This is something I have been meaning to ask here for a while:
I read recently that adrenal fatigue is bound to cause estrogen dominance as the body will use progesterone to make cortisol when the adrenal glands begin to struggle, and this in turn will lead to estrogen dominance.
All the so called Hertoghe doctors seem to prescribe both E and P to all women in their 40s. As so many other patients with Hashimoto's having spent a decade on T4 only drugs, I ended up with adrenal fatigue diagnosed by this hormone doctor.
I was put on both Estrogel (day 5-25 of cycle) and Utrogestan (200 mg day 15-25 of cycle) and have been on them for the past five years. I was 42 at the time I went on them, and I am still having regular periods. My OB-Gyn told me a few months ago that, based on my LH and FSH readings, she expects me to continue to have periods for at least three or four years.
I am honestly not sure which symptoms are peri-menopausal (if any), but I recently read that one way of deciding whether you are estrogen dominant or deficient is to notice how you feel in the week following your period, when estrogen levels start to rise. If you feel good during the first two weeks following your period, and only then, said this article, that means your body likes higher levels of estrogen. Then, you will start feeling worse about two weeks after your last and two weeks before your next period, as that is when E levels will start to decrease and progesterone levels rise.
I have noticed something in the past few months: that I seem to feel terrible during the week following my period. I am moody, have difficulty controlling my anger and lack motivation more generally. Of course, I always go back on Estrogel on day 5 of cycle.
I don't know if this means anything; could this indicate estrogen dominance rather than deficiency? Has anyone else experienced this, and noticed that stopping estrogen helped?
One thing is certain: the Hertoghe doctors may be much better than mainstream doctors, but they are far from perfect. I have learned a lot from posts here, and this has caused me to question some of their advice. I am especially wary of the assumption that all women in their 40s need to take both E and P. These doctors just look at your levels of each hormone and compare them to what they should optimally be in a healthy patient your age but, from what I gather from various article I have read on estrogen dominance vs deficiency, you should also compare the two to each other, in order to determine whether you are in fact estrogen dominant or deficient...?
Early in my hypo journey which started in Dec (not very long ago, but given what I've learnt it feels an age) I realised from many of the posts on HU and a number of helpful references, that I should stop HRT. I had been on it 18 months and it was a low dose and so decided to just stop 4 weeks ago - with hindsight I might have reduced gradually, but I am where I am! So far it's not so bad - time will tell.... watch this space! Awaiting bio progesterone cream to land in my lap!
What I am realising is that like the many myths that surround good health and the misinformation we are sold from 'those who are qualified' i.e high carbs, fats are bad, thyroid being in range etc etc there continues to be misunderstanding of our needs for additional oestrogen and progesterone. No surprise again that big pharma's hand is pulling the strings! It seems more like guesswork?
I don't yet have the answers, since this is another new eye opener (they just keep on comin ), but I have concluded that unopposed oestrogen is not a good place to be for me, and likely adding it to one's body (especially a synthetic type as I did, but also when so many other foods covert anyway) is not a good thing to do. I have no medical expertise but I am listening to my body ever more and gaining great insight through this forum and the many references people offer - currently reading Dr Lee. I am leaning towards getting hormones fully tested. Learner1 offers some great thoughts on DUTCH testing - thank you!
One things for sure, once entering the hypo/hashi arena, life ain't no bed of rose petals - more like a bed of thorns
• in reply to
SolsticeSS,
Have you not been taking progesterone along with estrogen?
• in reply to
Yes when I was on HRT but both were synthetic. I didn't know very much then, still a lot to learn now, but much much better informed.
It's early days being 'au naturel' but I seem to be oestrogen dominant - based upon symptoms. Everything I read suggests that combined HRT is a continuation of big pharma propaganda.
I need to read a bit more on how I dose with the progesterone cream - many suggest more initially because of oestrogen rebound/reawakening. But others say low and slow. But in any case it's taking an age to get here
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OK. The Hertoghe doctors at least only work with bio-identical HRT...
After starting NDT and my health improving I started researching sex hormones and realised I was most likely estrogen dominant and had low progesterone. I ordered Dr Lee's saliva test which came back as ED and low P. I started using natural progesterone cream and in the last 6 months have also started taking chaste berry and dim regularly. I'm now researching estriol as an addition as it seems many symptoms in peri menopausal /menopausal women can be alleviated by using natural estriol gel. Of course, this is all trial and error but we all need to take ownership of our own health if we want to feel any improvements as I have come to the conclusion that doctors just don't have enough knowledge or interest to make a difference.
Exactly. In the same way many GPs work on TSH numbers as a measurement, GPs also tend to go by the book of okay so your peri HRT might help. Admittedly mine did direct me at Menopause Matters which at least meant I could find out a bit. So I chose HRT with a progestin that was the best of a bad bunch!
I know GPs are strapped for time - 10mins is nothing. But I wish they would point you at the things you need to look into bio options, tests at the right time of cycle, vitamins etc. I hadn't realised quite how ignorant I was. But when you don't know what the questions should be, you ain't gonna ask them!
As you say you have to be responsible for your own health 🙄
Even when you do know what to ask doctors still won't know what to reply. My previous GP had no idea what to suggest to the constant heat I felt that she actually told me she didn't know what to do with me anymore and that I should just put up with the heat. Needless to say I no longer she her. HRT was never an option for me as I no longer want any of these synthetic solutions if I can treat my symptoms naturally. It does bother me though that I can't get any of these natural creams and gels in the UK and have to rely on foreign chemists.
That's very true. I suppose that Iike many, I grew up believing doctors knew best. Now I realise that's just not the case and we are naïve to believe they can. Although it would be a rare thing for most GPs to say 'I don't know'! Interestingly my hubby sees the same GP as I do and she has in the past said to him 'what do you think is wrong with you?' Despite my own 'struggles' I have to say as GPs go, I could be a darn sight worse off. So, as they say, be grateful for what you have!
At least members here can point in the right direction for getting the natural remedies we can't buy from UK sources.
Being estrogen dominant is very dangerous - I ended up with uterine cancer because of it. Wish I'd known about estrogen dominance 5 years sooner...
Progesterone is definitely protective. A bioidentical cream would be good, or there's Prometrium, prescription bioidentical progesterone - it's downside is that peanut oil is an ingredient, but if that doesn't bother you, it's fine.
I can't take estradiol as it could promote cancer. I do take estriol in cream form, though, which has never been linked to cancers.
The DUTCH test is quite useful... look at a diagram of hormone metabolites, including pregnenolone, progesterone, cortisol, DHEA and testosterone. The text will show which metabolites you have, and whether they're cancer promoting or not.
It's been interesting to learn how they move through the pathways, they don't distribute in as orderly a fashion as you might guess...my doctor had me take a big dose of pregnenolone to help my nervous system, and much to our surprise, it all went down to estradiol, bypassing DHEA and testosterone (which I was low in), and giving me all kinds of estrogen dominant symptoms, weight gain, painful breasts, etc.
The lesson here is to educate yourself on all the hormone metabolites. Understand what they do, and the benefits and risks. More is not better. Too little can make you feel awful. Too much can, too. Have respect for what they each do, and realize if you start taking any one hormone, it's likely you'll alter the entire balance.
I've found repeatedly that testing has given surprising answers when my hormones felt off, and as I need to stay safe, it's good to know what's going on.
I hope this makes sense...
One last thought...don't take any hormone that comes from a pregnant horse...not something that belongs in humans...
At least, the Hertoghe doctors (and I'm seeing one of them) only work with bio-identical hormones, so never Premarin or anything like that, and they only prescribe Estrogel (cream), never estrogen pills as Dr. H claims the cream protects the liver.
When you see a so called Hertoghe doctor, and pay +/-200 € (ca 170 GBP) for a consultation, and several hundreds of € for labs, you expect them to know what they are doing...which is why I was not critical at all at first, but accepted everything I was told and prescribed. Back then, five years ago, when I was first put on HRT, I had never even heard of estrogen dominance...now, I have read that your estrogen levels can be low; yet, they need to be put in relation to your progesterone levels which can be proportionally much lower, which means you can have low estrogen levels, yet, be estrogen dominant...in his book, "The hormone solution", Dr. H talks a lot about the benefits of estrogen therapy, but does not mention estrogen dominance at all...all he says is that you need to combine E with P unless you've had a hysterectomy.
• in reply to
Learner1 When you first mentioned all of this in my first post I was a bit overwhelmed as it was all so new - early days of understanding hypo. Having done a lot of reading since I am very grateful for the specifics you mentioned about gut health and female hormones. Now looking at those aspects.
And as you say there's of course the 3 Es to think about. Much research suggests that Estriol has positive actions particularly for VA etc. Dr Lee goes into understandable detail about the pathways. Not everything 'Estrogen/Oestrogen' is good, in fact it's decidedly questionable.
The illustrations of typical E & P levels at the stages in life of female hormonal change is really helpful, of course this has to be balanced with symptoms too, but suggest that E is still being produced in a greater proportion to P.
Natural is better, but ensuring the right E is necessary too.
I have no ovaries after my cancer treatment, so don't make hormones very much at all, so I take what I have. I'm doing fine on a lot more progesterone than estriol... and find that too much estrogen, whether estradiol or estriol, causes unwelcome symptoms.
I've seen a lot of women put on estradiol by their doctors, who are surprised when they get cancer.
Reducing toxicity and keeping sugar and excessive carbs out if the diet can reduce cancer risk also.
Yes, that is what I sometimes suspect...that is, that doctors assume that just because you are over 40 you "have to" suffer from estrogen deficiency, when in truth you may be estrogen dominant...it seems the body can make estrogen from fat, which is why E levels will never drop as low as P levels in menopause...also, I read the other day that, when you suffer from adrenal fatigue (which I have diagnosed with), your body can make cortisol from progesterone, which will further lower P levels compared to E levels...it's really complicated...much more complicated than those doctors seem to realise. I don't want to read too much into things, but I don't want to be on E for 10-15 years either if not completely necessary...
Ask your fancy doctor for a DUTCH test. It's the best, most cost effective one I've found, running $350 US. They're based in Oregon and the test is sent in a standard business envelope.
It will show if you have "pregnenolone steal" and where all your metabolites are going. My doctor and I have found the answers to be surprising at times, and have helped us dial in the right amount.
Being on a small amount of the hormones your body needs protects your bones, brain, etc. And can help manage weight, reducing fat, and the risk of cancer, if done right.
So you are in the US, then...? I doubt there is any lab offering a test like that in Europe...the Hertoghe doctors use a laboratory that offers 24 h urine analyses alongside ordinary blood tests, but that is as far as it goes...I am not even sure doctors here would be able to interpret the results of a DUTCH test correctly. But it's a very interesting suggestion and I'll look into it to see if it can be done here in Europe.
Google it and go through the videos on their website. They do a lot of the interpretation for you. I'm thinking your doctors can order it, and easy to ship long distances. It's far better and cheaper than all the other hormone tests I've done. The only drawback is results take about 3 weeks.
Hidden there are a couple of companies you can access in UK (poss Europe) for the DUTCH test. Someone on the forum posted links -I'm on mob so not easy to link them.
As an aside have a look at Estriol Cream as well - maybe not needed now but good to have a heads up on what's available.
As I've not long been off HRT I'm going to wait a bit before doing tests and using the P cream. If you do the test do post your thoughts 😊.
• in reply to
I will...if I ever get around to it, that is. But I'll look into various options if you live in mainland Europe.
this is an old thread but if you are wondering about where to get the Dutch test in Europe, I can help with that. Please get in touch with me at sh@nordic-labs.com
Thanks,
Susa
I just had a strange experience. The day before yesterday, my period started only 20 days after my latest one (which I thought would also be my last one because it was really sparse and only lasted for two days whereas, in the past, my periods have been heavy and lasted for seven days). I just thought "good riddance" as I will after all turn 49 in a few months...but then, quite unexpectedly, I got my period again, after only five days on progesterone (and fifteen days on Estrogel which contains estradiol).
What is strange is that I have been feeling much better for the past couple of days; sleeping through the night, I don't wake up drenched in sweat each morning, and I also feel less irritable. Estrogen levels drop when the period starts and then start rising again after about five days. If I feel better and some symptoms subside during the days when estrogen levels are low, I wonder if I can interpret this to mean that I should avoid going back on Estrogel...?
Also, I have read that the ovaries in fact produce three kinds of estrogen, and estradiol (prescribed by my doctor) does not even seem to be the one most abundantly produced. Yet, estradiol cream is all that is prescribed...is that the case everywhere? Is estradiol somehow supposed to convert to the other forms of estrogen, just like T4 is supposed to convert to T3...?
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), but I have concluded that unopposed oestrogen is not a good place to be for me, and likely adding it to one's body (especially a synthetic type as I did, but also when so many other foods covert anyway) is not a good thing to do. I have no medical expertise but I am listening to my body ever more and gaining great insight through this forum and the many references people offer - currently reading Dr Lee. I am leaning towards getting hormones fully tested. Learner1 offers some great thoughts on DUTCH testing - thank you! 
estrogen deficiency symptoms?
