Surviving the Estrogen rollercoaster & hacks for taming estrogen excess.

In this episode I discuss:

- What is estrogen?
- High estrogen or estrogen dominance? The signs of too much estrogen.
- What causes estrogen dominance?
- The importance of testing estrogen levels during perimenopause.
- Basic treatment ideas for estrogen
- 5 steps to naturally reduce excess estrogen

Enjoy!

In best health,
Dr Kirstey Holland

The information shared in this podcast does not substitute working with your primary health care provider; it is general in nature and not considered personalised advice.

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Transcript

Dr Kirstey Holland: 0:05

thank you so much for being here Surviving the estrogen roller coaster and perimenopause hacks for taming estrogen excess. What is estrogen, high estrogen or estrogen dominance and the signs of too much estrogen can include. Now, remember, perimenopause and menopause are not the same and I treat perimenopausal as well as menopausal women in my clinic. But I'm here to tell you that in perimenopause, the hormone that goes missing first is progesterone. So please be very mindful about the information that you see online on the I Web on Instagram. About the fact that perimenopausal women need oestrogen-absolutely you may. But I have a firm belief in testing rather than guessing. And as you know by now, I absolutely love the Dutch test and that is what's coming up next for you beautiful ladies inside the repair program we're going to move into Rebalance. But it is also a little word of warning with regards to all of the information that you see out there on the internet about oestrogen. Remember that oestrogen also has the capacity to move into the tissue. It's imperative to test estrogen in both urine metabolite as well as a blood test so that you get a full three dimensional picture of how much estrogen you have in your system. What causes estrogen dominance, and remember, again, estrogen dominance only relative to progesterone. The first part of the menstrual cycle, we're in a natural estrogen dominance, but in the second part of the cycle, we need progesterone to be dominant. We need progesterone to be a hundred to 200 times higher. than estrogen in the luteal phase or the second half of the menstrual cycle after we ovulate. What does it mean to have high estrogen? Testing your estrogen levels and the basic treatment ideas for high estrogen levels. Five steps to naturally reduce excess estrogen and promote hormonal balance. Perimenopause power, surviving the estrogen rollercoaster and perimenopausal hacks pertaining estrogen excess. So remember, progesterone goes missing in action. Progesterone modulates, estrogen, and she modulates your immune system. So for example, I'm humbled before you. I have a higher than optimal. Histamine level in my system at the moment. So I am reacting to external environmental allergens more than I usually would. Although in saying that I never had hay fever until I came to Australia. I spent 18 years in South Africa and never had hay fever. And I've come to Australia and I do suffer hay fever. And I do notice that my hay fever symptoms are worse now that I am perimenopausal because progesterone is no longer modulating. My immune system, as well as my mast cells. So it's complex. The perimenopausal and menopausal picture and the hormone rollercoaster is real and it is complex. So perimenopause is that phase before the final period that can last for 2 to 15 years. Can you believe we can actually experience these signs and symptoms for 15 years? The symptoms of perimenopause are temporary and can be treated with simple methods. A lot of them can. Thank you. Estrogen levels fluctuate during premenopause and can cause various symptoms. Now, this is due to the progesterone deficiency because estrogen starts to flail with progesterone not modulating her, particularly in that second part of the cycle. Metabolic health, gut health, and food choices can play a crucial role in balancing estrogen excess in relation to progesterone. Strategies to balance estrogen levels include stabilizing the nervous system, reducing histamine and mast cell activation, which is exactly what I'm trying to do at the moment. Nigella is absolutely incredible and I have a beautiful product called Hist Ease and that is bringing me great relief. Mast cell activation, very complex. Dr. Tanya Dempsey is the leading authority on mast cell activation. I really appreciate her treatment protocols and follow those closely with patients in my clinic. Reducing histamine and the mast cell activation and preventing those estrogen spikes. Taking bio identical or body identical progesterone according to the work of Professor Geraldine Prior can also relieve symptoms and support various functions. I personally take body identical micronized oral progesterone and I find it absolutely brilliant for sleep and absolutely brilliant for anxiety. I personally started to experience that progesterone deficiency anxiety early in perimenopause and body identical mic, oral micronized progesterone, put that to a stop. So it just shows how powerful that can be and it, RT isn't what it used to be. H r T isn't just a one size fits all, and it's not necessarily in estrogen replacement therapy anymore. It can be bioidentical progesterone on its biodentical with estrogen. Be individualized according to what your body needs. So this module aims to provide knowledge and tools for managing menopause symptoms and balancing excess estrogen levels. I'll just have a look and make sure that I don't have any questions. That's fine. Estrogen dominance. Now, when we're talking about estrogen dominance, we're talking about estrogen being dominant relative to progesterone. We have a natural physiological oestrogen dominance in the first part of the day 1 to day 14, oestrogen is high and that is absolutely normal for oestrogen to be dominant during that part of the cycle. Then from the day that you ovulate, the textbooks say day 14, but really women can ovulate. Anywhere between day eight and day 18. It's complex and it's individualized, but let's just say, for argument's sake, if you did ovulate on day 14, progesterone needs to be really high from day 14 to the following bleed. So that is where we need progesterone to be 100 to 200 times higher than estrogen in that cycle. If progesterone is deficient, oestrogen can be dominant in the luteal phase of the cycle and that is when it wreaks havoc. Oestrogen is a group of hormones, E1, E2 and E3, responsible for the development of secondary sex characteristics and regulating the reproductive system. Women have three types of oestrogen and amounts vary during different life stages. During menstruation, estrogen levels are low. Then rise during that follicular phase and peak just before ovulation. And drop going into that luteal phase, like I just mentioned before. High oestrogen or oestrogen dominance can cause various symptoms, like irregular or heavy periods, breast tenderness, bloating, mood swings, fatigue, difficulty sleeping, decreased sex drive, headaches, weight gain. hair loss, brain fog, and an increased risk of blood clots or stroke. That is why it is so important to test estrogen before taking in additional estrogen. If your estrogen were to be high and you were to pop on an estrogen patch. You could be exacerbating these symptoms thinking that you're using a medicine that is there to reduce them. The research suggests reducing histamine and mast cell activation to prevent estrogen dominance. The causes of oestrogen dominance, hormonal imbalances and medications, body fat, increased adiposity can actually behave like its own endocrine system and produce more oestrogen than necessary. Chronic stress can of course increase oestrogen due to the fact that the body is prioritizing stress hormone or cortisol over progesterone and therefore oestrogen is high due to the progesterone deficiency. Environmental factors with the xenooestrogens in plastic. And of course, poor liver function because we need to detoxify our estrogen through the large intestine and the liver because we need to use estrogen and then we need to lose it. We need to be able to detoxify it so that it doesn't recirculate. Causing a high estrogen presentation. Estrogen dominance is associated with several risks, including tumors in the uterine lining, several conditions like breast cancer, ovarian cancer, endometriosis pain, insulin resistance, polycystic ovarian syndrome, uterine cancer, and tumors on the ovaries and adrenal proliferative. Testing of estrogen dominance in perimenopause. The Dutch test is a specialized urine test that can be used to diagnose and monitor estrogen dominance by measuring hormone levels and their metabolites in the urine, including estrogen metabolites that can indicate estrogen dominance. When you only have a blood test, and I'm not saying don't test estrogen the blood, I actually quite like having both sets of data, so I like my patients to test estrogen. And we'll talk a bit more about the blood test between day one and day three of the cycle, if you're still cycling, so we can see what the blood plasma levels are like. But I really love the Dutch test because we not only see what the systemic estrogen levels are like, but we also see what their metabolites are doing and how detoxifying estrogen. Down the 2, 4, and the 16 hydroxy pathways. The 2 hydroxy pathway is safe. The 4 hydroxy pathway can damage DNA and RNA and is more 16 hydroxy pathway is more proliferative. So we need to know where the estrogen is, how much we have, and how it's detoxifying through the body in order for us to be able to change. The Dutch test specialized urine test that can be used to diagnose and monitor estrogen dominance by measuring hormone levels in the metabolites in the urine, including estrogen metabolites that can indicate estrogen dominance. That is not only what the Dutch test tests. The DUTCH test also tests progesterone, it does do the estrogens, and their metabolites. It shows us androgens and their metabolites, and then it goes into adrenal function. I love the DUTCH If you're going to do a DUTCH test, I highly recommend the DUTCH so that we can also see CAR, C A R, known as cortisol awakening response. So that is incredibly important in perimenopause as well. Because cortisol and progesterone play a role in this estrogen dominant picture, for example. And in the Dutch plus, we also see dopamine levels, the 6, the 12. We have a little indication on gut health and brain health as well as melatonin, which is really important for us sleep. And of course, don't forget that melatonin is an incredible antioxidant. Blood tests such as estradiol levels, follicle stimulating hormone levels and luteinizing hormone levels. As well as, in fact, sex hormone binding globulin can also be used to assess oestrogen levels and determine if someone has oestrogen dominance. And like I to test them through blood between day one and day three. The timing of hormone testing for oestrogen dominance is important. And it's usually based on the day of the menstrual cycle with the best time to test for estrogen levels, as I said, during that follicular phase of the menstrual cycle, and 5 to 7 days after ovulation, if you want them to look at estrogen in relation to progesterone levels. So between day 19 and 22. is when you would like to also test the progesterone levels if you're doing a blood test. Evaluating oestrogen levels. When, if you do the Dutch test, I do want you to do the Dutch test between day 19 and 22. And if you do not have a cycle, please reach out and we'll work out when you're going to test. Evaluating estrogen levels, especially in relation to progesterone during the luteal phase can help identify if symptoms such as weight gain, irritability and heavy periods are related to estrogen dominance. Interpreting hormone levels is complex and it should be done in the context of an individual's overall health and medical history. And of course, consultation with your healthcare provider, the basic treatment ideas, so dietary changes, absolutely incredible and very powerful. So eating a healthy, balanced diet with plenty of fiber. can help support healthy oestrogen metabolism. We have to get oestrogen through the large intestine and we need to get oestrogen moving through the liver. If you're taking in lots of toxic foods and alcohol, for example, the liver and the large intestine will make the oestrogen wait. This can be one of the reasons why oestrogen is recirculating through the bloodstream and causing a toxic load or an oestrogen dominant picture. So more fiber and less alcohol and less sugar. Gets that estrogen out through the liver and the large intestine limit or avoid alcohol, sugar, and of course, processed foods, regular exercise, absolutely brilliant to help us sweat and detoxify, but also build muscle and increase those endorphins, those feel good hormones to help keep that cortisol low. And of course, reduce body fat because we're building muscle, which can help lower estrogen levels and aim for at least 30 minutes of moderate intensity exercise. Most days of the week, stress reduction, finding ways to manage stress, decrease cortisol. So we can bring that progesterone up so that we don't have that extreme excess. And of course, I say, reduce stress in a way that you love and move in a way that you love. So meditation, yoga. Deep breathing all may be extremely helpful, walking on the beach. Some of my patients love those meditation coloring in books. I think that's a fabulous idea if that's what resonates for you. And journaling is brilliant too. Listening to music, cooking. Yeah, beautiful. Supplements and herbal remedies. Now here we need to be very careful. Of course, this repair program has an individualized component. So we will if you choose, do the DUTCH test together so that I can work and work out an individualized prescription for you with certain supplements such as omega 3 fatty acids, magnesium, vitamin B6, and some herbs such as chaseberry, dong guai, black cohosh may help regulate oestrogen levels and support healthy oestrogen metabolism. Stabilizing the nervous system is absolutely imperative to cortisol. So some of the supplements that I like are shown on the slide, but for example, if you are stressed out and tired, rhodiola is beautiful. If you are stressed out and wired, ashwagandha or trigandha is an absolutely incredible supplement for you. Stabilizing that nervous system. Magnesium, Melissa, passion Flower, the trine is absolutely brilliant and so is magnesium to relieve hot flushes and improve sleep. But don't forget, of course, we have plant-based melatonins and we have incredible nervous system support that we can use within the clinic dispensary. Reducing histamine and mast cell activation following a low histamine diet and basically, just to give you a quick idea to reduce histamines, things like avocados, citrus fruits, anything aged olives or cured meat or wine or anything that has been aged. We'll have a high histamine level, even down to leftovers. So if you eat fresh food and you stay away from leftovers, that can be very supportive to lower histamine levels. One shouldn't need to be on a low histamine diet long term. If high histamine levels are really bad, we can start to see breakouts in the skin. So we can start to see an eczema type presentation or really itchy skin. Thank goodness that hasn't happened to me yet. Hopefully it doesn't. Follow a lower histamine diet, take supplements that lower histamine. Nigella is incredible. Black seed is brilliant. The hist ease supplement in the clinic is incredible. It brings me so much relief. Of course, manage stress, avoid triggers, and take those antihistamines, those natural ones. And in actual fact, for some women, and I barely ever recommend pharmaceutical medication at all, but for some women, it is really beneficial to take an antihistamine. At night, to both reduce that histamine level, particularly if you find that you have PMD type symptoms, or PMDD type symptoms, PMS type symptoms, pre cycle, they can be extremely supportive for some patients. And of course, when the histamine levels get so bad I have been known to have that sort of tight chest from that allergic type bryonitis or that thunderstorm asthma. Antihistamines are life saving, so please be gentle on yourself in the same way that, you know, oh, God forbid you need a Panadol or a Tylenol to get rid of that headache. If something has gone wrong for you, please be gentle on yourself. We don't have to be perfect. We certainly don't have to be orthorexic in this program. We don't need to have the perfect diet, and we certainly don't need to have the perfect supplementation protocol either. We can sometimes rely on symptomatic relief. I think it's, there's a fine line between, treating and curing the cause, but also not having those those awful symptoms in your way for just a moment in time, when something like an antihistamine can bring you some relief. So five steps to naturally reduce excess estrogen and promote hormonal balance. Step one is to eat quality protein, garlic, onions, and cruciferous vegetables that support the liver in processing estrogen. The liver actually really needs protein in order to do its job. A B complex supplement or a DIM supplement may also be considered. I absolutely love sulforaphane or Pomegenex because it's such a gorgeous, it has pomegranate sulforaphane and coconut water. So topped up with all of those beautiful phytonutrients and those incredible antioxidants. So not only brilliant for detoxifying estrogen excess, but brilliant for our hair, skin and nails and hydration too. So hydration is imperative and be mindful that DIM is not always needed. Indole 3 carbinol or DIM can reduce oestrogen, but it can also ensure that oestrogen is detoxifying down the 2 hydroxy pathway. These are not the kind of supplements that I would recommend you use without testing first and, and having your one on one health consultation. All right. Step two is to treat underlying digestive issues that may be causing constipation. Again, we do not want that toxic reload. So we want to be having a bowel motion daily. Our patients now know how crazy and yeah how excited I am about daily bowel motions. So we do not want to prevent efficient elimination of estrogen. Step three is to eat fiber rich foods. So women need, especially perimenopausal women, need about 25 grams of fiber. So you also, at this point in time, know how much I love the GI Restore So please use that to bulk up your fiber if you're not getting enough in your two meals, if you are doing intermittent fasting and skipping breakfast at this point in time. So step three is to eat fiber rich foods, avocado, raspberries, artichokes, oatmeal. In the next phase, when you are out of your repair phase, we can start to reintroduce some of those good carbohydrates so be mindful if oatmeal is not good for you, please steer clear of that. And if you are going to eat oats, please make sure that they're organic. Almonds and broccoli to keep the bowels regular and help eliminate waste, including unnecessary estrogen, of course. Step four is to manage stress and use calming tactics like deep breathing. Adrenal support supplements may also be considered. So this approach step four is all about reducing that cortisol so that we can produce enough progesterone, or we can take our body identical progesterone and not have it overridden with that cortisol, creating an estrogen excess presentation. So honestly, during perimenopause, I see far more estrogen excess than I do estrogen deficiency. Of course, I see estrogen deficiency once women go into menopause. But in the perimenopausal phase in 23 years in clinical practice, I see more women with an estrogen excess presentation. So with regards to breathing, I want to share some technique with you. This is cutting edge research. Harvard University professors. It's been proven that the natural sigh like that is the best way for us to calm as quickly as possible. So it's super, super quick. It's super, super easy. Managing stress is about taking one deep breath in, followed by another quick, short breath in to fill those lungs. So a big, deep breath in. And do that three times, and that will help reduce cortisol and help you stay in that calm state. Of course, B5, which treats relationship and mum agro, is absolutely brilliant for doing this too. Step 5 is to get 7 to 8 hours of sleep a night. Research shows that men rarely need 8, women really need 8, and men can get away with 7. But it's, as an absolute minimum, you need 7 hours of sleep every single night. So use those blue light blocking glasses one to two hours before bedtime to shift those hormones into a more favorable state. If you need to, drink your sleepy time tea, have your plant based melatonin, do whatever it takes. Have a beautiful magnesium salts bath, do your meditation, do your stretching, do your yoga. Make sure you get eight hours of sleep. Estrogen dominance is reversible, so all of this, don't worry about it. If it sounds awful, if you are, do have an estrogen dominant presentation at the moment. Don't worry, I have had it, too. Milk Thistle is brilliant. There's another product called EstroClear, if that's appropriate, it is an absolutely brilliant product that saved my life. Estrogen dominance is reversible by implementing the suggested steps to improve estrogen progesterone balance and to heal the entire hormonal system. Of course, but one step at a time, microchanges, we will absolutely get there. Conclusion, we've focused on repairing estrogen excess during perimenopause. Balancing estrogen levels is crucial for optimal health. And addressing associated risks and symptoms. Strategies include dietary changes, exercise, stress reduction, supplementation, and herbal remedies. Gut health and liver function play a crucial role in efficient estrogen metabolism. And of course, consult with your healthcare practitioner. Do not do this on your own. And what I do want to say, which is so important, is women ask me all the time: why is it that my weight loss was never sustainable? Why is it that I wasn't able to keep the weight off? My answer is always the same. We need to first repair the gut, the immune system, the metabolism, the microbiome, and your mood. So the gut work needs to be done first, and then you need to ensure that you are sticking to your roadmap and your Peri Power Plan so that you can"80/20" it for the rest of your life. So 80 percent of the time you're eating according to this beautiful food protocol that you have devised for yourself at this point in time, and then 20 percent of the time your body can handle the"welcome to being human" moments. the birthday cake, the glass of wine, every now and then. Perimenopausal systems cannot stand alcohol. Brain fog cannot stand alcohol and estrogen detoxification can't stand it either. So if you are able to, I would highly recommend to make sure that you do the Repair and the Rebalance alcohol free. There really are only, 12 week programs. I will be increasing the one on one care. And of course, you know that you all have availability to me by the doctor in your pocket. So number one is Repair. Repair your immune system, your gut, your mood, your waistline, your metabolism, et cetera. That is what we have just done together. And then number two, we have to rebalance those hormones. We need to know what progesterone is doing, what estrogen is doing, how it's detoxifying. What the androgens are doing. How three of those hormones sets: the progesterones, the estrogens and the androgens, how they interplay, how all of that interplays with cortisol and then melatonin, and then we need to look at that OAT component of the DUTCH test, and of course your CAR, your cortisol awakening response. So if you ever thought that weight loss and vitality in perimenopause was complex: you are absolutely right. So thank you so much for your time again. I really appreciate it. I absolutely love that you are here. Take it easy and have a beautiful night.