If you were a patient in my office concerned about whether or not you were suffering from an underlying hormone imbalance, I would most likely order comprehensive hormonal profile via a saliva or capillary blood spot test. Still, in 9/10 cases, I could easily diagnose your hormone imbalance by asking you four simple questions. Those four questions are:
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Question #1: How Old Are You?
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Question #2: How Long Have You Been Overweight?
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Question #3: Are You Experiencing Symptoms of Estrogen Dominance?
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Question #4: Is Your Environment Putting You At Risk?
Here is what your responses would tell both me and you:
Question #1: How Old Are You?
If you are a woman over thirty years of age, you are most likely estrogen dominant. If you are a man over forty, you are most likely estrogen dominant
Why Age Matters
As a woman enters her early to mid-thirties, the balance of hormones within her body begins to shift, beginning with a decline in progesterone even while the ovaries are still producing enough estrogen to stimulate the monthly cycle. In fact, progesterone production declines 120 times more rapidly than does estrogen. It’s this downward shift in progesterone production that causes the body to become estrogen dominant.
A woman in her early to mid-thirties through her mid to late forties who is regularly menstruating is said to be pre-menopausal. At the time that a woman’s periods become irregular, sometimes skipping multiple months at a time, she is said to become peri-menopausal. In this stage of life, the ovaries’ production of estrogen is also declining, but progesterone production continues to decline even more significantly. The result: continued estrogen dominance.
Even during and after menopause, estrogen dominance is still a concern. The average age of a woman entering natural menopause in the United States is fifty-one years old. Many women make the mistake of thinking that if they are no longer menstruating, they no longer have to worry about the levels of hormones that are circulating in their body. This is wrong. It is misconception to believe that when a woman stops having periods, her ovaries turn off like a light switch.
While menopause evidences a drastic shift in your body’s hormonal equilibrium, it does not mean that the sex hormones are suddenly absent from the body. The ovaries of a menopausal woman are still quite actively producing forty to sixty percent of the estrogen produced by a pre-menopausal woman. Progesterone production, however, continues to decline. The result is that many menopausal and post-menopausal women continue to suffer from estrogen dominance.
Approximately one in every four American women will enter an abrupt, artificial menopause as a result of a surgical hysterectomy. If you are a woman who has had a partial hysterectomy, e.g. removal of the uterus only, you can still be estrogen dominant because your ovaries will continue to produce some estrogen and even less progesterone.
Now, if you are a woman who has had a complete hysterectomy, e.g. surgical removal of the entire reproductive tract including the uterus, tubes and ovaries, you can still be estrogen dominant.
Estrogen Dominant Men
With regard to men, Question #1 is easy. If you are a man over 40 years of age, your progesterone and testosterone levels have already started to decline. If you feel sluggish, bloated and/or lethargic, these are symptoms of an underlying hormonal imbalance. Your age and your symptoms indicate that you are in the midst of male menopause, or andropause. In addition to your age, decreased sexual appetite, abdominal weight gain and an inability to lose weight are two red flags signaling that you are most likely estrogen dominant.
Question #2: How Long Have You Been Overweight?
If you have been ten pounds overweight for a year or more, you are most likely caught in the cycle of increasing estrogen dominance. As described in Chapter One, high estrogen levels cause you to add more fatty tissue onto your body, which in turn, produces more estrogen in your body.
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Question #3: Do You Have Symptoms of Estrogen Dominance?
Weight gain is only one symptom of an underlying hormone imbalance. If two or more symptoms in the following checklist apply to you, and if these symptoms have been present for more than three months, your symptoms very likely signal that you are suffering from an underlying condition of estrogen dominance.
Why the Symptoms Are Often Overlooked |
Because hormone receptors are located throughout the body and in the brain, estrogen dominance can manifest in a host of physical, emotional, and mental ailments. In addition to causing your waistline to expand, symptoms of estrogen dominance can include anxiety, depression, fatigue, breast tenderness, headaches or migraines, digestive disorders, fuzzy thinking and/or memory loss, fatigue, and low libido.
Many patients who have the “love-handle blues” end up leaving their doctor’s offices with a prescription for antidepressants. Unfortunately, the inappropriate use of antidepressants to treat estrogen dominance is far too common. In recent years, more than 70 percent of prescriptions written for the type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) came from primary care and OB/GYN physicians; physicians who have no special training in mental health disorders!
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Question #4: Does Your Environment Put You At Risk?
Simply living in an industrialized nation puts you at risk. Of course, if you are in a work situation where you are constantly being exposed to toxic fumes or if your home is located near a toxic waste dump, the chances that your environment is contributing to your condition of estrogen dominance is even greater.
Environmental estrogens, or xenoestrogens can be found in certain pesticides, herbicides, fungicides, plastics, fuels, car exhausts, dry cleaning chemicals, industrial waste, meat from livestock fed estrogenic drugs to fatten them up and synthetic estrogens and synthetic progesterone (chemically termed progestin) found in the urine of millions of women taking birth control pills and synthetic hormone therapies that is flushed down the toilet and eventually makes it way back into the food chain. Over time, these foreign estrogens can dangerously accumulate and increase the estrogen load in the body.
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Younger Women and the Risk of Environmental Estrogen Exposure |
Chronic exposure to environmental estrogens can contribute estrogen dominance occurring at a much younger age. The increasing number of younger women who are experiencing “anovulatory” menstrual cycles is a silent signal of estrogen dominance. By definition, an anovulatory cycle is a menstrual cycle in which ovulation fails to occur, which means that a woman bleeds but doesn’t release an egg or ovulate. Anovulatory cycles occur when a person’s body isn’t making enough progesterone to balance out the estrogens that build up the uterine lining. Recent medical studies have shown that by age thirty-five, approximately 50% of women are having anovulatory cycles.
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What Now?
Based on your answer to all four questions and what you have read, you should now be able to determine if your age, your body fat, your physical, emotional and mental symptoms and/or your chronic exposure to environmental estrogens signal that you are suffering from an underlying hormonal imbalance called estrogen dominance.
It has been my experience that approximately eighty percent (80%) of women and men have found that they can successfully self treat their condition of estrogen dominance by using over-the-counter bio-identical progesterone cream to re-establish an equilibrium between estrogen and progesterone levels.
Still, one-size-will-not-always fit all. For those twenty percent of persons who do not achieve a full response or alleviation of symptoms after using the over-the-counter bio-identical progesterone cream, I recommend that they consider doing a saliva test and having a consultation with one of my trained nurse practitioners.
The good news is that you don’t have to live in hormone hell. There is hope and a solution waiting for you.
I wish you WELL!
Dr. Randolph
* Please Note: Because legally we are unable to provide prescriptions for telephone consultation patients unless they have been previously seen in my office, should you require a prescription for a more comprehensive panel of bio-identical hormone replacement, my nurse practitioner will advise you how to locate a physician and compounding pharmacy in your area.
