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Estrogen Dominance (The Silent Epidemic)

Michael Lam, MD, MPH


www.DrLam.com

Contents
Introduction
Modern Menstruation
Female Hormones
Estrogen
Progesterone
Estrogen Effect vs. Progesterone Effect
Estrogen Dominance
Estrogen Dominance in Pre-menopausal Women
Estrogen Dominance in Menopausal Women
Causes of Estrogen Dominance
Estrogen Dominance Continuum
Common Estrogen Dominance Conditions
A. Endometriosis
B. Premenstrual Syndrome (PMS)
C. Fibrocystic Breast
D. Pre-Menopausal Syndrome
E. Polycystic Ovary Syndrome (PCOS)
F. Uterine Fibroids
G. Breast Cancer
Estrogen Reduction Protocol
Case History
Summary
APPENDIX: Overview of a "Normal" Menstrual Cycle
APPENDIX:Menstrual Cycle Overview

Introduction

In the past 40 years, we have seen a dramatic rise in


female-related illnesses never seen before in history.
Today, we see the age of puberty (menarche)
dropping precipitously to as low as 10 years of age,
endometriosis afflicting 10% of all perimenopausal
women; Premenstrual Syndrome (PMS), rising and
afflicting close to 30% of perimenopausal women,
uterine fibroids affecting close to 25 % of women
from age 35 to 50, and breast cancer afflicting close
to 10% of all women. Being a woman in the 21st century is certainly a high risk profession.
Navigating through this hazardous profession is not easy. Imagine having endometriosis, PMS
and fibrocystic breasts when you were young, progressing to uterine fibroids, hysterectomy,
misguided hormone replacement and ultimately breast cancer as your menopause approaches.
The very thought of this journey can send chills up through anyone's spine. Fortunately,
scientific evidence is mounting that hormone disruption is the key cause of all these seemingly
separate but related diseases.

For too long, we have ignored the importance of hormone balance. For too long, physicians have
been misguided on the real truth on hormonal balance. Now, we know that the common thread
in many female hormone diseases such as those mentioned above is a little known condition
known as estrogen dominance. The underlying problem is a relative excess of estrogen and an
absolute deficiency in progesterone. In the west, the prevalence of estrogen dominance syndrome
approaches 50 percent in women over 35 years old.

Here are some typical complaints from patients having estrogen dominance:

- My breasts are swollen and getting bigger.

- I can't put on my rings on my fingers.

- I am more impatient now than ever.

- People tell me I am too bossy.

- I am getting cramps again like when I was younger.

- I just cannot have my period.

- I miss my periods regularly.

- My periods come irregularly.

- I get scared when I see large clots during my period.

- I have Pre-Menstrual Syndrome (PMS).

- When I get a hug, my breast hurts.

- I have fibroids.

- I have endometriosis.

- I cannot fit into my shoes.

- I have a cyst in my breast.


- I feel tired all the time.

Before we look at estrogen dominance in more detail, let us first review the basic menstrual
cycle and the key female hormones

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Modern Menstruation

One hundred years ago, the average woman started her menses at age 16. She got pregnant
earlier and more frequently. She often spent more time lactating. In total, women back then
experienced the menstrual cycle about 100 to 200 times in their lifetime. Today, the average
modern women starts her puberty at age 12, seldom lactates, has less children, and
menstruates about 350 to 400 times during a lifetime. Incessant menstruation has been
associated with the increased occurrence of a myriad of pathological conditions including
infertility, cancer, fibroids, anemia, migraines, mood shifts, abdominal pain, fluid retention, and
endometriosis. What a difference a century makes!

It is apparent that the modern woman is made to go through a lot more than her counterpart just a
century ago. Could this have any bearing on the epidemic of female related illness plaguing our
society ? To answer that question, let us now take a closer look at the hormones responsible for
regulating the female menstrual cycle.

Femal Hormones

The two primary female hormones secreted by the ovaries are estrogen and progesterone.
The properties of one offsets the other and together they are maintained in optimal balance
in our body at all times. Too much of one hormone or the other can lead to significant
medical problems.

Estrogen

Estrogen is produced in the ovaries. It regulates the menstrual cycle, promotes cell division and
is largely responsible for the development of secondary female characteristics during puberty,
including the growth and development of the breast and pubic hair. Estrogen therefore affects all
female sexual organs, including the ovaries, cervix, fallopian tubes, vagina, and breast. As a
general rule, estrogen promotes cell growth, including signaling the growth of the blood-rich
tissue of the uterus during the first part of the menstrual cycle and stimulates the maturation of
the egg-containing follicle in the ovary. It softens the cervix and produces the right quality of
vaginal secretion to allow the sperm to swim and to lubricate us during intercourse. Furthermore,
it lifts our mood and gives us a feeling of well-being.

In non-pregnant, pre-menopausal women, only 100-200 micrograms (mcg) of estrogen are


secreted daily. But during pregnancy, much more is secreted.

Estrogen in our body actually is not a single hormone but a trio of hormones working
together. The three components of estrogen are: estrone (E1), estradiol (E2), and estriol
(E3). In addition, there are at least 24 other identified types of estrogen produced in the woman's
body, and more will be discovered. In healthy young women, the typical mix approximates
15/15/70% respectively. This is the combination worked out by Mother Nature as optimum
for human females. Today, we use the word estrogen loosely to include also a family of
hormones, including animal estrogens, synthetic estrogens, phytoestrogens (plant
estrogens), and xenoestrogens (environmental estrogens, usually from toxins such as
pesticides).

Estrogen is a hormone that is pro-growth. Since too much of anything is generally not
good, the body has another hormone to offset and counterbalance the effects of estrogen. It
is called progesterone.

Progesterone

As its name implies, progesterone is a hormone that is pro-gestation. In other words, it


favors the growth and well-being of the fetus. Without a proper amount of progesterone,
there can be no successful pregnancy. It protects us against the "growth effect" of estrogen.
When progesterone is secreted, further ovulation is prevented from taking place in the
second half of the menstrual cycle, and a thick mucous that is hostile to sperm is produced
that prevents its passage into the womb.

Progesterone is made from pregnenolone, which in turn comes from cholesterol.


Production occurs at several places. In the women, it is primarily made in the ovaries just
before ovulation and increasing rapidly after ovulation. It is also made in the adrenal
glands in both sexes and in the testes in males. In women its level is highest during the
luteal period (especially from day 19-22 of the menstrual cycle). If fertilization does not
take place, the secretion of progesterone decreases and menstruation occurs 12 to 14 days
later under normal conditions. If fertilization does occur, progesterone is secreted during
pregnancy by the placenta and acts to prevent spontaneous abortion. About 20-25 mg of
progesterone is produced per day during a woman's monthly cycle. Up to 300-400 mg are
produced daily during pregnancy.

Estrogen Effect vs. Progesteron Effect


As mentioned earlier, progesterone acts as an antagonist to estrogen. For example, estrogen
stimulates breast cysts while progesterone protects against breast cysts. Estrogen enhances
salt and water retention while progesterone is a natural diuretic. Estrogen has been
associated with breast and endometrial cancers, while progesterone has a cancer preventive
effect. Studies have shown that pre-menopausal women who were deficient in progesterone
had 5.4 times the risk of breast cancer compared to healthy women.

The following table clearly shows how progesterone and estrogen balance each other. It is
very important to note that both hormones are necessary for optimum function.
Progesterone will not work without some estrogen in the body to "prime the pump", for
example.

Estrogen Effect Progesterone Effect


Causes endometrium to proliferate Maintains secretory endometriu
Causes breast stimulation that can lead to Protects against fibrocystic breast and
breast cancer prevents breast cancer
Increases body fat Helps use fat for energy
Increase endometrial cancer risk Prevents endometrial cancer
Increase gallbladder disease risk
Restrains osteoclast function slightly Promote osteoblast function, leading to bone
growth
Reduces vascular tone Restores vascular tone
Increase blood clot risk Normalize blood clot

Estrogen Dominance

Estrogen and progesterone work in synchronization with each other as checks and
balances to achieve hormonal harmony in both sexes. It is not the absolute deficiency of
estrogen or progesterone but rather the relative dominance of estrogen and relative
deficiency of progesterone that is main cause of health problems when they are off balance.

While sex hormones such as estrogen and progesterone decline with age gradually, there is
a drastic change in the rate of decline during the perimenopausal and menopausal years for
the women in these two hormones as mentioned earlier.

From age 35 to 50, there is a 75% reduction in production of progesterone in the body.
Estrogen, during the same period, only declines about 35%. By menopause, the total
amount of progesterone made is extremely low, while estrogen is still present in the body at
about half its pre-menopausal level.

With the gradual drop in estrogen but severe drop in progesterone, there is insufficient
progesterone to counteract the amount of estrogen in our body. This state is called estrogen
dominance. Many women in their mid-thirties, most women during peri-menopause (mid-
forties), and essentially all women during menopause (age 50 and beyond) are overloaded
with estrogen and at the same time suffering from progesterone deficiency because of the
severe drop in physiological production during this period. The end result - excessive
estrogen relative to progesterone, a condition we called estrogen dominance.

According to Dr. John Lee, the world's authority on natural hormone therapy, the key to
hormonal balance is the modulation of progesterone to estrogen ratio. For optimum health,
the progesterone to estrogen ratio should be between 200 and 300 to 1.

What is so bad about estrogen dominance? It is the root cause of a myriad of illnesses.
Conditions associated with this include fibrocystic breast disease, PMS, uterine fibroids,
breast cancer, endometriosis, infertility problem, endometrial polyps, PCOS, auto-immune
disorders, low blood sugar problems, and menstrual pain, among many others.

Questions? Ask me.

Estrogen Dominance in Pre-menopausal Women

There are two periods in a women's life that her progesterone level is low - at puberty and
again at peri-menopause ( the few years right before menopause). Between puberty and
peri-menopause, the production of progesterone can go astray, leading to estrogen
dominance as mentioned earlier. Between this period, estrogen dominance can also be the
result of excessive external estrogen intake (from diet and environment) or internal
estrogen production ( from obesity, birth control pills, or ovarian tumor).

Two common causes are:


A. Anovulation (lack of ovulation). Ovulation is the time of the month where an ovarian
follicle releases an ovum (egg). Under normal condition, the released egg makes it way from
the ovary to the uterus in preparation for fertilization. This usually happens from day 12 to
day 14 of the menstrual cycle. After the egg is released, the empty follicle becomes the
corpus luteum. This is the main factory where the production of progesterone takes place.

When the follicles become dysfunctional, no eggs are released. This is called anovulation. If
a woman is not ovulating, there would not be a corpus luteum and therefore no increased
progesterone production. Laboratory measurement would show both a low estrogen and a
low progesterone level. Many still have a seemingly normal menstrual cycle even if there is
no ovulation. The lack of progesterone, however, leads to relative estrogen dominance and
symptoms like PMS, mood swings, cramps, and tender breast. Anovulation is commonly
caused by exposure of female embryos to environmental estrogen (also called xenobiotic or
xenoestrogen) such as pesticides, plastic, and pollution. It is often related to a poor diet and
stress.

B. Luteal insufficiency. More frequent than anovulation, the egg is produced but the
corpus luteum malfunctions. It just does not make enough progesterone. Laboratory
measurements would show a high estrogen but low progesterone, and typical symptoms of
estrogen dominance would arise. Without adequate progesterone, the chance of achieving
pregnancy is reduced. Don't forget that progesterone is what keeps the womb going and it
nourishes the fetus.

Estrogen Dominance in Menopausal Women

The predominant reason why menopausal women developed estrogen


dominance is because they are being prescribed unopposed estrogen such
as Premarin as part of their hormone replacement therapy (HRT)
program. Despite decades of research clearly showing that HRT
significantly increased breast cancer, millions of women worldwide are
on unopposed estrogen for treatment of menopausal symptoms.

Obesity is another cause. During menopause, the amount of estrogen


produced from the ovaries decreases, but not as drastic when it comes to
another hormone that the ovaries produce called androstenedione (a male hormone). Fat
cells can convert androstenedione into estrogen. The amount of conversion in some people
is enough to maintain a reasonable estrogen level in the body well into the 70s. The result of
excessive estrogen and absolute deficiency in progesterone is clear - estrogen dominance.

We mentioned above our body is essentially soaked in a sea of estrogen. Where does the
estrogen comes from? Let us take a closer look.

Causes of Estrogen Dominance


Our body normally functions in perfect homeostasis. With the advent of society and
industrial state in the past 70 years, our body has been subjected to unprecedented insults
from environmental estrogen-like hormones. In less than one hundred years, we have
managed to turn our diet from whole fruits and whole food to fast and processed food. In
the past, cattle were raised on grass and natural organic feed and chickens were allowed to
run free. This is in stark contrast to the commercialization of cattle and poultry farms of
today where animals are in cages most of the time. Worse yet, feeds laced with pesticides
and hormones, both of which have estrogen-like activities, are routinely given to animals,
which in turn is passed to humans.

Women in non-industrialized cultures whose diets are whole food based and are untainted
with modern processed foods and pesticides seldom suffer a deficiency in progesterone and
the signs of estrogen dominance manifested as menopausal symptoms.

12 of the most common reasons:

1. Commercially raised cattle and poultry. These animals are fed estrogen-like hormones as
well as growth hormone that are passed onto humans. It takes 60 pounds of grain, feed,
and hay to produce one pound of edible beef. On the other hand, it only takes one pound of
feed to produce one pound of edible fish. Deep-sea fish such as halibut, sardines, cod, and
mackerel are good to consume. Young ones are often less contaminated than older fish, and
smaller fish are better shielded from contamination than larger fish like sharks and
swordfish. Avoid all coastal fish and shellfish, which are high in contaminants. Fish are far
superior to beef or chicken in terms of hormone load. It is interesting to note that one-half
of all antibiotics in the United States are used in livestock - 25 million pounds a year. These
antibiotics can contribute to hormone disruptor exposure. The use of antibiotics is
especially prevalent in poultry farms. It only takes 6 weeks now to grow a chicken to full
size (down from four months in 1940). Up to 80,000 birds may be packed into one
warehouse. Feeds used contain a myriad of hormone-disrupting toxins including pesticides,
antibiotics, and drugs to combat disease when so many animals are packed closely together.

2. Commercially grown fruits and vegetables containing pesticides. If you eat in any
developed countries, you are taking in pesticides from fruits and vegetables, many of which
are known hormone disruptors. Approximately 5 billion pounds of pesticides, herbicides,
fungicides, and other biocides are being added to the world each year. In the past 100
years, several hundred billions pounds of pesticides have been released into the
environment. Pesticides that are banned in the US, such as DDT, are being used in some
other countries freely. Illegal pesticides are being used on crops that we eat everyday. It is
estimated that a person eats illegal pesticides 75 times a year just by following USDA's
recommendation of five servings of fruits and vegetables a day if these are purchased in
regular supermarkets. Vegetables grown in developing foreign countries such as South
America and Africa find their way back to our dinner table in this global community.
Pesticide residues have chemical structures that are similar to estrogen. These are
eventually passed onto humans. Produce with the most pesticides reported in A Shopper's
Guide to Pesticdes in Produce include strawberries (contain vinclozolin, a known endocrine
disruptor), bell peppers, peaches, apples, apricots, and spinach. Foods with the least
amount of pesticides include avocados, corn, onions, sweet potatoes, bananas, green onions,
broccoli, and cauliflower. If you are eating non-organic fruits and vegetables, peel and
wash them well with diluted vinegar. This will help to reduce pesticides on the surface.
Needless to say, this will not help to rid of the pesticides inside. Discard the outer leaves of
leafy vegetables, and trim fat from meat and skin from poultry and fish that tend to collect
residues.

3. Exposure to xenoestrogen. When a female embryo develops in the womb, 500,000 to


800,000 follicles are created in the embryo, each enclosing an immature ovum. These
fragile ovarian follicles are extremely sensitive to the toxicity of environmental pollutants.
When the mother is exposed to toxic chemicals that resemble estrogen in its molecular
structure, she may experience no apparent damage outwardly. However the baby is more
vulnerable to these toxins that may damage its ovarian follicles and make them
dysfunctional. This will not be apparent until the baby reaches puberty some 10 to 15 years
later, when symptoms of incomplete ovulation or insufficient progesterone production can
be noted.

Petrochemical compounds found in general consumer products such as creams, lotions,


soaps, shampoos, perfume, hair spray and room deodorizers. Such compounds often have
chemical structures similar to estrogen and indeed act like estrogen. Other sources of
xenoestrogen include car exhaust, petrochemically derived pesticides, herbicides, and
fungicides; solvents and adhesives such as that those found in nail polish, paint removers,
and glues; dry-cleaning chemicals; practically all plastics, industrial waste such as PCBs
and dioxins, synthetic estrogens from urine of women taking HRT and birth control pills
that is flushed down the toilet and eventually found its way into the food chain and back
into the body. They are fat soluble and non-biodegradable.

4. Industrial solvents. A common source of industrial xenoestrogens often overlooked is a


family of chemicals called solvents. These chemicals enter the body through the skin, and
accumulated quickly in the lipid-rich tissues such as myelin (nerve sheath) and adipose
(fat). Some common organic solvents include alcohol like methanol, aldehydes like
acetaldehyde, glycol like ethylene glycol, and ketones like acetone. They are commonly
found in cosmetics, fingernail polish and fingernail polish remover, glues, paints, varnishes,
and other types of finishes, cleaning products, carpet, fiberboard, and other processed
woods. Pesticides and herbicides such as lawn and garden sprays, indoor insect sprays are
also sources of minute amounts of xenoestrogens. While the amount may be small in each,
the additive effect from years of chronic exposure can lead to estrogen dominance.

5. Hormone Replacement Therapy (HRT). HRT with estrogen alone without sufficient
opposing progesterone such as the drug Premarin should be banned. This increases the
level of estrogen in the body. Premarin, a estrogen only drug commonly used in the past 40
years, is the mainstay of estrogen replacement therapy (ERT). It is a patented,
chemicalized hormonal substitute that is not the same as what you have in your body. It
contains 48% estrone and only a small amount of progesterone which is insufficient to have
an opposing effect. The indiscriminate and over-prescription of Premarin to many who
may not need it is the problem. Symptoms include water retention, breast swelling,
fibrocysts in the breast, depression, headache, gallbladder problems, and heavy period.
The excessive estrogen from ERT also lead to increased chances of DNA damage, setting a
stage for endometrial and breast cancer.

6. Over production of estrogen. Excessive estrogen can arise from ovarian cysts or tumors.

7. Stress. Stress causes adrenal gland exhaustion and reduced progesterone output. This
tilts the estrogen to progesterone ratios in favor of estrogen. Excessive estrogen in turn
causes insomnia and anxiety, which further taxes the adrenal gland. This leads to a further
reduction in progesterone output and even more estrogen dominance. After a few years in
this type of vicious cycle, the adrenal glands become exhausted. This dysfunction leads to
blood sugar imbalance, hormonal imbalances, and chronic fatigue.

8. Obesity. Fat has an enzyme that converts adrenal steroids to estrogen. The higher the fat
intake, the higher the conversion of fat to estrogen. Overeating is the norm in developed
countries. A population from such countries, especially in the Western hemisphere where a
large part of the dietary calorie is derived from fat, has a much higher incidence of
menopausal symptoms. Studies have shown that estrogen and progesterone levels fell in
women who switched from a typical high-fat, refined-carbohydrate diet to a low-fat, high-
fiber and plant-based diet even though they did not adjust their total calorie intake. Plants
contain over 5,000 known sterols that have progestogenic effects. People who eat more
wholesome foods have a far lower incidence of menopausal symptoms because their pre-
and post-menopause levels of estrogen do not drop as significantly.

9. Liver diseases. Liver diseases such as cirrhosis from excessive alcohol intake reduce the
breakdown of estrogen. Taking drugs that can impair liver function may also contribute to
a higher level of estrogen.

10. Deficiency of Vitamin B6 and Magnesium. Both of these are necessary for the
neutralization of estrogen in the liver. Too much estrogen also tends to create deficiency of
zinc, magnesium and the B vitamins. These are all important constituents of hormonal
balance.

11. Increased sugar, fast food and processed food. Intake of these leads to a depletion of
magnesium.

12. Increase in coffee consumption. Caffeine intake from all sources was linked with higher
estrogen levels regardless of age, body mass index (BMI), caloric intake, smoking, alcohol,
and cholesterol intake. Studies have shown that women who consumed at least 500
milligrams of caffeine daily, the equivalent of four or five cups of coffee, had nearly 70%
more estrogen during the early follicular phase than women who consume no more than
100 mg of caffeine daily, or less than one cup of coffee. Tea is not much better as it contains
about half the amount of caffeine as compared to coffee. The exception is herbal tea like
chamomile which contains no caffeine.
In absolute terms, those who live in the developed world are bathed in a continuous sea of
estrogen and do not know it. Yes, we all have hormonal imbalances, and specifically -
estrogen dominance.

Estrogen Dominance Continuum

It is clear that estrogen dominance is the underlying common denominator for a variety of
illnesses and syndromes that were previously regarded as unrelated entities. They in fact
represent different expressions of the same illness in different cell settings. The continuum is a
state of excessive estrogen throughout one's lifetime, with different manifestation at different
times.

Conditions and diseases linked to this continuum includes:

- Allergies, including asthma, hives, rash, sinus congestion


- Autoimmune disorders such as SLE (lupus) and Hashimoto's thryoiditis
- Breast Cancer
- Copper excess and zinc deficiency
- Endometriosis
Endometrial cancer
- Gallbladder disease
- Syndrome X (Insulin resistance)
- Infertility
- Polycystic Ovaries
- Menopausal Symptoms
- Magnesium deficiency
- Osteoporosis
- PMS (Pre-menstrual syndrome)
- Pre-menopausal syndrome
- Hypothyroid-like condition
- Prostate Cancer
- Uterine fibroids

Common Estrogen Dominance Conditions

- Endometriosis
- Premenstrual Syndrome (PMS)
- Fibrocystic Breast
- Pre-menopausal Syndrome
- Polycystic Ovary Syndrome (PCOS)
- Fibroids
- Breast Cancer

Let us now look at each of these in more detail.


A. Endometriosis

Endometriosis is a very common condition. Statistics have it that approximately 10-15% of


women in their reproductive years from age 25 to 45 are affected. About 30% of affected
women are infertile. It is a condition where endometrium (the lining of the uterus) is found in
locations outside the uterus, such as the ovaries, fallopian tubes, vagina, abdomen, deep inside
the uterine muscle, bowel, bladder, utero-sacral ligaments (ligaments that hold the uterus in
place), peritoneum (covering lining of the pelvis and abdominal cavity), or other parts of the
body. It can grow between organs and cause them to stick together with adhesions.

The causes of endometriosis are not yet fully known. There are quite a few theories, from
genetics to toxic environment. Backward bleeding, or "retrograde menstruation" (when bleeding
that goes up into the uterus) is thought to be the leading cause. Endometrial cells are estrogen
responsive, and estrogen dominance is the norm in developed society. Many researchers believed
that estrogens and their close relative xenoestrogens (environmental estrogens) play a
significant causative role in this disease. Some have tried to link bleached tampons with
pollutants residues as the cause, but these have yet to be proven.

Risk Factors

- Family history of endometriosis, especially mother or sister.


- Late childbearing (after age 30).
- History of long menstrual cycles with a shorter than normal time between cycles.
- Abnormal uterus structure.
- Diet high in hydrogenated fat (trans-fat) such as French fries or cookies.
- Stress.

Symptoms and Diagnosis

Endometrial tissue responds to the same tissue as the uterus. It grows with estrogen, and may
bleed during the time of menstruation just like tissues in the uterus. The most common
symptom is pain and cramps that coincide with the menstrual cycle, and scar tissue can form
wherever the endometrial tissue is located as it can interfere with the function of the organs.
Other symptoms include heavy menstrual bleeding, pain during intercourse, abdominal pain and
or low back pain and diarrhea during menstruation. Sometimes there are no symptoms at all. The
degree of severity of the symptoms do not necessarily correlate with the degree of
involvement, as each person reacts differently. Having endometriosis increases the risk for
uterine fibroids or breast cysts, and may be accompanied by severe fatigue, chronic fatigue
syndrome, or fibromyalgia.

The only way to diagnose endometriosis is by laparoscopy, a surgical procedure where the
surgeon places a small scope inside the pelvic cavity looking for endometrial tissues. This is
often not successful, and a diagnosis can take years.

Surgical intervention focuses on the removal of endometrial tissues, while drug therapy focuses
on balancing the hormonal picture with birth control pills. Both are not very successful. More
than 500,000 surgeries are performed each year for endometriosis, and there is an upward
of 40% of recurrence, continued pain, and disability. This disease often subsides with
menopause when estrogen level is reduced in absolute terms. It also goes away when ovaries are
non-functional. This can be surgically induced by the removal of both ovaries, or chemically
induced by the use of drugs such on a temporary basis.

B. Premenstrual Syndrome (PMS)

In addition to menopausal symptoms commonly blamed on estrogen deficiency instead of


relative estrogen dominance, researchers noted that many women suffer a similar set of
symptoms associated with estrogen dominance during the menstrual cycle of each month. PMS
can affect women soon after puberty and all the way to menopause.

Here are some typical complaints of patients with PMS:

- My ring finger is getting swollen (indicative of water retention).


- My breasts are hot and tender (indicative of breast inflammation).
- I feel tired all the time (indicative of fatigue).
- I feel nervous and irritable (indicative of emotion instability).
- I feel like eating chocolate all the time (indicating an innate magnesium deficiency as
chocolate is high in magnesium).

This syndrome was first described in 1931. It is a well-established syndrome consisting of a host
of physical and emotional symptoms that develop after ovulation and before the onset of the
periods. The syndrome can range form a few days to two weeks. The intensity can be mild
(relieved by an aspirin) or it can be severe and debilitating. Generally, its symptoms intensify as
the period approaches. Interestingly, 95% of PMS can be vastly improved if steps are taken to
balance the body's hormone.

Dr. Katherine Dalton published the first medical report on PMS in 1953. She observed that an
administration of a high dose of progesterone by rectal suppository relieved symptoms of PMS.

It is important to note that not all PMS symptoms are caused by progesterone deficiency and
estrogen dominance. Hypothyroidism can produce similar symptoms. Stress leading to
adrenal exhaustion and low adrenal reserve commonly seen in working mothers for
example, can also cause similar symptoms. A diet low in fiber can cause estrogen to be
reabsorbed and recycled. An excessive intake of xenoestrogen-laced beef and poultry also
contributes to relative estrogen dominance associated with PMS. Many researchers think that
PMS may be linked to xenoestrogen exposure during embryo life, damaging the ovarian
follicle. The damaged ovaries from pollutants, while they are in the womb, could result in
infertility and chronic estrogen dominance decades later.

The key dietary adjustments are elimination of:

- Empty calories such as potato chips and other junk foods


- Hydrogenated fats (also called trans-fat) found in such foods as cookies and margarine
- Reduce calcium intake and increase magnesium intake

In addition, elimination of coffee, sugar, and alcohol frequently reduce the symptoms of PMS,
together with exercise, refrain from dairy products, and natural progesterone replacement. A diet
high in phytoestrogen or supplementation of isoflavone extract or DIM, as well as nutritional
supplementation with nutrients high in fatty acids such as evening primrose oil or fish oil to
reduce the inflammatory response also helps. Lastly and most importantly, the use of natural
progesterone cream should be considered.

C. Fibrocystic Breast

One of the most common reasons why women visit the gynecologist is the discovery of breast
lump. Fortunately, not all lumps are cancerous.

After needle biopsy and workup, many of these patients are told that they suffer from benign
cystic breast disease. The patient is reassured that the lumps are not cancerous for now.
However, it is most important to alert these patients that such lumps are the body's cry for more
progesterone. Estrogen promotes the growth and proliferation of breast cells. Breast fibrocysts
are an overgrowth of these normal breast tissues. The primary causative factor is excessive
estrogen. It is an early warning sign of progesterone deficiency and impending estrogen
dominance.

Progesterone cream is a good remedy. Apply 20 mg of progesterone cream from ovulation (day
12 to 14) until the day or two before the period starts. Normal breast tissue will return within 3 to
4 months. In addition to reducing estrogen, supplementing with natural vitamin E (alpha d-
tocopherol) and borage or evening primrose oil (omega-6) will help to reduce the inflammatory
response. Borage oil is preferred over evening primrose oil as it is more potent.

D. Pre-Menopausal Syndrome

Scientists have also identified a chronic condition similar to PMS, which they call pre-
menopause syndrome. The symptoms are similar to those of menopause, but they occur often
from the mid-thirties to early forties and years ahead of menopause. This may be due to primary
ovulation failure and the resultant lack of progesterone output from the ovaries. More often than
not, it is due to luteal failure (failure to produce enough progesterone) in pre-menopausal
women. In addition, there may also be stress induced adrenal gland exhaustion leading to a
reduction of progesterone output from the adrenal gland. The overall reduction in progesterone
level leads to a relative excess of estrogen or estrogen dominance. Pre-menopausal syndrome
may include PMS, fibrocystic breast, uterine fibroids, irregular periods, and endometriosis.

E. Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) is a condition where multiple cysts are found on the ovaries
together with other symptoms like anovulation (lack of ovulation), menstrual abnormalities,
hirsutism (facial hair), male pattern baldness, acne, and often obesity. It is estimated that 10 to 20
% of women today have PCOS, and among young women, this figure could be even higher,
thus qualifying PCOS as an epidemic.

PCOS takes place when the normal ovulation cycle of a woman is disrupted or stopped. This
upsets the normal balance between the glands of the pituitary, hypothalamus, and ovarian axis.
Under normal conditions, the hypothalamus regulates the hormone output of the ovaries and
synchronizes the menstrual cycle.

PCOS happens when this cycle is disrupted due to unsuccessful ovulation. This could take place
for a myriad of reasons, for example, the follicle migrates to the outside of the ovary, but does
not "pop" the egg and release it. This follicle thus becomes a cyst and there will be no
progesterone production. If for some reason these follicles are also unable to produce a mature
egg that can secrete the progesterone, the menstrual cycle is dominated by increased estrogen
and androgen production without progesterone. This hormonal imbalance is the main reason
behind PCOS.

These women may at the same time have different degrees of insulin resistance (Syndrome
X) and therefore higher incidence of Type II diabetes, unfavorable lipid patterns (usually
high triglycerides, high LDL and low HDL cholesterol), and a low bone density.
Laboratory tests often show higher than normal circulating androgens, especially
testosterone.

Since standard tests usually indicate that a woman with PCOS has plenty of estrogen, and
since she is still having periods, there is a danger that the doctor assumes she is still
ovulating and producing plenty of progesterone.

F. Uterine Fibroids

Uterine fibroids (uterine leiomyomata) are non-cancerous tumors consisting of fibers or fibrous
tissue that arise in the uterus. It is the most common tumor within the female genital tract. These
growths are highly sensitive to estrogen. They develop following the onset of menstruation,
enlarge during pregnancy, and decrease, often disappearing after menopause when the
estrogen level decreases by half. They can be as small as a hen's egg, or commonly grow to the
size of an orange or grapefruit. The largest fibroid on record weighed over 100 pounds. It afflicts
many women, especially from ages 35 to 50. One in 4 women in the U.S. have at least some
evidence of fibroids. Discovery is usually accidental, and coincidental with heavier period,
irregular bleeding, and/or irregular bleeding, or work up for endometriosis or PMS.

In cases where the tumor's size compromises other bodily function such as compression on the
bladder or excessive bleeding, surgery may be indicated. The most common surgery is
hysterectomy where the uterus is removed. Many hysterectomies, however, are performed way
before the patient reaches this stage. In fact, over 500,000 hysterectomies are performed every
year in the US alone as mentioned earlier.

Fibrous tissues are sensitive to estrogen. The higher the estrogen, the faster the fibroid grows.
While a fibroid in itself does not usually lead to cancer or become cancerous, it clearly signals a
serious underlying imbalance in the woman's reproductive and hormonal system. Specifically
there is an estrogen dominance and progesterone deficiency. Such imbalance does not only
affects the uterus, but affects other hormone-sensitive tissues such as breast, cervix, ovaries and
the vagina as well. If not taken care of, the consequences can be devastating.

The fibroid is clearly one part of a continuum of disease associated with estrogen dominance.

G. Breast Cancer

Breast cancer is a rampant epidemic, striking 1 in 9 women in the U.S., up from 1 in 30


women in 1960, before estrogen replacement therapy was popularized. The greatest surge of
breast cancer diagnoses is in the western hemisphere and now spreading globally to all
industrialized countries. Among women between the ages 18 to 54, it is the most common
cause of death. It is also the top cancer killer among women age 45 to 50.

There are many forms of breast cancer. Some grow slowly, while others are much more
aggressive. 90% of breast cancers start in the milk glands or milk ducts, and 10% in the
fatty or connective tissue. The size of the tumor alone is not an accurate marker for virulence.
About 15% of all breast cancer are called in situ carcinoma. This cancer is contained entirely
within a milk duct with no invasion into surrounding tissue. 92% of breast cancer stricken
women aged 30 to 39 and 43% of all women breast cancer in women aged 40 to 49 have
what is called ductal carcinoma in situ ( DCIS). This is considered a precursor to invasive
cancer. It is localized, but can be invasive. The diagnosis of DCIS has risen dramatically
with the advent of mammogram, since it often presents as small calcifications on this test.
Lobular carcinoma in situ (LCIS) occurs mostly in pre-menopausal women and does not form
palpable mass. Its detection is therefore more difficult. About 25% of women with LCIS
develops invasive breast cancer, often up to 40 years after finding the LCIS. Because of its low
virulence, many oncologist think of LCIS as atypical hyperplasia ( abnormal changes are
found in the cells but not necessarily cancerous) with higher propensity of breast cancer. Lastly,
invasive ductal and lobular breast cancer have the worse prognosis because cancer cells can
spread relatively quickly. Breast cancers are usually discovered when a women feels a painless
lump during a self breast examination. Other symptoms include an area of dimpled, creased skin
on the breast, vague discomfort in the breast; and indentation of the nipple.

FDA-approved estrogen drugs have been documented to cause cancer. Published studies
have shown that women taking estrogen and a synthetic progesterone drug had a 32 to 46%
increase in their risk of breast cancer. This was based upon a large pool of data from the famous
Nurses' Health Study conducted at Harvard Medical School. This study showed that the
carcinogenic risk of estrogen-progestin replacement therapy became most pronounced when it
was used for 10 or more years. However, recent data from the Breast Cancer Detection
Demonstration Project suggest that relative risk is increased by 20% even after four years of use
compared to no hormone treatment, and that surprisingly there was a 40% increased risk of
breast cancer using both estrogen and synthetic progesterone ( called progestin) combined,
compared to only 20% increase for estrogen alone. Clearly the progestin (such as Provera)
that is suppose counter-balance the estrogen is not what the body recognizes as good. The
body needs natural progesterone to counter the estrogen effect. Synthetic progesterones are far
from the natural form. While some studies in fact show that estrogen does not cause cancer in the
short-term, but in women taking estrogen and/or a synthetic progestin for more than 10
years, there appears to be a significantly elevated risk of breast, ovarian, and uterine
cancers.

In addition to breast cancer risk, long-term estrogen replacement therapy increased the
risk of fatal ovarian cancer. A large 7-year study included 240,073 pre- and post-
menopausal women focuses on this. After adjusting for other risk factors, women who used
estrogen for 6 to 8 years had a 40% higher risk of deadly ovarian tumors, while women
who used estrogen drugs for 11 or more years had a startling 70% higher risk of dying
from cancer of the ovaries

The highest incidence of breast cancer occurs when women are in their mid-thirties to their
mid-forties. The peak time is about 5 years before menopause. This is a time when the level
of estrogen is still high in the body, but a time where progesterone has already started it
precipitous drop. Studies have shown that by the time a lump is discovered in the breast,
the tumor has been there already for about 7 years. Clearly, non-genetically linked cancer
is one that started in the women early in her thirties and not a cancer of estrogen
deficiency. This is the time when many women in industrialized nations have anovulatory
cycles. As explained earlier, anovulation can be due to a variety of causes, the most
important being stress and excessive xenoestrogen exposure during prenatal life. Women
suffering from anovulation have reduced progesterone in their body and resulting
unopposed estrogen and estrogen dominance.-

Furthermore, xenoestrogen contributes to increased breast cancer risk by:

• Direct and persistent stimulation of the breast ductal cells unaccompanied by


progesterone
• Damage the ovaries, resulting in increased estrogen and decreased progesterone
secretion
• Suppress of the immune system

Clinicians have often reported seeing patients returning with breast lumps 6-12 months
after starting on HRT. This "classic history" reflects the effect of HRT on breast cells.
Researchers have shown that estradiol increased breast cell proliferation rate by 230%,
while progesterone decrease it by more than 400 %. When estradiol is combined with
progesterone, the normal proliferation rate is maintained. It is clear that unopposed
estrogen (especially estradiol) is an important causative factor of breast cancer. This is
well documented by numerous scientific studies. In addition, studies also show that
estrogen stimulates breast cell (and breast cancer cell) hyperplasia and dysplasia, whereas
progesterone inhibits it. Pathologically, estradiol has been shown to stimulate and up-
regulate the oncogene, Bcl-2, leading to cancer cell proliferation. Progesterone, on the other
hand, up-regulate the p53 gene that increases apoptosis and blocks the Bcl-2 carcinogenic
effect. It is clear that estrogen stimulates breast cancer while progesterone has the opposing
effect.
Studies after studies have now repeatedly shown that the majority of breast cancers in
adults are non-genetically linked, and upwards of 80% of breast cancer is caused by
estrogen dominance. Therefore, breast cancer can be cured and reversed if the body's
estrogen level is bought under control. It is not a coincidence that after menopause (and
reduced rate of estrogen production), the rate of increase in the risk for breast cancer
drops dramatically.

We shall not dwell in depth on breast cancer here. Suffice to say that reducing estrogen
aggressively forms the key foundation to prevention and treatment of breast cancer.

Estrogen Reduction Protocol

Questions? Ask me.

Strictly speaking, all of us, men or women alike, suffer from estrogen dominance. There
simply is so much of it around and it is impossible to fully escape its impact. Plastics, car
exhaust, meats, soaps, carpet, furniture, and paneling are just some of the examples. You may
have on-and-off sinus problems, headaches, dry eyes, asthma, cold hands and feet, and may not
attribute them to your exposure to xenoestrogen. Over time, the exposure can cause more chronic
problems such as arthritis, and gallbladder disease.

While a definitive diagnosis can be made through a thorough history and physical examination,
together with laboratory tests of estrogens and progesterone levels, this is seldom done. Instead,
synthetic estrogen such as Premarin ,or combination synthetic estrogen and synthethic
progesterone (such as Pempro) are often passed out on the premise that symptoms presented are
due to estrogen deficiency without any consideration for the progesterone part of the equation. In
reality, many are suffering from relative estrogen dominance.

This naturally oriented protocol is designed to reduced the body's estrogen load and
prevent onset of cancer. If you already have been diagnosed with cancer, more aggressive
action will be needed including include all these steps.

1. Natural Progesterone

The typical domino effect of estrogen dominance starts with proliferation of estrogen sensitive
cells, leading to overgrowth of endometrial lining, to PMS, to PCOS, to uterine fibroid, to
hysterectomy, to severe iatrogenic (doctor-caused) hormonal imbalance (when estrogen is given
alone with opposing progesterone), to misguided medication for depression and anxiety, to bone
loss and reduced libido. These all can be reduced if the amount of estrogen in the body is
normalized by administration of natural progesterone as a balancer.

Natural progesterone is therefore a cornerstone of estrogen reduction therapy. It helps to


reduce the risk of ovarian, endometrial and breast cancers, while unopposed estradiol causes that
is frequently associated with fibrocystic breast disease, endometriosis, PMS, fibroids, and breast
cancer. If you have symptoms of estrogen dominance but have not been diagnosed with
estrogen-related cancer, natural progesterone will still be valuable for its cancer prevention
properties. Specific dosage varies depending on the condition. Baseline saliva testing of
estrogen, progesterone, and their respective ratios should be undertaken. The body normally
produces 20 mg of progesterone a day. Replacement of this physiological amount in natural
cream form is suggested in most cases. There is a tremendous variation in the amount that
should be taken for optimum effectiveness. It is recommended that you consult a naturally
oriented physician prior to treatment.

2. Dietary Adjustments

Overeating and under-exercising are the norm in developed countries.


Populations from such countries, especially in the Western hemisphere,
derive a large part of their dietary calorie from fat. They also show a
much higher incidence of menopausal symptoms. Studies have shown
that the estrogen level fell in women who switched from a typical
high-fat, refined-carbohydrate diet to a low-fat, high-fiber, plant-
based diet even though they did not adjust their total calorie intake.
Plants contain over 5,000 known sterols that have progestogenic effects.
Cultures whose eating habits are more wholesome and who exercise
more have a far lower incidence of menopausal symptoms because
their pre- and postmenopausal levels of estrogen do not drop as significantly.

In non-industrialized societies not subjected to environmental estrogen insults,


progesterone deficiency is rare. During menopause, sufficient progestogenic substances are
circulating in the body to keep the sex drive unabated, bones strong, and passage through
menopause symptom-free.

Some years back, scientists discovered that unfermented soy and various cruciferous vegetables
such as broccoli, cauliflower, cabbage, kale, bok choy, and Brussels sprouts contain a high level
of phyto-estrogen. These compounds' chemical structure resembles estrogen but are many times
weaker in potency. Women consuming these vegetables reported some relief of menopausal
symptoms such as hot flashes. The prevailent wisdom is that women in menopause lacks
estrogen , and pyhto-estrogen replenish the body with estrogen. Soy and cruciferous vegetables
is heavily promoted.

It is now known that these vegetables work by competitively occupying the estrogen receptor
sites on the cell membrane to prevent internal estrogen from exerting its effects on the cell.
Those who have estrogen dominance may therefore experience relief of symptoms as phyto-
estrogen is many times weaker than the estrogen in our body.

While phyto-estrogen may work and relief symptoms, the long term effect is probably
undesirable because the estrogen receptor sites are still occupied, although by the less potent
phyto-estrogen. Overconsumption of phyto-estrogenic food such as unfermented soy and
cruciferous vegetables on a long term basis may actually not reduce the risk of estrogen
dominance significantly. Its akin to replacing one potent devil with a lesser potent one. It is far
more benefitial to rid of the estrogen from the receptor sites and replace them with progesterone.
Estrogen load will therefore reduce significantly, and the risk of estrogenic diseases such as
breast cancer will be less.

Furthermore, phyto-estrogen have been shown to inhibit the conversiion of T4 to the active T3
thryoid hormone, and can trigger hypo-thyroidism.

Women with estrogen dominance should only take unfermented soy such as tofu and cruciferous
vegetables in moderation. Those with a history of thyroid imbalance should refrain from such
vegetables.

A plant-based unprocessed whole-food diet is recommended. At least 15 grams of fiber should


be consumed a day. Avoid high-glycemic foods such as refined sugar. Avoid alcohol or drugs
that can damage the liver which will lead to an increase in estrogen due to the lack of estrogen
breakdown. Caffeine intake from all sources is linked with higher estrogen levels regardless of
age, body mass index (BMI), caloric intake, smoking, and alcohol and cholesterol intake.

3. Coffee and Tea

Studies have shown that drinking more than two cups of coffee a day may increase estrogen
levels in women. It could also lead to problems such as endometriosis and breast pain.

In a clinical trial conducted, about 500 women between the ages of 36 to 45 were studied. These
women were not pregnant, not breast-feeding or having hormonal treatment. They were
interviewed regarding their diets, smoking habits, height, and weight. Their hormone levels
during the first five days of their menstrual cycle was also measured. The results showed that
women who consumed more than one cup of coffee a day had significantly higher levels of
estrogen during the early follicular phase of their menstrual cycle. Those who consumed at
least 500 mg of caffeine daily, the equivalent of four or five cups of coffee had nearly 70%
more estrogen than women who consumed less than 100 mg of caffeine daily. Coffee
consumption increases estradiol levels. There are three different forms of estrogen in the body -
estrone, estradiol, and estriol. Estradiol is the form that is pro-cancerous.

Having high levels of estrogen for women in such cases can be detrimental as it can lead to
breast cancer in women and prostate cancer in men. Those who have a family history of cancer
also have a higher risk. Women should limit their intake of coffee to no more than one to two
cups daily to decrease their risk of having more serious health problems. Excessive chronic
coffee intake is associated also with adrenal fatigue and reduced progesterone production. The
proper progesterone to estrogen ratio is therefore not maintained, resulting in further estrogen
dominance.

Coffee (especially when accompanied with sugar) also creates an acidic internal environment.
The body will try to neutralize the acid by withdrawing valuable minerals such as magnesium
and calcium from the bone. This leads to mineral depletion if chronic and ultimately
osteoporosis.
In summary, coffee consumption can lead to increased estrogen, adrenal gland exhaustion,
and osteoporosis. Clearly, coffee is not the women's best friend by any means.

4. Detoxification

The liver has two mechanisms designed to help detoxify the body. They are called Phase 1 and
Phase 2 detoxification pathways. Individual xenoestrogen and metabolites, once entered our
body, usually follow one or both of the pathways.

Phase One - Detoxification Pathway

IN Phase one, enzymes present in the liver cell help convert toxins into metabolites through a
series of chemical reactions (such as oxidation, reduction and hydrolysis). One example of the
phase one pathway involves the Cytochrome P-450 enzyme. Toxins are rendered harmless in this
process and excreted through the kidneys. During this process, free radicals are often produced
which, if present in excessive amounts, can damage the liver cells. Fortunately, the body has a
built in protection mechanism and antioxidants (such as vitamin C and E and natural carotenoids)
can reduce the damage caused by these free radicals. If these antioxidants are lacking, the toxin
exposure is too high, the toxic chemicals can become very dangerous because some of them may
be converted from relatively harmless substances into potentially carcinogenic substances.

In our polluted environment, excessive amounts of toxic chemicals such as pesticides ,alcohol or
medication, can disrupt the P-450 enzyme pathway by causing over activity or 'induction'.
Substances that may cause overactivity (or induction) of the P- 450 enzyme pathway include
caffeine, saturated fats, trans-fat, paint fumes, car exhaust, cigarette smokes, and barbiturates. As
a result of this induction, high levels of free radical can be produced inside the body. In order to
enhance Phase 1 detoxification pathway and prevent free radical overload, a wide variety
of anti-oxidants including ascobic acid, lipoic acid, grape seed extract, quercetin, and N-
acetyl-cysteine is needed by the body.

Phase Two - Detoxification Pathway

In Phase two, the liver cells, in a process called conjugation, add another substance (eg. cysteine,
glutathione, glucuronide, sulphur or glycine molecule) to the toxic drug or chemical which has
entered the body. Once conjugated, the metabolite compound, whether it is toxic or not, is
neutralized and is rendered less harmful to the body. In Phase 2, drugs, toxins, and hormones are
converted into execretable substances that are in urn excreted from the body via watery fluids
such as bile or urine.

Studies have shown that calcium d-glucurate, a natural ingredient found in certain vegetables and
fruits can inhibit beta glucuronidase activity resulting in increased elimination of toxins from the
liver. Supplements of calcium d-glucurate will enhance the glucuronidation pathway critical in
the conjugation process. In addition, methionine, folic acid, Taurine, N-acetyl-cysteine are
very useful synergistic nutrients that will help this pathway.
Estrogen Metabolism

Estradiol (E2) is the principal and most active estrogen circulating inside our body, and its
breakdown, like many other steriodal hormones, occurs in the liver. The half-life of estradiol
(E2) is about 3 hours. There are multiple pathways that convert E2 to metabolites that have
widely different biological activities.

Estrone is the second most potent estrogen in circulation. It is easily converted back and forth
from estradiol through enzymatic reactions. Both estrone and estradiol are metabolized by a
process called hydroxylation. Some of the hydroxylated products are converted into estriol ( E3),
while others are further broken down and secreted out the body. E3 is further conjugated in the
liver and excreted in the urine..
Normal pre-menopausal women produce several hundred micrograms of estradiol every day.
Some of this estradiol find its way to binding with the nuclei in a wide variety of tissues,
resulting in genetic transcription as well as cellular division. While the production of estrogen is
going on, a similar amount of estradiol is removed from the body, primarily in the liver. This on
going production and destruction process results in a constant balance of estradiol in our body.

Since the metabolites are estrogen derivatives, they all possess estrogenic properties in
varying degrees, as they are all part of the estrogen family. The degree of the hydroxylation
(either through the two-hydroxylation or sixteen alpha-hydroxylation process) provides an
indication of the metabolite’s estrogenic potency.

Metabolites such as 2-(OH)-estrone or 2-(OH)-estradiol are considered good estrogen. They


are derived from hydroxylation of estrone and are the most prevalent metabolite of estradiol and
estrone. These good estrogens are present in decreased level in people who are obese and in
women who are on a diet high in animal fat . These good estrogens can be increased by
consistent moderate exercise, a diet high in protein and low in fat, and by the consumption of
food containing indol-3-carbinol such as cabbage and broccoli. In addition to being good
estrogens, both 2-(OH)-estrone and 2-(OH)-estradiol have been found to be powerful anti-
oxidants and can protect the lipid proxidation process by circulating iron molecules.

Another metabolite of estrone is called the 16 alpha-(OH) estrone. This is called the genotoxic
form of estrogen or “bad” estrogen. It has been shown to be more potent than estradiol. Due to
its ability to combine with estrogen receptors and transforming the nuclei to synthesize DNA, the
risk of breast cancer is increased significantly. For this reason, it is also called the transforming
estrogen. Another bad metabolite is 4-(OH)-estrone. This is a free radical generator and its role
as far as being a “bad estrogen” is still under intense investigation.

It should be clear that just as there are good and bad cholesterols, we have good and bad
estrogens. 2-(OH)-estrone is considered good, being a potent anti-oxidant and has anti-cancer
properties 4-(OH)-estrone as well as 16-alpha–(OH)-estrone are considered bad, being free
radical generators and at high level they are considered to be important indicators of cancer risk.
The ideal ratio of 2-(OH)-estrone to 16-alpha-(OH)-estrone as measured in the urine is 2.0
or more.
Studies have shown that 73% of breast cancer patients have a ratio below 2.0. In other words,
their 16-alpha- (OH) estrone level is high compared to the 2-(OH)-estrone. Studies have also
shown that women 35 years and older with breast cancer have 2-(OH)-estrone to 16-alpha–(OH)-
estrone ratio that is lower than control groups. Those women with the lowest ratio have a 30%
greater chance of developing breast cancer compared to the highest 2/3. The ratio of 2-(OH)-
estrone to 16-alpha–(OH)-estrone is significant and is an important predictive indicator of breast
cancer risk in postmenopausal women. Fortunately both levels can be measured in the urine.

In summary, estrogen is metabolized in the liver. Herbs that fortify the liver will speed up
estrogen clearance from the body. Estrogen that is not metabolized by the liver will
continue to circulate and exert it

The most impressive research has been done on a special extract of milk thistle (Silybum
marianum) known as silymarin, a group of flavonoids compounds. These compounds
protect the liver from damage and enhance the detoxification process.

Silymarin prevents damage to the liver by acting as an antioxidant. It is much more effective
than vitamin E and vitamin C. Numerous research studies have demonstrated its protective effect
on the liver. Extremely toxic chemicals such as carbon tetrachloride, amanita toxin,
galactosamine and praseodymium nitrate produce experimental liver damage in animals.
Silymarin has been shown to protect the liver against these toxins.

Silymarin also works by preventing the depletion of glutathione. The higher the glutathione
content, the greater the liver's capacity to detoxify harmful chemicals. Moreover, silymarin has
been shown to increase the level of glutathione by up to 35 %. In human studies, silymarin has
been shown to exhibit positive effects in treating liver diseases of various kinds including
cirrhosis, chronic hepatitis, fatty infiltration of the liver, and inflammation of the bile duct. The
common dosage for silymarin is 70 to 200 mg one to three times a day.

In addition, avoid caffeine, alcohol and medications that interfere with the liver's
detoxification mechanism.

5. Maintaining ideal body weight

Half of the adults in Europe and 61% of American adults are overweight. If you are overweight,
lose it as fat cells increase estrogen production. Aromatase is an enzyme that helps produce
estrone locally within fat cells. Estrone (one of the three main estrogen in the body) in turns fool
the pituitary gland into thinking, through a normal negative feedback mechanism, that there is a
sufficient amount of estrogen on board. Ovaries are therefore instructed not to produce hormone.
Progesterone output is thus reduced, setting up an environment of estrogen dominance. Obesity
also is associated with a higher output of testosterone that in turn will cause the liver to put out
more SHBG (sex hormone binding globulin). The more SHBG, the more hormones are bound
are not available to the cells.

Over-consumption of calories leads to increased metabolic activity in the body. This in turn leads
to excessive free radical formation. Free radicals damage cells and cause genetic mutations,
which ultimately can lead to cancer. Cancer is more common in overweight people. The
evidence on weight is strongest for post-menopausal breast cancer and cancer of the
endometrium (lining of the womb), gall bladder, and kidney.

Obesity is normally defined by the body mass index or BMI, which is calculated by dividing
weight in kilograms by height in meters squared. An index of between 18.5 and 25 is considered
healthy, while those with a score between 25 and 29 are classified as overweight and those
whose BMI is higher than that are considered obese. The target weight should be to attain
ideal body weight. Your ideal body weight can be calculated easily. For women, the formula is
100 pounds plus 5 pounds for every inch above 5 feet. Therefore, for a woman standing 5 feet 6
inches tall, her ideal weight is 100 + (5 pounds/inch x 6 inches) = 130 pounds. Give or take 5
pounds for large or small frame size respectively.

6. Exercise

Properly performed exercises have been shown to modulate hormonal imbalance through
the pre-menopausal years and beyond. Those who exercise regularly are also happier, less
depressed, and have an optimistic outlook on life. This results in increased life expectancy.
Statistically, life expectancy increases by two hours for every hour spent doing the proper
exercises.

Numerous studies have confirmed that vigorous exercise can reduce breast cancer risk. Dr.
Esther M. John, an epidemiologist at the Northern California Cancer Center in Union City, found
that even moderate consistent exercise over a lifetime can reduce a young woman's risk of
developing breast cancer by 33%, and the risk of breast cancer after menopause by 26% as
compare to those who are sedentary. Moderate exercise is brisk walking 2 miles three times a
week. In another study reported in the Journal Cancer, it was found that postmenopausal women
who exercise 1 hour each day can significantly cut their breast cancer risk. Regardless of age,
regular exercise is a proven key to reduction of breast cancer, not to mention the cardiovascular
health benefits.

Precision anti-aging exercises must incorporate flexibility, cardiovascular, and strength training
exercises. All it takes is 5 minutes of flexibility training every day, 20-30 minutes cardiovascular
training 3 times a week, and 15-20 minutes of strength training 2 times a week. A properly
structured program takes an average of 30 minutes a day, which is less than 2% of the entire day.
daily exercise can be broken down in to 10 minute blocks.

. Nutritional Supplementation

Attention

Because of tremendous individual variation, the use of nutritional supplement should therefore
be personalized for your body. While each natural compound has a specific purpose, the key to
recovery is take selected ones and combine them in a low dose cocktail that is tailored for your
body so that no high dose of any one compound is needed unless indicated. Simply taking the
entire list of supplements recommended below may actually cause more harm than good.
One person’s nutrient can be another person’s toxin. If you have a specific health concern and
wish my personalized nutritional recommendation, write to me by clicking here.

A . General foundational coverage

Pyridoxine 50-100 mg, Fish oil 200-1000 mg, natural vitamin E 90-400 I.U., Magnesium 200-
800 mg, vitamin C 100-1000 mg, folic acid 100-800 mcg; quercetin 350-1,000 mg;

B. Conversion of estrogen metabolite

Diindolylmethane (DIM) 60 mg standardized extract once or twice a day - The use of DIM is
compatible with other phyto-nutrients such as soy, black cohosh, red clover, and chaste berry
extract. Not everyone likes vegetables, and scientists are able to isolate the active ingredient of
cruciferous vegetables. It is called Indole-3-Carbinol (I3C). Unfortunately, I3C has drawbacks.
Fortunately, I3C combines with stomach acid to form 3,3-Diindolylmethane (DIM) which is
safe. DIM supplementation is available. DIM is a balancer of estrogen metabolism. It
increases 2 hydroxy-estrone, which is also known as the good or protective estrogen. It can be
used in conjunction with a phyto-estrogen such as isoflavone as well as other phyto-nutrients
such as soy, red clover, and chaste berry extractt in selected cases . Women who are on oral
contraceptives are advised to stay away as DIM might reduce their effectiveness. DIM works
well together with Tamoxifen and inhibits angiogenesis. DIM also raises progesterone level
when necessary. It is interesting to note that both isoflavone and DIM work along different
pathways. While studies have shown that supplementation with 200 mg per day of soy
isoflavone increases the production of estrogen metabolites, the effect is much less than that seen
with absorbable DIM. From a nutritional supplementation perspective, 70 - 400 mg may be used.

C. Liver function Enhancement

1. Antioxidants.

Antioxidants such as vitamins A, E, and especially C are essential for detoxification as they help
the cells to neutralize fee radicals that cause mutation and cellular damage. This is critical during
the Phase 1 detoxification process in the liver where free radicals are released.

Vitamins should be taken as a cocktail in optimum amounts because each vitamin is unique and
works on a particular part of the body. For example, both vitamins A and E are fat-soluble and
are found in our fatty tissues. They are particularly effective in preventing the oxidation of cell
membranes, which are made up of phospholipids.

On the other hand, vitamin C is water-soluble and fights free radicals in the plasma. Vitamin C
and E to regenerate each other as well. Vitamin C is especially vital in any detoxification
program, as the body needs it for energy to process and eliminate wastes.

2. Methionine
Methionine is one of the essential amino acids needed for good health but cannot be produced by
the body, and so must be provided through our diet.

One of the important functions of methionine is its ability to be a supplier of sulfur and other
compounds required by the body for normal metabolism and growth. Sulfur is a key element and
vital to our life. Without an adequate intake of sulfur, our body will not be able to make and
utilize a number of antioxidant nutrients. Methionine is also a methyl donor, capable of giving
off a molecule with a single carbon atom with 3 tightly connected hydrogen atoms, called a
methyl group which we need for a wide variety of chemical and metabolic reactions inside our
body.
Meat, fish, and dairy products are all excellent sources of methionine. Good food sources include
beans, eggs, fish, garlic, lentils, onion, soybeans, and yogurt. Vegetarians can obtain methionine
from whole grains, but beans are a relatively poor source of this amino acid.
Together with choline, and inositol, methionine belongs to a group of compounds called
lipotropics which help the liver to process fat in the body. Once in the liver, methionine is
converted into SAM(s-adenosyl methionine). As much as 8 grams of SAM is produced in the
liver each day when conditions are ideal. However, the amount of SAM produced in the body
can be reduced significantly when the liver function is compromised.

Methionine is a valuable nutritional compound of multiple benefits to the body. In Europe,


doctors have been using it with excellent results to treat depression, inflammation, liver diseases,
and certain muscle pains. Methionine is an especially important nutrient beneficial to those
suffering from estrogen dominance, where the amount of estrogen in the body is excessively
high when compared to its opposing hormone called progesterone. Similarly, those who are on
oral contraceptives or estrogen replacement therapy will find methionine to be helpful. Since
estrogen is cleared through the liver, an enhanced liver function will reduce the body’s estrogen
load. Specifically, methionine converts the stronger and carcinogenic “bad” estradiol (E2)
into estriol (E3) that is the “good” estrogen.

The body can convert methionine into cysteine, a precursor of glutathione. Methionine therefore
protects against glutathione depletion if the body is over loaded with toxins. Because glutathione
is the key neutralizer of toxins in the liver, high glutathione level protects the liver from the
damaging effects of toxic compounds. Methionine is also used by the body to make a substance
called choline that is essential for healthy cellular membrane function.

Most people consume enough methionine from a typical diet. The daily requirement varies
depending on the body weight, but approximately 100-1000 mg a day is sufficient for those
who are not estrogen dominant.

Most of us do not need to have methionine supplementation if we are in good health. However,
strict vegetarians and anybody who follows a low protein diet should consider methionine
supplementation. Those whose diet is high in soy should also consider methionine
supplementation as soy is low in amino acids. When taking methionine supplementation, intake
of taurine, cysteine, and other sulfur containing amino acids, as well as folic acid should also be
included. Recommended dosage ranges from 500 mg to 4,000 mg in divided dosages
throughout the day.
Because of this ability to enhance estrogen clearance from the liver, methionine
supplementation should be considered for anybody with symptoms of estrogen dominance,
including breast cancer. Excessive methionine intake in the presence of folic acid and
vitamin B6 deficiency can increase the conversion of methionine to homocysteine that is
linked to heart disease and strokes. Therefore it is essential that supplementation of folic acid
and vitamin B6 be added as well. Supplementation of up to 4 grams of methionine daily for long
periods of time has not been associated with any serious side effect.

3. SAMe

SAMe is the metabolite of methionine and has many good attributes. A daily dose of up to
1600mg of SAMe has been used to fight hepatitis and cirrhosis. Another major application of
SAMe involves the alleviation of depression. A dose of 800-1600mg a day helps to elevate mood
and provide relief to those who are clinically depressed. Both methionine and SAMe have anti-
inflammatory effects and are therefore used often in combination to treat osteoarthritis. A daily
dose of 5g of methionine has been linked to reduced lymph rigidity and Parkinson’s disease.
However, the use of SAMe has not been able to reproduce similar effects. SAMe however, is
helpful to those who have multiple sclerosis. SAMe’s anti-inflammatory properties have also
proven helpful with fibromyalgia when taken at 1gram a day. In Britain, methionine as well as
SAMe are quite frequently used in the treatment of chronic fatigue.

4. Taurine.

Taurine is an important amino acid in our body. It is found mostly in our central nervous system,
skeletal muscle, and in greater concentration in our heart and brain. It is made from two sulfur-
containing amino acids called methionine and cysteine in conjunction with vitamin B6.
Methoinine and cysteine are found in egg yolk and meat as well.

Taurine is commonly found in animal protein but not in vegetable protein. Vegetarians with a
low intake of protein may have difficulty producing taurine in their bodies. In addition to meat,
taurine is found in abundance in shell fish. Vegetarians as well as those on a low fat diet will
have to be mindful on the amount of taurine consumed.

In cells, taurine keeps potassium and magnesium inside the cell while keeping excessive sodium
out. In this sense it works like a diuretic. But unlike prescription diuretics, it is not a cellular
poison. It does not act against the kidney, but improves kidney function instead. Taurine is very
useful in fighting tissue swelling and fluid accumulation. People with heart failure, liver disease,
late stage ovarian cancer, congestive heart failure frequently have unwanted fluid accumulation
inside their bodies. Taurine has been very successfully used to treat people with high blood
pressure. When excessive fluid in the body is normalized, the blood pressure becomes
normalized. Taurine functions to dampen the sympathetic nervous system, thereby relieving
arterial spasm. When the blood vessels relax, the body’s blood pressure will fall.

There have been studies showing the positive effectiveness of taurine on heart failure. Aside
from having diuretic properties, taurine is able to strengthen the heart muscles and maintain
proper calcium balance. Together with Coq10 and carnitine, taurine is able to regulate the heart’s
contractility and guard against the toxic threat of chemotherapeutic drugs such as
adriamycin(doxorubicin). Working together with magnesium, taurine also is able to regulate
heart rhythm and help to stabilize it.

Taurine is an important amino acid in the female body. The female hormone estradiol
depresses the formation of taurine in the liver. Women who are on estrogen replacement,
birth control pill, or those suffering from excessive estrogen (this is a widespread condition
commonly called estrogen dominance) may need more taurine. Taurine is also helpful in
clearing excessive fluid retention during menstrual period. Furthermore, synthetic estrogen
replacement therapy blocks the production of taurine in the body , as well as in the case of
chemotherapy and the lack of good bacteria in the intestinal tract.

Suggested Dosage: Between 1 and 3g a day, there is usually no problem. However at a


dosage of more than 5g a day, taurine may occasionally cause loose stool. The general dosage for
people who have edema, high blood pressure, and seizure disorders range from 0.5-4g a day. In
high doses, taurine may increase slightly the secretion of stomach acid.

5. Fish Oil

A diet low in fish oil decreases the ratio of 2-(OH)- estrogen to 16-alpha-(OH)-estrogen and
thereby increases cancer risk. Intake of fish oil also has been observed to inhibit the
formation of human breast cancer cells in laboratory studies.

Lean fish, which is typically found in warmer water, tends to have lower concentration of EPA
and DHA and higher concentration of arachidonic acid. Several theories have been proposed to
explain the link between the high intake of fish oil and the low risk of cancer. Among the most
important is the inhibition of ecosinoids production from arachidonic acid (AA), and omega 6.
Ecosinoids belongs to a class of compounds that are derived from poly and saturated fatty acid
including prostaglandins, hydroxyl, prostaglandins, and leukotrienes. Prostaglandins are
unsaturated fat that perform a wide variety of actions. Prostaglandin E2 (PGE2) have been linked
to the formation of several types of breast and prostrate cancer. Tumor cell generally produce a
large amount of AA derived from PGE2. Fish oil inhibits the oxidation of AA to PGE2.
Ecosinoids derived from AA also is related to the modulation of estrogen metabolism. DHA has
been shown to improve the response of breast tumors to cytotoxic agents.

Inflammatory molecules called leukotrienes are one of several substances that are released by
mast cells during an asthma attack, and it is the leukotrienes which are primarily responsible for
the bronchoconstriction. In chronic, more severe cases of asthma, general bronchial hyperactivity
(or smooth muscle twitchiness) is largely caused by eosinophils, which are attracted into the
bronchioles by leukotrienes (and other chemoattractants) and which themselves also produce
leukotrienes. Thus leukotrienes seem to be critical both in the triggering of acute asthma attacks
and in causing longer term hypersensitivity of the airways in the case of chronic asthma.
Leukotrienes are derived from arachidonic acid, the precursor of prostaglandins.
Suggested Dosage: 500 to 10,000 mg a day.

6. Calcium-d-glucarate

D-Glucaric acid is a nontoxic, natural compound. One of its derivatives is the potent beta-
glucuronidase inhibitor (1,4-GL). 1,4-GL increases the detoxification of carcinogens and tumor
promoters by inhibiting beta-glucuronidase and preventing hydrolysis of their glucuronides. 1,4-
GL and its precursors such as calcium D-glucarate may exert their anti-cancer action through
alterations in steroidogenesis. This is accompanied by changes in the hormonal environment and
the proliferative status of the target organ. Glucarates may directly detoxify any environmental
agents responsible for cancer formation. It has been postulated that D-glucarate exerts some of
its effects by equilibrium conversion to D-glucarolactone, a potent beta-glucuronidase inhibitor.
Laboratory studies comparing calcium glucarate (CGT) with a known chemo-preventive
agent, 4-HPR during Initiation Phase (I), Promotion Phase (P), and Initiation plus Promotion
Phase (I+P) together showed that CGT reduced tumor multiplicity by 28 percent, 42 percent and
63 percent for the various stages respectively as compared to 4-HPR which reduce tumor
multiplicity 63 percent, 34 percent and 63 percent respectively. The maximum effect occurred
during the P and I+P phases. In particular, studies have showed that the chemo-preventive effect
was synergistic when CGT was used together with 4-HPR.

This is one of the most important nutrient to enhance liver function.

Suggested Dosage: 250-1,000 mg a day.

7. Silymarin

Much research has been done on a special extract of milk thistle (Silybum marianum) known as
silymarin, a group of flavonoid compounds. These compounds protect the liver from damage and
enhance the detoxification process.

Silymarin prevents damage to the liver by acting as an antioxidant. It is much more


effective than vitamin E and vitamin C. Numerous research studies have demonstrated its
protective effect on the liver. Experimental liver damage in animals is produced by extremely
toxic chemicals such as carbon tetrachloride, amanita toxin, galactosamine and praseodymium
nitrate . Silymarin has been shown to protect the liver against these toxins.

Silymarin also works by preventing the depletion of glutathione. The higher the glutathione
content, the greater the liver's capacity to detoxify harmful chemicals. Moreover, silymarin has
been shown to increase the level of glutathione by up to 35 percent. In human studies, silymarin
has been shown to exhibit positive effects in treating liver diseases of various kinds including
cirrhosis, chronic hepatitis, fatty infiltration of the liver, and inflammation of the bile duct. The
common dosage for silymarin is 70 to 200 mg one to three times a day.

Suggested Dosage: standardized extract 200-800 mg a day

8. N-acetyl-cysteine (NAC)
NAC is also a good natural chelator of lead and mercury from dental amalgam fillings, cadmium
and lead from paint and cigarette smoke. Because it is produced in living organism from the
amino acid cysteine, it is a natural sulfur-containing compound and a natural and powerful anti-
oxidant as well. Having these duo properties make NAC an indispensable nutrient in liver
fortification and detoxification tool concurrently.

N-Acetyl Cysteine is a more stable compound than taking oral cysteine, but as it is metabolized,
some N-Acetyl Cysteine may be oxidized and become insoluble. This may form kidney stones. It
is therefore recommended that individuals taking NAC take should also be taking vitamin C to
prevent NAC from being oxidized.

Estrogen is metabolized in the liver. By enhancing liver function, more estrogen is broken
down in the body , reducing the overall estrogen load.

Suggested Dosage: 350 -2,000 mg a day

9. Lipoic Acid. Called the universal antioxidant for its ability to dissolve well in water and in fat
environment, Lipoic acid increase the effectiveness or potency in other antioxidants. It can cross
the blood brain barrier while others cannot . It can easily reach all parts of the liver easily
when other nutrients have difficulty. One of the most beneficial effects of both alpha Lipoic
acid is its ability to regenerate other essential antioxidants such as vitamins C and E, coenzyme
Q10, and glutathione. The evidence is especially strong for the ability of Lipoic acid to recycle
vitamin E. This is apparently achieved directly by quenching tocopherol radicals or indirectly by
reducing vitamin C or increasing the levels of ubiquinol (a derivative of CoQ10) and glutathione
that in turn, helps to regenerate tissue levels of vitamin E.

Suggested dosage: 125-1,000 mg a day

10. Quercetin: Extensively researched, this flavonoid damages cancer cells only and leaves
normal cells intact. Food sources include onion and apples. It acts synergistically with
chemotherapy agents like tamoxifen, cisplatin, Adriamycin and also radio therapeutic agents. It
is a potent aromatase inhibitor and reduces the metastatic potential of cancer cells. It stimulate
the immune system like reishi and maitake mushroom, a potent antioxidant and free radical
scavenger, and alters the mitotic cell cycle in tumor cells and genetic expression. Most
importantly, it is anti-angiogenesis and enhances apoptosis. It increases the intracellular
glutathione level, thereby enhancing liver function. It acts synergistically with hyperthermia
treatment protocols.

It inhibits mutant P53 protein that arrest the G2 end phase of the cell cycle. Most drugs only
inhibit the G1 phase. It induces apoptosis of cancer cells. It suppresses glycolysis and ATP
production, interferes with ion pump systems, various signal transduction pathways, and
inhibition of DNA polymerase B and I. It binds to estrogen receptor sites, working like
tamoxifen and inhibit the growth of estrogen positive and estrogen negative cells. It inhibits
mutant P21 gene found in over 50 percent of colon cancers which signals DNA replication in
cancer cells.
Vitamin C enhances the effectiveness of quercitin, and vice-versa. One caution is that tangeretin,
a flavonoid found in citrus fruits, completely blocked the inhibitory effect of tamoxifen on
mammary cancer in mice. Another study also showed that tamoxifen and genistein
synergistically inhibit the growth of estrogen receptor-negative breast cancer cells. Until more
confirmatory studies are conducted and the flavonoid-tamoxifen interactions more thoroughly
investigated, it is best to avoid high therapeutic ( over 1,500 mg) doses of flavonoid
compounds in breast cancer treated with tamoxifen. Low remission and preventive doses
(350 to 1500 mg) are acceptable and helps to reduce estrogen sensitive receptors.

Suggested Dosage: 350 mg to 3,000 mg a day

11. Grape Seed Extract

In 1951, a French researcher named Dr. Jacques Masquelier patented the process of extracting
proanthocyanidins from the bark of the European coastal pine tree. The extracted
proanthocyanidins, which are powerful antioxidant nutrients from the bioflavonoid family of
compounds, were named Pycnogenol® (pronounced Pick-nah-geh-nol).

The name pycnogenol can refer to two things. Besides Dr. Masquelier's trademarked compound,
Pycnogenol® is also the name of a variety of compounds that contain proanthocyanidins (the
active ingredient in Pycnogenol). These compounds can be derived from a variety of natural
sources, such as grape seeds, which contain a high concentration of these substances.

The extracted proanthocyanidins (PCO) functions the same way as Vitamins C and E. By
scavenging free radicals, it can help to fortify Phase 1 of the liver detoxification pathway,
resulting in an increase of estrogen clearance. With less estrogen, heavy menstrual bleed
can be normalized.

What makes PCO so effective? Firstly, it is rapidly absorbed due to its excellent water solubility
and distributed throughout the body within twenty minutes. It can be retained for as long as 72
hours while it neutralizes free radicals and prevents oxidation. It also works synergistically with
other anti-oxidants like Vitamin C, quercitin, and lipoic acid, thereby enhancing their effects.
The results usually noted are delayed signs of aging, improved circulation as well as a stronger
immune system. PCO also arms the human body with excellent antioxidant nutritional support
for a variety of body repairs. It makes capillaries less susceptible to fragility and rupture;
consequently, PCO is useful in blood vessels related conditions like varicose veins, peripheral
hemorrhage, diabetic retinopathy, and high blood pressure.

Compared to other nutrients normally prescribed for the above conditions, PCO demonstrated a
threefold improvement of their damaged capillaries. PCO works by inhibiting the release of
unwanted collagenases, which breaks down proteins. Whenever there is tissue damage and/or
inflammation, these collagenases are released, thus causing the decay of the fragile capillary
walls. Proanthocyanidins strengthen our capillary walls, making them valuable for circulatory
disorders of all kinds, including varicose veins, hardening of arteries, and impaired blood flow to
the brain.
19 years after Dr Masquelier patented the process, proanthocyanidins were also extracted
from grape seeds. Pycnogenol®'s bioflavonoid concentration is 85% while that of grape
seeds' stands is higher at 92% to 95%. The cost of the grape seed extract is also much less
expansive.

Some people have replaced their vitamins supplements totally with Pycnogenol®, thinking that it
offers better protection. This is an incorrect assumption. It should be understood that any
compounds with proanthocyanidins cannot take the place of the other vitamins. PCOs work
together with vitamins to increase the overall effectiveness of each other. In other words, PCOs
should be taken in addition to and not in place of common well-researched and established
antioxidants such as Vitamin C and E. For practical purposes, the small difference in
bioflavonoid concentration between Pycnogenol® and grape seed extract is insignificant for the
same dosage. Based on cost factors however, grape seed extract is usually recommended.

Suggested dosage: 100 to 1,000 mg a day.

Significantly higher dosages are needed for specific problems. To limit heavy menstrual
flow, up to 3,000 mg a day may be required. Therapeutic effects can be seen as early as one
month, with menstrual flow reduced from 7 days to 4 days.

D. Control of estrogen dominance symptoms

Gamma aminobutyric acid for emotional stability at 250-2,000 mg; taurine for excessive
fluid accumulation at 300 - 3,000 mg; chromium polynicotinate to help control sugar
craving at 100- 800 mcg; Glutamine to enhance energy and enhance gastric function at 300-
3,000 mg a day;

Avoid Iron unless you are anemic.

Avoid copper unless adviced by a health care professional.

8. Reduced Environmental Estrogen

Last but not least, external estrogen load is a key component that everyone

- Throw away all pesticides, herbicides, and fungicides.

- Throw away cosmetics that have toxic ingredients such and switch to organic and
"clean" cosmetics.

- Throw away nail polish and nail polish removers.

- Use organic soaps and toothpastes.

- Don't use fabric softeners as it puts petrochemical right on your skin.


- Use only naturally based perfumes. Most perfumes are
petrochemically based.

- Have a good water filter for your source of water.

- Do not use plastic goods since all plastic leach into the environment.

- Eat only organic based whole foods.

- Avoid surfactants found in many condoms and diaphragm gels.

- New carpet can give off noxious fumes.

- Be aware of noxious gas such as that from copiers and printers, carpets, fiberboards,
computer monitors that emit high level of electromagnetic force ( EMF).

- Avoid X-rays as much as possible.

- Do not microwave food in plastic containers, and especially avoid the use of plastic
wrap to
cover food for microwaving.

- Wash your food well to rid the pesticides. Bathe the washed food in ozonated water for
20
minutes before cooking.

9. Stress Reduction

The adrenal gland is where stress is expressed. Chronic stress leading to adrenal fatigue is a
leading cause of progesterone depletion and thus estrogen dominance. Balancing excessive
estrogen requires taking into consideration steps to reduce and remove stressors which
compromise adrenal function . Many women with estrogen dominance will see their symptoms
improve by simply optimizing the adrenal gland function for the simple reasons that a properly
functioning adrenal gland will put out the necessary progesterone needed to balance any
excessive estrogen.

10. Pregnenolone and DHEA Supplementation

Pregnenolone and DHEA are precursors of progesterone, estrogen, and androgen. Fortification
of the adrenal function with these two hormones are particularly effective in reducing adrenal
fatigue, together with identification and removal of stressors. This is especially true if there are
signs of chronic stress response.

Case History
Vivian is a 46-year-old mother of two. She has a history of mild PMS. For the past year prior
to consulting me, she started to have heavy period and well as urinary urgency. She has to go to
the bathroom more frequently due to compression of the fibroid on the bladder. A qualified
gynecologist saw her and complete investigation was carried out. Ultrasound study of her uterus
showed the presence of 2 uterine fibroids (4.2 x 5.7 x 4.9 cm, and 2 x 1.8 cm respectively).
Her surgeon recommended total hysterectomy with removal of ovaries. This is the standard
conventional treatment. She wants to avoid surgery if possible. She knows she is suffering
from estrogen dominance but is not sure on how to proceed properly to get the maximum result
in a short period of time.

Vivian consulted me to help her reduce her fibroids naturally. After discussing with her the
various options she has , both naturally and conventionally, Vivian decided to try the natural
way. She was started on an personalized estrogen reduction program. A complete
personalized nutritional cocktail was prepared for her to help her reduce her internal estrogen
load. Lifestyle and dietary changes were implemented. The right amount of natural progesterone
cream was administered and adjusted over time. Vivian stayed on the program faithfully. She
had a repeat ultrasound done 6 months later. The results are astounding . The larger
fibroid has shrunk by 25% . It measures 4.6 x 4.4 x 3.3 cm. The smaller fibroid has shrunk
by 50%. It measures only 1.6 x 0.8 cm. Vivian’s urinary urgency due to the compression of
the fibroid on the bladder has subsided.

This is just one of many examples of cases showing how a good estrogen reduction program
can effectively control and often, reverse uterine fibroid growth. Embarking on a properly
tailored estrogen reduction program should be considered for anyone suffering from estrogen
dominance. There is no downside and everything to gain. Surgical intervention should be
considered only as a last resort.

Summary

Estrogen Dominance is the result of excessive estrogen and progesterone deficiency. It affects
about 50% of Western women. It is an epidemic of gigantic proportion. The primary causes are
excessive environmental estrogen , obesity, stress, poor diet, lack of exercise, and unopposed
estrogen given as part of a hormone replacement therapy. Estrogen dominance is a major root
cause of a myriad of conditions including PMS, endometriosis, cystic breast disease, PCOS,
uterine fibroid, and breast cancer. Fortunately, the level of estrogen in our body can be
reduced. Following the estrogen reduction protocol will go a long way to reduce the amount of
estrogen in our body and curing women from the dreaded illness mentioned above.

Important Note:

In the female, a large part of the hormonal balance is controlled by the three major glands:
the adrenal gland, the thyroid gland, and the ovaries. Maintaining a proper balance among
these three glands is of critical importance in any estrogen dominance recovery program.
Excessive estrogen affects both thyroid and adrenal function, and in turn, dysfunctional thyroid
and adrenal fatigue makes estrogen dominance worse. They all go hand in hand. When not
functioning properly, these three glands , controlling the majority of the hormones in the body,
can lead to a viscous downward cycle of hormonal imbalance. Worse yet is that conventional
medicine often times are mislead into treating symptoms after symptoms without addressing the
root cause. A wide variety of prescription from sleeping pills to anti-depressants are dispensed.
Unfortunately, such symptom-based protocol will often make things worse instead of better.

As a result , many following the advice of well-trained but misguided doctors may not find
relief with conventional medicine or even with natural compounds unless special attention
is paid to make sure that the thyroid and adrenal glands are functioning properly during
the recovery. Any attempt to overcome one without paying attention to the others will more
likely than not result in failure and discouragement on both the physician and the patient. The
key is to find a qualified naturally oriented physician who is experienced in all aspect of
hormonal balancing. A knowledgeable physician will be able to tell which part of the
hormonal system is imbalanced with a detail history. Laboratory test are seldom necessary
in the hands of a good clinician.

Appendix

Overview of a "Normal" Menstrual Cycle

The menstrual cycle is like a fine-tuned symphony, a fascinating interplay of hormones and
physiological responses played out in the orchestra of our magnificent body. Mother nature
prepares us for a potential pregnancy every cycle, whether or not you want to actually conceive.
Let us take a tour of the normal 28-day cycle known as the menstrual cycle.

Menstruation (Day 1)

Day 1 of your cycle is defined as the first full day of menstrual bleeding. The uterine lining
built up from the immediate preceding cycle is sloughed off and cleared away. Hormone levels
from the previous cycle take a sharp decline. The result is a myriad of physical and emotional
symptoms commonly associated with menstruation.

Pre-Ovulation (Day 2 -14)

The menstrual bleeding usually lasts a few days. From Day 2 on, the body is already starting to
prepare itself for the next cycle. Under the influence of Follicle Stimulating Hormone (FSH) and
LH (Luteinizing Hormone) from the pituitary gland, the ovarian follicle starts to manufacture
and secrete estrogen. Estrogen causes the uterine lining to grow. About 15 to 20 eggs start to
mature in each ovary during this period. Each egg is encased and protected in its own follicle.
The follicles also produce estrogen, the hormone necessary for ovulation to eventually occur.
The level of estrogen slowly rises during this period as the uterus lining thickens and starts
its preparation to receive the egg if ovulation occurs. A race progresses for one follicle to
become the largest. Eventually, ovulation occurs when one ovary releases an egg from the most
dominant follicle.
Ovulation (Day 14-15)

Although it averages about two weeks, this race to release an egg can take anywhere from about
8 days to a month or longer to complete. The key factor that determines how long it will take
before you ovulate is how soon your body reaches its estrogen threshold. The high levels of
estrogen will trigger an abrupt surge of Luteinizing Hormone (LH). It's this LH surge that causes
the egg to literally burst through the ovarian wall, usually within a day or so of the occurrence
that we called ovulation. After ovulation, the egg tumbles out into the pelvic cavity, where it is
quickly transported into the fallopian tubes. The remainder of the ruptured follicle (called the
corpus luteum) recedes back to the ovary and begins an important task of secreting progesterone.
Why is progesterone so important? It causes an increase in blood vessels to the uterine lining in
order to provide nutrients for the fetus in case fertilization occurs. It also inhibits other eggs from
developing, and causes the Basal Body Temperature (BBT) to rise about half a degree.

Luteal Phase (Day 15-30)

The luteal phase is the period of time (usually 11-14 days) following ovulation. In simple terms,
it is the last 2 weeks of the menstrual cycle.

The egg can be fertilized within 24 hours of release, while it is still in the fallopian tubes. If the
egg is fertilized, the pituitary gland produces hCG which causes the increased production of
progesterone. The progesterone level reaches its peak on day 19-22, after which the level starts
to fall if no fertilization took place. The progesterone in turn causes the basal body temperature
to remain high throughout the luteal phase and after the 14th day. High progesterone levels are
also responsible for "morning sickness" and other symptoms of pregnancy.

If the egg is not fertilized within 24 hours, the corpus luteum regresses and slows its
progesterone production. After reaching peak production on day 19-22, the progesterone level
starts its decline. Without progesterone's support of the rich uterine lining, menstruation begins
as the slough begins and the uterus clears itself and prepares once again for the next cycle.

Menstrual Cycle Overview

The time from the beginning of menstruation counting forward to ovulation can vary
tremendously from 8 to 14 days. However, the time from start of menses, counting backwards, to
ovulation of the previous month is quite consistent at 14 days. This can be significant for those
who have irregular cycles and are trying to determine when ovulation is taking place each month.

This menstrual cycle occurs on a monthly basis from onset of menses at age 12 or thereabouts.
The exact number of days varies from person to person. In general, the menstrual cycle lasts
anywhere from 28 to 35 days. It is usually only interrupted by pregnancy.
Peri-menopause (Age 45-50)

Peri-menopause is a transitional stage of two to ten years before the complete cessation of the
menstrual period (and thus, onset of menopause). Its average duration is six years, and can
appear in women from 35 to 50 years of age. Peri-menopause is caused by the declining function
of the ovaries, although women are still menstruating. A woman can find herself experiencing
puzzling changes, and not know why. What is actually going on is a steep decrease of
progesterone with a gradual decrease in estrogen. The manifestations of peri-menopause can
vary greatly. Some of the common symptoms include:

• Menstrual cycles usually become shorter, longer, or unpredictable the closer the women
approaches menopause.
• Headaches and breast engorge before period.
• Cramping with periods and mid-cycle pain.
• Bleeding problems, such as spotting or heavy period.
• Weight gain around the waist.
• Muscles becoming less firm.
• Hot flashes (recur during menopause).
• Depression, fear, and apathy.
• Nasal congestion, recurrent respiratory infection.
• Memory loss and foggy thinking.
• Loss of balance and dizziness.
• Irritability
• Reduced sex drive
• Headache.

No two women will experience peri-menopause in the same way. Unfortunately, this is a
period where attention to hormonal balance is overlooked as women are told that there is little
they can do to avert many of the same symptoms that usually come on during menopause. It is
also a critical period for the women as it represents the last window of opportunity for
hormonal balancing before the dawning of menopause.

Menopause (Age 50 and beyond)

The onset of menopause signals the ending of a woman's reproductive cycle. Menopause actually
begins after the women's last period, with an average age of 50. This event marks the
culmination of many years of pre- and peri-menopausal changes during which hormones secreted
by the ovaries estrogen and progesterone decline.

The timing of the average menopause is linked to a number of factors. Smokers, those who are
nutritionally depleted, those who do not have children, and those who had their uterus
removed without the removal of ovaries tend to have an earlier menopause by up to 2 years
or more due to reduced estrogen output from the ovaries.

Women who are obese or suffer from PMS or fibroids tend to have a later menopause
because of excessive estrogen
Menopausal symptoms vary considerably from person to person. Asians are known to have few
to no symptoms other than irregular menses. Western women, however, have much higher
incidences of body changes such as hot flashes, night sweats, fatigue, thinning of hair,
insomnia, breakthrough bleeding, breast tenderness, vaginal dryness, food allergies,
indigestion, reduced libido, forgetfulness, heart palpitations, loss of bladder control,
frequent urination, night sweats, painful intercourse, and joint pains, to name a few.
Changes in metabolism may lead to osteoporosis, rise in blood pressure, increased fats in the
blood, atherosclerosis, increased risk of strokes. Changes in emotion can result in depression,
anxiety, irritability. The average woman gains eight pounds in the first two years "living hell."

Typically, menopause is diagnosed when the women has the following:

- FSH blood level greater than 50 mIU/mg and

- Estradiol serum level less than 50 pg/ml; or

- No menstrual period for one full year

A pelvic ultrasound will typically shown a thin endometrium (lining of the uterus) and small
ovaries that may be atrophied.

Menopause usually progresses through 3 stages that last about 10 years. The first few years
signifies onset of menopause. These years are the most problematic.

For the past 40 years, the conventional wisdom is that menopause is caused by the absolute
deficiency of estrogen. Estrogen replacement has been prescribed to millions of women
since the mid 1960s. This explanation has now been shown to be an incomplete answer.
Many women who cannot be prescribed estrogen found relief if given natural progesterone
alone. Clearly there is more to the menopausal picture than deficiency of estrogen alone. Let us
now look more deeply into the female hormones.

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