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Want to Learn More About Your Body’s System of Communication?

 

Announcing a New Series:

How Your Body Talks:

Estrogen and Progesterone

Stan Gardner, M.D., CNS

Women are different than men (believe it or not!). Some of that difference is related to different levels of messengers called hormones. Two of the hormones–estrogen and progesterone–communicate different things to the same organ. To make matters more complicated, their levels change, depending on the time of month or stage of life.

The Reproductive Years (About age 11 to 45 to 50)

During the reproductive years, most women have regular periods. Part of the purpose of menstruation is to prepare the uterus and body for pregnancy. Of the two hormones I mentioned in the previous paragraph, estrogen levels only change a little during the month. Your body’s hormones are always talking to various tissues. Progesterone levels are quite low from the start of the period until the egg is released from the ovary (ovulation). The scar tissue (corpus luteum) generated where the egg leaves the ovary produces high levels of progesterone until a day or two before the next period starts.

In the uterus, estrogen tells the inside of the uterus (the lining) to produce more cells. When progesterone is produced, it tells the newly produced cells to develop or mature to get ready for a fertilized egg. The fertilized egg loves the newly developed cells, burrows in and starts to divide and divide, becoming a new human being 9 months later.

If the egg is not fertilized, the corpus luteum stops producing progesterone. It tells the uterine cells to remove themselves from the uterus (through the menstrual cycle) and starts the whole process over again.

Estrogen and progesterone talk to nine other organs, and for the most part they confuse the organs by giving them opposing directions.

In the ovary, estrogen stimulates the maturation of the egg. Estrogen tells the egg to move toward the outside of the ovary as it matures. Meanwhile, progesterone suppresses further egg release. If these two hormones were not giving conflicting information, twins and triplets would be much more common.

Balance and Counterbalance

Here are some other fascinating ways that estrogen and progesterone balance and counterbalance in the body:

  • In the breasts, estrogen stimulates tissue growth, occasionally so much that it causes discomfort. Progesterone provides protection from cancer. Because of high progesterone levels during pregnancy, women with multiple pregnancies have a reduced rate of breast cancer.
  • In the bones, estrogen slows bone loss. When estrogen levels drop at menopause, bone loss (osteoporosis) accelerates as the FSH level (follicular stimulating hormone, another hormone messenger that talks to the ovary) rises. Progesterone stimulates new bone growth.
  • In the thyroid, estrogen interferes with the thyroid hormones, while progesterone talks to the thyroid gland and improves its function.
  • In the brain, estrogen stimulates function and improves mental sharpness. Progesterone helps to calm the brain and acts almost like an anti-depressant.
  • Estrogen increases deposition of fat, especially on the hips and thighs. (Testosterone tends to put fat in the abdomen.) Progesterone tells the fat to break down.
  • Estrogen tells the cells to make more progesterone receptors, while progesterone up-regulates estrogen receptors.
  • Estrogen increases retention of water, including helping to hydrate the skin. Progesterone acts as a natural diuretic.
  • Estrogen decreases libido, while progesterone increases it.

Estrogen speaks exclusively to two organs, without counter-talk from progesterone:

First, it talks to support the lining in the blood vessels.

Second, estrogen increases collagen production. Collagen is the connective tissue in the body. Faster healing and softer, more elastic skin take place when estrogen speaks to the connective tissue.

What happens when Estrogen levels are too high, compared to Progesterone levels?

When estrogen talks too loudly, and progesterone influence is minimized, it is called estrogen dominance. This condition causes some classic symptoms:

  • Water retention
  • Breast tenderness, lumps, cysts
  • Moodiness, emotionally labile, anxiety, depression
  • Decreased libido
  • Heavy bleeding, clotting, and/or cramping
  • Fibroids, endometriosis
  • Polycystic ovarian syndrome

What Happens When Estrogen (and Progesterone) Levels Drop?

When neither estrogen nor progesterone talks to the body, some women have no problems, while others are incapacitated. This time of life is called menopause, and may happen naturally or after surgical removal of the ovaries.

The following difficulties may arise with onset of menopause:

  • Mental fog, forgetfulness
  • Anxious, depressed, mood change
  • Hot flashes, night sweats
  • Dry eyes, skin, vagina
  • Insomnia
  • Fatigue
  • Pain and stiffness
  • Palpitations, (racing heart)
  • Headaches
  • Feeling bloated

Is There Any Help?

Yes, there is help, if it is needed.

First, however, let me state that I am opposed to synthetic, chemically changed forms of estrogen. These forms of treatment include a chemical group(s) that has been added to the chemical structure of estrogen the body makes, so it can be patented and sold as a pharmaceutical.

Unfortunately, that extra chemical has caused unwanted side effects. This causes a number of problems, which come from communicating to the wrong organ in the wrong way:

  • Blood vessel clots, causing heart attack, stroke
  • Endometrial and breast cancer
  • Double the risk of dementia
  • Double the chance of surgery to remove the gall bladder

If there is a reason to treat hormonal issues, my first choice is to choose herbs and natural products that function as phytoestrogens and support, or speak to the ovaries.

Some of these include:

  • Angelica sinensis
  • Blessed thistle
  • Licorice root
  • Wild yam
  • Motherwort herb
  • Black cohosh
  • Cramp bark
  • Dong quai

Although these natural products may not be as strong as bio-identical estrogen and progesterone, they may talk to your organs well enough to solve the problem.

Bone Density

Bone loss around the time of menopause is a reason to be aggressive with reducing the FSH level. In treating patients with bone loss, I typically start with progesterone, to see if stimulating the estrogen receptors is enough to solve the problem. If not, then bio-identical estrogen is usually needed.

If, on the other hand, estrogen is talking too loudly in your body (dominating), then bio-identical progesterone is usually needed. I generally prefer that a local compounding pharmacist formulate the progesterone, rather than a pharmaceutical firm, which tends to use unnecessary fillers. Unfortunately, insurance companies tend to pay for pharmaceuticals, rather than healthier, more natural products.

When neither estrogen nor progesterone is communicating with your body, and you need help (sometimes desperately!), I always start with a natural product. If that is insufficient, the next step is progesterone. Everyone likes progesterone—just look at what it does to the body. If more is still needed, I pay attention to symptoms and response to what has been added, and then add bio-identical estrogen until the symptoms resolve.

To your dynamic health and energy,

Dr. Stan Gardner

If you would like more information about Dr. Gardner and his philosophies, please feel free to explore this site. Dr. Gardner’s office is in Sandy, UT. Phone number 801-302-5397. 

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Hormones and Hot Flashes

hot flashes- no,, not me, my wife 🙂 She is 59, eats healthy, has over the last year lost 60+ pounds, still has a ways to go, works out on a regular basis. the hot flashes are causing chronic sleep deprivation: exercise, sugar free diet, black cohosh– none of these seem to help– any suggestions you might have on other alternatives would be appreciated- She does not want to use hormone replacement therapy.

Menopausal symptoms are caused by dropping estrogen levels when the ovaries stop working. Some women don’t have any symptoms, while others are physically incapacitated with symptoms.  The symptoms usually  last a few years. 

Treatment consists of trying to increase the responsiveness of the cells that need estrogen.  Phytoestrogens like black cohosh, chasteberry, dong quai, red clover are weak estrogens, and may help. 

If healthy living and phytoestrogens are insufficient, then I suggest bioidentical hormones progesterone, and if symptoms still persist, then add bioidentical estrogen.  The other test that is important to get around the time of menopause is a FSH level.  The follicular stimulating hormone was part of the cycling of periods, and may go up when the periods stop.  If it is above 80, it contributes to osteoporosis.  Bioidentical hormones would then be indicated to decrease that level.  In this, as in all medical decisions, make sure you consult with your doctor and get the appropriate testing done.  

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Thyroid Questions

I was diagnosed with Hashimoto’s Thyroiditis. When I asked for Armour Thyroid Extract, or some other kind of natural thyroid replacement hormone, I was refused. I was told those are dangerous and was prescribed Levothyroxine. I still have symptoms of low thyroid. Is it true the natural replacements are bad for you? What about levothyroxine and synthroid? Thank you.

Hashimoto’s thyroiditis is an autoimmune disease.  The body attacks itself (in this case, it targets the thyroid gland).  You can be hypothyroid, euthyroid (normal thyroid), or hyperthyroid with this process, depending on what is happening in the thyroid gland.

Treatment of low thyroid (and high thyroid) starts with iodine, which is part of the thyroid hormone.  Most people with your affliction also need to supplement their thyroid levels.

My choice of preference is thyroid extract from porcine thyroid.  Many animal extracts of thyroid were tried years ago, and porcine thyroid glands were found to have the best response clinically and by laboratory testing in humans.  The products with these ingredients today are called Armour thyroid, Westhroid, Naturethroid, which are brand names of the same product made by different companies.  Conventional medicine used these years ago.  They are not dangerous.

I’m not sure why companies shifted to chemical substitutes, but one reason could be that the pharmaceutical industry could not patent them because they are ‘natural.’  Synthroid (chemical name levothyroxin, T4) and Cytomel (chemical name triiodothyroxin, T3) are the synthetic versions of thyroid hormone made by pharmaceuticals and used by conventional medicine.

When a patient comes in to see me, and they are on Synthroid, I shift them to the thyroid extracts and find about 60% do better, 10% do worse, and 30% can’t tell any difference.

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Testosterone Levels: Not Just for Men

What can I do to raise my testosterone levels?

Testosterone is an important hormone in both men and women, and low levels result in:

  • a lack of drive or motivation,
  • decreased energy, and
  • loss of vitality.

I recommend a free testosterone level to properly assess what your body recognizes and responds to. If it is in the bottom range of the normal for 26 year olds, you may benefit from raising it. (The reason I say 26 year olds is because the reference decreases as we age, but I don’t think the healthy range changes as we age.)

Exercise is the natural way to raise the level.   For many of us, however, it often takes testosterone shots, creams or pellets to get the levels up. This would need a physician prescription to get started with the treatment.

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Pregnenolone Steal

Do you have any information on your site about the pregnenolone steal and the corresponding hormonal cascade and health consequences?

The pregnenolone steal is a name given to the hormone production deficit of certain hormones when the stress hormones, cortisol and cortisone, are over-produced. All our hormones come from cholesterol, which converts into pregnenolone as the first step. It then goes on to produce many hormones, including the estrogens, testosterone, progesterone, aldosterone (to regulate salt and water in the body), and the stress hormones.

If the body demands more cortisol because of stress, the body will convert more of the pregnenolone to cortisol at the expense of the other hormones (except progesterone, which is on the pathway to cortisol). The lowering of the testosterone and estrogen leg is called pregnenolone steal. The lower levels of testosterone and estrogen impart the effects noticed in the body. There are two ways to treat the deficiency:

1. Add bio-identical cortisol (hydrocortisone) at low doses to supplement the adrenal gland so it does not have to work so hard to maintain high levels of cortisol, thus releasing the pregnenolone to make more of the estrogens and testosterone.

2. Use bio-identical testosterone or estrogens to relieve the deficiency. Ultimately, the stressors must be better managed so the adrenal is not overworked, hopefully before it goes into adrenal exhaustion and stops working.