Estrogen dominance vs deficiency (long post!)

OK, so this subject is getting more and more interesting to me, especially since I've been on both estrogen and progesterone (both natural) for the past five and a half years, and it's often recommended you don't stay on them for more than five years or the risk of breast cancer among other things increases. I found the following articles both interesting and a little scary:

members.tripod.com/~Nettie_...

drnorthrup.com/estrogen-dom...

I have to admit I cannot remember how I was diagnosed both estrogen and progesterone deficient...if it was based on my age (I was 42 when I had my first appointment with my current hormone doctor), or because I was diagnosed with adrenal deficiency, or possibly both. But I was put on both Estrogel (day 5-25 of cycle) and Utrogestan (100 mg, later raised to 200 mg, at bedtime, day 15-25 of cycle).

I did not have any real problems until lately but, looking back, I realise that NDT has not worked as well for me as expected, and that I need high doses of it to make it work optimally and keep my free Ts in range. A couple of years ago, I self-diagnosed with excessive rT3 levels and took T3 only for a while (ordered online), but felt much worse on that, so I guess my problem was not high rT3 levels after all.

I have since read that estrogen dominance increases levels of thyroid binding protein, and both T4 and T3 attach to it, thus decreasing the levels of free Ts available to the body. That could explain why I seem to require high doses of NDT to rid myself of all symptoms, keep my FT4 and FT3 in range, and feel truly well.

I find the information on this subject contradictory and confusing. However, from what I gather, after reading lots of articles on estrogen deficiency vs dominance, it seems no woman should take estrogen before menopause unless specific conditions are fulfilled (hysterectomy etc). I have been on both E and P for almost six years, and I am still having periods (although they have been erratic lately). I am 48.

Lately, I have been experiencing symptoms which seem to be present in both E deficiency and dominance, such as sleeping problems (waking up several times every night), night sweats, hot flushes, as well as erratic periods (sometimes coming as often as every three weeks, lasting three days instead of six or seven, then back to normal).

I do know that I was put on HRT years before the first signs of peri-menopause appeared and, in retrospect, I am beginning to wonder if that was indeed a good idea...however, back then, I did not not know half as much as I do now, and I was just grateful to have found a hormone specialist willing to prescribe the hormones I was convinced I needed as a result of my hypothyroidism and adrenal fatigue.

I would be interested in hearing from as many members as possible who have been on either or both hormones, especially if you're peri- or postmenopausal. What worked for you? How long did you take them? If something did not work for you and you changed your treatment somehow, what did you change and how did it work out? Anything would be of interest, as I realise I cannot depend entirely on doctors, not even so called hormone specialists, in this case. I simply cannot see myself continuing to use E and P indefinitely...at least not E, although P does not seem uncontroversial, either. And few doctors (at least conventional doctors) seem to think you should continue to use sex hormones once menopausal.

I sometimes get the impression the so called hormone doctors think anyone over 40 needs to supplement all hormones simply because they will start declining at that age. But many of the articles by US doctors I've read on the subject claim that you can have lowish E levels, yet be estrogen dominant because your P levels are even lower compared to your E levels (it seems P levels start decreasing earlier and much more markedly than E, thus creating an imbalance pretty early on, and often years before the first signs of peri-menopause), making it hazardous to prescribe E simply because you are X years old. Also, I have never been able to fully understand which standards these hormone doctors use. Are there recommended/ideal levels of sex hormones for a given age group, or are we just supposed to take enough hormones to restore our levels to what they looked like in our early 20s?

I know I can and should discuss this with my doctor, and I will (my next appointment is a little over a month), but there is so much knowledge and expertise here that I'd really appreciate comments and feedback from members...because this is one area where I am not sure I fully trust my doctor. I sometimes get the impression they just keep prescribing hormones, just looking at your levels on a given day, but don't bother comparing them to see how they relate to each other...and I understand that is crucial when it comes to deciding whether you are E dominant or deficient (and it seems many symptoms can be present in both both cases as well, which only adds to the confusion...).

[phoenix23002]

Hi, anna. Out of the blue, I started having heavy periods, moodiness, brain fog and especially.... insomnia. I hated the insomnia in particular. This was back in the mid-nineties when I was in my early fifties (can't remember exactly). I heard of a book titled.. "What Your Doctor May Not Tell You About Menopause" by Dr. John Lee. He was the pioneer doctor who used natural progesterone cream on his women patients and noted startling results from supplementing the cream.

Intrigued, I read the book. My mother had passed away from a brain hemorrhage at a young age and my sister was close to me in age ... didn't know any older women so no one to give me any insight into approaching menopause. The information in the book gave me the confidence to plow into self-dosing. It didn't take long for me to see results. Being able to sleep was the first thing that righted itself; then the brain fog, moodiness and the flooding stopped.

This was twenty years ago and I still use natural progesterone cream two weeks out of each month and I am now almost 75 yrs young. We never stop making estrogen... levels of estrogen just drop to lower levels so that we no longer have periods. But, progesterone levels drop suddenly. We make tons and tons of progesterone while we are pregnant. Is that where that lovely pregnant 'glow' comes from? lol.. You can check to see if you can purchase the book, new or used, on Amazon. After reading it, you will probably know more than most doctors know about your hormones and how your body works. Oh... and supplementing natural progesterone also protects our bone health and slowly helps to balance all our hormones which explains how/why progesterone helps correct insomnia (sleep is controlled by the hormone melatonin).

[Hidden in reply to phoenix23002]

Thanks a lot, very informative

Speaking of Dr. Lee, I just stumbled upon this article:

bonvida.biz/pages/articles/...

I would not mind continuing to use natural progesterone (pills or cream) indefinitely, but I am having more and more serious concerns about the safety of long-term use of estrogen...even natural estrogen. Judging from the article linked to above, I am currently not estrogen deficient but rather dominant as my periods are about three weeks apart (they used to be very regular, every 28 days)...

The realisation is beginning to dawn on me that doctors don't always know more than we do, so sometimes, we just need them to write scripts for the drugs that we do need...while ignoring the rest they say. That's how I have been dealing with scripts for HGH injections all along, BTW...I simply cannot bring myself to give myself daily injections of it. I am not saying it can never be beneficial, just that I personally could never envisage it.

[phoenix23002 in reply to Hidden]

I read the article and estrogen dominance vs estrogen deficiency? potatos... potatoes.. lol.. Part of our existence is that we will produce less and less estrogen as time goes by. This is perfectly normal. Supplementing with NATURAL progesterone 'blunts' the effects of the estrogen our bodies produce and is protective of our breasts and reproductive organs.

When we first start progesterone, it will sensitize our cells to estrogen and our other hormones and we can even experience some of the estrogen dominance symptoms for a few months then it all settles down again as we continue using the natural progesterone.

I agree about the continuing use of estrogen. The right kind of estrogen in small doses can be helpful but I think even tapering off of supplemented estrogen is smart as we get older. That is just my very personal opinion. Folks should do their own research and homework so they can make informed decisions for themselves and their bodies.

And, yes. That is what I do.. educate myself and use my sweet doc for prescriptions and tests. Here in the US, docs are handcuffed to the 'standard of care' dictated by the AMA or they find themselves in hot water. Things aren't as bad here as they are in the UK with the NHS but it means docs are reluctant to help us or get involved with alternative treatments/medications. We are on our own but at least we have freer access to alternatives, herbals, homeopathy etc.

[Hidden in reply to phoenix23002]

What you say makes a lot of sense

Also, I have been wondering lately how taking estrogen will affect natural aging, and if I will just continue to ovulate and have monthly periods if I stay on it...another reason IMHO to wean off it.

Dr. Lee's book sounds interesting; I will see if it's still available.

Thanks for all your valuable input,

Anna

[Angel_of_the_North in reply to Hidden]

I take 2mg of oestrogen a day and don't have periods.

[magsyh]

I am now 59 and just gone through menopause. Ive had 12 years of hell but never had a hot flush. I found every doc I spoke to had different ideas about hormones. At end of day they were useless because I was different and they all asked the same questions did i have hot flushes? No, ok its not ur hormones then? I was obviously estrogen dominant even had large fibroids and heavy bleeding till I was 57. I kept asking for progesterone and was told no at your age you dont need it! They kept trying to push estrogen on me i kept saying no. I get private scans now as nhs were no help. They even refused to test my hormones. So i did that privately too. My progesterone was so low they couldnt read it. My estrogen is also low but what is important is P to E2. Mine was only 5:1 it should be 100:1 post menopause to feel well. A fertile woman should be much higher. My womb lining was growing out of control so i started using natural progesterone cream. My womb lining a year later is 3.6mm. The nhs werent bothered they just kept doing biopsies. No I dont trust docs anymore. I realise how little they really know and once you reach a certain age they are not interested. So if your gut instinct is telling you something i would question it. If i were in your shoes ditch the estrogen and get ur hormone ratio tested. Im 59 I have never looked my age. If you want the best anti wrinkle treatment ever buy jojoba oil it works miracles on little lines and uneven complexion. Xx

[Hidden in reply to magsyh]

Thank you so much for this input and suggestions, very useful indeed!

The more I read and hear from others, the more I begin to question the need for estrogen replacement in every woman over 40...!

[Angel_of_the_North]

I've been on them for more than 5 years (7). I think it depends more on how you react - uterine lining etc- than the actual time in years (which seems to have been picked out of a hat). If it was not such an obvious number (eg 4.5 or 6), I'd trust it more - a bit like 5 a day. I've been advised to have a pelvic scan every year, as well as bloods. My bloods aren't like a 20-year-olds, more like a normal post-menopausal woman as opposed to like someone who didn't make any hormones at all to speak of. No periods (and none for several years before I started on hormones - I tried all the natural remedies before going for HRT). My doctor is from a different school of thought and I take same dose every day, every month. My progesterone has been increased a couple of times.

[Hidden in reply to Angel_of_the_North]

Interesting!

I agree you should not focus too much on numbers; that goes for thyroid hormone levels, including the TSH, as well...

However, I have been thinking more and more about the importance of balancing E and P (E= estrogen, P = progesterone), and how many women are prescribed estrogen at the first signs of peri-menopause...the Hertoghe doctors at least insist you need to take P as well, for ten days every cycle, which I understand is safer than using E alone...however, if, after a certain age, P levels fall much faster and more steeply than E (which the body continues to make from fat), then it's no wonder if some women continue to have in imbalance between the two hormones, even if their doctor is careful to prescribe P along with E.

I have been having some very strange symptoms which I never attributed to E dominance, such as brittle nails, hair loss (at least I have a lot of hair so nobody notices), night sweats and disturbed sleep (I always thought E deficiency caused those), as well as mental disorientation, confusion and memory problems (mentioned in the first article I linked to in the original post).

My GP referred me to a neurologist late last year, and half a dozen EEGs, a CAT scan and an IRM were ordered. They could find no reason for my mental problems, so the diagnosis was "atypical epilepsy" for which I was prescribed an anti-epileptic drug. I have been on it for the past six months and, although I have seen some improvement, I am still not 100% symptom free. When I saw him in late May, the neurologist suggested I keep taking the anti-epileptic drug as it seems to be calming down whatever invisible hyperactivity is going on in my brain, but it goes without saying that I'd like to wean off it one day. One common side effect of this drug is increased irritability, but that could also be caused by fluctuating sex hormone levels...after all, I'm 48.

Until I found the article in question yesterday, I never made the possible connection between my mental problems and estrogen dominance, and I still think it sounds a bit far-fetched and would almost offer me a too easy way out of all this...but, I cannot deny that I display surprisingly many of the 35 symptoms of E dominance listed in the article.

I was put on HRT in late 2011, just before I turned 42, and the first mental problems appeared in early 2014, right after I turned 45...after a little over two years on HRT.

[Angel_of_the_North in reply to Hidden]

I have had brittle nails since my teens and hair loss for the last 25+ years, so I don't think they are necessarily related to oestrogen. I have always taken progesterone as well (every day) and now don't get disturbed sleep often - sometimes I do - but nothing like I did before the HRT. I was in my mid 50s when I started it and post-menopause.

[phoenix23002]

anna... have you tested your iron, B 12 and D 3? Have your optimized your thyroid medication dosage? When we are stressed and our adrenals are under fire (so to speak), they will 'swipe' hormones from wherever they can. This is just my opinion but I think supplementing natural progesterone (I think the cream is best) and in a way that mimics our bodies normal production of progesterone, it helps the adrenals to have more hormones to draw on if and/or as needed... a cushioning perhaps?

Being hypo and experiencing estrogen dominance/deficiency have some symptoms in common. Plus both conditions' symptoms are all over the map and often overlap.

I just find it very telling that thyroid problems often surface among women in their early, mid-forties... just as their hormones begin to get out of whack. Then when you throw xenoestrogens (fake, synthetic, chemical estrogens from food, products etc) into the mix, it can become a real mess and hard to sort out.

[Hidden in reply to phoenix23002]

Not for a while, but I am due to have tests in two weeks (seeing my hormone doc in a month, and usually go to the lab two weeks before that), and will have both iron, B12 and D3 tested.

I remember something I read in Mary Shomon's book "Living well with hypothyroidism" years ago, right after being diagnosed with Hashimoto's at age 31...it's the first book I ever read on the subject, and I keep coming back to it.

She says in the book that menopause can wreak havoc on an already unstable endocrine system, and now I understand what she means...I know the adrenal glands usually continue to produce some of the hormones the ovaries are no longer producing after menopause, but does that apply to those of us diagnosed with adrenal fatigue as well...? Is the latter a temporary or a permanent condition? Is it reversible or irreversible? Not even so called hormone specialists seem to agree on the subject...the Hertoghe doctors in Belgium seem to consider it permanent and keep renewing your prescription for HC or Medrol, year after year.

I will start by stopping Estrogel, and using progesterone only for a while (day 15-25 of cycle). The problem is my periods are all over the place; lately, I've had two periods with only 18-19 days between, followed by a normal (28 days cycle) period, only to have my periods start again on day 19...so not sure when to take P, to be honest. Maybe my periods will become more regular without E, or this will just get worse until my periods stop altogether...? To be honest, I'd welcome that.

[Angel_of_the_North in reply to Hidden]

I take all hormones every day - but I'm post menopause in case that makes a difference.

[Hidden in reply to Angel_of_the_North]

Yes, I think it does, as I remember reading somewhere (cannot remember where right now) that women still having periods should not take E, only P.

[Hidden in reply to Hidden]

Hi Anna, we have exchanged info on E & P a few months back. Just to recap I am 52 still peri and stopped synth HRT, which I had been on for 18 months, in Jan,when I also started on thyroid meds. At that time I was also reading about E & P and believed, through symptoms and blood test that I was E Dom. So I had my pot of P at the ready waiting till I had thyroid in a better place. Incidentally my cycles too are very erratic which made testing a little tricky. I'm obviously getting closer to meno.

What I have found since being on P cream, now 2 months, which I take from about day 12 for 10 days (suits my cycles) is that I no longer have breast tenderness, sleep a little better, and suffer less PMT and periods are significantly less painful and lighter. Though this month I am heading towards a longer cycle so wishing I'd started a little later and a few days longer! But it seems to help. I only take a small amount as suggestions seems to be go low and slow. We are all different and this is just my experience.

So, I am 6 months on, and of course thyroid will play a part in all of this. But I too think that whilst peri and with E Dom, taking E (all 3) seems a bad idea. I know you were taking Bio, but even so it is questionable whilst still peri. When I spoke to GP about P only she said that only needed to balance E and no benefit in it's own. So on that basis I decided that her view was typical of GP thinking and unhelpful for me.

I think there are benefits to using just estriol when required.

I don't know if any of that is helpful, it's all a bit of a game, isn't it 😊.

[Hidden in reply to Hidden]

It's very helpful indeed, thank you so much!

I believe P is what protects us from cardiac disease, and that's the reason why postmenopausal women run the same risk as men to end up with heart problems. When we are no longer producing P, there is nothing to protect our heart or blood vessels...So I'd definitely say P has a role to play on its own...!

Thanks again for your input, what you say is both interesting and useful!

[Hidden in reply to Hidden]

That's interesting about heart protection, I think I may have missed that and something to read up on. Thanks 😊

[Hidden in reply to Hidden]

johnleemd.com/heart-disease...

[Simba1992]

Stumbled on this. Might interest you.

raypeat.com/articles/articl...

[Hidden in reply to Simba1992]

Very interesting, indeed, thank you so much!!!

[phoenix23002 in reply to Hidden]

anna... here is another article that illustrates the link between adrenals and progesterone. I think adrenal fatigue or adrenal exhaustion can be treated but I am woefully ill-informed about the condition because I have never had it myself.

raypeat.com/articles/articl...

You might google (search) for something called an adrenal cocktail. Adrenals run on salt (natural or celtic salt) and adding 1/2 to 1 tsp of natural salt to a glass of water and drank twice per day or so can help to support our adrenal function. You can also add some lemon juice and a sweetner like stevia or agave to the mix which can make the 'cocktail' more palatable.

[Hidden in reply to phoenix23002]

Wow, that really sounds great...since being diagnosed with hypertension years ago, and put on drugs, I have avoided salt like the plague...but not all salts are created equal, right...? Thanks again, really helpful

[phoenix23002 in reply to Hidden]

anna... do read up on the adrenal cocktail and the use of salt and, of course, don't overdo it. I would start off small and drink plenty of fluids with the 'cocktail'. Often when we don't consume enough fluids, the body will stubbornly hold onto the fluids we do take in. I think the STTM website has some useful info on adrenals and treating them.

[Hidden in reply to phoenix23002]

Once again, thanks a lot