September 18, 2023 • 26 mins
Send me a text if you liked this episode.
In this episode I discuss:
- What is estrogen?
- High estrogen or estrogen dominance? The signs of too much estrogen.
- What causes estrogen dominance?
- The importance of testing estrogen levels during perimenopause.
- Basic treatment ideas for estrogen
- 5 steps to naturally reduce excess estrogen
Enjoy!
In best health,
Dr Kirstey Holland
The information shared in this podcast does not substitute working with your primary health care provider; it is general in nature and not considered personalised advice.
Visit us online for more information or if you wish to work with Dr Holland.
thehollandclinic.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Kirstey Holland (00:05):
thank you so much for being here Surviving
the estrogen roller coaster andperimenopause hacks for taming
estrogen excess.
What is estrogen, high estrogenor estrogen dominance and the
signs of too much estrogen caninclude.
Now, remember, perimenopause andmenopause are not the same and I
(00:26):
treat perimenopausal as well asmenopausal women in my clinic.
But I'm here to tell you that inperimenopause, the hormone that
goes missing first isprogesterone.
So please be very mindful aboutthe information that you see
online on the I Web onInstagram.
About the fact thatperimenopausal women need
(00:47):
oestrogen-absolutely you may.
But I have a firm belief intesting rather than guessing.
And as you know by now, Iabsolutely love the Dutch test
and that is what's coming upnext for you beautiful ladies
inside the repair program we'regoing to move into Rebalance.
(01:07):
But it is also a little word ofwarning with regards to all of
the information that you see outthere on the internet about
oestrogen.
Remember that oestrogen also hasthe capacity to move into the
tissue.
It's imperative to test estrogenin both urine metabolite as well
as a blood test so that you geta full three dimensional picture
(01:28):
of how much estrogen you have inyour system.
What causes estrogen dominance,and remember, again, estrogen
dominance only relative toprogesterone.
The first part of the menstrualcycle, we're in a natural
estrogen dominance, but in thesecond part of the cycle, we
need progesterone to bedominant.
We need progesterone to be ahundred to 200 times higher.
(01:49):
than estrogen in the lutealphase or the second half of the
menstrual cycle after weovulate.
What does it mean to have highestrogen?
Testing your estrogen levels andthe basic treatment ideas for
high estrogen levels.
Five steps to naturally reduceexcess estrogen and promote
hormonal balance.
Perimenopause power, survivingthe estrogen rollercoaster and
(02:13):
perimenopausal hacks pertainingestrogen excess.
So remember, progesterone goesmissing in action.
Progesterone modulates,estrogen, and she modulates your
immune system.
So for example, I'm humbledbefore you.
I have a higher than optimal.
Histamine level in my system atthe moment.
(02:34):
So I am reacting to externalenvironmental allergens more
than I usually would.
Although in saying that I neverhad hay fever until I came to
Australia.
I spent 18 years in South Africaand never had hay fever.
And I've come to Australia and Ido suffer hay fever.
And I do notice that my hayfever symptoms are worse now
that I am perimenopausal becauseprogesterone is no longer
(02:58):
modulating.
My immune system, as well as mymast cells.
So it's complex.
The perimenopausal andmenopausal picture and the
hormone rollercoaster is realand it is complex.
So perimenopause is that phasebefore the final period that can
last for 2 to 15 years.
Can you believe we can actuallyexperience these signs and
(03:19):
symptoms for 15 years?
The symptoms of perimenopauseare temporary and can be treated
with simple methods.
A lot of them can.
Thank you.
Estrogen levels fluctuate duringpremenopause and can cause
various symptoms.
Now, this is due to theprogesterone deficiency because
estrogen starts to flail withprogesterone not modulating her,
(03:42):
particularly in that second partof the cycle.
Metabolic health, gut health,and food choices can play a
crucial role in balancingestrogen excess in relation to
progesterone.
Strategies to balance estrogenlevels include stabilizing the
nervous system, reducinghistamine and mast cell
activation, which is exactlywhat I'm trying to do at the
(04:02):
moment.
Nigella is absolutely incredibleand I have a beautiful product
called Hist Ease and that isbringing me great relief.
Mast cell activation, verycomplex.
Dr.
Tanya Dempsey is the leadingauthority on mast cell
activation.
I really appreciate hertreatment protocols and follow
those closely with patients inmy clinic.
(04:22):
Reducing histamine and the mastcell activation and preventing
those estrogen spikes.
Taking bio identical or bodyidentical progesterone according
to the work of ProfessorGeraldine Prior can also relieve
symptoms and support variousfunctions.
I personally take body identicalmicronized oral progesterone and
(04:45):
I find it absolutely brilliantfor sleep and absolutely
brilliant for anxiety.
I personally started toexperience that progesterone
deficiency anxiety early inperimenopause and body identical
mic, oral micronizedprogesterone, put that to a
stop.
So it just shows how powerfulthat can be and it, RT isn't
what it used to be.
(05:05):
H r T isn't just a one size fitsall, and it's not necessarily in
estrogen replacement therapyanymore.
It can be bioidenticalprogesterone on its biodentical
with estrogen.
Be individualized according towhat your body needs.
So this module aims to provideknowledge and tools for managing
(05:26):
menopause symptoms and balancingexcess estrogen levels.
I'll just have a look and makesure that I don't have any
questions.
That's fine.
Estrogen dominance.
Now, when we're talking aboutestrogen dominance, we're
talking about estrogen beingdominant relative to
(05:49):
progesterone.
We have a natural physiologicaloestrogen dominance in the first
part of the day 1 to day 14,oestrogen is high and that is
absolutely normal for oestrogento be dominant during that part
of the cycle.
Then from the day that youovulate, the textbooks say day
14, but really women canovulate.
(06:12):
Anywhere between day eight andday 18.
It's complex and it'sindividualized, but let's just
say, for argument's sake, if youdid ovulate on day 14,
progesterone needs to be reallyhigh from day 14 to the
following bleed.
So that is where we needprogesterone to be 100 to 200
times higher than estrogen inthat cycle.
(06:33):
If progesterone is deficient,oestrogen can be dominant in the
luteal phase of the cycle andthat is when it wreaks havoc.
Oestrogen is a group ofhormones, E1, E2 and E3,
responsible for the developmentof secondary sex characteristics
and regulating the reproductivesystem.
Women have three types ofoestrogen and amounts vary
(06:55):
during different life stages.
During menstruation, estrogenlevels are low.
Then rise during that follicularphase and peak just before
ovulation.
And drop going into that lutealphase, like I just mentioned
before.
High oestrogen or oestrogendominance can cause various
symptoms, like irregular orheavy periods, breast
(07:17):
tenderness, bloating, moodswings, fatigue, difficulty
sleeping, decreased sex drive,headaches, weight gain.
hair loss, brain fog, and anincreased risk of blood clots or
stroke.
That is why it is so importantto test estrogen before taking
in additional estrogen.
If your estrogen were to be highand you were to pop on an
(07:39):
estrogen patch.
You could be exacerbating thesesymptoms thinking that you're
using a medicine that is thereto reduce them.
The research suggests reducinghistamine and mast cell
activation to prevent estrogendominance.
(08:01):
The causes of oestrogendominance, hormonal imbalances
and medications, body fat,increased adiposity can actually
behave like its own endocrinesystem and produce more
oestrogen than necessary.
Chronic stress can of courseincrease oestrogen due to the
fact that the body isprioritizing stress hormone or
cortisol over progesterone andtherefore oestrogen is high due
(08:24):
to the progesterone deficiency.
Environmental factors with thexenooestrogens in plastic.
And of course, poor liverfunction because we need to
detoxify our estrogen throughthe large intestine and the
liver because we need to useestrogen and then we need to
lose it.
We need to be able to detoxifyit so that it doesn't
recirculate.
(08:46):
Causing a high estrogenpresentation.
Estrogen dominance is associatedwith several risks, including
tumors in the uterine lining,several conditions like breast
cancer, ovarian cancer,endometriosis pain, insulin
resistance, polycystic ovariansyndrome, uterine cancer, and
tumors on the ovaries andadrenal proliferative.
(09:11):
Testing of estrogen dominance inperimenopause.
The Dutch test is a specializedurine test that can be used to
diagnose and monitor estrogendominance by measuring hormone
levels and their metabolites inthe urine, including estrogen
metabolites that can indicateestrogen dominance.
When you only have a blood test,and I'm not saying don't test
(09:33):
estrogen the blood, I actuallyquite like having both sets of
data, so I like my patients totest estrogen.
And we'll talk a bit more aboutthe blood test between day one
and day three of the cycle, ifyou're still cycling, so we can
see what the blood plasma levelsare like.
But I really love the Dutch testbecause we not only see what the
(09:53):
systemic estrogen levels arelike, but we also see what their
metabolites are doing and howdetoxifying estrogen.
Down the 2, 4, and the 16hydroxy pathways.
The 2 hydroxy pathway is safe.
The 4 hydroxy pathway can damageDNA and RNA and is more 16
(10:15):
hydroxy pathway is moreproliferative.
So we need to know where theestrogen is, how much we have,
and how it's detoxifying throughthe body in order for us to be
able to change.
The Dutch test specialized urinetest that can be used to
diagnose and monitor estrogendominance by measuring hormone
levels in the metabolites in theurine, including estrogen
(10:36):
metabolites that can indicateestrogen dominance.
That is not only what the Dutchtest tests.
The DUTCH test also testsprogesterone, it does do the
estrogens, and theirmetabolites.
It shows us androgens and theirmetabolites, and then it goes
into adrenal function.
I love the DUTCH If you're goingto do a DUTCH test, I highly
recommend the DUTCH so that wecan also see CAR, C A R, known
(11:02):
as cortisol awakening response.
So that is incredibly importantin perimenopause as well.
Because cortisol andprogesterone play a role in this
estrogen dominant picture, forexample.
And in the Dutch plus, we alsosee dopamine levels, the 6, the
12.
We have a little indication ongut health and brain health as
(11:22):
well as melatonin, which isreally important for us sleep.
And of course, don't forget thatmelatonin is an incredible
antioxidant.
Blood tests such as estradiollevels, follicle stimulating
hormone levels and luteinizinghormone levels.
As well as, in fact, sex hormonebinding globulin can also be
used to assess oestrogen levelsand determine if someone has
(11:44):
oestrogen dominance.
And like I to test them throughblood between day one and day
three.
The timing of hormone testingfor oestrogen dominance is
important.
And it's usually based on theday of the menstrual cycle with
the best time to test forestrogen levels, as I said,
during that follicular phase ofthe menstrual cycle, and 5 to 7
(12:06):
days after ovulation, if youwant them to look at estrogen in
relation to progesterone levels.
So between day 19 and 22.
is when you would like to alsotest the progesterone levels if
you're doing a blood test.
Evaluating oestrogen levels.
When, if you do the Dutch test,I do want you to do the Dutch
test between day 19 and 22.
And if you do not have a cycle,please reach out and we'll work
(12:29):
out when you're going to test.
Evaluating estrogen levels,especially in relation to
progesterone during the lutealphase can help identify if
symptoms such as weight gain,irritability and heavy periods
are related to estrogendominance.
Interpreting hormone levels iscomplex and it should be done in
the context of an individual'soverall health and medical
(12:50):
history.
And of course, consultation withyour healthcare provider, the
basic treatment ideas, sodietary changes, absolutely
incredible and very powerful.
So eating a healthy, balanceddiet with plenty of fiber.
can help support healthyoestrogen metabolism.
We have to get oestrogen throughthe large intestine and we need
(13:13):
to get oestrogen moving throughthe liver.
If you're taking in lots oftoxic foods and alcohol, for
example, the liver and the largeintestine will make the
oestrogen wait.
This can be one of the reasonswhy oestrogen is recirculating
through the bloodstream andcausing a toxic load or an
oestrogen dominant picture.
So more fiber and less alcoholand less sugar.
(13:36):
Gets that estrogen out throughthe liver and the large
intestine limit or avoidalcohol, sugar, and of course,
processed foods, regularexercise, absolutely brilliant
to help us sweat and detoxify,but also build muscle and
increase those endorphins, thosefeel good hormones to help keep
that cortisol low.
(13:57):
And of course, reduce body fatbecause we're building muscle,
which can help lower estrogenlevels and aim for at least 30
minutes of moderate intensityexercise.
Most days of the week, stressreduction, finding ways to
manage stress, decreasecortisol.
So we can bring thatprogesterone up so that we don't
have that extreme excess.
(14:18):
And of course, I say, reducestress in a way that you love
and move in a way that you love.
So meditation, yoga.
Deep breathing all may beextremely helpful, walking on
the beach.
Some of my patients love thosemeditation coloring in books.
I think that's a fabulous ideaif that's what resonates for
you.
And journaling is brilliant too.
Listening to music, cooking.
(14:39):
Yeah, beautiful.
Supplements and herbal remedies.
Now here we need to be verycareful.
Of course, this repair programhas an individualized component.
So we will if you choose, do theDUTCH test together so that I
can work and work out anindividualized prescription for
you with certain supplementssuch as omega 3 fatty acids,
(15:02):
magnesium, vitamin B6, and someherbs such as chaseberry, dong
guai, black cohosh may helpregulate oestrogen levels and
support healthy oestrogenmetabolism.
Stabilizing the nervous systemis absolutely imperative to
cortisol.
So some of the supplements thatI like are shown on the slide,
(15:22):
but for example, if you arestressed out and tired, rhodiola
is beautiful.
If you are stressed out andwired, ashwagandha or trigandha
is an absolutely incrediblesupplement for you.
Stabilizing that nervous system.
Magnesium, Melissa, passionFlower, the trine is absolutely
brilliant and so is magnesium torelieve hot flushes and improve
(15:46):
sleep.
But don't forget, of course, wehave plant-based melatonins and
we have incredible nervoussystem support that we can use
within the clinic dispensary.
Reducing histamine and mast cellactivation following a low
histamine diet and basically,just to give you a quick idea to
reduce histamines, things likeavocados, citrus fruits,
(16:08):
anything aged olives or curedmeat or wine or anything that
has been aged.
We'll have a high histaminelevel, even down to leftovers.
So if you eat fresh food and youstay away from leftovers, that
can be very supportive to lowerhistamine levels.
One shouldn't need to be on alow histamine diet long term.
(16:29):
If high histamine levels arereally bad, we can start to see
breakouts in the skin.
So we can start to see an eczematype presentation or really
itchy skin.
Thank goodness that hasn'thappened to me yet.
Hopefully it doesn't.
Follow a lower histamine diet,take supplements that lower
histamine.
Nigella is incredible.
Black seed is brilliant.
(16:51):
The hist ease supplement in theclinic is incredible.
It brings me so much relief.
Of course, manage stress, avoidtriggers, and take those
antihistamines, those naturalones.
And in actual fact, for somewomen, and I barely ever
recommend pharmaceuticalmedication at all, but for some
women, it is really beneficialto take an antihistamine.
At night, to both reduce thathistamine level, particularly if
(17:15):
you find that you have PMD typesymptoms, or PMDD type symptoms,
PMS type symptoms, pre cycle,they can be extremely supportive
for some patients.
And of course, when thehistamine levels get so bad I
have been known to have thatsort of tight chest from that
allergic type bryonitis or thatthunderstorm asthma.
(17:39):
Antihistamines are life saving,so please be gentle on yourself
in the same way that, you know,oh, God forbid you need a
Panadol or a Tylenol to get ridof that headache.
If something has gone wrong foryou, please be gentle on
yourself.
We don't have to be perfect.
We certainly don't have to beorthorexic in this program.
We don't need to have theperfect diet, and we certainly
(17:59):
don't need to have the perfectsupplementation protocol either.
We can sometimes rely onsymptomatic relief.
I think it's, there's a fineline between, treating and
curing the cause, but also nothaving those those awful
symptoms in your way for just amoment in time, when something
like an antihistamine can bringyou some relief.
So five steps to naturallyreduce excess estrogen and
(18:19):
promote hormonal balance.
Step one is to eat qualityprotein, garlic, onions, and
cruciferous vegetables thatsupport the liver in processing
estrogen.
The liver actually really needsprotein in order to do its job.
A B complex supplement or a DIMsupplement may also be
considered.
I absolutely love sulforaphaneor Pomegenex because it's such a
(18:43):
gorgeous, it has pomegranatesulforaphane and coconut water.
So topped up with all of thosebeautiful phytonutrients and
those incredible antioxidants.
So not only brilliant fordetoxifying estrogen excess, but
brilliant for our hair, skin andnails and hydration too.
So hydration is imperative andbe mindful that DIM is not
(19:04):
always needed.
Indole 3 carbinol or DIM canreduce oestrogen, but it can
also ensure that oestrogen isdetoxifying down the 2 hydroxy
pathway.
These are not the kind ofsupplements that I would
recommend you use withouttesting first and, and having
your one on one healthconsultation.
(19:24):
All right.
Step two is to treat underlyingdigestive issues that may be
causing constipation.
Again, we do not want that toxicreload.
So we want to be having a bowelmotion daily.
Our patients now know how crazyand yeah how excited I am about
daily bowel motions.
So we do not want to preventefficient elimination of
(19:45):
estrogen.
Step three is to eat fiber richfoods.
So women need, especiallyperimenopausal women, need about
25 grams of fiber.
So you also, at this point intime, know how much I love the
GI Restore So please use that tobulk up your fiber if you're not
getting enough in your twomeals, if you are doing
(20:05):
intermittent fasting andskipping breakfast at this point
in time.
So step three is to eat fiberrich foods, avocado,
raspberries, artichokes,oatmeal.
In the next phase, when you areout of your repair phase, we can
start to reintroduce some ofthose good carbohydrates so be
mindful if oatmeal is not goodfor you, please steer clear of
(20:28):
that.
And if you are going to eatoats, please make sure that
they're organic.
Almonds and broccoli to keep thebowels regular and help
eliminate waste, includingunnecessary estrogen, of course.
Step four is to manage stressand use calming tactics like
deep breathing.
Adrenal support supplements mayalso be considered.
So this approach step four isall about reducing that cortisol
(20:49):
so that we can produce enoughprogesterone, or we can take our
body identical progesterone andnot have it overridden with that
cortisol, creating an estrogenexcess presentation.
So honestly, duringperimenopause, I see far more
estrogen excess than I doestrogen deficiency.
(21:10):
Of course, I see estrogendeficiency once women go into
menopause.
But in the perimenopausal phasein 23 years in clinical
practice, I see more women withan estrogen excess presentation.
So with regards to breathing, Iwant to share some technique
with you.
This is cutting edge research.
Harvard University professors.
(21:30):
It's been proven that thenatural sigh like that is the
best way for us to calm asquickly as possible.
So it's super, super quick.
It's super, super easy.
Managing stress is about takingone deep breath in, followed by
another quick, short breath into fill those lungs.
So a big, deep breath in.
(21:53):
And do that three times, andthat will help reduce cortisol
and help you stay in that calmstate.
Of course, B5, which treatsrelationship and mum agro, is
absolutely brilliant for doingthis too.
Step 5 is to get 7 to 8 hours ofsleep a night.
Research shows that men rarelyneed 8, women really need 8, and
(22:17):
men can get away with 7.
But it's, as an absoluteminimum, you need 7 hours of
sleep every single night.
So use those blue light blockingglasses one to two hours before
bedtime to shift those hormonesinto a more favorable state.
If you need to, drink yoursleepy time tea, have your plant
based melatonin, do whatever ittakes.
(22:37):
Have a beautiful magnesium saltsbath, do your meditation, do
your stretching, do your yoga.
Make sure you get eight hours ofsleep.
Estrogen dominance isreversible, so all of this,
don't worry about it.
If it sounds awful, if you are,do have an estrogen dominant
presentation at the moment.
Don't worry, I have had it, too.
Milk Thistle is brilliant.
There's another product calledEstroClear, if that's
(22:58):
appropriate, it is an absolutelybrilliant product that saved my
life.
Estrogen dominance is reversibleby implementing the suggested
steps to improve estrogenprogesterone balance and to heal
the entire hormonal system.
Of course, but one step at atime, microchanges, we will
absolutely get there.
Conclusion, we've focused onrepairing estrogen excess during
(23:21):
perimenopause.
Balancing estrogen levels iscrucial for optimal health.
And addressing associated risksand symptoms.
Strategies include dietarychanges, exercise, stress
reduction, supplementation, andherbal remedies.
Gut health and liver functionplay a crucial role in efficient
(23:42):
estrogen metabolism.
And of course, consult with yourhealthcare practitioner.
Do not do this on your own.
And what I do want to say, whichis so important, is women ask me
all the time (23:53):
why is it that my weight loss was never
sustainable?
Why is it that I wasn't able tokeep the weight off?
My answer is always the same.
We need to first repair the gut,the immune system, the
metabolism, the microbiome, andyour mood.
So the gut work needs to be donefirst, and then you need to
(24:13):
ensure that you are sticking toyour roadmap and your Peri Power
Plan so that you can"80/20" itfor the rest of your life.
So 80 percent of the time you'reeating according to this
beautiful food protocol that youhave devised for yourself at
this point in time, and then 20percent of the time your body
can handle the"welcome to beinghuman" moments.
(24:34):
the birthday cake, the glass ofwine, every now and then.
Perimenopausal systems cannotstand alcohol.
Brain fog cannot stand alcoholand estrogen detoxification
can't stand it either.
So if you are able to, I wouldhighly recommend to make sure
that you do the Repair and theRebalance alcohol free.
There really are only, 12 weekprograms.
(24:56):
I will be increasing the one onone care.
And of course, you know that youall have availability to me by
the doctor in your pocket.
So number one is Repair.
Repair your immune system, yourgut, your mood, your waistline,
your metabolism, et cetera.
That is what we have just donetogether.
And then number two, we have torebalance those hormones.
We need to know whatprogesterone is doing, what
(25:17):
estrogen is doing, how it'sdetoxifying.
What the androgens are doing.
How three of those hormonessets: the progesterones, the
estrogens and the androgens, howthey interplay, how all of that
interplays with cortisol andthen melatonin, and then we need
to look at that OAT component ofthe DUTCH test, and of course
your CAR, your cortisolawakening response.
(25:37):
So if you ever thought thatweight loss and vitality in
perimenopause was complex (25:41):
you are absolutely right.
So thank you so much for yourtime again.
I really appreciate it.
I absolutely love that you arehere.
Take it easy and have abeautiful night.
thank you so much for being here Surviving
the estrogen roller coaster andperimenopause hacks for taming
estrogen excess.
What is estrogen, high estrogenor estrogen dominance and the
signs of too much estrogen caninclude.
Now, remember, perimenopause andmenopause are not the same and I
(00:26):
treat perimenopausal as well asmenopausal women in my clinic.
But I'm here to tell you that inperimenopause, the hormone that
goes missing first isprogesterone.
So please be very mindful aboutthe information that you see
online on the I Web onInstagram.
About the fact thatperimenopausal women need
(00:47):
oestrogen-absolutely you may.
But I have a firm belief intesting rather than guessing.
And as you know by now, Iabsolutely love the Dutch test
and that is what's coming upnext for you beautiful ladies
inside the repair program we'regoing to move into Rebalance.
(01:07):
But it is also a little word ofwarning with regards to all of
the information that you see outthere on the internet about
oestrogen.
Remember that oestrogen also hasthe capacity to move into the
tissue.
It's imperative to test estrogenin both urine metabolite as well
as a blood test so that you geta full three dimensional picture
(01:28):
of how much estrogen you have inyour system.
What causes estrogen dominance,and remember, again, estrogen
dominance only relative toprogesterone.
The first part of the menstrualcycle, we're in a natural
estrogen dominance, but in thesecond part of the cycle, we
need progesterone to bedominant.
We need progesterone to be ahundred to 200 times higher.
(01:49):
than estrogen in the lutealphase or the second half of the
menstrual cycle after weovulate.
What does it mean to have highestrogen?
Testing your estrogen levels andthe basic treatment ideas for
high estrogen levels.
Five steps to naturally reduceexcess estrogen and promote
hormonal balance.
Perimenopause power, survivingthe estrogen rollercoaster and
(02:13):
perimenopausal hacks pertainingestrogen excess.
So remember, progesterone goesmissing in action.
Progesterone modulates,estrogen, and she modulates your
immune system.
So for example, I'm humbledbefore you.
I have a higher than optimal.
Histamine level in my system atthe moment.
(02:34):
So I am reacting to externalenvironmental allergens more
than I usually would.
Although in saying that I neverhad hay fever until I came to
Australia.
I spent 18 years in South Africaand never had hay fever.
And I've come to Australia and Ido suffer hay fever.
And I do notice that my hayfever symptoms are worse now
that I am perimenopausal becauseprogesterone is no longer
(02:58):
modulating.
My immune system, as well as mymast cells.
So it's complex.
The perimenopausal andmenopausal picture and the
hormone rollercoaster is realand it is complex.
So perimenopause is that phasebefore the final period that can
last for 2 to 15 years.
Can you believe we can actuallyexperience these signs and
(03:19):
symptoms for 15 years?
The symptoms of perimenopauseare temporary and can be treated
with simple methods.
A lot of them can.
Thank you.
Estrogen levels fluctuate duringpremenopause and can cause
various symptoms.
Now, this is due to theprogesterone deficiency because
estrogen starts to flail withprogesterone not modulating her,
(03:42):
particularly in that second partof the cycle.
Metabolic health, gut health,and food choices can play a
crucial role in balancingestrogen excess in relation to
progesterone.
Strategies to balance estrogenlevels include stabilizing the
nervous system, reducinghistamine and mast cell
activation, which is exactlywhat I'm trying to do at the
(04:02):
moment.
Nigella is absolutely incredibleand I have a beautiful product
called Hist Ease and that isbringing me great relief.
Mast cell activation, verycomplex.
Dr.
Tanya Dempsey is the leadingauthority on mast cell
activation.
I really appreciate hertreatment protocols and follow
those closely with patients inmy clinic.
(04:22):
Reducing histamine and the mastcell activation and preventing
those estrogen spikes.
Taking bio identical or bodyidentical progesterone according
to the work of ProfessorGeraldine Prior can also relieve
symptoms and support variousfunctions.
I personally take body identicalmicronized oral progesterone and
(04:45):
I find it absolutely brilliantfor sleep and absolutely
brilliant for anxiety.
I personally started toexperience that progesterone
deficiency anxiety early inperimenopause and body identical
mic, oral micronizedprogesterone, put that to a
stop.
So it just shows how powerfulthat can be and it, RT isn't
what it used to be.
(05:05):
H r T isn't just a one size fitsall, and it's not necessarily in
estrogen replacement therapyanymore.
It can be bioidenticalprogesterone on its biodentical
with estrogen.
Be individualized according towhat your body needs.
So this module aims to provideknowledge and tools for managing
(05:26):
menopause symptoms and balancingexcess estrogen levels.
I'll just have a look and makesure that I don't have any
questions.
That's fine.
Estrogen dominance.
Now, when we're talking aboutestrogen dominance, we're
talking about estrogen beingdominant relative to
(05:49):
progesterone.
We have a natural physiologicaloestrogen dominance in the first
part of the day 1 to day 14,oestrogen is high and that is
absolutely normal for oestrogento be dominant during that part
of the cycle.
Then from the day that youovulate, the textbooks say day
14, but really women canovulate.
(06:12):
Anywhere between day eight andday 18.
It's complex and it'sindividualized, but let's just
say, for argument's sake, if youdid ovulate on day 14,
progesterone needs to be reallyhigh from day 14 to the
following bleed.
So that is where we needprogesterone to be 100 to 200
times higher than estrogen inthat cycle.
(06:33):
If progesterone is deficient,oestrogen can be dominant in the
luteal phase of the cycle andthat is when it wreaks havoc.
Oestrogen is a group ofhormones, E1, E2 and E3,
responsible for the developmentof secondary sex characteristics
and regulating the reproductivesystem.
Women have three types ofoestrogen and amounts vary
(06:55):
during different life stages.
During menstruation, estrogenlevels are low.
Then rise during that follicularphase and peak just before
ovulation.
And drop going into that lutealphase, like I just mentioned
before.
High oestrogen or oestrogendominance can cause various
symptoms, like irregular orheavy periods, breast
(07:17):
tenderness, bloating, moodswings, fatigue, difficulty
sleeping, decreased sex drive,headaches, weight gain.
hair loss, brain fog, and anincreased risk of blood clots or
stroke.
That is why it is so importantto test estrogen before taking
in additional estrogen.
If your estrogen were to be highand you were to pop on an
(07:39):
estrogen patch.
You could be exacerbating thesesymptoms thinking that you're
using a medicine that is thereto reduce them.
The research suggests reducinghistamine and mast cell
activation to prevent estrogendominance.
(08:01):
The causes of oestrogendominance, hormonal imbalances
and medications, body fat,increased adiposity can actually
behave like its own endocrinesystem and produce more
oestrogen than necessary.
Chronic stress can of courseincrease oestrogen due to the
fact that the body isprioritizing stress hormone or
cortisol over progesterone andtherefore oestrogen is high due
(08:24):
to the progesterone deficiency.
Environmental factors with thexenooestrogens in plastic.
And of course, poor liverfunction because we need to
detoxify our estrogen throughthe large intestine and the
liver because we need to useestrogen and then we need to
lose it.
We need to be able to detoxifyit so that it doesn't
recirculate.
(08:46):
Causing a high estrogenpresentation.
Estrogen dominance is associatedwith several risks, including
tumors in the uterine lining,several conditions like breast
cancer, ovarian cancer,endometriosis pain, insulin
resistance, polycystic ovariansyndrome, uterine cancer, and
tumors on the ovaries andadrenal proliferative.
(09:11):
Testing of estrogen dominance inperimenopause.
The Dutch test is a specializedurine test that can be used to
diagnose and monitor estrogendominance by measuring hormone
levels and their metabolites inthe urine, including estrogen
metabolites that can indicateestrogen dominance.
When you only have a blood test,and I'm not saying don't test
(09:33):
estrogen the blood, I actuallyquite like having both sets of
data, so I like my patients totest estrogen.
And we'll talk a bit more aboutthe blood test between day one
and day three of the cycle, ifyou're still cycling, so we can
see what the blood plasma levelsare like.
But I really love the Dutch testbecause we not only see what the
(09:53):
systemic estrogen levels arelike, but we also see what their
metabolites are doing and howdetoxifying estrogen.
Down the 2, 4, and the 16hydroxy pathways.
The 2 hydroxy pathway is safe.
The 4 hydroxy pathway can damageDNA and RNA and is more 16
(10:15):
hydroxy pathway is moreproliferative.
So we need to know where theestrogen is, how much we have,
and how it's detoxifying throughthe body in order for us to be
able to change.
The Dutch test specialized urinetest that can be used to
diagnose and monitor estrogendominance by measuring hormone
levels in the metabolites in theurine, including estrogen
(10:36):
metabolites that can indicateestrogen dominance.
That is not only what the Dutchtest tests.
The DUTCH test also testsprogesterone, it does do the
estrogens, and theirmetabolites.
It shows us androgens and theirmetabolites, and then it goes
into adrenal function.
I love the DUTCH If you're goingto do a DUTCH test, I highly
recommend the DUTCH so that wecan also see CAR, C A R, known
(11:02):
as cortisol awakening response.
So that is incredibly importantin perimenopause as well.
Because cortisol andprogesterone play a role in this
estrogen dominant picture, forexample.
And in the Dutch plus, we alsosee dopamine levels, the 6, the
12.
We have a little indication ongut health and brain health as
(11:22):
well as melatonin, which isreally important for us sleep.
And of course, don't forget thatmelatonin is an incredible
antioxidant.
Blood tests such as estradiollevels, follicle stimulating
hormone levels and luteinizinghormone levels.
As well as, in fact, sex hormonebinding globulin can also be
used to assess oestrogen levelsand determine if someone has
(11:44):
oestrogen dominance.
And like I to test them throughblood between day one and day
three.
The timing of hormone testingfor oestrogen dominance is
important.
And it's usually based on theday of the menstrual cycle with
the best time to test forestrogen levels, as I said,
during that follicular phase ofthe menstrual cycle, and 5 to 7
(12:06):
days after ovulation, if youwant them to look at estrogen in
relation to progesterone levels.
So between day 19 and 22.
is when you would like to alsotest the progesterone levels if
you're doing a blood test.
Evaluating oestrogen levels.
When, if you do the Dutch test,I do want you to do the Dutch
test between day 19 and 22.
And if you do not have a cycle,please reach out and we'll work
(12:29):
out when you're going to test.
Evaluating estrogen levels,especially in relation to
progesterone during the lutealphase can help identify if
symptoms such as weight gain,irritability and heavy periods
are related to estrogendominance.
Interpreting hormone levels iscomplex and it should be done in
the context of an individual'soverall health and medical
(12:50):
history.
And of course, consultation withyour healthcare provider, the
basic treatment ideas, sodietary changes, absolutely
incredible and very powerful.
So eating a healthy, balanceddiet with plenty of fiber.
can help support healthyoestrogen metabolism.
We have to get oestrogen throughthe large intestine and we need
(13:13):
to get oestrogen moving throughthe liver.
If you're taking in lots oftoxic foods and alcohol, for
example, the liver and the largeintestine will make the
oestrogen wait.
This can be one of the reasonswhy oestrogen is recirculating
through the bloodstream andcausing a toxic load or an
oestrogen dominant picture.
So more fiber and less alcoholand less sugar.
(13:36):
Gets that estrogen out throughthe liver and the large
intestine limit or avoidalcohol, sugar, and of course,
processed foods, regularexercise, absolutely brilliant
to help us sweat and detoxify,but also build muscle and
increase those endorphins, thosefeel good hormones to help keep
that cortisol low.
(13:57):
And of course, reduce body fatbecause we're building muscle,
which can help lower estrogenlevels and aim for at least 30
minutes of moderate intensityexercise.
Most days of the week, stressreduction, finding ways to
manage stress, decreasecortisol.
So we can bring thatprogesterone up so that we don't
have that extreme excess.
(14:18):
And of course, I say, reducestress in a way that you love
and move in a way that you love.
So meditation, yoga.
Deep breathing all may beextremely helpful, walking on
the beach.
Some of my patients love thosemeditation coloring in books.
I think that's a fabulous ideaif that's what resonates for
you.
And journaling is brilliant too.
Listening to music, cooking.
(14:39):
Yeah, beautiful.
Supplements and herbal remedies.
Now here we need to be verycareful.
Of course, this repair programhas an individualized component.
So we will if you choose, do theDUTCH test together so that I
can work and work out anindividualized prescription for
you with certain supplementssuch as omega 3 fatty acids,
(15:02):
magnesium, vitamin B6, and someherbs such as chaseberry, dong
guai, black cohosh may helpregulate oestrogen levels and
support healthy oestrogenmetabolism.
Stabilizing the nervous systemis absolutely imperative to
cortisol.
So some of the supplements thatI like are shown on the slide,
(15:22):
but for example, if you arestressed out and tired, rhodiola
is beautiful.
If you are stressed out andwired, ashwagandha or trigandha
is an absolutely incrediblesupplement for you.
Stabilizing that nervous system.
Magnesium, Melissa, passionFlower, the trine is absolutely
brilliant and so is magnesium torelieve hot flushes and improve
(15:46):
sleep.
But don't forget, of course, wehave plant-based melatonins and
we have incredible nervoussystem support that we can use
within the clinic dispensary.
Reducing histamine and mast cellactivation following a low
histamine diet and basically,just to give you a quick idea to
reduce histamines, things likeavocados, citrus fruits,
(16:08):
anything aged olives or curedmeat or wine or anything that
has been aged.
We'll have a high histaminelevel, even down to leftovers.
So if you eat fresh food and youstay away from leftovers, that
can be very supportive to lowerhistamine levels.
One shouldn't need to be on alow histamine diet long term.
(16:29):
If high histamine levels arereally bad, we can start to see
breakouts in the skin.
So we can start to see an eczematype presentation or really
itchy skin.
Thank goodness that hasn'thappened to me yet.
Hopefully it doesn't.
Follow a lower histamine diet,take supplements that lower
histamine.
Nigella is incredible.
Black seed is brilliant.
(16:51):
The hist ease supplement in theclinic is incredible.
It brings me so much relief.
Of course, manage stress, avoidtriggers, and take those
antihistamines, those naturalones.
And in actual fact, for somewomen, and I barely ever
recommend pharmaceuticalmedication at all, but for some
women, it is really beneficialto take an antihistamine.
At night, to both reduce thathistamine level, particularly if
(17:15):
you find that you have PMD typesymptoms, or PMDD type symptoms,
PMS type symptoms, pre cycle,they can be extremely supportive
for some patients.
And of course, when thehistamine levels get so bad I
have been known to have thatsort of tight chest from that
allergic type bryonitis or thatthunderstorm asthma.
(17:39):
Antihistamines are life saving,so please be gentle on yourself
in the same way that, you know,oh, God forbid you need a
Panadol or a Tylenol to get ridof that headache.
If something has gone wrong foryou, please be gentle on
yourself.
We don't have to be perfect.
We certainly don't have to beorthorexic in this program.
We don't need to have theperfect diet, and we certainly
(17:59):
don't need to have the perfectsupplementation protocol either.
We can sometimes rely onsymptomatic relief.
I think it's, there's a fineline between, treating and
curing the cause, but also nothaving those those awful
symptoms in your way for just amoment in time, when something
like an antihistamine can bringyou some relief.
So five steps to naturallyreduce excess estrogen and
(18:19):
promote hormonal balance.
Step one is to eat qualityprotein, garlic, onions, and
cruciferous vegetables thatsupport the liver in processing
estrogen.
The liver actually really needsprotein in order to do its job.
A B complex supplement or a DIMsupplement may also be
considered.
I absolutely love sulforaphaneor Pomegenex because it's such a
(18:43):
gorgeous, it has pomegranatesulforaphane and coconut water.
So topped up with all of thosebeautiful phytonutrients and
those incredible antioxidants.
So not only brilliant fordetoxifying estrogen excess, but
brilliant for our hair, skin andnails and hydration too.
So hydration is imperative andbe mindful that DIM is not
(19:04):
always needed.
Indole 3 carbinol or DIM canreduce oestrogen, but it can
also ensure that oestrogen isdetoxifying down the 2 hydroxy
pathway.
These are not the kind ofsupplements that I would
recommend you use withouttesting first and, and having
your one on one healthconsultation.
(19:24):
All right.
Step two is to treat underlyingdigestive issues that may be
causing constipation.
Again, we do not want that toxicreload.
So we want to be having a bowelmotion daily.
Our patients now know how crazyand yeah how excited I am about
daily bowel motions.
So we do not want to preventefficient elimination of
(19:45):
estrogen.
Step three is to eat fiber richfoods.
So women need, especiallyperimenopausal women, need about
25 grams of fiber.
So you also, at this point intime, know how much I love the
GI Restore So please use that tobulk up your fiber if you're not
getting enough in your twomeals, if you are doing
(20:05):
intermittent fasting andskipping breakfast at this point
in time.
So step three is to eat fiberrich foods, avocado,
raspberries, artichokes,oatmeal.
In the next phase, when you areout of your repair phase, we can
start to reintroduce some ofthose good carbohydrates so be
mindful if oatmeal is not goodfor you, please steer clear of
(20:28):
that.
And if you are going to eatoats, please make sure that
they're organic.
Almonds and broccoli to keep thebowels regular and help
eliminate waste, includingunnecessary estrogen, of course.
Step four is to manage stressand use calming tactics like
deep breathing.
Adrenal support supplements mayalso be considered.
So this approach step four isall about reducing that cortisol
(20:49):
so that we can produce enoughprogesterone, or we can take our
body identical progesterone andnot have it overridden with that
cortisol, creating an estrogenexcess presentation.
So honestly, duringperimenopause, I see far more
estrogen excess than I doestrogen deficiency.
(21:10):
Of course, I see estrogendeficiency once women go into
menopause.
But in the perimenopausal phasein 23 years in clinical
practice, I see more women withan estrogen excess presentation.
So with regards to breathing, Iwant to share some technique
with you.
This is cutting edge research.
Harvard University professors.
(21:30):
It's been proven that thenatural sigh like that is the
best way for us to calm asquickly as possible.
So it's super, super quick.
It's super, super easy.
Managing stress is about takingone deep breath in, followed by
another quick, short breath into fill those lungs.
So a big, deep breath in.
(21:53):
And do that three times, andthat will help reduce cortisol
and help you stay in that calmstate.
Of course, B5, which treatsrelationship and mum agro, is
absolutely brilliant for doingthis too.
Step 5 is to get 7 to 8 hours ofsleep a night.
Research shows that men rarelyneed 8, women really need 8, and
(22:17):
men can get away with 7.
But it's, as an absoluteminimum, you need 7 hours of
sleep every single night.
So use those blue light blockingglasses one to two hours before
bedtime to shift those hormonesinto a more favorable state.
If you need to, drink yoursleepy time tea, have your plant
based melatonin, do whatever ittakes.
(22:37):
Have a beautiful magnesium saltsbath, do your meditation, do
your stretching, do your yoga.
Make sure you get eight hours ofsleep.
Estrogen dominance isreversible, so all of this,
don't worry about it.
If it sounds awful, if you are,do have an estrogen dominant
presentation at the moment.
Don't worry, I have had it, too.
Milk Thistle is brilliant.
There's another product calledEstroClear, if that's
(22:58):
appropriate, it is an absolutelybrilliant product that saved my
life.
Estrogen dominance is reversibleby implementing the suggested
steps to improve estrogenprogesterone balance and to heal
the entire hormonal system.
Of course, but one step at atime, microchanges, we will
absolutely get there.
Conclusion, we've focused onrepairing estrogen excess during
(23:21):
perimenopause.
Balancing estrogen levels iscrucial for optimal health.
And addressing associated risksand symptoms.
Strategies include dietarychanges, exercise, stress
reduction, supplementation, andherbal remedies.
Gut health and liver functionplay a crucial role in efficient
(23:42):
estrogen metabolism.
And of course, consult with yourhealthcare practitioner.
Do not do this on your own.
And what I do want to say, whichis so important, is women ask me
all the time (23:53):
why is it that my weight loss was never
sustainable?
Why is it that I wasn't able tokeep the weight off?
My answer is always the same.
We need to first repair the gut,the immune system, the
metabolism, the microbiome, andyour mood.
So the gut work needs to be donefirst, and then you need to
(24:13):
ensure that you are sticking toyour roadmap and your Peri Power
Plan so that you can"80/20" itfor the rest of your life.
So 80 percent of the time you'reeating according to this
beautiful food protocol that youhave devised for yourself at
this point in time, and then 20percent of the time your body
can handle the"welcome to beinghuman" moments.
(24:34):
the birthday cake, the glass ofwine, every now and then.
Perimenopausal systems cannotstand alcohol.
Brain fog cannot stand alcoholand estrogen detoxification
can't stand it either.
So if you are able to, I wouldhighly recommend to make sure
that you do the Repair and theRebalance alcohol free.
There really are only, 12 weekprograms.
(24:56):
I will be increasing the one onone care.
And of course, you know that youall have availability to me by
the doctor in your pocket.
So number one is Repair.
Repair your immune system, yourgut, your mood, your waistline,
your metabolism, et cetera.
That is what we have just donetogether.
And then number two, we have torebalance those hormones.
We need to know whatprogesterone is doing, what
(25:17):
estrogen is doing, how it'sdetoxifying.
What the androgens are doing.
How three of those hormonessets: the progesterones, the
estrogens and the androgens, howthey interplay, how all of that
interplays with cortisol andthen melatonin, and then we need
to look at that OAT component ofthe DUTCH test, and of course
your CAR, your cortisolawakening response.
(25:37):
So if you ever thought thatweight loss and vitality in
perimenopause was complex (25:41):
you are absolutely right.
So thank you so much for yourtime again.
I really appreciate it.
I absolutely love that you arehere.
Take it easy and have abeautiful night.
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