Oestrogen dominance, also known as oestrogen excess, occurs when the level of oestrogen outweighs the level of progesterone in the body. This is said to be caused by a decrease in progesterone without a subsequent decrease in oestrogen. From a naturopathic perspective, oestrogen dominance is not only to do with internal hormone imbalance however even more so by external environmental oestrogens known as xenoestrogens.
Excess oestrogen is associated with many health conditions in women and men.
- Weight gain
- Mood swings
- Irregular periods
- Heavy bleeding
- Low libido
- Fibrocystic breast disease
- Polycystic Ovary Syndrome
- Breast cancer
- Ovarian cancer
- Endometrial cancer
- Colon cancer (Advanced colon cancer is associated with a loss of oestroegn receptor β, the predominant oestrogen receptor in colon tissue. Colon cancer is treated with ER (oestrogen receptor)β-specific agonists.
- Benign Prostatic Hyperplasia (BPH)
- Prostate cancer (oestrogen is a major influence in prostate cancer)
- Gynaecomastia (Man boobs)
- Male patterned baldness
- Low libido
- Erectile Dysfunction
- Weight gain
Xenoestrogens are “foreign” oestrogens often widely used industrial compounds such as PCB, BPA and Phthalates, that exert oestrogenic effects though they differ chemically from the naturally occurring oestrogens produced by the endocrine system. Xenoestrogens are also called environmental hormones or EDC (Endocrine Disrupting Compounds).
Xenoestrogens are serious environmental hazards that have hormone disruptive effects on wildlife and humans. Xenoestrogens include pharmacological oestrogens (the drug ethinyl oestradiol used in contraceptive pill and HRT derived from pregnant horses (Conjugated equine oestrogens)) and other chemicals that have oestrogenic effects. Xenoestrogens have been introduced into the environment by industrial, agricultural and chemical companies and consumers only in the last 70 years. Xenoestrogens also include phytoestrogens (oestrogenic substances from plants), but these do not pose health risks but instead reduce the risk of oestrogen dependant cancers.
The Oral Contraceptive Pill (OCP), Hormone Replacement Therapy (HRT) and cancer
Conjugated equine oestrogens increase the risk of heart disease, strokes, emboli and breast cancer while offering only mild protection against osteoporosis and colorectal cancer. Unopposed oestrogen can also result in endometrial hyperplasia, a precursor to endometrial cancer. The extensive use of high-dose estrogens for birth control in the 1970s is thought to have resulted in a significant increase in the incidence of this type of cancer.
Xenoestrogens and fish
Discharge from humans, partcularly from women in the pill and HRT enters wastewater treatment plants and release a large amount of xenoestrogens into streams, which lead to immense alterations in aquatic life, fish being extremely susceptible to pollutants. When comparing fish from above a wastewater treatment plant and below a wastewater treatment plant, studies found cell changes in ovaries and testicles, gonadal intersex (appearing to be female on the outside, but having mostly male-typical anatomy on the inside), reduced gonad size and altered sex ratios, decreased sperm concentration and motility in male fish exposed to xenoestrogens and disrupted spermatogenesis.
Negative health effects of xenoestrogens
Xenoestrogens have been implicated in a variety of medical problems and during the last 10 years many scientific studies gave much hard evidence of adverse effects in the human health as well as the wildlife. Xenoestrogens act as false messengers and disrupt the process of reproduction. Xenoestrogens, like all oestrogens, can increase growth of the endometrium, so treatments for endometriosis include avoidance of products which contain them. Likewise, avoiding them prevents the onset or aggravation of adenomyosis.
Xenoestrogens and cancer
Another potential effect of xenoestrogens is on oncogenes, specifically in relation to breast cancer. There is substantial evidence in a variety of recent studies to indicate that xenoestrogens, Bisphenol A (in plastic bottles), increases breast cancer growth in tissue culture. There has been speculation that falling sperm counts in males may be due to increased oestrogen exposure in utero as external xenoestrogens affecting the internal testosterone-oestrogen balance.
Xenoestrogens are everywhere
A 2008 report demonstrates further evidence of widespread effects of feminising chemicals on male development as a worldwide phenomenon. 99% percent of over 100,000 recently introduced chemicals are underregulated, according to the European Commission.
Chemicals shown to have oestrogenic effect
- alkylphenols (intermediate chemicals used in the manufacture of other chemicals)
- atrazine (weedkiller)
- 4-Methylbenzylidene camphor (4-MBC) (sunscreen lotions)
- butylated hydroxyanisole, BHA (food preservative)
- bisphenol A ( monomer for polycarbonate plastic and epoxy resin; plastic bottles, antioxidant in plasticizers)
- dichlorodiphenyldichloroethylene (one of the breakdown products of DDT) erythrosine, FD&C Red No. 3
- ethinylestradiol (combined oral contraceptive pill) (released into the environment [via urine] as a xenoestrogen)
- heptachlor (restricted insecticide)
- lindane, hexachlorocyclohexane (restricted insecticide)
- metalloestrogens (a class of inorganic xenoestrogens)
- methoxychlor (banned insecticide)
- nonylphenol and derivatives (industrial surfactants; emulsifiers for emulsion polymerization; laboratory detergents; pesticides)
- pentachlorophenol (restricted general biocide and wood preservative)
- polychlorinated biphenyls, PCBs (banned; formerly used in electrical oils, lubricants, adhesives, paints)
- parabens (most creams and lotions)
- phenosulfothiazine (a red dye)
- phthalates (plasticizers) in vinyl flooring
- DEHP (plasticizer for PVC)
- Propyl gallate (used to protect oils and fats in products from oxidation)
- Aluminum deodorants
Aluminum in deodorants is an oestrogen mimicker linked to breast cancer
Aluminium salts are the antiperspirant agent in deodoramts, but the effects of widespread, long term and increasing use remain unknown, especially in relation to the breast, which is a local area of application. Clinical studies showing a disproportionately high incidence of breast cancer in the upper outer quadrant of the breast together with reports of genomic instability in outer quadrants of the breast provide supporting evidence for a role for locally applied cosmetic chemicals in the development of breast cancer.
Aluminium is toxic to genes and is capable of causing both DNA alterations. This may explain its potential role in breast cancer if such effects occurred in breast cells. Oestrogen is a well established influence in breast cancer. Results is this study demonstrated that aluminium in the form of aluminium chloride or aluminium chlorhydrate can interfere with the function of oestrogen receptors of breast cancer cells.
Given the wide exposure of the human population to antiperspirants, it will be important to establish dermal absorption in the local area of the breast and whether long term low level absorption could play a role in the increasing incidence of breast cancer
Darbre PD., Aluminium, antiperspirants and breast cancer. J Inorg Biochem. 2005 Sep;99(9):1912-9.
Phytoestrogens, natures way to protect against synthetic oestrogens
Phytoestrogens are plant-derived xenoestrogens, not generated within the endocrine system but consumed by eating phytoestrogonic plants. Also called "dietary oestrogens", they are a diverse group of naturally occurring nonsteroidal plant compounds that, because of their structural similarity with oestradiol (17-β-oestradiol), have the ability to cause oestrogenic or/and antiestrogenic effects.
Mechanism of action
Phytoestrogens exert an effect by binding to oestrogen receptors. There are two variants of the oestrogen receptor, alpha (ER-α) and beta (ER-β) and many phytoestrogens display somewhat higher affinity for ER-β compared to ER-α. ERα is certainly associated with more differentiated tumours, while evidence that ERβ is involved is controversial.
In addition to interaction with ERs, phytoestrogens may also modulate the concentration of endogenous oestrogens by binding or inactivating some enzymes, and may affect the bioavailability of sex hormones by binding or stimulating the synthesis of sex hormone binding globuline (SHBG).
Dietary oestrogens unlike synthetic oestrogen are amphoteric
The similarities, at molecular level, of oestrogens and phytoestrogens allow them to mildly mimic and sometimes act as antagonists of oestrogen. This is unlike synthetic xenoestrogens which do not antagonise naturally occuring oestrogen. Phytoestrogens are known as amphoteric, that means they are capable of either occupying oestrogen receptors in cases of oestrogen deficiency and exerting an oestrogen effect, or alternatively in cases of oestrogen excess, phytoestrogens can occupy the oestrogen receptors and block the negative effects of excess oestrogen allowing for removal of this excess oestrogen via the enterohepatic circulation (healhy liver and bowel).
Whilst there is alot of information advising people with conditions associated with excess oestrogen to avoid phytoestrogesn this advise is absurd. All epidemiological studies have shown that a diet high in naturally occuring phytoestrogens is protective against oestrogen dependant diseases including cancer.
Other health benefits of phytoestrogens
Researchers are exploring the nutritional role of these substances in the regulation of cholesterol, and the maintenance of proper bone density post-menopause. Evidence is accruing that phytoestrogens may have protective action against diverse health disorders, such as prostate, breast, bowel, and other cancers, cardiovascular disease, brain function disorders and osteoporosis, and epidemiological information from Asian culture shows that phytoestrogens alleviate the symptoms of menopause.
Excess phytoestrogens may effect male fertility and libido
Consuming excess in the male species may affect their fertilty. In the 1940s it was noticed for the first time that red clover (a phytoestrogens-rich plant) pastures had effects on the fertility of grazing sheep. According to Buddhist monks, soy suppresses sexual desire. A 2010 meta-analysis however, of fifteen placebo-controlled studies said that "neither soy foods nor isoflavone supplements alter measures of bioavailable testosterone concentrations in men." Furthermore, Isoflavones supplementation has no effect on sperm concentration, count or motility, and show no changes in testicular or ejaculate volume.
Normal amounts of isoflavone rich foods are advisable for men, protecting them from xenoestrogens. The advice however in erectile dysfunction and infertility in men is to avoid excess consumption of these foods. The main offenders are excess, soy products, including soy flour, soy milk, tofu and tempeh, flaxseed, and hops (in beer). Please read also Naturopathic Causes and Treatment of Erectile Dysfunction.
Healthy soy products
Whilst there is definate health benefits from eating phytoestrogens in their natural form and as nature intended, certain soy producst are not healthy. In Asia, soy beans are never eaten in their natural state as they are extremely difficult to digest. Instead rather, soybeans are made into soy products including soy milk, tofu and tempeh. These products are easier to digest and epidemiologically consumption of these products in Asia is shown to have many helath protecting effects incluidng reducing the risk of cardiovascular disease, cancer and symptoms of menopasue.
The dangers of soy protein isolate
Soy protein isolate is a highly processed protein that is isolated from soybeans. It is a common ingredient in many so called health foods and is used in soy flour. Part of the manufacturing process of soy protein isolate involves acid washing soy beans in aluminum tanks. This results in high levels of aluminum being leached into the final product. Textured vegetable protein (TVP) is made by spraydrying the resultant curds at high temperatures to produce a high-protein powder. Nitrites, which are potent carcinogens, are formed during this spray-drying process as well as a toxin called lysinoalanine is formed during alkaline processing. Avoid soy protein isolate and products containing soy flour.
GM soy and pesticides
Genetically modified soy is deisgned to be pestiside resitant. Quite simply this means that the spy plant can withstand being prayed by strong pesticides such as Roundup. This means that genetically modified soy has large amounts of pesticide residues in the end product. At all costs avoid GM soy. Buy organic tofu, tempeh and soymilk only.
Soy and allergy
Finally, soy is also a highly allergic food, one of the top 8 food allergens in fact. It is wise to remember this in case of people with atopic conditions such as asthma, eczema, hayfever and urticaria. When it comes to allergy it is best to reduce and rotate rather than eliminate as complete eliminations causes increased sesitivity.
Naturopathic treatment principles to avoid health risks associated with xenoestrogens
1. Increase consumption of phytoestrogens
Food sources of pytoestrogens
- Kudzu root ( a thickener)
- Soybeans/soy milk
- Sesame seeds
- Dried beans
- Brown rice
- Mung beans
- Wheat germ
- Rice bran
- Soy linseed bread
Flax seed and other oilseeds contained the highest total phytoestrogen content, followed by soybeans and tofu. The highest concentrations of isoflavones are found in soybeans and soybean products followed by legumes, whereas lignans are the primary source of phytoestrogens found in nuts and oilseeds (e.g. flax) and also found in cereals, legumes, fruits and vegetables.
Phytoestrogen content varies in different foods, and may vary significantly within the same group of foods (e.g. soy milk, tofu) depending on processing mechanisms and type of soybean used. Legumes (in particular soybeans), whole grain cereals, and some seeds are high in phytoestrogens.
2. Increase SHBG
Sex hormone-binding globulin (SHBG) is a glycoprotein that binds to sex hormones, specifically testosterone and oestradiol. Other steroid hormones such as progesterone, cortisol, and other corticosteroids are bound by transcortin. Conditions with low SHBG include polycystic ovary syndrome diabetes. There has recently been research to link high SHBG levels with breast and testicular cancer as well. A low fat high fibre diet with regular exercise naturally increase SHBG and decreases the risk of hormone dependant cancers.
Tymchuk CN,etal., Effects of diet and exercise on insulin, sex hormone-binding globulin, and prostate-specific antigen. Nutr Cancer 1998;31(2):127-31.
Phytoestrogens stimulate the synthesis of sex hormone binding globuline (SHBG)
Increase isoflavones found naturally in soy products such as tofu and tempeh, chickpeas and kudzu root. Isoflavones are phytoestrogenic therefore protect the body from the negative effects of oestrogen excess. They also increase SHBG. Brassicacaea family vegetables such as brocolli, cauliflower,cabbage, curly kale, pakchoi ect., also increase SHBG thereby improving the removal of excess hormones form circulation. Nettle root also normalises SHBG. Exercise and fibre also increase SHBG.
3. Improve Enterohepatic Circulation
In layman terms this is a sluggish liver and poor bowl flora. As hormones are fatty substances they need a healthy bile flow to break them down and healthy bowel flora to remove them from bowel. Please see also the Sluggish Liver Explained and Carahealth Liver.
4. Naturopathic lifestyle advice to avoid xenoestrogens
- Eat regular and liberal amounts of phytoestrogens. Again these protect your body from the xenoestrogens by occypying the oestrogen recoetors and allowing for removal of cancer causing oestrogesn by a healthy enterophepatic circulation.
- Avoid commercially-raised, non-organic meats such as beef, chicken, and pork. Lamb is relatively clean meat.
- Avoid non-orgainc ommercial dairy products including milk, butter, cheese, and ice cream (organic products do not contain bovine growth hormone).
- Avoid unfiltered water, including water you bathe in. Do not drink water formplastic bottles or filter water using plastic. Use Carahealth Water Filter, Carahealth Bath Filter and the Carahealth Shower Filter. Avoid plastic water filters nand water in plastic bottles.
- Avoid non eco laundry detergent.
- Avoid Primpro, DES, Premarin, Cimetidine (Tagamet) and Birth Control Pills.
- Avoid Hormone replacement therapy (HRT).
- Avoid creams made with paraben preservatives.
- Avoid vinyl flooring.
- Avoid teflon pans.
- avoid aluminium pans.
- Avoid synthetic processed soy.
- Avoid shampoos, lotions, soaps, cosmetics that contain paraben or phenoxyethanol.
- Avoid reheating foods in plastic or styrofoam containers.
- Avoid drinking out of plastic cups and containers.
- Avoid air fresheners (contain pthalates).
- Use glass or ceramics whenever possible to store food and water.
- Heat up your food using a glass or ceramic bowl covered with dish. When plastic is heated, it diffuses very rapidly into food.
- Use Condoms without spermicide for birth control instead of birth control pill
- Eat plenty of foods naturally high in phytoestrogens. DO NOT avoid phytoestrogens as epidemiological studies everywhere have shown these to be effective in reducing rates of hormone dependant cancers, including breast and prostate.
- Instead avoid synthetic derivations of soy including soy protein isolate.
Carina is available to lecture for your group or institution on this subject.
Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu. is a practitioner of 11 years, complementary medicine lecturer of 4 years and mother of six in Galway, Ireland who practices what she teaches.
For an appointment call Carina directly on 083 34 66 333.
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Carahealth Galway Ireland. Acupuncture, Naturopathy, Homeopathy, Herbal Medicine, Nutrition, Nutritional Therapy, Flower Essences, Iridology, Short Courses, Cosmetic Acupuncture