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Functional Integrative Medicine Practice of Dr. Nadia Ali
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7 Root causes of imbalanced estrogen and progesterone
Around 30-40% of the female population in the reproductive age experiences hormonal imbalance. Premenstrual Syndrome (PMS), menopausal symptoms, weight gain, fibroids, fibrocystic breasts, insomnia, endometriosis, polycystic ovaries, infertility, mood swings, and bloating are experienced by women with an abnormal hormone balance. These symptoms significantly reduce the quality of life on a daily basis and predispose women to serious complications such as breast cancer, high blood pressure, fatigue, memory loss and brain fog.
Hormonal imbalances can predispose us to the development of diseases such as cardiovascular disease (heart disease), reproductive cancers (such as breast and cervical), and even osteoporosis (brittle bones). Additionally, imbalances predispose us to weight gain, dementia (memory loss), anxiety, and depression. Balancing our hormones optimizes the ability of our body to function as well as prevent complications associated with excess or deficiency of essential hormones.
The links between cancer and hormonal imbalances cannot be overlooked. Oral contraceptive use has been directly linked to breast and cervical cancer. Endometriosis has been linked to endometrial cancer. Fibroids are linked to uterine cancer. More importantly, a study found that “women with moderate PMS pain had a 30% increased risk of ovarian cancer, while women with severe menstrual pain had 51% increased risk.”
What causes Hormonal Imbalance?
An interesting study on ethnic minorities in America found that exposure to American culture predisposes these women to increased prevalence of hormonal imbalance. There are 7 key factors that directly impact the balance of estrogen and progesterone.
Dysbiosis simply means imbalanced gut bacteria. Digestive tract plays a very important role in the metabolism of estrogen hormone. Gut bacteria can produce toxins such as beta glucuronidase which may inhibit the excretion of estrogen leading to symptoms of hormonal imbalance.Similarly peritoneal fluid in the pelvic cavity can directly transport inflammatory cytokines from the gut to the reproductive organs. A study showed direct correlation between abnormal gut bacteria and Polycystic Ovary Disease (PCOS).
2. Adrenal imbalance
Altered level of Cortisol has been found in women experiencing PMS and other hormonal imbalance related symptoms. Increased production of Cortisol directly inhibits the production of Progesterone, a phenomenon known as Pregnenolone Steal Syndrome. In addition, it can cause an increase in production of estrogen. Both of these can lead to hormonal imbalance.
Xenoestrogens are chemicals in our environment which we use on a daily basis, such as soaps, cosmetics, shampoos, etc. that mimic estrogen like effect in the body. Compounds such as pesticides and fertilizers also act as Xenoestrogens and are consumed through fruits, vegetables and meat. These compounds are also termed endocrine disruptors because they have the ability to significantly alter our hormonal balance. Unfortunately, the body does not have the capacity to metabolize xenoestrogens leading to their accumulation in our tissues and persistent activity over time. Exposure to synthetic hormones such as oral contraceptive pills can also produce hormonal imbalance.
Our nutritional status determines if our reproductive organs can function effectively. Food can contribute to inflammation and can also be a source for healing inflammation. It provides the basic material that we need to make hormones, enzymes as well as chemical messengers that help our organs and cells communicate with each other. An example is Omega 3 fatty acids which have been known to improve fertility in men and women by structurally improving the reproductive organs and functionally through increase in reproductive hormones.
Infections such as mold, Candida, and sexually transmitted diseases such as Human Papilloma Virus (HPV) play an important role in causing hormonal imbalance. These diseases can cause persistent inflammation of the reproductive organs and can also contribute to infertility. They are a source of low level systemic inflammation and may increase Cortisol hormone production and disrupt thyroid hormone balance. All of these factors can disrupt the estrogen, progesterone and testosterone balance.
6. Stress and lack of sleep
Our lifestyle plays a very important role in keeping our hormones balanced. The degree of stress on our system, the amount of sleep that we get, the time we allocate to physical activity and self care have an independent impact on inflammation, Cortisol and thyroid gland and thus have direct implications for Estrogen and Progesterone.
7. Thyroid hormones
Thyroid gland releases thyroid hormones that impact every cell and system of the body including the reproductive organs as well as production of reproductive hormones; estrogen, progesterone, testosterone and prolactin. An imbalanced thyroid gland with excess or deficient thyroid hormone leads to hormonal imbalance and severe symptoms at multiple levels.
A Functional approach to Hormonal Balance
A functional approach requires that each of the above areas are assessed in women experiencing symptoms of hormonal imbalance. These factors need to be addressed appropriately in order to relieve symptoms but also to prevent serious complications. Any and every symptom that we experience is simply our body’s cry for help and it is much easier to help the body when issues are beginning to unfold than to address them when severe damage is already done.
A DM, K S, A D, Sattar K. Epidemiology of Premenstrual Syndrome (PMS)-A Systematic Review and Meta-Analysis Study [published correction appears in J Clin Diagn Res. 2015 Jul;9(7):ZZ05]. J Clin Diagn Res. 2014;8(2):106–109. doi:10.7860/JCDR/2014/8024.4021
Pilver CE, Kasl S, Desai R, Levy BR. Exposure to American culture is associated with premenstrual dysphoric disorder among ethnic minority women. J Affect Disord. 2011;130(1-2):334–341. doi:10.1016/j.jad.2010.10.013
Liu R, Zhang C, Shi Y, et al. Dysbiosis of Gut Microbiota Associated with Clinical Parameters in Polycystic Ovary Syndrome. Front Microbiol. 2017;8:324. Published 2017 Feb 28. doi:10.3389/fmicb.2017.00324
Lulu Hou, Yamei Huang & Renlai Zhou (2019) Premenstrual syndrome is associated with altered cortisol awakening response, Stress, 22:6, 640-646, DOI: 10.1080/10253890.2019.1608943
Minerva Ginecologica 2014 August;66(4):365-75. Premenstrual syndrome and beyond: lifestyle, nutrition, and personal facts. Bianco V. 1, Cestari A. M. 2, Casati D. 1, Cipriani S. 3, Radici G. 4, Valente I
Alvergne A, Vlajic Wheeler M, Högqvist Tabor V. Do sexually transmitted infections exacerbate negative premenstrual symptoms? Insights from digital health. Evol Med Public Health. 2018;2018(1):138–150. Published 2018 Jul 3. doi:10.1093/emph/eoy018