrawal symptoms are quite severe and wean off of the SSRIs (Prozac and Zoloft belong to this class of medications) requires medical assistance. Thus, it is a treatment choice that should come with a thorough explanation of what it is doing and how does it affect the body long term.
HI Tracey,
I am wondering if you can post (or point to where I can find) good studies and research on estrogen dominance. I want to talk with some colleagues about this, but they are more likely to be receptive to the idea if there is research to back it up. When I search on UpToDate and PubMed, nothing comes up, Wikipedia has a poor description unfortunately too. I know through this program and other functional medicine practitioners that it is definitely occurring and is important, but has there been research done? I even tried researching xenoestrogens with not much success. Perhaps I am not researching the correct terms. Thanks for your help,
Ah, great question! We’re not there yet, but I believe the next decade will produce what you seek. Alas, I think a big part of your challenge is that published clinical research tends to (1) focus on diagnosable disease states vs. upstream systemic imbalance states that lead to dysfunction which can eventually result – downstream – in a very rich variety of disease states and (2) is more likely to focus on a single driver dynamic e.g. http://ehp.niehs.nih.gov/1306648/ or https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074428/ vs. the collective impact of many/diverse dynamics contributing to an end state. To use a more general analogy, you can find myriad studies explaining how/why water is polluted by very specific agents, but you will be hard pressed to find one that simply concludes overall “and this creates a Toxic State in the water”. It took decades of similar dynamics before insulin resistance became acknowledged as an upstream root cause of Type 2 diabetes. There are also many possible contributors to estrogen dominance, and the collection that affects a given individual is unique. Depending on your genetics, nutrition, environment, and history, you and I may have very different responses to the same single stimulus. The same is true of food,… Read more »
Hi, if someone had breast cancer (estrogen-receptor positive) and are on Tamoxifen but the estrogen levels are still very high, what can they eat/ do to make sure the cancer does not come back? Thanks
Tamoxifen is a drug that is metabolized in the liver by cytochrome P450 to yield active metabolites that have the ability to block the estrogen receptors. Therefore the drug doesn’t affect the estrogen levels but the ability of estrogen to bind its receptors. It is important to support healthy hormone detox by diminishing the sources of external estrogens (xenoestrogens) from our foods and personal hygiene products. This post will be helpful:
https://schoolafm.com/ws_qa/estrogen-dominance-and-congested-liver/ as well as this review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939980/
Hello SAFM, are there any markers in conventional labs that indicate estrogen dominance?
Indeed, there are not! The concept of estrogen dominance (ED) is a perfect example of the importance (when viewing health issues through a functional medicine lens) of the need to consider all data and all aspects of a person’s lifestyle. One might have ED because of xenoestrogen influence (which is not measurable at all given the huge variety of molecular profiles that can have this effect), because of insufficient progesterone, or because of poor clearance of endogenous estrogens or estrogen metabolites. More targeted functional testing – such as a DUTCH test kit – can give you insight into *some* of these dynamics, but even then, we have to rely on symptoms and experience as additional puzzle pieces to get a full picture view. With conventional blood levels of hormones, the ONLY thing you are getting feedback on in aggregate endogenous production of hormones; that data doesn’t even give you insight into Total vs. Free levels of estrogens and progesterone…much less those hormone metabolites or clearance. In the same way that over half of people in the hospital having had a heart attack have optimal or even low/low-normal cholesterol (which shocks many), there are plenty of individuals who have had hormone-mediated… Read more »
I have a client that has freckling on the neck that is a band around her neck. It continues to get worse and is darker than her normal skin color. She has gone to specialists and no one can figure it out. She currently covers it with tattoo cover up make up and is so embarrassed by it. Could this be a product of estrogen dominance?
I think you may be speaking of acanthosis nigricans: https://www.medicinenet.com/image-collection/acanthosis_nigricans_picture/picture.htm . Sometimes it presents as a very dark grey/brown shading and other times more of a spotty “freckling”. And indeed, it is associated with a variety of hormonal imbalances including autoimmune dynamics such as cushing’s disease (AI disorder characterized by very high cortisol). But more commonly, it is an outgrowth specifically of insulin resistance (where insulin is high). A toxic effect is created by excess hormone binding that promotes tissue dysfunction. This may interest you: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144206/ .
I know that in many homes, especially in the south, they use water pipes that are made of PVC. Is this exposure contributing to estrogen dominance? Would you consider PVC an endocrine disruptor? If so, is there any way to filter these chemicals out of the water?
Indeed, I am particularly passionate about water filtration. A great place to start is an under-the-sink filter in the kitchen and an in-line filter for the shower. Look for a four-stage R/O system that certifies removal of both chlorine and fluoride. This level of filtration will also take care of known endocrine disruptors as well (such as BPA and phthalates – common additives to PVC). Whether the PVC in question contains various contaminants depends on the year it was built and the brand of the material. Because water is a key foundation for help, I am passionate about filtration regardless. More effort is involved in this one, but you could also consider something like a Berkey filter e.g. https://theberkey.com/pages/test-result .
I made a recommendation to a client with Enlarged Prostate to take Metagenics EstroFactors and his response was – that’s for menopausal women. I’m not taking medication for menopause… I have explained this supplement is to support the removal of too much estrogen. Any suggestions on getting around the male perspective of women have estrogen and men have testosterone and never the two shall meet…???
Sure! I would actually encourage him to read this article. If you had hormone data in hand (e.g. DUTCH), the data might strongly influence him; I have seen this happen many times where the numbers speak in ways that I simply cannot. The data would also clarify how much of his BPH is due to estrogen overload vs. high levels of DHT vs. rock-bottom progesterone. But we also have to meet clients where they are. In this case, given a focus on this particular symptom, I would use Gaia’s Prostate Health formula (he’ll LOVE that name!): http://www.gaiaherbs.com/products/detail/59/Prostate-Health . And also a good B-complex (e.g. Thorne Basic B) and 40-60mg zinc daily in divided doses (e.g. picolinate) and make sure his magnesium is optimal. And then teach him about high-insulin-producing diets (e.g. refined carbohydrates, sugar, beer) promote a man’s conversion of testosterone to estrogen. Powerful knowledge!
Two of my daughters, ages 17 and 23, perspire excessively, especially when working out. We eat a very healthy diet. Are they too young for this to be caused by estrogen dominance?
Unfortunately, they are NOT too young for estrogen dominance! Keep in mind that perspiration is normal – a primary way in which the body cools itself and providing detoxification too. But yes, if it’s excessive, that may be a warning sign. Their having strong PMS symptoms and perhaps heavy or lengthy menstrual flows or breast tenderness would also be of note and some confirmation. Alas young people can be more vulnerable to this imbalance given their frequent use of conventional personal hygiene products which are often loaded with xenoestrogens. Even with a healthy diet, this external hormonal load can have negative effects. Keep in mind that conventionally raised beef, dairy products, and non-organic foods can also be contributors too. I recommend educating them about the importance of choosing natural, low-chemical personal hygiene products, not drinking beverages from cans (BPA in the lining is a xenoestrogen), and eating cruciferous vegetables daily. Seemingly simple choices can make a big difference!