diagram of the chemical structure of estrogen

What is Estrogen?

Estrogen, also spelt oestrogen, is one of the two main female hormones, along with progesterone, although men make this hormone too.  It is produced mainly by ovarian follicles in women and testes in men but is also made in fat, liver, adrenal, breast and nervous system tissues.  There are actually many forms of the hormone.  Estradiol is the main form.  Other forms include estrone and estriol.

What Does Estrogen Do?

The function of estrogen 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.  In males, secondary sex characteristics include the growth of facial hair and development of an Adam’s apple. It 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.

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

In addition, estradiol increases oxytocin production and expression of oxytocin receptors in the brain.  Oxytocin is a hormone that facilitates childbirth, lactation, regulates maternal behaviour, social attachment, affiliation, and trust. It is an antioxidant, has anti-inflammatory effects and moderates the nervous system.

The estradiol form of the hormone is 12 times as potent as estrone, 80 times as potent as estriol.

What are the Signs of Low Estrogen Levels?

Signs of low levels in women may include vaginal dryness, urinary tract infections/UTI’s, irregular periods, hot flashes, headaches or migraines, irritability, mood swings, depression and cognitive decline.

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 heavy periods, acne, clots in the menstrual flow, breast tenderness, depression, highly emotional, endometriosis, PMS, migraines and uterine fibroids.

Signs of high estrogen in men may include prostate cancer, benign prostatic hypertrophy/BPH, heart disease, gynecomastia, low libido, low muscle mass and depression.

What are Normal Estrogen Levels?

Estrogen levels vary throughout a woman’s menstrual cycle, so the answer to this depends on where the woman is at in her cycle.  At the clinic, I would typically want to do an estrogen test 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 should be beginning to mature and release estradiol.  Measuring it on day 3 helps to ensure that this process is on track.  Midcycle measurements are used to assess the level at or around ovulation.  This is the peak 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 has measured.   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, where my ideal level is specifically for day 3 or mid-cycle.

What Causes Low Estrogen or Estrogen Deficiency?

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.  The immediate building block to make estrogen is testosterone.  So an obvious reason for low estrogen would be low testosterone.  Then we have to determine what causes low testosterone.  Half of your testosterone is produced in the ovaries, the other half comes from your adrenal glands or stress glands. Which 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.

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.    A third reason for it to be low is that there may be an excess of another hormone that is suppressing estrogen 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:

  1. Insulin.  The enzyme that makes estrogen, 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 reducing the intake of these foods.
  2. 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 function normally.  These include pyridoxal-5-phosphate, vitamin B12, methyltetrahydrofolate (5-MTHF), magnesium, indole-3-carbinol and calcium-d-glucarate.  Eating more leafy greens and cruciferous vegetables can help supply these, otherwise, they can be taken in supplemental form to assist efficient liver detoxification of estrogen.

Healthy estrogen levels are vital for both men and women.  If the levels are either low or high, there are strategies using natural therapies to lower high estrogen in males and females and restore healthy hormone balance.

How to Fix Low Estrogen or Estrogen Deficiency

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

  1. Adrenal gland insufficiency – 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 may also help.
  2. Hypothyroidism – the 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 the 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 is suggesting that Hashimoto’s may be due to a latent infection, in which case supporting healthy immune system function may help.
  3. 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.
  4. Excessive androgens – if levels of male hormones or androgens are sufficiently high, they can suppress ovulation, thereby suppressing estrogen production.  In this case, the solution is to reduce the androgen excess through diet, stress reduction, exercise and natural remedies like inositol, black cumin seed, saw palmetto and nettle root.
  5. High prolactin – there are five typical reasons why prolactin can be elevated: excess estrogen, pregnancy, breastfeeding, stress and a prolactinoma or prolactin-secreting tumour of the pituitary gland.  Stress is the more common factor.  In women who are NOT pregnant or breastfeeding, vitamin B6 and an herb called Chastetree can help reduce prolactin levels to allow healthy ovulation and estrogen production.
  6. Low body fat – If your body fat or caloric intake drops excessively low, your body will temporarily turn off the reproductive organs.  The body perceives this situation as potential starvation and will conserve energy and redirect it to the most vital organs like the heart and lungs and away from the reproductive organs.  Maintaining a 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 phytoestrogen.  There is considerable concern and controversy over consuming these plant-based hormones.  Should you consume soy? Does soy cause cancer? 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, thought to be about a thousand times weaker than your own. Any of the research on soy and hormone-related cancers like breast cancer has found that soy may have a protective effect.  That is, high intake of soy is associated with lower incidence of breast cancer.  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.