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Estrogen

diagram of the chemical structure of estrogen
The Structure of Estrogen

What is Estrogen?

Estrogen, also spelled oestrogen, is one of the two main female hormones, although men make this hormone too.  It is produced mainly by ovarian follicles in women. It comes from the testes in men. But, body fat, liver, adrenal, breast, and nervous system tissues also make it.  There are actually many forms of the hormone.  Estradiol is the main form.  Other forms include estrone and estriol. The estradiol form of the hormone is 12 times as potent as estrone, 80 times as potent as estriol.

What Does Estrogen Do?

The function of this hormone is that it stimulates the development of secondary sex characteristics in women.  Secondary sex characteristics are visible changes that happen to both men and women at puberty.  Examples of these include the growth of pubic hair, enlargement of the breasts, and widening of the hips in females.

Estrogen also:

  • promotes the growth of the uterine lining and the muscular layer of the uterus
  • maintains the health of the skin and bones, and
  • helps protect the brain and the nervous system
  • increases oxytocin.  Oxytocin is a feel-good hormone that is involved in attachment to others.  It is an antioxidant, has anti-inflammatory effects and moderates your nervous system.

In men, estradiol moderates libido and helps with erectile function and sperm production.

What are the Signs of Low Estrogen Levels?

Signs of low levels in women include:

Signs of low levels in males may include:

  • low bone density
  • low libido
  • erectile dysfunction and
  • an increase in abdominal fat.

What are the Signs of High Estrogen Levels?

Signs of excess in women may include:

Signs of high estrogen in men include:

  • prostate problems
  • benign prostatic hypertrophy/BPH
  • heart disease
  • breast enlargement
  • low libido
  • low muscle mass and
  • depression.

When Should I Measure Estrogen Levels?

Estrogen levels vary throughout a woman’s menstrual cycle.  At the clinic, I typically do a blood test for it at two points of a woman’s cycle: either on the third day of her period or in the middle of her cycle.  The reasoning behind this is that day 3 is when egg follicles begin to mature and release estradiol.  Measuring it on day 3 ensures that this process is on track.  Midcycle measurements assess the level at or around ovulation.  This is the peak level.

What is a Normal Estrogen Level?

Here are the normal ranges for estrogen according to the lab and also the range for where I would ideally like it to be:

Lab Range for day 3 in women: 60 – 824 pmol/L

Estimated Ideal Range for day 3 in women: 150-200 pmol/L

Estimated Ideal Range for midcycle: 1000-1500 pmol/L

Lab Range for estrogen in men: <200 pmol/L

Estimated Ideal Range in men: 129-142 pmol/L

Why is there a difference between the ideal ranges and the lab range?

Lab ranges are just averages of the population that the lab measures.  They are not necessarily a reflection of what is ideal for a particular hormone.  Also, the lab range for women encompasses the entire follicular phase, which is day 1 of your period to ovulation. My ideal level is specifically for day 3 or mid-cycle.

What Causes Low Estrogen?

There are multiple possibilities as to why this hormone might be low.  To begin to answer this, we need to know a little bit about how it is produced.

How Do You Make Estrogen?

The immediate building block to making estrogen is testosterone.  So an obvious reason for low levels would be low testosterone.  Then we have to determine what causes low testosterone.  Half of your testosterone is produced in your ovaries.  The other half comes from your adrenal glands or stress glands. This means that if testosterone is low, there is a 50% chance that it is because your adrenal glands are not producing their share.  There are a number of means of supporting healthy adrenal gland function so that they better support the ovaries in making estrogen.

How Does Your Thyroid Affect Estrogen?

Another reason for low estrogen can be that your thyroid is underactive.  The entire hormone-producing system (the endocrine system) works together.  If your thyroid is underactive, everything in your body can run just a bit slower than it should.  Supporting healthy thyroid function can help if this is the cause.

How Do the Other Hormones Affect Estrogen?

A third reason for it to be low is that there may be an excess of another hormone that is suppressing its production.  For example, high levels of prolactin can suppress the ovaries.  In this case, we need to investigate which hormone may be causing the suppression and address the cause of that.

What Causes High Estrogen?

There are two main factors that will drive higher than normal levels of estrogen:

Insulin

The enzyme that makes it, aromatase, works faster when there are higher levels of insulin in your blood. What causes higher levels of insulin is a higher intake of high glycemic index starches and sugars.  So, in order to correct this, we look to reduce the intake of these foods.

Liver detoxification

It’s your liver’s job to remove estrogen.  It does this through a series of steps known as phase I and phase II liver detoxification.  These steps are dependent on a number of co-factors for them to work normally.  These include pyridoxal-5-phosphate, vitamin B12, methyltetrahydrofolate (5-MTHF), magnesium, indole-3-carbinol, and calcium-d-glucarate.

Eating more leafy greens and vegetables like kale and broccoli supplies these. Otherwise, they can be taken in supplement form to assist efficient liver detoxification of hormones.

Healthy estrogen levels are vital for both men and women.  If the levels are either low or high, there are natural medicine strategies to restore healthy hormone balance.

How to Fix Estrogen Deficiency

How to fix the problem depends on why it’s low.  Factors that can cause low estrogen include:

Adrenal gland insufficiency or HPA axis dysfunction

Supporting the adrenal glands involves replenishing vital vitamins and minerals like vitamin C, B5, B6, magnesium, and zinc.  Adaptogenic herbs like Schisandra, Rhodiola, Ashwagandha, and Reishi also help.

Hypothyroidism

Your thyroid may be low due to nutritional deficiency or a condition known as Hashimoto’s thyroiditis.   Depending on the cause, the solution may be to support your thyroid with nutrients like copper, zinc, selenium iodine, and tyrosine.  A word of caution, too much iodine can cause problems.  Avoid supplementing unless you are under the supervision of a naturopathic doctor. Research suggests that Hashimoto’s may be due to latent infection.  In which case, supporting healthy immune system function helps.

Menopause

Post-menopause women do still produce a certain amount of estrogen.  Maintaining healthy testosterone levels through weight training and adrenal gland support can ensure optimal levels after menopause.

Excessive androgens

If levels of male hormones or androgens are too high, they can suppress ovulation, thereby suppressing estrogen production.  In this case, the solution is to reduce the androgen excess.  We do this through diet, stress reduction, exercise, and natural remedies like inositol, black cumin seed, saw palmetto, and nettle root.

High prolactin

There are five typical reasons why prolactin can be too high:

  • excess estrogen
  • pregnancy
  • breastfeeding
  • stress and
  • a prolactinoma or prolactin-secreting tumour of the pituitary gland.

Stress is one of the more common factors.  In women who are NOT pregnant or breastfeeding, vitamin B6 and an herb called Chastetree can help reduce prolactin levels.  This allows healthy ovulation and estrogen production.

Low body fat

If your body fat or caloric intake drops excessively low, your body will temporarily turn off your reproductive organs.  Your body perceives this situation as potential starvation and will conserve energy.  It will redirect it to the most vital organs like your heart and lungs to keep you alive.  Maintaining healthy body weight and avoiding overly restrictive diets can help maintain healthy estrogen levels.

High Estrogen Foods

Plants contain their own form of estrogen, also known as a phytoestrogen.  There are considerable concerns and controversy about consuming these plant-based hormones.  Should you consume soy?  Will soy make fibroids worse? The answer to all of these questions is that there is no research to support the idea that soy causes any kind of problems related to hormones.

Plant forms of estrogen are very weak.  They are thought to be about a thousand times weaker than your own.  Other foods high in phytoestrogens include flaxseeds, licorice root, oats, barley, sesame seeds, and yams.

For help with estrogen or any other health problem, book an appointment here or call the office for more information at 416-481-0222.

by Dr. Pamela Frank, BSc(Hons), ND

Estrogen Research

Randolph JF Jr, Kipersztok S, Ayers JW, Ansbacher R, Peegel H, Menon  The effect of insulin on aromatase activity in isolated human endometrial glands and stroma. Am J Obstet Gynecol. 1987 Dec;157(6):1534-9.

Picture of Toronto Naturopath Doctor Dr. Pamela Frank, Best Naturopath in Toronto many times over
Dr. Pamela Frank, BSc(Hons), Naturopathic Doctor

Dr. Pamela has practiced as a naturopathic doctor in Toronto since 1999. She has received numerous “Best Naturopath in Toronto” awards. She is registered with the College of Naturopaths of Ontario.

Dr. Pamela Frank uses a natural treatment approach that may include acupuncture, herbal medicine, nutrition, diet, vitamins, supplements, and other natural remedies to restore balance and provide long-term resolution to almost any health problem.

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