Estrogen is a critical hormone for women, and the benefits of estrogen go well beyond reproduction. Estrogen fluctuations and decline in perimenopause contribute to a host of uncomfortable symptoms. In menopause, low estrogen levels may increase the risk for chronic diseases.
Understanding estrogen helps us understand the changes women undergo in perimenopause and beyond. Today’s article will dive deep into estrogen and offer integrative solutions for finding balance and ease during this hormonal transition.
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Let’s jump into this essential women’s health topic!
What is Estrogen? Role of Estrogen and Estrogen Receptors
Estrogen is a steroid hormone, primarily produced in the ovaries, that promotes female characteristics, reproduction, and total body health.
Estrogen is a general term that encompasses all estrogens. The three main estrogens are:
Estradiol is the most abundant estrogen during the reproductive years; it’s also found in bioidentical hormone replacement therapy.
Hormones travel through the bloodstream. Free estrogen enters cells and binds to estrogen receptors, which regulate many complex processes within cells and tissues. There are several types of estrogen receptors, with alpha and beta the most prominent. Abnormal estrogen signaling may play a role in endometriosis, breast cancer, and other diseases.
Healthy estrogen signaling supports:
When estrogen has played its role, the body clears what is no longer needed. The liver detoxifies estrogen in two phases of chemical reactions, and then the estrogen metabolites leave the body via the colon. If the liver or digestive tract is sluggish or imbalanced, the body may have difficulty clearing estrogen, contributing to hormonal imbalances.
The gut microbiome plays a significant role in maintaining healthy estrogen levels. The gut microbiome refers to the trillions of microorganisms inhabiting the digestive tract, primarily the large intestine. The estrobolome is a subset of the microbiome involved with estrogen metabolism. This collection of bacteria is involved in estrogen regulation, either allowing it to be excreted or to recirculate.
Estrogen in Perimenopause and Menopause
During the reproductive years, estrogen levels rise and fall in a predictable pattern. Estrogen increases in the first half of the menstrual cycle, promoting the growth of the uterine lining. It drops before ovulation and then rises again after ovulation. If the egg isn’t fertilized, it will fall again and the period comes.
In perimenopause, the years leading up to menopause and the end of the monthly cycle, estrogen is unpredictable. In fact, estrogen swings can feel like a hormonal rollercoaster; like you are in puberty, only in reverse.
Menstrual cycles become irregular in perimenopause, and you may experience times when estrogen levels are high and other times when estrogen is low. As you get closer to menopause, the one-year mark without a cycle, estrogen levels will decline and remain low through the post-menopause years.
Estrogen dominance describes the hormonal landscape where estrogen is high relative to progesterone. This imbalance can happen in the reproductive years (hello PMS) and is more likely in perimenopause as progesterone levels decline. There are two cases of estrogen dominance:
Symptoms of elevated estrogen or estrogen dominance may include:
Symptoms of low estrogen include many of the classic perimenopause and menopause symptoms:
Estrogen plays a protective role in women’s health. In menopause, when estrogen levels are steadily at their lowest, women’s risk for chronic diseases like dementia, heart disease, and osteoporosis increases.
How to Support Estrogen in Perimenopause and Menopause
On the one hand, perimenopause is a natural hormonal transition. And on the other hand, this transition, especially in a modern context, can significantly affect the quality of life and future health for women.
In integrative medicine, we combine modern and holistic approaches, personalizing the plan for each woman to address her unique symptoms and long-term health goals. Here are some of the integrative tools to consider for estrogen support:
Read more about the TārāMD food as medicine approach here.
While you can’t avoid everything, you can take strategic steps to identify and minimize exposures. In addition, you can support the body’s detoxification systems (including the gut and liver) by eating the foods listed above and working with your TārāMD provider for other tools and helpful supplements.
Read more about endocrine disruptors in this article.
Phytoestrogens are weaker than human estrogen and can help modulate the estrogen response. During low estrogen, phytoestrogens bind to receptors and elicit a response, but when estrogen is high, these weaker estrogens can displace your body’s estrogen, dampening the response.
Phytoestrogens may be beneficial for managing symptoms during perimenopause and menopause. Use them when estrogen levels are high, low, or fluctuating. You can increase phytoestrogens in food to a therapeutic dose. Options include:
Phytoestrogen supplements are another option to consider. Examples include:
Because the adrenals can make estrogen, supporting the adrenal glands by lowering and managing stress becomes very important in perimenopause and beyond. Learning healthy coping strategies that work for you and practicing them regularly is worth the time and dedication. For many women, addressing stress means slowing down, letting go, and clarifying your priorities. Dedicating time to fun and relaxation is also essential.
There continues to be fear about hormone therapy because of the Women’s Health Initiative, but current research supports the benefits of this therapy for women, especially when choosing bioidentical hormones.
We believe in informed consent and that women deserve more options regarding their perimenopausal and menopausal care. BHRT is an effective option for many women, especially with a supportive diet and lifestyle changes. It’s not a fit for every woman, but when it is, it can be life-changing.
If you are in any stage of perimenopause and are dealing with uncomfortable symptoms that impact your quality of life, TārāMD can help you find the strategies and support you need. There’s no need to suffer in silence; supporting your estrogen and overall health can help you feel like yourself and live your most vibrant life. Why wait? Please reach out today to schedule an appointment.