We have spoken often about estrogen dominance as a huge driver of immune system dysregulation and more specifically autoimmune disease. And, at the same time, a huge driver of how women get all kinds of cancer.
This can make estrogens seem like bad hormones to have. This is not the case at all. Yes, too much of a good thing is not good. But not enough of a good thing is not good either.
The estrogens normally in the human body are estradiol, estrone and estriol. These are the only estrogens that should ever be in our bodies. These are called “natural estrogens.”
Synthetic estrogen is not the same chemical structure of estrogen that a person is born with. Thus, we should not put them into our bodies. We should never use medicines that contain synthetic estrogen. These non-bioidentical, not like our own estrogen, estrogen-like estrogens would include medicines like Premarin. How did they get the name Premarin? It comes from Pregnant Mares (a female horse) Urine. Pre mar in.
Often times estrogen dominance is caused by progesterone levels dropping while estrogen levels stay good. This is a big driver of chronic disease. Such as when estrogen dominance is present in young women prior to menopause. This will increase their risk of getting breast cancer 5.4 times normal! While also increasing their chance of dying from cancer 10 times more than normal! Remember that cancer is an immune system dysfunction.
Estrogen dominance can also occur when someone has too little estrogens and progesterone at the same time. Progesterone is just relatively a lot lower than the low levels of estrogen.
So what’s the big deal when estrogen levels are too low? Well, estrogen has 400 different functions in the body. Let me list some of them.
Stimulates the production of choline acetyltransferase, an enzyme which prevents Alzheimer’s disease
Increases metabolic rate. Think losing weight more easily and improving lean body mass.
Improves insulin sensitivity. A direct connection between estrogen and insulin. Think preventing and reversing insulin resistance/pre-diabetes/metabolic syndrome/diabetes.
Regulates body temperature.
Helps prevent muscle damage.
Helps maintain muscle.
Improves sleep.
Reduces risk of cataracts.
Helps maintain the elasticity of arteries.
Dilates small blood vessels.
Inhibits platelet stickiness.
Decreases the accumulation of plaque on arteries.
Enhances magnesium uptake and utilization.
Maintains the amount of collagen in the skin. Think younger looking skin.
Decreases blood pressure.
Decreases LDL cholesterol. The “bad” cholesterol.
Helps maintain memory.
Increases reasoning and new ideas.
Helps with fine motor skills.
Increases the water content of skin and is responsible for its thickness and softness.
Enhances the production of nerve-growth factor. Think making new connections between brain cells and having healthier nerves in general.
Increases HDL cholesterol by 10-15%. The “good” cholesterol.
Reduces the overall risk of heart disease by 40-50%.
Acts as a natural calcium channel blocker to keep arteries open.
Enhances energy.
Improves mood.
Increases concentration.
Maintains bone density.
Helps prevent glaucoma.
Increases sexual interest.
Reduces homocysteine. High homocysteine has been associated with increased risk of heart attacks, stroke, cancer, mood issues, Alzheimer’s disease, osteoporosis, autoimmune disease etc…
Decreases wrinkles.
Protects against macular degeneration.
Decreases risk of colon cancer.
Helps prevent tooth loss.
Aids in the formation of neurotransmitters in the brain such as serotonin which decreases depression, irritability, anxiety, and pain sensitivity.
Now, you can see why it is so important to have the correct amount and the correct type of estrogen in a women’s body.
When using estrogens as a medicine, only topical estrogens should ever be used. Putting it on the skin, alternating between the inner thighs and the buttocks. Or, as a vaginal cream. It should never be taken by mouth. Even the commercially available estradiol capsule should never be used because it is taken by mouth.
Oral capsules of estradiol can cause so many problems and have been shown in study after study to not be as good as topical applications. Estrone should never be used. Estradiol can be used alone but much of the time a combination of estradiol and estriol is best.
This combination can be made by a compounding pharmacist at any ratio. Compounding pharmacies will actually custom make medicines for any patient. The most common ratios are 80/20 and 50/50 estriol/estradiol. This is commonly written by the prescribing doctor as BiEst 80/20 or BiEst 50/50. My favorite compounding pharmacy is one called Pharmacy Solutions out of Ann Arbor, Michigan. They can ship medicines to almost every state in the United States.
When using estrogen as a medicine, a women should always take progesterone as well. You never want to take estrogen without also taking progesterone. Estrogen will tend to irritate breast tissue while progesterone will protect breast tissue. You also don’t want to create estrogen dominance by only using estrogen. They also work together, hand in hand, to help with so many bodily functions. For example, progesterone helps to make good, new, strong bones while estrogen helps prevent excessive bone loss.
A women’s brain likes to have different amounts of estrogen some days compared with other days. In women who have gone through menopause already, estrogens could be used 6 out of every 7 days for example.
In future blog posts I will talk about the function of other hormones.
“Got a Revolution, got to Revolution.” Jefferson Airplane
Dr. David Bilstrom
Autoimmune Functional Medicine Doctor
