What is Estrogen?
“Estrogen” is a term used to refer to the three different estrogen hormones produced by the body: estrone (E1), estradiol (E2), and estriol (E3). Estradiol is considered the estrogen with the most impact on mood and behavior.[1] Estradiol is produced and released by the ovaries.[2],[3] The estrogens can also be synthesized in the brain by aromatization (chemical conversion) of testosterone.[4] There are estradiol receptors throughout the entire body, even in bones.[5]
Estrogen Dominance
In 1996, physician John R. Lee released his iconic book: What your doctor may not tell you about menopause in which he coined the term “estrogen dominance”.[6] Estrogen dominance is the notable rise in estrogen, mostly during peri-menopause and menopause, which is no longer matched by sufficient progesterone. Dr. Jerilynn Prior asserts that estrogen dominance is also seen in younger women who have not yet reached peri-menopause.[7] High estrogen is associated with an exaggerated bodily stress response and mood turbulences, making sex hormone analysis an integral tool in understanding mood and behavioral disturbances.[8]
Some common symptoms of estrogen dominance[9]:
- Depression/anxiety
- Hair thinning/loss
- Increased PMS symptomology
- Breast tenderness/fibrocystic breasts
- Low libido
- Bloating/weight gain
- Poor sleep/insomnia
Fluctuating Estrogen
Estrogen and progesterone levels rise rapidly at the onset of puberty and, in cycling women, fluctuate throughout the month. In the luteal phase, or the second half of the menstrual cycle, PMS symptomology may develop due to temporary estrogen dominance. If estrogen is not matched by sufficient progesterone during this time, mood disturbances may ensue.[10] Pregnant women also experience a rise in estrogen and progesterone levels which then fall rapidly at postpartum. At perimenopause, levels often become irregular and then gradually decline.[11]
Estrogen and Mood
Healthy levels of estrogen are necessary for optimal mood and behavior. Estrogen stimulates increased dopamine and serotonin receptors in certain parts of the brain, and depression is associated with a decrease in estrogen levels.[12],[13] For this reason, synthetic estrogen was introduced as a treatment protocol for depressed, menopausal women in 1966 by Dr. Robert A. Wilson. It wasn’t until 2002, six years after Dr. Lee coined “estrogen dominance”, that synthetic estrogen was considered a potential health hazard, as women taking synthetic estrogen presented with osteoporosis, poor heart health, and cognitive impairments.[14]
Estrogen, Behavior, and Neurotransmitters
Estradiol supports dominant behavior in women, leading researchers to assert that estradiol plays a role in women parallel to that of testosterone in men.[15] Estradiol can modulate calcium concentrations, protein phosphorylation, and diverse signaling pathways within seconds.[16] Estrogen is also associated with increased neuronal excitability, with estradiol specifically increasing neuronal response to glutamate, the body’s primary excitatory neurotransmitter.[17],[18] Researchers have even found an association between seizure frequency and higher estradiol-to-progesterone ratios.[19] GABA, the body’s primary inhibitory neurotransmitter, is necessary for feelings of calm, relaxation, and rest. Estrogens inhibit GABA synthesis, while progesterone counteracts this inhibition.[20]
Rebalancing Sex Hormones: Estrogen and Beyond
Due to estrogen’s wide array of effects in the body, it is easy to understand the plethora of potential issues that can stem from estrogen dominance. On the contrary, some women have too much progesterone and too little estrogen. Feelings of sluggishness, fatigue, and sleepiness are associated with this imbalance. Correcting hormone imbalances requires working with a practitioner familiar with neuroendocrine biomarker testing, bio-identical hormone therapy, nutritional supplements, and patience.[21]
If you believe you may suffer from estrogen dominance, contact your healthcare provider or find a provider in our network to discuss sex hormone analysis.
References
[1] Stanton, S. J., & Edelstein, R. S. (2009). The physiology of women’s power motive: Implicit power motivation is positively associated with estradiol levels in women. Journal of Research in Personality, 43(6), 1109-1113.
[2] Stanton, Ibid.
[3] Rehman, R., Khan, R., Baig, M., Hussain, M., & Fatima, S. S. (2014). Estradiol progesterone ratio on ovulation induction day: a determinant of successful pregnancy outcome after intra cytoplasmic sperm injection. Iranian journal of reproductive medicine, 12(9), 633.
[4] Cornil, C. A., Ball, G. F., & Balthazart, J. (2006). Functional significance of the rapid regulation of brain estrogen action: where do the estrogens come from?. Brain research, 1126(1), 2-26.
[5] Nilsson, S., Makela, S., Treuter, E., Tujague, M., Thomsen, J., Andersson, G., … & Gustafsson, J. Å. (2001). Mechanisms of estrogen action. Physiological reviews, 81(4), 1535-1565.
[6] Foss, K. (2007, 04). Estrogen nation. Chatelaine, 80, 73-74,76,78. Retrieved from http://nclive.org/cgi-bin/nclsm?url=http://search.proquest.com/docview/214082397?accountid=8385
[7] Foss, Ibid.
[8] Shansky, R. M., Rubinow, K., Brennan, A., & Arnsten, A. F. (2006). The effects of sex and hormonal status on restraint-stress-induced working memory impairment. Behavioral and Brain Functions, 2(1), 8.
[9] Goncalves, K. (2017, March 01). Hormones Out of Balance? Could be Estrogen Dominance. Retrieved from https://www.thefamilythathealstogether.com/estrogen-dominance-signs-symptoms-causes/
[10] Ueda, Etsuko. (2013, January 2). Estrogen dominance: it’s not just a theory. Retrieved March 5, 2018, from http://hormoneresearch.blogspot.com/2008/05/lets-get-it-started.html#_edn8
[11] Vemuri, M & Williams, K.E.. (2011). Update on estrogen and progesterone as treatments of mood disorders in women. Psychiatric Times. 28. 58-63.
[12] Fink, G., Sumner, B. E., Rosie, R., Grace, O., & Quinn, J. P. (1996). Estrogen control of central neurotransmission: effect on mood, mental state, and memory. Cellular and molecular neurobiology, 16(3), 325-344.
[13] de Novaes Soares, C., Almeida, O. P., Joffe, H., & Cohen, L. S. (2001). Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial. Archives of general psychiatry, 58(6), 529-534.
[14] Foss, op. cit.
[15] Stanton, op. cit.
[16] Cornil, op. cit.
[17] Vemuri, op. cit.
[18] Stevens, S. J., & Harden, C. L. (2011). Hormonal therapy for epilepsy. Current neurology and neuroscience reports, 11(4), 435-442
[19] Stevens, Ibid.
[20] Stevens, Ibid.
[21] Ueda, op. cit.
Clinical Contributor
Sophie Thompson
Clinical Support Specialist at Sanesco International, Inc.
Sophie recently obtained her degree in Biology from UNCA in Asheville. Born and raised in Asheville, her hobbies include painting, writing and spending quality time with her dog and her family.
