Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: jasper on September 07, 2016, 10:29:17 AM
-
Naturopaths/alternative medicine etc all talk about estrogen dominance as the big evil. In the mainstream, estrogen seen as good and progesterone a necessary evil (most of the time)? I am confused as to whether estrogen dominance (which you would probably have on hrt if using minimum necessary progesterone) exists? What am I missing here? thanks
-
It's not so much a question of whether oestrogen is good and progesterone is bad, it's that an imbalance between the two causes unpleasant symptoms. Most women become oestrogen dominant in peri, as progesterone is the first hormone to fall. The relative dominance of oestrogen to progesterone gives us heavy bleeding, a short cycle, fibroids etc - and are seen as signs of oestrogen dominance, but could equally be considered progesterone deficiency. Our peri and menopausal symptoms are caused by an imbalance between the two, and falling oestrogen overall. Oestrogen falls more slowly than progesterone throughout peri, stopping periods when it falls below a certain point, and then slowly coming into balance with progesterone again - albeit at much lower levels - at the end of the menopausal period. That's the theory anyway! I think naturopaths and alternative medicine get worried about estrogen dominance because it can also be caused by xenoestrogens from plastic and environmental toxins.
-
thanks Imega - this is what I had always understood but the impression I get from reading Studd etc and most posts here is that a lot of the time progesterone makes those in peri/menopause feel bad and the idea is too take the minimum to ensure a bleed, rather than because the 2 hormones need to stay in balance?
-
I've often wondered this about oestrogen dominance/progesterone deficiency and have been told it's non existent but here's my theory:
I have been on oestrogen only hrt since I was 32 after my hysterectomy (ovaries started failing shortly after op)(I'm now nearly 50)
All those years from age 32 to 45 on oestrogen only hrt I was fine and I presume I was still producing progesterone and testosterone throughout those years as well as ovulating myself intermittently
Age 45 I started feeling poorly and tests showed peri with dropping progesterone levels and docs said nothing they can do, oestrogen levels were always good so I asked could I have progesterone to balance out as 'something' was causing these symptoms, no they said because I have no uterus although women who had hysterectomy because of endometriosis should have progesterone as there could be bits of uterus left
I kept asking maybe my body craves the levels back up but no answers were given
I bought utrogestan myself and tried it, I think I actually felt better on it, I took it orally and had no problems, and I felt calmer. I was called to new nurse to review my hrt and I told her about the utrogestan , OMG she went mad, you'd think I'd been snorting cocaine in back alleys by her reaction, she said I must stop immediately and she thinks I'm taking too much oestrogen and it's probably my testosterone being low that is causing my symptoms
By the way, I did suggest many times that if its not progesterone deficiency could they look into testosterone deficiency but no one would, so I tried balancing the oestrogen/progesterone myself
I'm being tested for testosterone next Wednesday
Annie x
-
GPs are loathe to go the testosterone route with women in case we require it ::)
…….. by xenoestrogens from plastic and environmental toxins …….. - discuss?
-
Menomale what hormones are you taking in hrt ?
Annie x
-
You can see my medicine regime just below my posts:
50, 8 months last period, newbie on HRT, Estradiol 1mg, Estriol 2.5mg, Progesterone 50mg (bioidentical) daily transdermal cream, DHEA 25 mg pill 3x/week, Utrogestan 100mg vag. Perimeno at 44 y/o. Hot flushes, depression, anxiety, migraine. Blood tests: hormones all postmeno. Suppl. Vit B12 and D3.
Also I have a thread named "First HRT experience: full description" http://www.menopausematters.co.uk/forum/index.php/topic,32988.msg527992.html#msg527992
I'm sorry I'm such a dope at times, I didn't notice !
So you're not on testosterone ? Does DHEA convert to testosterone?
I'm interested to see what my T levels are as I have every symptom and anxiety is one of them!
11 days is still early, many on here say it can take up to 3 months, hang in there
Ps- your doc is thorough with the tests !
Annie x
-
I'm afraid I'm very cynical about why naturopaths, and the like, talk about estrogen dominance. Basically proper estrogen (as opposed to phytoestrogens) is prescription only, so therefore they can't sell it to you. However, progesterone creams are very easily obtainable, and can even be bought over the counter, and these alternative practitioners make most of their money out of selling you stuff.
This fad for "estrogen dominance" has seen a lot of women suffering from progesterone toxicity because they self medicate, and think if a little makes you feel good then a lot must make you feel great. Big mistake.
It is possible for estrogen to be dominant to progesterone during peri, while all our hormones are in chaos, but estrogen itself would also be declining. If menopause was caused by estrogen dominance, as its "inventor" Dr Lee claims, then basically we wouldn't be menopausal.
-
Good luck Menomale , I really hope it works for you xx
-
This is EXACTLY the question I have been trying to find the answer to myself! Jasper, thank you from bringing this up.
I have been on a 25 mcg patch and 100mg Utrogestan (vaginally for 14 days of the month) I only started HRT on 26th July.
Things were going okay, until last Thursday when I started my Utrogestan. All of a sudden I couldn't fall asleep or stay asleep. I had my FSH, estradiol and progesterone levels tested on day 21 of my cycle.
Given my symptoms, I was expecting progesterone dominance to be the problem. I've searched high and low for what exactly is the 'optimum' ratio between progesterone and estrogen. I only found one website that discussed it in detail and the consensus was that the P/E2 Ration should be 100-500.
My ratio was only 77 so that theory went out the window. If this ratio is to be believed, most of us on here are pretty much stuffed aren't we??
I've read both of Doctor Elizabeth Vliet's books from cover to cover and while she discussed ratios, she didn't actually provide an optimal figure. What I DID glean from her book though, was that while my estradiol blood levels were 'acceptable' (IE: Above 100 pg/ml), they were probably not optimal. I upped my patch to 37.5 and in the last couple of nights my sleep has improved.
I'm afraid I'm very cynical about why naturopaths, and the like, talk about estrogen dominance. Basically proper estrogen (as opposed to phytoestrogens) are prescription only, so therefore they can't sell them to you. However, progesterone creams are very easily obtainable, and can even be bought over the counter, and these alternative practitioners make most of their money by selling you stuff.
Dana, I think you're right. I think that maybe this 'magical P/E2' ratio figure is probably touted by the progesterone-cream pushers. At least that is what by body is telling me.
-
Annie0710 - I remember Suzanne Somers saying in her book that she had had a hysterectomy and was not given progesterone initially as its seen not to be needed. She felt much better when she went on it as she believes all women need it. Perhaps you'll find some more on which symptoms it helped her with if you Google it.
It makes sense as surely we need all our hormones, including testosterone.
-
Oh Dangermouse !
I actually felt better on it and had no side effects from using it orally but my surgery won't even discuss it saying it's only useful for one thing during meno and nothing else
Yet some of these women on the hysterectomy forum are being prescribed it for their emotional wellbeing
Annie x
-
Just thought I'd add to the prog yes/no debate. I'm not sure about oestrogen dominance theory and know that it's been poo-pooed by a lot of eminent medics who know better and state that it was a marketing tool used by Dr Lee to sell his cream (which I also know nothing about) but....... I've recently started using utro 100 v route nightly as well as considerably upping my E patch and I have to say, so far, I feel great. No fluid retention/less disrupted sleep/night sweats and joints starting to ease off. Now, this could be extra E doing the work but I know that on this level of E, I'd be up like a balloon with water. It's early days but I'm watching closely. Perhaps, as Hurdity says, we all need to find our 'sweet spot' - hope to god I've found mine - it's been a journey!!
Good luck everyone.
Dxx
-
Oh Dawncam hopefully you'll carry on feeling great
I think the prog slightly lowers your oestrogen so that also could be why the balance is good for you
Annie X
-
Hi Dawncam
I think the difference is that you are using both estrogen and progesterone. Those who support the estrogen dominance theory just want women using progesterone creams, which subsequently puts everything out of whack and can lead to some nasty side effects. Dr Lee's theories gets no support from experts in the field.
-
thanks everyone for your thoughts here - the experiences of post menopausal women doing better with some progesterone certainly raises some questions. I know the estrogen dominance theory was originally about adding in progesterone only but I am still wondering if the reason I am having so many side effects from the patch is due to needing more progesterone (I am in not yet in full peri yet so need it anyway but was trying estrogen first alone and am still having regular periods on it). I am exasperated as better initially (migraines) on patch and then when I raised dose but the effect doesn't last.
-
I think one has to remember what 'dominance' means :-\. Because certain hormones drop off or rise doesn't mean there's a dominance …….
-
Well this question often raises its head. Not sure what all the talk is about optimum ratios - I can't believe any site seriously asks us to consider this. I mean during our periods for example - we start off as "oestrogen dominant" and the ratio of O to P peaks at mid cycle when we are feeling at our best usually - ie when we are the most "oestrogen dominant". The progesterone begins to rise, oestrogen crashes, and then rises again as progesterone also rises. About at week 21 progesterone is at its peak and oestrogen is low - I suppose we are then relatively "progesterone dominant" until they both fall to a low level at the start of the bleed - presumably neither is then "dominant" according to the theory. The last week of the cycle and the first few days of the new cycle are the times when most women feel at their worst so nothing to do with oestrogen dominance!
The point I'm trying to make is 1) that the ratio changes all the time and 2) women usually feel at their best in the phase of their cycle when they are "oestrogen dominant".
There is a lot of nonsense put out on the web about all of this - and yes in an attempt to get women to buy the dreaded progesterone cream!
In post-menopause progesterone levels are similar to those in the follicular phase ( first half) of the menstrual cycle. Naturally if women start to have anovulatory cycles - additional progesterone is not produced - but there is always the background prog needed for physiological functions still being produced - just not in the large amounts needed to maintain a pregnancy.
"Balancing" hormones is complex because the endocrine system is also very complex and involves a lot of different hormones and feedback mechanisms. Adding oestrogen back through HRT is the easiest (and generally effective) way of restoring our deficient hormone - but can't hope to replicate the natural process.
There is no need (as far as I know) for to balance oestrogen with progesterone except to protect the uterus lining. In pharmaceutical quantities progestogens do exert other effects - mostly negative, but some women find the sedative effects calming. I don't think this has anything to do with balancing oestrogen though - it just acts as a depressant and dampens down emotions etc? Testosterone though is a different matter - and from what I understand the balance between O and T is more crucial to our well-being and what makes us female.
Dawncam - the "sweet spot" I (and others) refer to - is getting the right level of oestrogen.
Btw I have read nothing about ratios so the above is based only on my (limited) knowledge of the menstrual cycle. If anyone can point me to some academic study of this ( not a US site that's selling stuff!) I would be interested :)
Hurdity x
-
In perimenopause an unusual situation can arise as levels of progesterone have been gradually falling over many years and oestrogen can be at its highest level in a woman's life, due to the surges.
For me right now I feel better in the 2nd half of my cycle so I guess they could call this an oestrogen-dominant phase. Oestrogen does not make me feel good right now unless I use it to override my cycle and dampen my own too high levels.
Post meno is a whole different story though as both oestrogen and progesterone are low.
Oh and just to add that I think the 'dominance' language comes from the pill, as my 30 year old book on the pill puts different pills in the category of oestrogen or progesterone dominant. It has a mathematical formula where you would times the progesterone by the set strength of it (Norethisterine would have one figure and Levonorgestrel would have another etc.) and then you'd apply that to the oestrogen amount to find out which was which. It worked, as an endocrinologist told me I had to have an oestrogen dominant pill (she used that wording too) and it made me feel the complete opposite of the prog dominant pills which had been making me feel bad at the time.
-
Since being on patch, I am feeling better in 2nd half of my cycle too and pretty awful in first half. Isn't first half more estrogen dominant and 2nd half more progesterone dominant, rather than the other way round?
-
Yes jasper - that's correct! Oestrogen dominance mainly during first half of cycle not second half (although I don't like to use the term!). I should really have said women feel at their best during the first part of their cycle usually when the bleed has finished. When the bleed starts, apart from the period pains etc, oestrogen is at its lowest and starts to rise - by about Day 5 it should have risen to a decent level to feel better. I know that I used to feel the oestrogen rising at some point after my period started - I used to feel terribly tense with pms, headache, irritability etc - usual thing - which continued for a few days - and suddenly it would be like a cloud lifting. Unfortunately for women who do not like progesterone this good feeling is short-lived because progesterone is at its peak by about Day 21 when oestrogen is low, about a week before the period.
Hurdity x
-
That's interesting, I never suffered pmt etc, I only knew my period was due by dates
But My sex drive was always at its highest before and during a period, I used to think I was abnormal as it's usually a no no during period time with women
Annie X
-
I had dreadful PMT in my 30s :-\ :'(. As well as a higher sex drive pre-bleed. So that's 2 of us so completely normal then ;)
-
thanks Hurdity - so what is confusing me is that I feel best in 2nd half of my cycle and pretty awful from day 1-12!! This is making no sense to me :-(