All of our sex hormones and cortisol, start from cholesterol. Yes, that cholesterol, which makes the traditional physicians jump, take out their prescription pads and scribble a cholesterol lowering drug and shove it towards the poor unsuspecting patient. For some patients, statin drugs are beneficial and vital, but these are the ones with heart disease, stroke, diabetes and some familial forms of illnesses which cause their cholesterol to go high, but for the vast majority of patients these drugs are unnecessary and in fact, can cause more harm than benefit. One of the damages is that by reducing the cholesterol too low, these drugs have an immense impact on the hormones which are derived from the parent compound, cholesterol. The majority of patients, both women, and men, start feeling tired and fatigued with decreased libido after starting these drugs because lowering cholesterol also lowers their sex hormones and cortisol levels.
This was just a brief FYI. Let’s talk about one of our hormones estrogen!!!
Some of the essential functions of estrogen are: Helps maintain muscle, dilates small arteries and improves blood flow, maintains the elasticity of the skin and decreases wrinkles, prevent the vaginal lining to become dry, increases production of serotonin in our brain and improves our mood, maintains the strength of our bones, increases sexual interest, increases concentration, improves our energy, helps support our memory, lowers blood pressure, helps with deep sleep, regulates body temperature, improves the good cholesterol and improves the sensitivity of our cells and tissues to insulin and regulates blood sugar levels.
In females, there are three types of Estrogens; they are E1 (Estrone), E2 (Estradiol), and E3( Estriol). E1 is the primary estrogen which the body makes postmenopausally. High levels of E1 can lead to breast and uterine cancer. E1 is the estrogen that is caused by the fat cells, so more obese a female is more E1 produced and higher the risk of breast or uterine cancer.
E2 is the most potent estrogen. It is 12 times stronger than E1 and 80 times stronger than E3. It is the primary estrogen that is produced before menopause. High levels of E2 are also associated with the risk of breast and uterine cancer. But E2 is the primary estrogen that has protective effects on the bone, skin, heart, and brain.
E3 has much less stimulating effects compared to E1 and E2; in fact, studies have shown that E3 protects against breast and uterine cancer. Asian and vegetarian women have higher levels of E3 and much lower rates of breast cancer. When E3 is given in a much higher amount compared to E2, in the form of compounded bioidentical hormone (Bi Est ), it balances the adverse effects of E2 while promoting its positive impact.
Excess estrogen concerning another sex hormone progesterone is called estrogen dominance, and this can have adverse effects on our body like fatigue, anxiety, fibroids, endometriosis, infertility, abnormal menstruation, PMS and even breast cancer. Causes of estrogen dominance include; impaired elimination of estrogen from our body mostly through our stool and some via urine, excessive fat tissue, lack of exercise, consuming food with estrogen ( hormone fed livestock) or taking birth control pills with just estrogen and no progesterone and diet low in fiber and grains.
New research is showing that it’s not just the total amount of estrogen in our body but how we metabolize our estrogen. Basically, when estrogen is broken down, it can either becomes 2-Hydroxyestrone or 16-Hydroxyestrone; I know these are difficult to pronounce, so let’s say kid number 2 and kid number 16. Kid 2 is a good kid; it does not cause cancer, while kid 16 is the bad one, which can increase the risk for disease. This kid 16 is associated with obesity, hypothyroidism, inflammation, high intake of saturated fats, and pesticide toxicity. But Little of kid 16 is desirable as it decreases the risk of osteoporosis. For health, we need more of kid two and less of kid 16. Things that can help favor kid 2 are moderate exercise, weight loss, cruciferous vegetables, flax, organic soy, omega three fatty acids, weight loss, spices like turmeric and rosemary, and some supplements like I3C/DIM, vitamin B6 B12, and Folate. More of kid two also decreases the risk for PMS, PCOS, and endometriosis.
The decision to do hormone replacement therapy needs to be made after weighing the risks against benefits. If the dangers of replacement are more than the benefits, then it is better not to go for hormone therapy and try to balance hormones through other routes. But if the decision is made about hormone replacement, then bioidentical hormones are the way to go. Being chemically similar in structure to our own natural hormones, bioidentical hormones fit the hormone receptors perfectly and have much less side effects. Usually, physicians who use bioidentical hormones, do so after hormone testing, so that they can accurately dose the hormones for that individual patient and not utilize the cookie-cutter same form and dose approach for all.
Hormone replacement therapy with estrogen should be transdermal ( through the skin) and not through the mouth. Because oral estrogen is then taken to the liver via blood after being absorbed from our gut and in the liver it is converted into some metabolites ( broken down products), and these products can have undesirable effects like; elevate blood pressure, make the blood thicker or sticky leading to blood clots with risk for heart attack and stroke, gallstone, decrease growth hormone, increase weight gain and increase risk for breast cancer. Also, estrogen should always be combined with progesterone to maintain proper balance and ratio and avoid risks and side effects.
On my next blog, I’ll discuss the other sex hormone Progesterone and how both bioidentical progesterone and BiEst (Estradiol and Estriol) are used to help menopausal/perimenopausal women and women with endometriosis and PCOS. Sometimes in women with severe PMS, hormone therapy can be useful too. We will dive a little deeper into which women would benefit from and for whom it is more riskier to have hormone replacement, and they should avoid it.
If you would like more info on hormones you can join our Facebook group on Bioidentical Hormones:
Where you can also take part in our Balancing your Hormones challenge where we will talk about our challenge at our upcoming event: Balancing your Hormones on December 3rd at District Drugs in Rock Island, IL. Please click on the link for the next event:
Sayed Shah, MD
Mandala Integrative Medicine