Dysmenorrhea, the medical term which describes painful menstrual cramps, is extremely prevalent in North America. It is almost unusual for a woman’s menstrual cycle to be perfectly healthy – free from menstrual cramps, PMS, clotted blood, a heavy flow, and arriving on time approximately every four weeks.
Certain underlying factors will predispose one to experience a less-than-ideal monthly flow, such as a diet high in sugar, carbohydrates and poor-quality oils, a lack of exercise, excessive stress, drinking caffeine and a history of pelvic inflammatory disease.
One of the most common causes of female menstrual complaints is an imbalance in estrogen and progesterone termed estrogen dominance. Compared to progesterone, estrogen is relatively dominant, meaning that estrogen can be too high or too low, but progesterone is always too low in proportion to estrogen. Menopausal complaints frequently arise from estrogen dominance as well. The balance between these two hormones matters more than the amount of each.
I have listed some of the more common symptoms of estrogen dominance below:
- Breast tenderness, enlargement and/or fibrocystic breasts
- Anxiety, irritability, agitation and anger
- Mood swings, depression, emotional/weepy
- Acne, especially hormonal acne that worsens on a cyclical basis
- Cramps, heavy bleeding, prolonged bleeding and blood clots
- Water retention, bloating and weight gain
- Fat gain, especially in the abdominal, hip, and thigh areas
- Menstrual conditions: endometriosis, fibroids, ovarian cysts, irregular periods, Pap smear abnormalities
- Libido issues: decreased, increased or fluctuating sex drive
- Cancers of the breast, uterus, cervix and ovaries
- Insulin resistance and blood sugar swings/crashes
- Cravings for carbohydrates like bread, pasta, sweet foods and chocolate
- Headaches and migraines
The relationship between estrogen and progesterone can be opposing or complimentary. For example, while estrogen promotes insomnia and agitation, progesterone promotes a deep sleep and a sense of calm. Another example is that estrogen can act on bone to decrease bone break down and progesterone compliments that action by helping to build up bone.
The adrenal glands are also involved in a proper estrogen-to-progesterone balance. These hormonal glands, which sit upon your kidneys, produce cortisol and adrenaline among other hormones to allow your body to deal with stresses effectively. These stresses can be mental or psychological in nature or can come from within the body: overgrowth of pathogenic bacteria, yeast, or parasites, blood sugar swings, toxins, food allergies and sensitivities, alcohol, caffeine, medications, viruses, etc. To put it bluntly, the adrenal glands endure a lot of ‘wear and tear’ over the course of a lifetime and will impact your reproductive hormones, namely the estrogen and progesterone balance. As stress levels increase and the demand for cortisol in the body rises, the adrenal glands will “steal” progesterone to synthesize cortisol which contributes to low progesterone. When one takes steps to correct adrenal hypofunction, it helps to correct the estrogen dominance.
Besides adrenal fatigue and stress, other common causes of estrogen dominance are:
- Xenoestrogen exposure
- Being overweight or obese (adipose, or fat cells, produce extra estrogen)
- Using hormone replacement therapy
- Not ovulating every month (this can be due to an anovulatory cycle or due to hormonal contraception which halts ovulation)
- Consumption of trans-fats and higher carbohydrate intake
- Nutritional deficiencies such as magnesium and B vitamins
- Having a luteal phase defect (less progesterone is produced in the second half of the cycle)
Having higher levels of estrogen in the body can mask symptoms of low thyroid function by creating the appearance of higher thyroid hormone levels on blood tests. Hypothyroidism is a very commonly missed disorder which affects virtually every system in our body by slowing cellular metabolism.
Obviously estrogen dominance needs to be corrected, so how do we do that?
My top five suggestions for rebalancing the ratio of estrogen and progesterone:
- Detoxify. This includes a colon and liver cleanse. The liver is the main organ responsible for metabolizing hormones and we want to ensure it’s doing its job well! Your naturopathic doctor will have recommendations for a healthy detoxification program.
- Clean up your environment! Avoid exogenous sources of estrogen by choosing organic produce, dairy and meats. Drink filtered water to reduce chlorine consumption and consider a filter on your shower. Eliminate hormonal contraceptives and hormone replacement therapy (or switch to bio-identical hormone replacement therapy if your salivary test results show deficiencies). Move away from purchasing foods in plastics (or microwaving plastics & plastic wrap!) and tin cans; instead buy glass-jar products and store refrigerated left-overs in glass or ceramic containers. Commit to purchasing household cleaners that are environmentally friendly with no harsh chemicals, and ensure topical creams and moisturizers contain nothing but natural ingredients that you can recognize.
- Cruciferous vegetables. These contain active ingredients that work to help the body eliminate excess estrogens. Consider eating them daily in raw, steamed or stir-fried forms.
- Chastetree. This is an herb which acts at the level of the anterior pituitary to help normalize hormones and is particularly good at raising progesterone levels. Alternatively, if the estrogen dominance is extremely severe, progesterone cream can be attained from a compounding pharmacy with a prescription. By starting with a very low dose and working up to the optimal level the estrogen-to-progesterone ratio can be normalized faster.
- Diet & lifestyle must not be overstated! Walk, jog, hike, bike, swim, chuck balls… do whatever you have to do to get your heart rate pumping for 30 minutes, most days of the week. Ideally, you’d have some fun doing so! If you find yourself constantly struggling with stress, seek out therapies to help such as yoga, meditation, relaxation CDs, nature walks, gardening, hiring a life coach, or joining a choir.
Hormone balance is key to a happy, healthy life!