Estradiol (E2) - Premenopause (luteal)

Why do Estrogen levels increase?

- Overweight/obesity

- Peri-menopause = surges of estrogen

- Diabetes

- PCOS

- Estrogen supplementation

- Steroid medications

- Poor liver clearance so estrogens build up

- Dysbiosis/Estrobolome problems

- Over aromatization from testosterone

- Environmental estrogens (difficult to test however)

- Alcohol (2 or more glasses/day shown to increase estrogen)

- Ovarian cysts

- Having elevated testosterone levels – testosterone gets converted to estrogen through the aromatase enzyme. Therefore, having Polycystic Ovarian Syndrome (PCOS), over supplementing with testosterone or DHEA or generally having a high production of this hormone, can lead to more estrogen being produced as a byproduct.

In men – over aromatization from testosterone to estrogen due to inflammation and blood sugar/insulin issues, environmental/xenoestrogen exposure (this does not show up on DUTCH testing, but they can cause symptoms), moderate alcohol use, and obesity

Common symptoms of elevated estrogen:

- In women – mood swings, weight gain, breast tenderness, fibrocystic breasts, heavy menses, fibroid/polyp development.

- In men – breast development, weight gain, and mood swings.

Common ways to lower estrogen:

Please consult with your health care provider about advice/treatment/diagnosis. The following statements are general informational statements.

- In women - address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber (especially ground flax seeds), increased detoxification support, and weight loss

- In men – address the cause, avoid alcohol, avoid environmental/xenoestrogens, DIM/I3C supplementation, calcium-d-glucurate, increased fiber, decrease blood sugar and insulin, increased detoxification support, weight loss, and things that block aromatase (Chrysin, Damiana, Zinc and pharmaceutical aromatase inhibitors)

Other general interventions to keep in mind that can be beneficial for everyone if you don’t know the status of your hormones includes:

- Avoiding xenoestrogen exposure. Here is a great link to the top endocrine disruptors to avoid your environment [L]:

- Eat more cruciferous vegetables from the Brassica family- broccoli, kale, Brussels sprouts, cauliflower, cabbage, kale, etc.  

- Support your liver on-goingly – from the basic lemon water to increasing consumption of dandelion or dandelion tea, doing a liver cleanse twice a year and reducing consumption of sugar and alcohol.

- Make sure your bowels are going – lots of fluids and high fiber in your diet will help regulate your bowel movements and make sure your hormones are properly detoxified rather than sitting in your body and recirculating back in the system.

Why does estrogen decrease?

- Age (peri-menopause and menopause)

- Irregular cycles/skipped cycles/anovulation

- Hysterectomy with ovaries removed

- Anorexia

- Low cholesterol (backbone to hormones)

- Extreme exercise or training

- Extreme stress resulting in skipped menses

- Under appropriate body weight percentage for height/age (Mixed research: suggested <15% body fat = amenorrhea)

- Hypogonadism (ovaries fail)

- Hypopituitarism (pituitary not communicating)

- Decreased blood flow to the ovaries (Ex. Surgery or smokers)

- Breast feeding

- Hypothyroidism

- PCOS

- Fertility medications

- Opioid pain medications (in last 6 months)

- Hormonal birth control – pill, patch, ring, implant, injection

Common symptoms of low estrogen:

- In women - fatigue, depression, hot flashes, night sweats, vaginal dryness, pain with intercourse, low libido, joint pain, brain fog, migraines/headaches, fertility issues, dry skin

- In men - not generally considered symptomatic, but in very extreme cases men may have similar symptoms as in the list above for women

Common ways to raise estrogen:

In women - address the cause, phytoestrogens such as Red Clover, Dong Quai, Kudzu, soy, diosgenin, genistein, fennel, and Black Cohosh (although studies are mixed on whether it acts as a phytoestrogen or not), Maca, and bioidentical estrogen replacement

The most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving absorption or increasing estradiol.