Estrogen Rollercoaster? Here’s How to Support Hormone Balance the Smart Way
When it comes to hormone balance, the goal is to achieve “Goldilocks” hormone levels ~ that is, not too much, not too little, just right levels of hormones. Each woman is unique, which means she will thrive and feel best when hormones are at her own unique “Goldilocks” levels.
Perimenopause is marked by a period of wildly fluctuating estrogen levels, followed by a decline in estrogen as a woman gets closer to menopause. Even with the best food, nutrients, and lifestyle remedies, it’s unrealistic to expect balanced hormone levels during this time unless a woman is using hormone replacement. That said, we always want to create a strong foundation for health, doing our best to make food and lifestyle choices that support a healthy body. We also want to do our best to reduce our exposure to endocrine-disrupting chemicals, which significantly contribute to hormone imbalances.
The tips and remedies in this handout are designed to help support estrogen balance in the body. Hormones are complicated, and they are intricately connected. If we “fix” one hormone imbalance, we could inadvertently throw our other hormones out of balance. So, we always want to think about the BIG picture of hormones and not just focus on one single hormone.
Remedies for low estrogen
Hang on to a little extra body fat.
Many women in their 40s begin to notice that they can no longer shed those extra few pounds that used to come off quite easily. Believe it or not, your body may be holding onto those extra pounds for a reason. Aside from body fat being an essential source of energy, body fat is an endocrine hormone, meaning body fat makes estrogen. Women who have a few extra pounds on their bodies during perimenopause tend to suffer less “low estrogen” symptoms than super thin women. As much as you may be cursing that excess body fat, it might come in handy during the perimenopausal/menopausal years.
Reducing stress can boost estrogen.
You may recall that perimenopause marks the time when sex hormone production begins its gradual decline from ovarian sex hormone control to adrenal sex hormone control. Since the adrenal glands are tasked with stress hormone production and take on the added role of sex hormone production during perimenopause and menopause, reducing stress is one way to ensure that the adrenals can perform the critical task of sex hormone production, and that includes estrogen production.
When I discuss reducing stress, I am not just talking about daily life’s mental and emotional stress. I am talking about anything that stresses the body out for some women, such as extreme exercise, food sensitivities, hormone imbalances, toxins, viruses, and caffeine. The more you can reduce stress in the body, the more you will ease the burden on your adrenals. This will allow the adrenals to produce sex hormones more effectively.
Ensure you are getting the proper nutrients.
Nutrient deficiencies are a significant culprit for low estrogen (and imbalanced hormones overall). Magnesium has been shown to reduce hot flashes, and B6, B12, and folate (folate and folic acid are NOT the same) are cofactors needed for estrogen production. Zinc, Vitamin D and Vitamin C appear to play a role in estrogen production. Some experts believe that Vitamin E acts just like estrogen at the cellular level. It acts almost like a bioidentical hormone and can help with vaginal dryness, skin elasticity, and other low estrogen symptoms. When choosing Vitamin E, you’ll want to choose a supplement that contains mixed tocopherols and tocotrienols. Typical dosing is 400 mg/day. It may take 30 days or longer to see results with most nutrients.
I hate to break it to you, but refined sugar depletes nutrients, so you’ll want to make an effort to reduce the “white stuff” in your diet as much as possible.
Flaxseeds may help boost estrogen.
Flaxseeds are in a class of foods known as phytoestrogens, meaning they contain estrogenic properties that can act like estrogen in the body. Phytoestrogens have a weaker estrogenic effect than the estrogen that our bodies make. However, they can still pack a punch and be helpful when a woman suffers from low estrogen or wildly fluctuating estrogen.
The lignans in the flaxseeds may also offer protection against breast cancer. It’s important to note that flaxseed oil does not have the same effect. Typical dosing is two tablespoons of ground flaxseeds per day, although dosing may vary from woman to woman. Remember that it must be ground for the flaxseed to work its estrogen magic. That said, I recommend buying organic flaxseed in whole seed form and then grinding the flaxseeds in a coffee grinder at home. The reason why? As soon as flaxseed has been ground, it begins to oxidize. And since there is no way of knowing how long ground flaxseed has been sitting on the grocery store shelf or at Amazon, you’ll want to buy flaxseed in its whole seed form. Then grind only one week’s worth of flaxseeds and store them in the refrigerator to minimize oxidation of the omega-3 polyunsaturated fats that become exposed to air after grinding.
Organic, fermented soy may help.
There seems to be much controversy surrounding the use of soy to support estrogen balance in the body. The bulk of the controversy surrounding soy is related to poor quality, heavily processed, genetically modified soy. About 90% of U.S. soy is genetically modified, and that’s the kind of soy we want to stay away from. Like flaxseed, soy contains phytoestrogens that may be helpful during the perimenopausal transition. Studies in Asia focusing on women who eat whole and fermented soy show reduced symptoms of low estrogen — specifically hot flashes, lower breast cancer rates, and osteoporosis. But studies in the U.S. have been inconclusive about soy’s ability to dampen down the effects of perimenopause. That said, the U.S. studies do show that soy may provide some symptom relief in peri/menopausal women.[1],[2] So, it may be worth considering including soy in moderation.
Maca root may ease peri/menopausal symptoms.
Maca root is a cruciferous vegetable that may increase estrogen and modulate all of your hormones. Maca tends to help with hot flashes, low libido, depression (especially in women with SSRI use), improvement in metabolism, weight loss, reduction of anxiety, vaginal dryness, memory, and concentration. Dosing depends on the woman, as some women can experience increased anxiety if they add too much maca too quickly.
The typical maca root (powder form) dosing starts at around a half teaspoon per day. Women may increase as tolerated. Regarding the capsule form, I recommend following the manufacturer’s instructions. My favorite maca supplement for perimenopause is from the makers of Femmenessence. They have three different options to choose from: MacaHarmony, geared for the reproductive years; MacaLife, for women in perimenopause; and MacaPause, for women who are in menopause.
Black cohosh may help hot flashes and your mood.
The exact mechanism of action by which black cohosh works is not fully understood. Older studies suggest that black cohosh may have an estrogenic effect on the body. Still, newer research suggests it may act on serotonin receptors instead, which can be super helpful for hot flashes and mood improvement. Black cohosh (40-80 mg per day), when combined with St. John’s Wort (300 mg three times per day), has been shown to improve some low estrogen symptoms.[3], [4] Warning: Women on antidepressants should always consult their physician before taking St. John’s Wort.
If you suffer from vaginal dryness, which is often the result of low estrogen (as well as other hormonal decline), there are a few more specific remedies:
Good, old-fashioned vaginal lubricants and moisturizers can provide short-term relief from vaginal dryness and discomfort during sex. I’ll be honest and tell you that most of my clients feel like these are just temporary fixes, and I have to agree. They don’t address the heart of the issue, which is a decline in hormones. But it’s worth trying as they can be beneficial in mild cases of vaginal dryness.
Vaginal creams that include DHEA can work wonders to bring some life back to your lady parts. Dr. Anna Cabeca developed a formula called Julva that contains DHEA and some other vagina supportive nutrients. I’ve had clients who swear by this formula.
Bezwecken has an entire lineup of vaginal “cubes” that can help restore the vaginal tissue. Some of their formulations strictly address rehydration of the vagina, while others contain DHEA, which can work on a deeper level. This is similar to Julva, which I mentioned above.
Low-dose, over-the-counter vaginal estriol preparations are available. You’ll want to be sure that you look for a cream that is organic (we don’t want to apply creams to our lady parts that contain toxins) and from a reputable company and that you follow the manufacturer’s instructions. Ideally, you would apply the cream to the outside of the vagina, the labia minora, the clitoris, the opening of the vagina (introitus), and/or in the lower third of the vagina.
Prescription-strength bioidentical estrogen systemically and vaginal estrogen can make a BIG difference. Systemic transdermal (i.e., topical) bioidentical Bi-Est contains two estrogens —estradiol and estriol — and is only available by prescription, but it can help with vaginal dryness and a whole host of other menopausal symptoms. Systemic Bi-Est isn’t enough for some women to resolve vaginal dryness and atrophy. In that case, estrogen can be used locally in the vagina in combination with systemic therapy. Several different vaginal formulations, including a vaginal ring, tablets, and creams that work locally on the vagina to restore vaginal health.
While oral DHEA is available over the counter, it has not been shown to address vaginal dryness or atrophy and is often used in combination with low estrogen remedies. Topical DHEA is a different story and has been shown to reduce vaginal dryness, improve vaginal pH, strengthen the vaginal musculature, decrease pain during intercourse, and increase sexual arousal and libido. Where do I sign up, right? This one is only available by prescription, so you’ll need to work with a hormone expert on this one.[5]
When it comes to low estrogen, one thing to remember is that the body is always trying to find balance. If a woman’s estrogen has been low for quite some time, her body will often make more estrogen receptors to provide more opportunities for estrogen to affect the cells. Keep that in mind if you choose to take action to boost estrogen in your body. Suppose you’ve had low estrogen for a while. In that case, it’s easy to completely overload your estrogen receptors and end up with a massive estrogenic effect in your body that will leave you feeling worse than you did before you began treatment. Many conventional doctors don’t understand this concept and start women off on high-dose hormone replacement therapy right out of the gate. I always recommend introducing hormones (or any of the remedies listed) very slowly and gradually to allow the body time to adjust.
Remedies for high estrogen (often referred to as estrogen dominance, which is high estrogen in relation to progesterone)
Avoid dairy and conventionally raised meats
Yep, these babies are loaded with hormones from a lactating animal or injected with hormones in the case of conventionally farmed meat. If you’ve got too much estrogen in relation to progesterone, then removing these foods can make a BIG impact.
Eat a low-glycemic, nutrient-dense diet
A higher-glycemic diet promotes higher blood sugar levels, which promotes higher conversions of sugar to fat. Fat makes estrogen, and we want less of it.
Reduce or eliminate caffeine
I hate to say it, but caffeine upregulates estrogen receptors, meaning caffeine makes estrogen receptors more sensitive to estrogen. This doesn’t mean that you have to eliminate caffeine entirely, but most research shows that the tipping point for women is between one and two cups of coffee —not giant mugs, just regular cups.
Clean up your personal care and household products
These products contain estrogen-mimicking chemicals, which means they look a lot like the estrogen in your body, and they fit into the estrogen receptors in your body, too. So, chemicals like triclosan or oxybenzone (both popular ingredients in personal care products) can essentially plug into estrogen receptors on your breasts or uterus, negatively influencing the behavior of those cells. It’s best to avoid these products altogether.
Reduce stress
When the body is stressed, it produces cortisol. Cortisol and progesterone are both made from the same raw material: pregnenolone. The body will always prioritize which hormone to make based on what’s happening then. If the body is stressed, it will make cortisol, which means it may not make enough progesterone to balance out the estrogen. (You may have to read that one a couple of times.) Bottom line: You need to reduce your stress hormones if you want balanced sex hormones.
Support liver detoxification
Your liver is your body’s primary detoxification organ. It detoxifies every toxin that enters your body and detoxifies all of the hormones your body makes, including estrogen. If your liver doesn’t detoxify well, you are going to have an excess of estrogen (and estrogen metabolites) circulating around your body. So, supporting your liver is vital to break down estrogen properly. Eating cruciferous veggies and taking essential supplements is a great way to support the liver!
Once your liver does all of the hard work of detoxifying estrogen, estrogen is carried out of your body via poop. If you are not pooping every day, your colon will reabsorb whatever resides there, and yep, that estrogen that your body worked so hard to detoxify will get reabsorbed into your body. You need to be pooping EVERY SINGLE DAY if you want balanced hormones.
References
[1] Franco, Oscar H., et al. “Use of Plant-Based Therapies and Menopausal Symptoms.” Jama, vol. 315, no. 23, 2016, p. 2554., doi:10.1001/jama.2016.8012.
[2] D'anna, Rosario, et al. “Effects of the Phytoestrogen Genistein on Hot Flushes, Endometrium, and Vaginal Epithelium in Postmenopausal Women.” Menopause, vol. 14, no. 4, 2007, pp. 648–655., doi:10.1097/01.gme.0000248708.60698.98.
[3] Uebelhack, Ralf, et al. “Black Cohosh and St. John’s Wort for Climacteric Complaints.” Obstetrics & Gynecology, vol. 107, no. 2, Part 1, 2006, pp. 247–255., doi:10.1097/01.aog.0000196504.49378.83.
[4] Chung, Da-Jung, et al. “Black Cohosh and St. John's Wort (GYNO-Plus®) for Climacteric Symptoms.” Yonsei Medical Journal, vol. 48, no. 2, 2007, p. 289., doi:10.3349/ymj.2007.48.2.289.
[5] Labrie, Fernand, et al. “Science of Intracrinology in Postmenopausal Women.” Menopause, vol. 24, no. 6, 2017, pp. 702–712., doi:10.1097/gme.0000000000000808.