We must not fear estrogen—our own queen of hormones. With all the current talk of estrogen dominance, plus the 2002 HRT scare, estrogen has acquired a bad reputation it does not deserve.
Estrogen is good for sleep, mood, and libido
Our main estrogen, estradiol, sensitizes the brain to oxytocin and dopamine and boosts serotonin. It supports healthy mood and sleep and is also important for skin, bone health, insulin sensitivity, metabolic rate, and libido.
Too little estrogen can cause depression and severe insomnia, which is why taking estrogen can relieve those symptoms.
Too much estrogen can cause symptoms because it stimulates the mast cells and histamine. Read The curious link between estrogen and mast cells and histamine. Estrogen is a great hormone but needs to be kept in check.
How to keep estrogen in check
- Reduce histamine and mast cell activation. Inflammation impairs estrogen detoxification and upregulates estrogen receptors. Furthermore, estrogen-induced mast cell activation or high histamine can create many of the symptoms typically attributed to so-called “estrogen dominance”—a term I don’t use.
- Ensure adequate progesterone. Progesterone counterbalances estrogen and shelters tissue (including breast tissue) from estrogen’s stimulating effects. During the reproductive years, the only way to make progesterone is with regular, healthy ovulation. After menopause, the only way to have progesterone is to take micronized progesterone, not progestin. Read The crucial difference between progesterone and progestins.
- Promote healthy estrogen detoxification or clearance. Healthy estrogen clearance or detoxification requires many steps, including the healthy activity of the magnesium-dependent COMT enzyme and a healthy gut microbiome. If the microbiome is disrupted by antibiotics or other factors, then estrogen metabolites can be reabsorbed.
- Stabilize receptors with iodine. Iodine deficiency can make tissue (including breast tissue) hyperreactive to estrogen. Consider supplementing with iodine to calm the body’s response to estrogen.
- Identify and correct insulin resistance because insulin is a growth hormone and promotes cell division in hormone-sensitive tissues, such as the uterus and breasts. Furthermore, the pattern of weight gain associated with insulin resistance can increase estrogen via increased activity of the enzyme aromatase.
A modern approach to hormone therapy
Modern hormone replacement is body-identical topical estradiol plus oral micronized progesterone.
Hormonal birth control is not a good type of hormone therapy
Hormonal birth control is a particularly soul-crushing type of hormone therapy because it suppresses the body’s own estradiol and progesterone and replaces them with contraceptive drugs.
