Go off estrogen...?

I hope it's OK to ask about other hormones than thyroid hormones as well.

I was put on bio-identical estrogen (Estrogel) last year, to be used 25 days a month, along with progesterone (Utrogestan, 200 mg) to be taken ten days a month. The hormones were prescribed by the anti-aging doctor who also prescribes NDT.

However, I am not sure estrogen has been good for me. Since starting it, I have developed new symptoms such as bloating, swollen, tender breasts, and weight gain. After being overweight for years on T4 only (diagnosed with Hashimoto's 19 years ago), I had finally managed to lose 20 kilograms on Thyroid-S, and had a normal BMI for the first time in decades. Since July 2018, when I was put on estrogen, I have gained 20 kgs and seem unable to lose weight no matter what I do. After doing well on NDT for years, I now feel slightly hypothyroid even on 5 grains of NDT daily. I have not had labs since going on estrogen/progesterone (next doctor's appointment is in October).

I have read a lot about estrogen dominance, and how it can wreak havoc on the body. All of the symptoms I've developed in recent months are indicative of estrogen dominance. Also, I used to gain weight all over my body, whereas now, it's mainly in the abdominal area.

Some alternative doctors in the US claim that most peri-menopausal women (I'm 48) are actually estrogen dominant, not estrogen deficient, and need progesterone but not estrogen.

Also, I have been diagnosed with adrenal fatigue, took prednisolone (5 mg daily) for a couple of years (prescribed by same doctor) but weaned off it as I did not feel comfortable taking steroids indefinitely. I have read that, when the adrenal glands cannot make enough cortisol, the body will use progesterone to make cortisol (as the body prioritizes cortisol over sex hormones), making estrogen dominance even worse.

I have read that estrogen increases levels of TBG (thyroid-binding hormone), so that less thyroid hormone enters the cells, thus causing hypothyroidism even if someone is on thyroid hormone replacement.

I'd be interested to know if anyone else has experienced the same thing, and felt better after going off estrogen?

[Angel_of_the_North]

Those are symptoms of too much oestrogen (or too little progesterone), so why don't you just lower the dose slightly until you can see the doctor again? biodentical hormones have been shown to be protective against breast cancer - and I can tell you that vaginal atrophy and other low oestrogen symptoms are really, really nasty. Are you getting a check up with bloods at least once a year and pelvic scan? Get a phone consultation if you don't feel right and can't easily go for a physical appointment.

[Hidden in reply to Angel_of_the_North]

Thanks for your input!

Yes, I see the hormone/anti-aging doctor once a year and my gynaecologist as well. Last year, I was diagnosed with ovarian cysts which, I've found out, can also be caused by high estrogen levels.

The problem is some doctors claim we make enough estrogen even after menopause, and that it's the estrogen/progesterone ratio that is the real problem, not estrogen deficiency per se...so it's difficult to know what to think sometimes...!

[Angel_of_the_North in reply to Hidden]

I thought ovarian cysts were caused by high androgen levels - do they test your DHEA and testosterone? I was definitely oestrogen deficient (and progesterone deficient) running up to and after menopause. Bioidenticals gave me my life back. However, my doctor is one of those who believes giving the same dose every day rather than trying to emulate a menstrual cycle. So I take more progesterone than you every day. They are two different schools of thought and "never the twain shall meet"

[Hidden in reply to Angel_of_the_North]

Yes, my anti-aging doctor tests both testosterone and DHEA. I plan to go to the lab in September ahead of my October appointment.

It's confusing because some sites say symptom X is indicative of estrogen dominance, while others say it's indicative of estrogen deficiency...so it's easy to get lost in this jungle of information online...!

[radd]

ASanderson69,

Agree with everything you say but I wouldn’t stop oestrogen. Just lower it or increase progesterone.

I take my Utrogestan for 25 days out of 28 day cycle. I am supposed to bleed on these three days but never have as everything was so messed up, but like AOTN, bio-identical HRT gave me my life back.

[Hidden in reply to radd]

How much Utrogestan do you take? I read that some do better on 100 mg 25 days a month, rather than 200 mg ten days a month.

[radd in reply to Hidden]

ASanders69

Yes. 100mg.

[Greekchick]

Hi ASanders,

I was on HRT for 5 years between the ages of 55 and 60. I never felt better in my life and my borderline hyperthyroidism improved while I was on HRT.

I found in the beginning I was on too much progesterone, and it made me very moody and irritable. Once my dose was adjusted I felt great. I hated to go off it but the guidelines back then were 5 years max and not after 60.

Even with estrogen/progesterone we are all so different with respect to dosing. I would tend to agree with radd - in your case more progesterone may be indicated .

Hope you resolve your issue and feel better soon. All the best to you.

[Hidden in reply to Greekchick]

Thanks for your input! Can I ask how much progesterone was too much for you? It seems too much progesterone can cause the same symptoms as estrogen dominance, so I should also keep an eye on my progesterone levels...

[Greekchick in reply to Hidden]

I was on 0.5 mg of Estrace (estradiol) and 100 mg Prometrium (progesterone) daily. I was also started on 200 mg of Prometrium but then it was lowered to 100 and I felt great. The estradiol stayed the same dose. Hope this helps!

[Hidden in reply to Greekchick]

Thanks! It's interesting that you did better on 100 mg than 200 mg of progesterone...too much of a good thing is still too much...!

Can I ask why you were told to take it every day? My doctor said I should take it ten days a month as long as periods are regular, then I can take it for 25 continuous days, but that it's important to have five hormone-free days every month.

Also, I've been wondering if an OTC progesterone cream such as Biovea could be equally effective...? Some claim oral progesterone is not absorbed as well as transdermal P, but my doctor never mentioned that possibility.

[Greekchick in reply to Hidden]

I needed it everyday because I was menopausal and had no periods - it was based on my age. Hope that helps!

[Hidden in reply to Greekchick]

Yes, makes sense, thanks!

[Angel_of_the_North in reply to Hidden]

I started with transdermal creams but found them totally ineffective. Others find them great. To get my dose of progesterone with Biovea cream would mean just over 6 doses a day

[Angel_of_the_North in reply to Hidden]

When my progesterone was too high I get felt sleepy and unmotivated (just blah about everything) - not irritable - what made me irritable was testosterone (full on 'roid rage), so I now I don't take it; I have DHEA instead. I'm on 2mg bi-est a day, and 125mg progesterone and 12.5mg DHEA (100mg progesterone was too little and 150 too much)

[Hidden in reply to Angel_of_the_North]

Unfortunately, Utrogestan is only available as 100 and 200 mg soft capsules so impossible to split...I've heard about others who did not get any effect from Biovea progesterone cream so I think it would be better to stay on Utrogestan for the time being.

Thanks for your input!

[Hidden]

Expect you have read information about food and oestrogen dominance . Too much fat can encourage oestrogen dominance. Expect you will say you don't eat much dairy but some people just dont realise how much they are eating with milk yoghurt and cheese . If you have gained so much weight with oestrogen then it is back to the drawing board on your visit to your doctor. A test for diabetes might help. Dairy contains lactose which is milk sugar so going lactase free might help lower your carbs. Hard cheese is ok like cheddar as it doesn't contain much lactin/lactase, though it contains fat which may be indigestible. Hope you find the right pathway as everyone is different.

[Greekchick in reply to Hidden]

I agree with you about the dairy. I haven’t eaten dairy in years because I am lactose intolerant (even with Lactaid it makes no difference) and I could not digest hard cheese - too much fat. Of course as you say, these things don’t apply to all of us - we are so different!

[Hidden in reply to Greekchick]

Me too but only found out a year or so of weight increase and diabetes. By removing the hidden sugar in cheese and grains I managed to control diabetes but have to watch other multifold intolerances which create histamines and cause other problems with gut. To think a food intolerance test could help years of discomfort makes you wonder about nhs diagnostics as tests are only limited to egg dairy and gluten .

[Greekchick in reply to Hidden]

At least you figured it out and are better! I also cut out sugar from my diet about 3 years ago (don’t have diabetes) and I found by just doing that, my weight was easier to maintain and I had no puffiness at all. Amazing that small changes can yield such big results.

[Hidden in reply to Greekchick]

Yes . Am wary of hormone treatment but some folks swear by it. Have heard progesterone cream is helpful for deficiency. Read research on vitamin k deficiency which can affect ovaries giving rise to cysts but the intricate balance of vitamin d k a d c research is still ongoing. Guess it is a combination of hormones that keeps the endocrine system in sync.

[Hidden in reply to Hidden]

Interesting! I tried a low carb/high fat diet a few years ago (max 5% of energy coming from carbs) and did not do well on it at all...I simply cannot eat that much fat. The proponents of LC diets say you need to replace the energy from carbs with fat, but that did not work for me. Following their advice, I tried adding virgin coconut oil to my coffee and felt nauseous. I went off the LC diet and tried a low glycemic diet instead which worked much better and led to weight gain (with most carbs coming from vegetables, berries, and some fruit).

Some years ago, I read the "Eat right for your type" book and, interestingly enough, it says persons with blood type A should not eat too much meat and are basically vegetarians. According to this theory, they don't do well on high-fat diets and should not limit their carb intake excessively. Although I am not a vegetarian, I don't feel well when I eat too much red meat, and cannot eat large amounts of fat, but feel much better on a diet consisting mainly of fish and poultry along with vegetables.

But you are right about the hidden sugar in many common foods that are often promoted as healthy and good for us...

I've also read that weight loss can cause estrogen dominance as estrogen is stored in fat tissue, so when fat tissue decreases estrogen is released.

[Greekchick in reply to Hidden]

I did poorly on a keto diet because my body hates fats! I am on a low carb, moderate protein, lots of veggies and some fruits, small quantity of fat restricted to olive oil which I seem to do well with. I tried gluten free but it did nothing for me and I missed the small amount of carbs I was eating. I seem to be able to maintain my weight and feel good on this regimen - but obviously, everyone seems to do well on different combinations of food depending on their disease and overall metabolic profile.

[Hidden in reply to Greekchick]

Great to know, thanks for sharing! I find saturated fat (butter, cream, sour cream, full-fat cheese) especially difficult to digest. Like you, I seem to do better on olive oil.

[Serendipitious]

ASanders69,

“Some alternative doctors in the US claim that most peri-menopausal women (I'm 48) are actually estrogen dominant, not estrogen deficient, and need progesterone but not estrogen.”

I’m currently reading The Period Repair Manual by Dr Lara Briden, ND. It’s a fantastic book and she also states that during perimenopause the body can often produce way loads of oestrogen. This is a short quote:

“Perimenopause is a time of “estrogen on a roller coaster” when you can, at times, have more estrogen than ever before. And yet your doctor may offer you estrogen replacement during perimenopause. Do you really want more estrogen when your own is already surging too high?“

Plus you have a lot less progesterone naturally to balance it out, so yes maybe you have too much oestrogen and still not enough progesterone to balance it out?

[radd in reply to Serendipitious]

Serendipitous,

It is fairly common knowledge (even in GP’s) that progesterone starts to decrease 10-15 years before menopause.

Therefore most (healthy) women then suffer oestrogen dominance, which is possibly exacerbated further by oestrogen accumulated from surrounding environmental factors.

The problems are doctors are led to believe :

1) oestrogen dominance is not important because progesterone is not further required, even though in every text book it is known as the opposing hormone to oestrogen and has very specific functions.

2) the adrenals will sequester enough of each hormone to prevent the usual later bone weakening, hair loss, chin hair, etc .. but in many people for a variety of reasons, their adrenals don’t. I was totally deficient in both O & P.

3) that HRT can be unnecessary, especially the more expensive bioidentical HRT because they don’t understand the complexities of methylation.

4) the intricate relationship between hormones working together is not as important as it really is. It took HRT to make my thyroid meds work well.

We should have hormone specialists in “all hormones”. Not an endo fior thyroid and a gyn for sex organs and a neurologist or psychiatrist for head, etc .. because all hormones work together.

[Hidden in reply to radd]

I could not agree more!

[Hidden in reply to Serendipitious]

Yes, that is what I've been thinking lately, especially since I have been displaying many symptoms indicative of estrogen dominance. One new and rather irritating symptom is swollen and tender breasts all the time.

I've been considering going off estrogen for some time, continue to take progesterone only, and see if I notice any difference.

The recent weight gain is worrying. After being diagnosed with insulin resistance a few years ago, I managed to lose 20 kilograms using berberine. I kept my new weight for three years until I started piling on weight again at an alarming rate last summer. Now, I cannot lose a single pound, no matter what I do.

Estrogen dominance is one cause of weight gain, especially around the waist.

High testosterone is another probable cause, but I don't know how likely it is that my testosterone levels would be out of range...could high estrogen/low progesterone possibly cause that...?

I've been considering adding DHEA, but prefer to wait until I've had labs before I start experimenting with hormones. It's obvious that there is some hormonal imbalance causing recent symptoms such as weight gain, bloating, and swollen breasts, so it would be unwise to start self-diagnosing and -treating at this point...

[radd in reply to Hidden]

ASanders69,

Agree, as patience could save you a lot of time & grief in the long run, but still wouldn't stop oestrogen as a deficiency has consequences too.

Elevated cortisol is another cause of weight gain & fat around the middle.

[Hidden in reply to radd]

Yes, I have been considering that too...not sure what could cause high cortisol levels, though...I was diagnosed with adrenal fatigue a couple of years ago, improved on low doses of prednisolone, but weaned off it because I feared the long-term side effects of steroid use...and have been doing pretty well since. I now take Nutri Adrenal Extra (after reading the book "Your thyroid and how to keep it healthy" by Dr. Durrand-Peatfield who recommends prescription drugs for short-term use only and then NAX).

But what could possibly cause elevated cortisol levels in someone diagnosed with adrenal fatigue? I'd be really interested to explore various options as I am not 100% sure my recent weight gain problems are caused by estrogen dominance, only that something is off...

[Murphysmum]

Your case is more complicated than mine but I just wanted to tell you about my oestrogen dominance.

I’m 42 now and hypothyroid for about 17 years. After having a thyroid “crash” as I call it in 2017 I began having problems with my sex hormones too. I had a coil removed in September 2017 and a few months after I developed really bad pain during my period and the swollen sore breasts became unbearable.

I spoke to my doctor who said I had extra cells growing on the outside of the cervix (I’m not awake yet, can’t remember the official name!) and prescribed me painkillers to help each month.

Suffice to say they did nothing. The pain was worse than I’ve ever had, even childbirth, only for about 12 hours but it meant life was on hold every month for a time.

I looked into it and it all seemed to be due to oestrogen dominance, despite my results at the gp being “in the normal range”.

I began to self treat with biovea progesterone cream and the symptoms receded. I have no sore boobs and the pain during my period is almost gone. I had to stop using tampons etc as they were too painful but I’ve been able to return to these recently.

As I say, different story to yours but I thought it might lend weight to your too much oestrogen idea. I’m now at the point I need to visit my gp to discuss use of the cream long term. I’m not sure what I do from here and if it’s safe to keep using it. I think I still have a higher level of oestrogen but as it didn’t show up as out of the ordinary on tests before, I don’t think it will now!

[Hidden]

Wow, that's very interesting and helpful info, thank you so much!

Yes, the more I read about it, the more I suspect estrogen dominance (basically, too little progesterone in relation to estrogen).

The swollen breasts in particular are getting more and more problematic.

Interesting also to hear about your experience with P cream. Some health care professionals claim they are not standardised and that oral P should be used instead, but many seem to do great on transdermal P so I may give that a chance. I like the idea of the hormone being absorbed through the skin rather than the stomach.

[radd in reply to Hidden]

The transdermal cream v oral capsules is usually determined by the amount one needs to replace.