There are three main pathways by which the body metabolizes estrogen. These pathways are the 2-H estrogens, the 4-H estrogens, and the 16-H estrogens. The 4-H and 16-H estrogens are believed to the more carcinogenic. The 2-H estrogens are believed to be ANTIcarcinogenic. Recently in the Journal of the American Medical Association, it was reported that estrogen replacement therapy (ERT) increases the exposure of the highly estrogenic 4- and 16- hydroxylated estrogens. Also, ERT increases breast density, making early detection by mammography difficult.

How to Promote Healthy Estrogen

Isoflavones (often referred to as phytoestrogens) from soybeans are considered adaptogens for managing estrogen balance. In other words, they help increase estrogen in individuals with a low-estrogen imbalance and they decrease estrogen in those with a high-estrogen imbalance. The soy isoflavones genistein and daidzein are the most studied estrogen-modulating compounds from plants.^2-4 Isoflavones from red clover and the Kudzu vine have also been shown to have estrogen activity-modulating effects. In addition to soy, red clover, and the Kudzu vine; chasteberry (Vitex agnus-castus L.), black cohosh (cimicifuga racemosa), and essential fatty acids (such as flax and fish oil), have been demonstrated historically to have hormone activity-modulating effects.

Another way to promote the “friendly” 2-H pathway by lowering the more carcinogenic 16-H pathway is administration of the phytonutrient indole-3-carbinol (I3C).^7-8 Now found in capsule form this nutrient is derived from the cruciferous family of vegetables, mostly notably broccoli and to a lesser degree Brussels’ sprouts, cauliflower, and cabbage. Another important and common finding that warrants consideration for perimenopause is low levels of progesterone. This is especially important because, among other reactions in the body, low progesterone is related to a short luteal phase (the part of the menstrual cycle when ovulation occurs) and a short luteal phase is associated with increased bone loss.

Hormones and Bone Density

This is a very important situation to consider because bone mineral density studies are usually not ordered until after menopause but the average age of perimenopause is 47 and bone mineral loss begins at around the age of 40—10 or 15 years before it is usually even tested for. And as with many situations in the body, the earlier an imbalance is detected the better the prognosis. As I indicated in a previous article osteoporosis is the number one bone condition in the United States. Eight million women have osteoporosis, over a million with fractures, many of which were potentially preventable. There are over 70,000 deaths related to preventable hip fractures and over 50,000 requiring long term care.⁹

Control your Sugar

Another important aspect to recognize is that hyperinsulinemia (high levels of insulin in the blood) influences estrogen synthesis and overall hormone balance or imbalance. A number of nutritional, diet, and lifestyle interventions can improve insulin sensitivity and reduce symptoms associated with these hormone imbalances in women. The dietary program needs to include low glycemic index foods, such as most fruits, berries, nuts, a variety of vegetables, whole grains (not refined grains), fish, eggs, soy products, lean turkey, and lamb.

Know your Thyroid and Vitamin D Levels

Thyroid function is another important area that appears to change in the perimenopausal period. Many of the common symptoms of perimenopause may be attributed to thyroid dysfunction such as weight gain, depression, anxiety, fatigue, cold intolerance, loss of libido, and abnormal menses.

As part of the perimenopausal evaluation, I would, therefore, recommend a comprehensive thyroid panel. If hypothyroidism is evident, I may suggest the following: elimination of dietary sources of gluten-containing grains such as wheat, and casein-containing products from dairy, such as milk, cheese, etc. These potential food antigens could induce antibodies that cross-react with the thyroid gland.

The thyroid gland is very dependent upon sufficient levels of vitamin D. Vitamin D is a powerful hormone- and immune-modulator. Vitamin D is also essential for proper bone density, among many other benefits for the body. In short, get your vitamin D tested. Other nutritional supplements may be beneficial for a thyroid imbalance, give us a call and we can help you with that.

Stress and Adrenal Cortisol

One major underlying issue to consider is that a stress hormone called cortisol plays a major factor in disrupting the orchestrated symphony of the body that is the endocrine hormonal system. Among other lifestyle factors exercise has been proven time and again to have direct positive benefits on stress and on the hormone imbalances related to menopause. Recent studies indicate that moderate physical exercise in menstruating women increases 2-hydroxyestrogen formation.

In another study, the frequency of moderate and severe hot flashes was investigated in postmenopausal women who took part in physical exercise on a regular basis and was compared to that in a control group. The study clearly demonstrated that regular physical exercise (average of 3.5 hours per week) decreased the frequency and severity of hot flashes.

Some other benefits include decreased blood cholesterol levels, decreased bone loss, decreased fat storage, improved ability to deal with stress, improved circulation, improved heart function, increased endurance and energy, increased self-esteem and mood, reduced blood pressure, and relief from hot flashes.

In summary, treatment for symptoms associated with perimenopause needs to be centered around balancing estrogen, raising progesterone levels, controlling insulin and blood sugar, and correcting thyroid imbalances.

In addition to previously mentioned nutrients, I would consider standardized botanical medicines. Black cohosh (Cimicifuga racemosa) helps to reduce hot flashes. Chasteberry (Vitex agnus-castus) used for symptoms of perimenopause. Dong Quai (Angelica sinensis) and licorice (Glycyrrhiza glabra) have also been shown to decrease symptoms associated with perimenopause and menopause. Also consider gamma oryzanol for hot flashes and soy protein isoflavones. Certain individuals may benefit from natural micronized progesterone augmentation. To really understand what your body needs, the best thing you could do is take the guess work out and get tested.

Laboratory Recommendations:

Female hormone Panel (FHP™)
Details: The Female Hormone Panel™ (FHP™) is a non-invasive test consisting of 11 saliva specimens collected during specified time periods throughout the menstrual cycle. The ovaries are a major component of the female reproductive cycle and they release hormones in a cyclical manner which is referred to as the menstrual cycle. The Female Hormone Panel™ provides a dynamic mapping of the free fraction levels of Estradiol (E2) and Progesterone (P) throughout one cycle. In addition, the cycle average of Testosterone (T) and DHEA are measured.

Includes: Estradiol (x11), Progesterone (x11), cycle average Testosterone and DHEA/DHEA-S, 3 Progesterone production indices, 4 Estradiol production indices, a full cycle P/E ratio graph and an example of a restorative plan. The expanded Female Hormone Panel™ (eFHP™) includes an additional five (5) FSH and five (5) LH measurements.

Post Menopause Panel (PostM™)
Details: Menopause is a natural and usually gradual change in glandular function in women resulting in substantial shifts in hormone levels. The Postmenopause Panel™ provides measurements of six key hormones.

Includes: measurements of six key hormones: Estrone (E1), Estradiol (E2), Estriol (E3), Progesterone (P), Testosterone (T) and DHEA, DHEA-S (pooled).

8-Hormone Panel (8-HP™)
Details: Similar to the Adrenal Stress Index, the 8HP includes Cortisol (X4) and DHEA, but it also includes the reproductive hormones: Estradiol, Progesterone, and Testosterone.

Includes: Cortisol (x4), DHEA/DHEA-S, Estradiol, Progesterone, Testosterone

You also may want to consider a basic blood panel that includes Glucose and a Thyroid Panel. Check out Pure Chem Basic™.

Female hormone Panel (FHP™)
Details: The Female Hormone Panel™ (FHP™) is a non-invasive test consisting of 11 saliva specimens collected during specified time periods throughout the menstrual cycle. The ovaries are a major component of the female reproductive cycle and they release hormones in a cyclical manner which is referred to as the menstrual cycle. The Female Hormone Panel™ provides a dynamic mapping of the free fraction levels of Estradiol (E2) and Progesterone (P) throughout one cycle. In addition, the cycle average of Testosterone (T) and DHEA are measured.

Includes: Estradiol (x11), Progesterone (x11), cycle average Testosterone and DHEA/DHEA-S, 3 Progesterone production indices, 4 Estradiol production indices, a full cycle P/E ratio graph and an example of a restorative plan. The expanded Female Hormone Panel™ (eFHP™) includes an additional five (5) FSH and five (5) LH measurements.

The dietary supplements below may be very helpful: 

• Vitamin D
• NewGreens (antioxidant superfood)
• Women’s  Pure Pack
• Breast Health Complete
• Chaste Tree (Vitex)
• EstroFactors
• Black Cohosh 2.5

Dietary Recommendations: 

• Eat soy products in moderation (tofu, tempeh, edamame, etc.)
• Eat more organic vegetables, eggs, onions, nuts and seeds, cruciferous vegetables (broccoli, cauliflower, cabbage, and Brussels’ sprouts), and buckwheat.
• Eliminate all forms of coffee and start drinking green tea.
• Replace refined flour products with sprouted grain breads.
• Eat more legumes and fish, skin-less chicken, and lamb over beef. Only eat organic and hormone-free.
• Eat more meals at home.

Lifestyle Recommendations: 

• Spend quality time in prayer or meditation every day, connecting with your inner spirit.
• Take a yoga class twice a week.
• Have a massage once a month.
• Take up some form of art that allows for creative expression.
• Practice breathing exercises.
• Get in the sun for about 20 minutes each day.
• If you say you do not have time for these recommendations, sacrifice something else, don’t sacrifice your health. We live in bodies where all the systems are very interrelated in a web-like balance of interactions. We cannot just listen to one instrument when addressing the human body but rather have to respect and consider the entire symphony. As usual, I would recommend a consultation for an individualized, comprehensive assessment.

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References

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7. Rev Endocr Metab Disord. 2001; 2 (1): 45-64.
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11. Acta Obstet Gynecol Scand. 69 (1990): 409-12.
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13. JAMA. 2001;285(11):1489-1499.

 This post was syndicated from Pure Prescriptions.