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In all my time in medicine, and that’s 30 years, I remain in awe of this amazing machinery – the human body. The last two decades in the field of endocrinology (aka “hormones”) have taught me one thing: the playing fields are not equal. Many males would definitely not survive even a few months in estrogen-surging bodies.

Hormone balance

When it comes to hormones, too much or too little can be pathological. It’s all about balance. This also means that the treatment has to be individualized – it’s not the proverbial “one size fits all” approach.

This balance or “dance” as I call it, between estrogen and progesterone is essential for puberty, the monthly cycle, ovulation, pregnancy, and peace on earth. However, with estrogen dominance or excess, this balance is lost, and chaos ensues.

I feel it explains why our daughters are menstruating earlier, with each generation, and perhaps why women experience more intense premenstrual symptoms and dreaded adult acne. My clients often tell me that it’s wrong to get zits in your 40s. 

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Estrogen Dominance

So, what’s causing this estrogen dominance? It may be the excess estrogens consumed in commercially farmed meat, poultry, and dairy products. The estrogen from contraceptive pills gets passed into urine, which makes its way into the water ecosystem. Furthermore, xenoestrogens are molecules that mimic estrogen function but are not estrogens. These are found in fresh produce sprayed with herbicides and insecticides. Some xenoestrogens are naturally occurring in foods, such as soya.

These xenoestrogens, some heavy metals, and industrial pollutants have the potential to stimulate estrogen receptors, which leads to higher estrogen-to-progesterone ratios.

I believe it may play a role in some of the causes of first-trimester miscarriages, endometriosis, adenomyosis, fibroadenomas in the breasts, and even the dreaded “C” word: breast cancer. All of the above have one thing in common: excess estrogen and relatively low progesterone.

The symptoms of the perimenopausal state have the same common denominator. Yes, estrogen dominance. In this state, progesterone drops first and the ovaries generally overcompensate, under the influence of a pituitary hormone called FSH, to produce estrogen. The result is PMS “on steroids”, breast tenderness, water retention, bloating, headaches, acne, pigmentation, anxiety, and the “middle spread”. Weight gain in the midriff area when you haven’t changed your eating or activity levels – what’s with that? 

Is there a solution?

Yes. Whether it’s premenstrual symptoms, acne, endometriosis, fertility issues, or breast fibroadenomas, it’s about restoring balance. The treatment has to be tailored by your doctor with either one or a combination of the contraceptive pill, synthetic estrogen blockers, and progesterone supplementation.

Lastly, most of my clients are on a natural product called Estrogen Balance. It contains three natural Asian herbs: brassica oleracea varigate italica, nasturtium officinale, and uncaria tomentosa, collectively known as estrogen adaptogens (ever wondered why Asian women have the lowest rate of breast cancer?). It also has enough indole-3 carbinol and diindolylmethane, which decrease the production of estrone, the predominant estrogen sub-type in estrogen-dominant states. 

So, if you think this affects only the fairer sex, think again. 

Male fertility has halved since the turn of the century. Ever wondered about those man boobs? The imbalance between testosterone and estrogen can even have a negative effect on your bedroom.

Estrogen Balance may also help men with these overactive aromatase enzymes that produce too much estrogen.

Conclusion

Lastly, it’s important to note that the liver is responsible for metabolizing hormones. Genetics and environmental factors influence the phase 1 and 2 detoxifying pathways found in the liver. Keep the liver healthy so that hormones can be effectively metabolized.

Longevity is as much about quality as duration. Balance is key in all aspects of one’s life. So, calm the mind with meditation, breathwork, and mindfulness. Be active and get in those 10 000 steps a day – and bring balance, wholeness, and natural foods back into your life.

Dr. Sindeep Bhana

Dr. Sindeep Bhana

Dr. Sindeep Bhana is a Principal Specialist and Head of Endocrinology and Metabolism at Chris Hani Baragwanath Academic Hospital.  He is also the Head of Diabetes, Endocrine, and Metabolism in Internal Medicine at Chris Hani Baragwanath Hospital – where he is involved in several publications, poster presentations, and numerous pharmaceutical trials. He's also an alumnus of the University of the Witwatersrand. He is currently the Founder/Director of the Centre for Medical Excellence in Waverley. In 2004, he received a gold medal from the University of the Witwatersrand for teaching excellence.  He is also the recipient of the highly respected Phillip Tobas award for teaching. Dr. Bhana has appeared on multiple Media shows on a wide range of topics.

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