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Hormones are amazing, powerful, dangerous and confusing. Hormones are released from endocrine glands. The major endocrine glands in the body are the pineal gland, pituitary gland, pancreas, thyroid gland, parathyroid gland, hypothalamus, adrenal glands, testes and ovaries. Here, we are going to focus on the hormone estrogen—the good, the bad and the ugly. Unfortunately, given today’s health challenges, there is a fair bit of ugly.
Estrogen is a messenger to different tissues throughout the body. You can tell how powerful it is by looking at a 10-year-old girl and a 16-year-old girl—quite amazing changes in just a few years! Estrogen’s message is to grow and be free. It grows the lining of the uterus to prepare for the potential fertilized egg to be dropped into the nest and nourished. It grows breast tissue and causes fat redistribution. Estrogen increases the collagen content of skin to help with growth and regeneration. These are all things we want.
Problems arise when estrogen starts to misbehave, and/or estrogen impersonators sneak into our bodies. These can stimulate the wrong kinds of growth and lead to a wide variety of health problems—from endometriosis and uterine fibroids to very difficult perimenopause and menopause transitions to breast, uterine, cervical and ovarian cancer.
When the amount of estrogen starts to climb, and we don’t have enough progesterone on board to balance it out, we call it “estrogen dominance.”
Estrogen has three major types, called estrone (E1), estradiol (E2) and estriol (E3). They can also have subtypes, of which some of the members are helpful and productive, while others can be problematic or even dangerous.
Estrogen changes form during its lifecycle and is metabolized by differing pathways in the body. The healthiest pathway is called 2-hydroxy (this is short for an incredibly long chemical notation). This is a healthy way to metabolize estrogen because it stays in its healthiest form. Unfortunately, if the majority of estrogen is metabolized via a less healthy pathway called 16-hydroxy, it can contribute to health problems and increase the risk for uterine, breast, ovarian and cervical cancer in women.
If that wasn’t problematic enough, fat cells make and release estrogen, so body composition plays a role in estrogen dominance. The third way we have excessive estrogen exposure is via compounds in our environment that are estrogen imposters. They look so much like estrogen that they act like this hormone if they get into our body. Environmental estrogens are called xenoestrogens, and are found in many places, including pesticides on non-organic produce, plasticizers and the BPA in plastic bottles.
These dysfunctional forms of estrogen can lead to endometriosis, uterine fibroids, menstrual migraines, serious PMS or perimenopause symptoms, cervical dysplasia and hormonally related cancers.
Diindolylmethane (DIM)
I admit, that is a mouthful of a word, so easier to call it DIM. However, it is one of my favorite suggestions for anyone struggling with estrogen related problems. DIM is a compound metabolized from cruciferous vegetables like cauliflower, cabbage and broccoli. Unfortunately, you would have to eat two pounds of raw broccoli to reach the clinically studied level of DIM.
When I talk to customers or patients, I explain that DIM does not increase or decrease your estrogen levels. It acts like a traffic cop in your body, and waves more of the estrogens down the good pathway instead of the bad one. This can be marvelously beneficial for all problems of a dysfunctional estrogenic nature, including reducing risk of hormone-related cancers.
DIM and Cancer
One issue that may respond well to DIM are problematic genes called BRCA1 that predispose some women to breast cancer. A human clinical trial found that women taking supplemental DIM had a 34 percent improvement in BRCA1 expression. The researchers stated this natural compound stimulated the body’s genetic expression in favor of suppressing tumor formation.
More clinical studies found that when women with the altered BRCA gene used DIM for one year, they had lower amounts of abnormal tissue. The researcher reported that this potentially also reduced tumor risk.
Endometrial cancer is cancer of the lining of the uterus and is a serious risk for women, especially for those who have had increased estrogenic exposures, regardless of source. Researchers in California have demonstrated that DIM has a significant anti-tumor effect on endometrial cancer cells.
DIM and Other Hormonal Issues
DIM has been used successfully for endometriosis, a painful overgrowth of the tissue lining the uterus.
A long-term study of DIM in polycystic ovarian syndrome (PCOS) helped regulate androgen levels and reduce symptoms over the course of 10 months.
Menstrual migraines are triggered by the sudden drop of estrogen prior to menstruation. DIM can reduce or even eliminate these headaches, especially when used in conjunction with coenzyme Q10 (CoQ10).
Women often have a PAP smear on a regular basis to test for cervical cancer. The results can be healthy—no cancer, or positively cancer, or several levels in between called dysplasia. This means the cells are progressively abnormal but not yet malignant. DIM has been used by integrative practitioners to treat women in this middle zone to eliminate dysplasia.
Weight gain in the buttocks, hips and thighs has an estrogenic component. While not a miracle weight-loss drug, DIM can help the body better metabolize estrogen so less adipose tissue is sent to these areas.
DIM is useful for problems with menstrual pain, and hormonal transitions like perimenopause and menopause.
When I see women who are complaining of any issue related to dysfunctional estrogenic activity, DIM is generally my first recommendation.
Fiber
When I talk to women about hormonal issues, one of the first questions I ask is about fiber in the diet. I am often met with puzzlement. After all, they want to know more about their hormonal issues and are not asking about constipation.
People need 25 to 30 g of fiber a day, and most people do not come anywhere close to that amount. The reason a woman needs to increase fiber if experiencing hormonal problems is that fiber is a super sponge. When the liver processes old used up estrogen or toxic xenoestrogens for elimination, it dumps them into the intestines to be carried out with the food train. However, if there is little to no fiber in the food, there is nothing to soak up and bind the estrogens. Then, these broken compounds are reabsorbed and circulated through the body once more.
If a person cannot get all the fiber they need from their meals, it can be quite beneficial to add a quality fiber supplement once or twice daily around meals.
Curcumin, Detoxification and Inflammation
Curcumin has been shown to boost detoxification enzymes, making it easier for your body to eliminate xenoestrogens that come from environmental pollution. Curcumin’s anti-inflammatory and antioxidant activity protects the liver as it processes these toxins, as well, and the liver is a critical organ for healthy estrogen metabolism and elimination.
Because curcumin is anti-inflammatory, it can provide powerful pain relief, always useful with menstrual pain and other issues. Clinical studies have shown that it can relieve PMS symptoms, help with women struggling with endometriosis, and helps prevent a variety of cancers.
Grape Seed Extract and Aromatase
Grape seed extract contains oligomeric proanthocyanins (OPCs) that can be especially beneficial for women struggling with dysfunctional estrogen activity.
A clinical study of women in menopause found that grape seed extract reduces hot flashes, anxiety, sleeplessness and other uncomfortable symptoms. The study participants also saw an increase in lean muscle mass and a reduction in blood pressure as an added bonus.
Perhaps grape seed extract is best known in the treatment of estrogenic dysfunction as a partial aromatase inhibitor. Aromatase is an enzyme that converts androgens into estrogens. Overactive aromatase activity can be especially problematic in breast cancer, so being able to downregulate this activity can be quite useful.
Research has also shown that grape seed extract is also useful for endometriosis and irregular menstrual cycles. Newer tannin-free forms of grape seed extract can perform even better, since they have 100 percent absorbability compared to standard grape seed extract with tannins.
Even More Useful Interventions
Even if I were to write a book, I could not cover every intervention useful for estrogen dominance and dysfunctional estrogenic activity. Just a few more things to consider are chaste tree berry extract and topical progesterone cream. Make sure the progesterone cream is marked as USP progesterone for its content, as some wild yam creams contain no active progesterone.
Melatonin is powerful in regulating circadian rhythms, and that promotes healthier estrogen metabolism as well. It also has anti-cancer properties.
There are many more effective natural interventions, and you may have to experiment a bit to find your best protocol. However, it is worth the effort when you feel the result. VR
References:
1 Kotsopoulos J, Zhang S, Akbari M, et al. BRCA1 mRNA levels following a 4-6-week intervention with oral 3,3’-diindolylmethane. Br J Cancer. 2014 Sep 23;111(7):1269-74.
2 Leong H, Firestone GL, Bjeldanes LF. Cytostatic effects of 3,3’-diindolylmethane in human endometrial cancer cells result from an estrogen receptor-mediated increase in transforming growth factor-alpha expression. Carcinogenesis. 2001 Nov;22(11):1809-17.
3 Sepkovic DW, Raucci L, Stein J, et al. 3,3’-Diindolylmethane increases serum interferon-γ levels in the K14-HPV16 transgenic mouse model for cervical cancer. In Vivo. 2012 Mar-Apr;26(2):207-11.
4 Sepkovic DW, Stein J, Carlisle AD, Ksieski HB, Auborn K, Bradlow HL. Diindolylmethane inhibits cervical dysplasia, alters estrogen metabolism, and enhances immune response in the K14-HPV16 transgenic mouse model. Cancer Epidemiol Biomarkers Prev. 2009 Nov;18(11):2957-64.
5 Chai NC, Peterlin BL, Calhoun AH. Migraine and estrogen. Curr Opin Neurol. 2014 Jun;27(3):315-24.
6 Goel A, Jhurani S, Aggarwal BB. Multi-targeted therapy by curcumin: how spicy is it? Mol Nutr Food Res. 2008;52(9):1010-30.
7 Aggarwal BB, Sundaram C, Malani N, Ichikawa H. Curcumin: the Indian solid gold. Adv Exp Med Biol. 2007;595:1-75.
8 Meeran SM, Ahmed A, Tollefsbol TO. Epigenetic targets of bioactive dietary components for cancer prevention and therapy. Clin Epigenetics. 2010;1(3-4):101-116.
9 Shehzad A, Wahid F, Lee YS. Curcumin in cancer chemoprevention: molecular targets, pharmacokinetics, bioavailability, and clinical trials. Arch Pharm (Weinheim). 2010;343(9):489-99.
10 Khazaei Koohpar Z, Entezari M, Movafagh A, Hashemi M. Anticancer Activity of Curcumin on Human Breast Adenocarcinoma: Role of Mcl-1 Gene. Iran J Cancer Prev. 2015 May;8(3):e2331.
11 Goel A, Aggarwal BB. Curcumin, the golden spice from Indian saffron, is a chemosensitizer and radiosensitizer for tumors and chemoprotector and radioprotector for normal organs. Nutr Cancer. 2010;62(7):919-30.
12 Kijima I, et al. Grape seed extract is an aromatase inhibitor and a suppressor of aromatase expression. Cancer Res. 2006;66(11):5960-7.
13 Eng ET, Ye J, Williams D, Phung S, et al. Suppression of estrogen biosynthesis by procyanidin dimers in red wine and grape seeds. Cancer Res. 2003 Dec 1;63(23):8516-22.
14 Wen W, Lu J, Zhang K, Chen S. Grape seed extract inhibits angiogenesis via suppression of the vascular endothelial growth factor receptor signaling pathway. Cancer Prev Res (Phila). 2008 Dec;1(7):554-61.
15 Kakaiy A, Ayen E, Sadrkhanlou R, Sarrafzadeh Rezaei F. Comparing protective effect of grape seed extract versus atorvastatin on endometriosis in rat model: Evidence for immunohistochemical and biochemical alterations. Vet Res Forum. 2015 Spring;6(2):101-10. Epub 2015 Jun 15.
16 Sapwarobol S, et al. Postprandial blood glucose response to grape seed extract in healthy participants: A pilot study. Pharmacogn Mag. 2012;8(31):192-6.
17 Décordé K, et al. Chardonnay grape seed procyanidin extract supplementation prevents high-fat diet-induced obesity in hamsters by improving adipokine imbalance and oxidative stress markers. Mol Nutr Food Res. 2009;53(5):659-66.
Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
Hormones are amazing, powerful, dangerous and confusing. Hormones are released from endocrine glands. The major endocrine glands in the body are the pineal gland, pituitary gland, pancreas, thyroid gland, parathyroid gland, hypothalamus, adrenal glands, testes and ovaries. Here, we are going to focus on the hormone estrogen—the good, the bad and the ugly. Unfortunately, given today’s health challenges, there is a fair bit of ugly.
Estrogen is a messenger to different tissues throughout the body. You can tell how powerful it is by looking at a 10-year-old girl and a 16-year-old girl—quite amazing changes in just a few years! Estrogen’s message is to grow and be free. It grows the lining of the uterus to prepare for the potential fertilized egg to be dropped into the nest and nourished. It grows breast tissue and causes fat redistribution. Estrogen increases the collagen content of skin to help with growth and regeneration. These are all things we want.
Problems arise when estrogen starts to misbehave, and/or estrogen impersonators sneak into our bodies. These can stimulate the wrong kinds of growth and lead to a wide variety of health problems—from endometriosis and uterine fibroids to very difficult perimenopause and menopause transitions to breast, uterine, cervical and ovarian cancer.
When the amount of estrogen starts to climb, and we don’t have enough progesterone on board to balance it out, we call it “estrogen dominance.”
Estrogen has three major types, called estrone (E1), estradiol (E2) and estriol (E3). They can also have subtypes, of which some of the members are helpful and productive, while others can be problematic or even dangerous.
Estrogen changes form during its lifecycle and is metabolized by differing pathways in the body. The healthiest pathway is called 2-hydroxy (this is short for an incredibly long chemical notation). This is a healthy way to metabolize estrogen because it stays in its healthiest form. Unfortunately, if the majority of estrogen is metabolized via a less healthy pathway called 16-hydroxy, it can contribute to health problems and increase the risk for uterine, breast, ovarian and cervical cancer in women.
If that wasn’t problematic enough, fat cells make and release estrogen, so body composition plays a role in estrogen dominance. The third way we have excessive estrogen exposure is via compounds in our environment that are estrogen imposters. They look so much like estrogen that they act like this hormone if they get into our body. Environmental estrogens are called xenoestrogens, and are found in many places, including pesticides on non-organic produce, plasticizers and the BPA in plastic bottles.
These dysfunctional forms of estrogen can lead to endometriosis, uterine fibroids, menstrual migraines, serious PMS or perimenopause symptoms, cervical dysplasia and hormonally related cancers.
Diindolylmethane (DIM)
I admit, that is a mouthful of a word, so easier to call it DIM. However, it is one of my favorite suggestions for anyone struggling with estrogen related problems. DIM is a compound metabolized from cruciferous vegetables like cauliflower, cabbage and broccoli. Unfortunately, you would have to eat two pounds of raw broccoli to reach the clinically studied level of DIM.
When I talk to customers or patients, I explain that DIM does not increase or decrease your estrogen levels. It acts like a traffic cop in your body, and waves more of the estrogens down the good pathway instead of the bad one. This can be marvelously beneficial for all problems of a dysfunctional estrogenic nature, including reducing risk of hormone-related cancers.
DIM and Cancer
One issue that may respond well to DIM are problematic genes called BRCA1 that predispose some women to breast cancer. A human clinical trial found that women taking supplemental DIM had a 34 percent improvement in BRCA1 expression. The researchers stated this natural compound stimulated the body’s genetic expression in favor of suppressing tumor formation.
More clinical studies found that when women with the altered BRCA gene used DIM for one year, they had lower amounts of abnormal tissue. The researcher reported that this potentially also reduced tumor risk.
Endometrial cancer is cancer of the lining of the uterus and is a serious risk for women, especially for those who have had increased estrogenic exposures, regardless of source. Researchers in California have demonstrated that DIM has a significant anti-tumor effect on endometrial cancer cells.
DIM and Other Hormonal Issues
DIM has been used successfully for endometriosis, a painful overgrowth of the tissue lining the uterus.
A long-term study of DIM in polycystic ovarian syndrome (PCOS) helped regulate androgen levels and reduce symptoms over the course of 10 months.
Menstrual migraines are triggered by the sudden drop of estrogen prior to menstruation. DIM can reduce or even eliminate these headaches, especially when used in conjunction with coenzyme Q10 (CoQ10).
Women often have a PAP smear on a regular basis to test for cervical cancer. The results can be healthy—no cancer, or positively cancer, or several levels in between called dysplasia. This means the cells are progressively abnormal but not yet malignant. DIM has been used by integrative practitioners to treat women in this middle zone to eliminate dysplasia.
Weight gain in the buttocks, hips and thighs has an estrogenic component. While not a miracle weight-loss drug, DIM can help the body better metabolize estrogen so less adipose tissue is sent to these areas.
DIM is useful for problems with menstrual pain, and hormonal transitions like perimenopause and menopause.
When I see women who are complaining of any issue related to dysfunctional estrogenic activity, DIM is generally my first recommendation.
Fiber
When I talk to women about hormonal issues, one of the first questions I ask is about fiber in the diet. I am often met with puzzlement. After all, they want to know more about their hormonal issues and are not asking about constipation.
People need 25 to 30 g of fiber a day, and most people do not come anywhere close to that amount. The reason a woman needs to increase fiber if experiencing hormonal problems is that fiber is a super sponge. When the liver processes old used up estrogen or toxic xenoestrogens for elimination, it dumps them into the intestines to be carried out with the food train. However, if there is little to no fiber in the food, there is nothing to soak up and bind the estrogens. Then, these broken compounds are reabsorbed and circulated through the body once more.
If a person cannot get all the fiber they need from their meals, it can be quite beneficial to add a quality fiber supplement once or twice daily around meals.
Curcumin, Detoxification and Inflammation
Curcumin has been shown to boost detoxification enzymes, making it easier for your body to eliminate xenoestrogens that come from environmental pollution. Curcumin’s anti-inflammatory and antioxidant activity protects the liver as it processes these toxins, as well, and the liver is a critical organ for healthy estrogen metabolism and elimination.
Because curcumin is anti-inflammatory, it can provide powerful pain relief, always useful with menstrual pain and other issues. Clinical studies have shown that it can relieve PMS symptoms, help with women struggling with endometriosis, and helps prevent a variety of cancers.
Grape Seed Extract and Aromatase
Grape seed extract contains oligomeric proanthocyanins (OPCs) that can be especially beneficial for women struggling with dysfunctional estrogen activity.
A clinical study of women in menopause found that grape seed extract reduces hot flashes, anxiety, sleeplessness and other uncomfortable symptoms. The study participants also saw an increase in lean muscle mass and a reduction in blood pressure as an added bonus.
Perhaps grape seed extract is best known in the treatment of estrogenic dysfunction as a partial aromatase inhibitor. Aromatase is an enzyme that converts androgens into estrogens. Overactive aromatase activity can be especially problematic in breast cancer, so being able to downregulate this activity can be quite useful.
Research has also shown that grape seed extract is also useful for endometriosis and irregular menstrual cycles. Newer tannin-free forms of grape seed extract can perform even better, since they have 100 percent absorbability compared to standard grape seed extract with tannins.
Even More Useful Interventions
Even if I were to write a book, I could not cover every intervention useful for estrogen dominance and dysfunctional estrogenic activity. Just a few more things to consider are chaste tree berry extract and topical progesterone cream. Make sure the progesterone cream is marked as USP progesterone for its content, as some wild yam creams contain no active progesterone.
Melatonin is powerful in regulating circadian rhythms, and that promotes healthier estrogen metabolism as well. It also has anti-cancer properties.
There are many more effective natural interventions, and you may have to experiment a bit to find your best protocol. However, it is worth the effort when you feel the result. VR
References:
1 Kotsopoulos J, Zhang S, Akbari M, et al. BRCA1 mRNA levels following a 4-6-week intervention with oral 3,3’-diindolylmethane. Br J Cancer. 2014 Sep 23;111(7):1269-74.
2 Leong H, Firestone GL, Bjeldanes LF. Cytostatic effects of 3,3’-diindolylmethane in human endometrial cancer cells result from an estrogen receptor-mediated increase in transforming growth factor-alpha expression. Carcinogenesis. 2001 Nov;22(11):1809-17.
3 Sepkovic DW, Raucci L, Stein J, et al. 3,3’-Diindolylmethane increases serum interferon-γ levels in the K14-HPV16 transgenic mouse model for cervical cancer. In Vivo. 2012 Mar-Apr;26(2):207-11.
4 Sepkovic DW, Stein J, Carlisle AD, Ksieski HB, Auborn K, Bradlow HL. Diindolylmethane inhibits cervical dysplasia, alters estrogen metabolism, and enhances immune response in the K14-HPV16 transgenic mouse model. Cancer Epidemiol Biomarkers Prev. 2009 Nov;18(11):2957-64.
5 Chai NC, Peterlin BL, Calhoun AH. Migraine and estrogen. Curr Opin Neurol. 2014 Jun;27(3):315-24.
6 Goel A, Jhurani S, Aggarwal BB. Multi-targeted therapy by curcumin: how spicy is it? Mol Nutr Food Res. 2008;52(9):1010-30.
7 Aggarwal BB, Sundaram C, Malani N, Ichikawa H. Curcumin: the Indian solid gold. Adv Exp Med Biol. 2007;595:1-75.
8 Meeran SM, Ahmed A, Tollefsbol TO. Epigenetic targets of bioactive dietary components for cancer prevention and therapy. Clin Epigenetics. 2010;1(3-4):101-116.
9 Shehzad A, Wahid F, Lee YS. Curcumin in cancer chemoprevention: molecular targets, pharmacokinetics, bioavailability, and clinical trials. Arch Pharm (Weinheim). 2010;343(9):489-99.
10 Khazaei Koohpar Z, Entezari M, Movafagh A, Hashemi M. Anticancer Activity of Curcumin on Human Breast Adenocarcinoma: Role of Mcl-1 Gene. Iran J Cancer Prev. 2015 May;8(3):e2331.
11 Goel A, Aggarwal BB. Curcumin, the golden spice from Indian saffron, is a chemosensitizer and radiosensitizer for tumors and chemoprotector and radioprotector for normal organs. Nutr Cancer. 2010;62(7):919-30.
12 Kijima I, et al. Grape seed extract is an aromatase inhibitor and a suppressor of aromatase expression. Cancer Res. 2006;66(11):5960-7.
13 Eng ET, Ye J, Williams D, Phung S, et al. Suppression of estrogen biosynthesis by procyanidin dimers in red wine and grape seeds. Cancer Res. 2003 Dec 1;63(23):8516-22.
14 Wen W, Lu J, Zhang K, Chen S. Grape seed extract inhibits angiogenesis via suppression of the vascular endothelial growth factor receptor signaling pathway. Cancer Prev Res (Phila). 2008 Dec;1(7):554-61.
15 Kakaiy A, Ayen E, Sadrkhanlou R, Sarrafzadeh Rezaei F. Comparing protective effect of grape seed extract versus atorvastatin on endometriosis in rat model: Evidence for immunohistochemical and biochemical alterations. Vet Res Forum. 2015 Spring;6(2):101-10. Epub 2015 Jun 15.
16 Sapwarobol S, et al. Postprandial blood glucose response to grape seed extract in healthy participants: A pilot study. Pharmacogn Mag. 2012;8(31):192-6.
17 Décordé K, et al. Chardonnay grape seed procyanidin extract supplementation prevents high-fat diet-induced obesity in hamsters by improving adipokine imbalance and oxidative stress markers. Mol Nutr Food Res. 2009;53(5):659-66.
Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
