Estrogen and Progesterone: Two Key Female Hormones
Contributing Author: Kalish, Daniel D.C.
For two decades Daniel Kalish, D.C. has successfully treated patients with hormone imbalances, food cravings, fatigue, depression, digestive distress, and many other health complaints. Dr. Kalish founded The Natural Path Clinic California, where he led a staff of physicians, nutritionists, chiropractors, psychotherapists, physical therapists, personal trainers, massage therapists and acupuncturists for more than ten years. He currently maintains an active international phone consultation practice with patients and trains physicians in natural medicine. He has designed health programs for countless professional athletes including the world’s top skateboarders, hockey players, elite runners, tri-athletes, golfers, tennis players and world-class weight lifters. Download his ebook Your Guide to Healthy Hormones.
» Website: www.drkalish.com
Few people had much awareness of estrogen and progesterone until recent studies revealed the dangers of female hormone replacement therapy. Millions of women had been taking synthetic hormones for years, yet the role these hormones play is still largely misunderstood. The goal of this article is to clear up some of the confusion.
The Role of Estrogen
For decades, drug companies and doctors pointed to estrogen deficiency as the main problem behind the common symptoms of menopause. For those of us who practice natural medicine, however, these same symptoms signal an imbalance in both the ovarian hormones and those that generate the stress response. We believe that the solution lies in re-establishing the natural balance of multiple hormones, rather than simply increasing the amount of estrogen in a woman’s system.
Estrogen, Diet, and Exercise
A 1998 study of 625 female runners in the United States supports Dr. Ellison’s theory. The runners had higher levels of physical activity and far less obesity than average women, and reported being able to reduce the discomforts of menopause with increased exercise. Indeed, for some women, changes in diet and exercise alone can eliminate many menopausal symptoms.
Estrogen and Environmental Factors
How Estrogen Affects the Body
Another role of estrogen is to stimulate cell growth. Therefore, when taken in excess, estrogen causes excessive cell growth and increases the risk of certain types of cancer.
Excess estrogen is also associated with other health problems that, while less dangerous, are uncomfortable and potentially debilitating, such as the water retention that many women experience as bloating and weight gain, and an increase in gall bladder problems. It also causes a loss of zinc, a mineral vital to the repair of soft tissue. Low zinc levels make it more difficult to recover from injury and affect immune function, making people more susceptible to colds and flu.
The Role of Progesterone
The Estrogen-Progesterone Balance
Also, many women have more than one factor contributing to hormone imbalance, such as low estrogen combined with low progesterone and high stress hormone levels. It is hardly surprising that they exhibit symptoms ranging from mood swings to insomnia. Estrogen-progesterone imbalances are not exclusive to menopausal women.
In menstruating women, estrogen peaks at ovulation, around two weeks into the typical 28-day cycle. This is followed by a surge of progesterone in the second half of the cycle as the egg is released. This natural cycle can be disrupted, however, by disturbances in the circadian rhythm, or 24-hour cycle, of production of the essential hormone cortisol. The daily rhythm is the driving force behind regulating the monthly cycle, and when cortisol levels are disturbed by irregular sleep patterns, skipped meals, emotional stress, or other factors, the result is hormonal symptoms. And in effect, the entire system becomes imbalanced.
Correcting Hormonal Imbalance
Progesterone creams have become popular because they can be bought without a prescription. They are fast acting because they are absorbed directly and rapidly into the bloodstream. However, it is difficult to get exact dosages each day, and some women build up high progesterone levels with extended use of creams. High progesterone levels can lead to many symptoms such as fatigue, insomnia and depression. Furthermore, some women have an enzyme that converts progesterone from the creams into other hormone compounds, and this can interfere with successful treatment.
Bioidentical progesterone tablets taken under the tongue or in liquid form tend to be the best options for most women. It’s easiest to get precise daily doses, and like creams these forms deliver hormones directly to the bloodstream.
Likewise, many women who are low in estrogen require the use of bioidentical estrogen to achieve hormone balance. Natural estrogen can be prescribed in pills, gels, patches, or troches (sublingual lozenges). When a patient chooses one of these forms of prescription estrogen, I work with her medical doctor to coordinate this treatment with the rest of her program. Patients also can use phytoestrogen compounds — natural, plant-based formulas — that can be obtained without a prescription. I have found that most of my patients are willing to improve their diet and exercise patterns will have complete symptom relief by using an adrenal hormone program plus plant-based natural progesterone and estrogen.
Insulin is yet another hormone we produce that coordinates with our sex and stress hormones. Patients with a condition known variously as Metabolic Syndrome, Syndrome X, or insulin resistance will not fully benefit from the typical female hormone programs until their metabolism is healed. Dr. Diana Schwarzbein, an endocrinologist in Santa Barbara, California who has used bioidentical hormone programs with thousands of patients, has pioneered the use of bioidentical female hormone therapy in conjunction with lifestyle changes. Her books are a must read for anyone who wants to learn more about this subject.
Dr. Kalish: One of my patients provides a prime example of estrogen-progesterone imbalance. Helen is a 58-year-old athlete with a long history of hormonal problems that led her to undergo a hysterectomy followed by hormone replacement.
Helen: When I went to Dr. Kalish I was desperate, and — to be honest — quite pessimistic. An athlete friend of mine who is a long-standing patient of his suggested I go when I complained to her about my inability to lose weight even though I was eating healthy and exercising several times a week. She said that he did natural hormone replacement therapy, and this intrigued me because I’ve always been interested in natural health alternatives and I wasn’t feeling any better with the hormone replacement therapy I was prescribed after my hysterectomy.
Dr. Kalish: When I first saw Helen, she was frustrated by her inability to lose weight despite a restricted diet and a heavy training schedule. She was experiencing back and lower-extremity joint pain after running. She also reluctantly admitted to feeling moody and depressed after starting an estrogen regimen, and her symptoms were getting worse.
Helen: I had a good feeling about Dr. Kalish right off the bat. The first thing he did was reassure me that my problems were normal and that he had successfully treated thousands of women just like me! This was hopeful news, and I was excited to find out the results of the lab tests that he ordered for me.
Dr. Kalish: Lab testing showed that Helen’s estrogen levels while using HRT were alarmingly high. Since she wasn’t taking any progesterone, her ratio of progesterone to estrogen was greatly disturbed. She needed to lower her estrogen dosage and increase her progesterone levels.
Helen: When Dr. Kalish explained my lab results to me in my follow-up consultation, I was shocked and somewhat angry that I had been prescribed such an excessive dosage of estrogen. I was very curious to see the results of Dr. Kalish’s treatment.
Dr. Kalish: After only a few weeks of treatment with bioidentical progesterone, and a shift to a bioidentical estrogen at the appropriate dosage, Helen’s mood swings were gone and her depression had greatly diminished. Without the excess water weight and body fat promoted by the estrogen, she returned to her normal weight. The progesterone also had an anti-inflammatory effect, helping her to resume her running program without the constant joint pain.
Helen: It’s been six months, and I am feeling much more like myself these days. I am able to maintain my weight, and the occasional migraines I was having have vanished. I have been given my vitality back, and I am living the kind of active life I love.
Unfortunately, Helen’s situation is far from unusual. In addition to placing themselves at heightened risk of life-threatening illnesses, many women on HRT are only further disturbing further their estrogen-progesterone ratio. My technique of carefully testing hormone levels, combined with a more healthful diet, adequate exercise, and stress reduction, can put their lives back on track.
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