Oestrogen Dominance in Menopause

Oestrogen Dominance in menopause? Is this even possible, I hear you say! 

Most women, understandably, believe that if they have low oestrogen, they couldn’t possibly have Oestrogen Dominance. After all, it seems like a contradiction that you could be oestrogen dominant while your oestrogen levels are declining or are already low…

YOU CAN HAVE LOW OESTROGEN LEVELS BUT STILL HAVE OESTROGEN DOMINANCE

So what’s happening? It's not simply an excess of oestrogen, as is commonly seen in the early stages of Perimenopause, but rather issues with the hormone ratios and metabolism of oestrogen.

There Are Two Main Causes of Oestrogen Dominance in Menopause

1) The Ratio of Oestrogen to Progesterone is Off

This occurs when there is insufficient progesterone to balance out the aggressive estradiol, even if both oestrogen and progesterone levels are low - as occurs in peri- and menopause.

Once we reach the age of 40, the levels of progesterone in our body start to decrease rapidly. Even though oestrogen levels can remain high and fluctuate, the decline in progesterone is much faster than that of oestrogen, causing an imbalance between these two hormones. This hormonal imbalance leads to a condition called "Oestrogen Dominance." Even during menopause, the levels of progesterone in our body are much lower than those of oestrogen. This happens because oestrogen can still be synthesised by the aromatase enzyme, which converts androgens into oestrogen in the adrenal glands and fat tissues.

Oestrogen and progesterone work as “balanced partners.” They both play a role in fertility, beauty, mood, and overall health and vitality. However, progesterone is really there to oppose oestrogen. 

Oestrogen tends to have a more aggressive effect on the body, and progesterone is there to calm it. But both hormones work to keep the body in balance. 

When progesterone drops faster than oestrogen, it creates an imbalance, resulting in oestrogen dominance, which has been linked to oestrogen-related cancers.

2) There’s an Issue with Breaking Down Oestrogen into Clean and ‘Dirty’ Oestrogens

The liver's Phase 1 detoxification process involves breaking down estradiol and oestrone into smaller fragments, which is the first step in eliminating metabolised or "dirty" oestrogen. Three different pathways are available for breaking down oestrogen:

  •       2-hydroxyestrone (2-OH): a “good” or often called protective pathway and oestrogen that does not stimulate cell growth and can block the action of stronger, potentially cancer-causing oestrogens.

  •       4-hydroxyestrone (4-OH): potentially harmful, with increased oestrogenic activity. A “dirty” oestrogen. This is the pathway I genetically favour!

  •       16-alpha-hydroxyestrone (16-OH): potentially harmful and often called the proliferative pathway, associated with an increased risk of fibroids, endometriosis, cysts, migraines and even potentially breast cancer. A “dirty” oestrogen.

We need to increase the production of 2-OH while minimising the production of 4-OH and 16-OH. If the liver is unable to break down oestrogens efficiently, it generates excessive amounts of "dirty" oestrogens leading to oestrogen dominance. Hence, maintaining a healthy liver is crucial in managing oestrogen

As we grow older, our liver tends to become less efficient than it was in our younger years. Another crucial organ to consider is the gut, particularly if you're experiencing issues with oestrogen metabolism. The "estrobolome," a group of oestrogen-metabolising bacteria, plays a critical role in maintaining balanced hormone levels. If these bacteria are damaged, whether due to antibiotic use, toxins, or other factors, they may no longer be able to effectively break down oestrogen, resulting in Oestrogen Dominance.

Conclusion

Going through peri- and menopause doesn’t exclude women from having Oestrogen Dominance.

The GOOD NEWS is that Oestrogen Dominance is highly reversible and manageable. It’s just a matter of getting started. You can read all about the Oestrogen type in my Book Eat Right, Lose Weight. You can also book a Dutch Test to look at your actual hormone levels and oestrogen metabolism pathways and also consider booking our Hormones DNA test.

Health, Hormone, Oestrogen, ProgesteronePippa Campbell