Supplement Support for Estrogen Dominance in Perimenopause

Estrogen Dominance

This month, I’m focusing on estrogen dominance. I’ve focused on estrogen metabolism and managing estrogen dominance with lifestyle changes in previous weeks. If you missed these, you can read them here and here. This week, I’ll look at supplements that can help with estrogen dominance.

To review, estrogen dominance happens because of three main reasons:

1. You have insufficient progesterone to oppose estrogen.  
2. Your body is not breaking down estrogen well due to compromised liver enzyme function, decreased methylation, and/or constipation, allowing estrogen metabolites to recirculate and act in toxic ways.
3. You’re being exposed to toxins that sit in the estrogen receptor which blocks the “real” estrogen from doing its job.

Estrogen dominance does NOT happen because your ovaries suddenly go haywire and decide to produce tons more estrogen!

More than 70% of women experience estrogen dominance. The symptoms range from lumpy and fibrocystic breasts to thyroid nodules, hot flashes, fibroids, uterine polyps, painful, heavy, or irregular periods to infertility and miscarriages, from mood swings to insomnia, and weight gain to fatigue.

Top Supplements for Estrogen Dominance

The approach that generates the fastest and most profound changes combines diet and lifestyle changes with supplements.

Diet is the foundation of all hormone healing. Supplements are amplifiers and healing accelerators.

Supplements that Increase Progesterone Levels

Vitex (chasteberry)

Researchers believe that vitex works by decreasing levels of the hormone prolactin. This helps rebalance other hormones, including estrogen and progesterone — thus reducing ED symptoms.

The side effects of chasteberry may include:

• Acne
• Headache
• Unusual menstrual bleeding for several months
• Rash
• Stomach upset
• Weight gain
• Dizziness

Vitamin C

Research has shown that women who take Vitamin C have significantly increased levels of progesterone in their systems. In fact, women who took 750mg of Vitamin C per day had an increase of 77%. 

Progesterone cream

Supplementing progesterone cream is another way to balance estrogen. This product is available over-the-counter. It is generally safe, but not without possible side effects. It may make symptoms worse before they get better because it increases the sensitivity of estrogen receptors. I highly recommend testing to be sure you need this before self-treating.

Possible side effects include drowsiness, increased depression, and possible weight gain. In addition, women with low cortisol may notice an increase in anxiety and insomnia since progesterone can be used to make cortisol.

Supplements that Impact Estrogen Metabolism

It is important to understand that supplements that work in Phase 1 and Phase 2 will help optimize estrogen metabolism, but if your digestive health is poor (e.g. constipation is a problem or your beta-glucruonidase is high), all of these metabolites may back up in the liver, making you feel worse than ever. So, it’s important to solve metabolic problems in reverse order….Phase 3 (bowel movements), Phase 2 (beta-glucuronidase), and then Phase 1.

DIM/I3C

DIM or I3C is ideal for you if:

• Your Phase 1 metabolism is sluggish.
• You are high in testosterone, and you convert testosterone to estrogens.
• Your 4-OH and/or 16-OH metabolites are elevated.

DIM is a type of compound known as a ‘plant indole.’

Plant indoles are found in cruciferous vegetables such as broccoli, cabbage, and cauliflower and are among the nutrients that give these vegetables their well-known healthful properties.

The primary plant indole is found in cruciferous vegetables, known as Indole 3 Carbinol (I3C), which converts to DIM in the body.

I3C and DIM have been studied for their health-promoting benefits when used as supplements. While both may help support healthy estrogen metabolism, DIM may be a better option as it does not produce the unwanted side effects of I3C (including possible nausea and equilibrium issues).

DIM is not a magic cure for everyone with estrogen dominance. If your Phase 1 metabolism is good, you don’t need it. If your Phase 2 metabolism is sluggish, then the metabolites that DIM is pushing toward Phase 2 can back up and may make you feel worse. It can have side effects such as headaches and can turn urine a pale orange or pink color. This is nothing to worry about.

DIM is safe when taken with Tamoxifen, birth control pills, and other herbs; such as St. John’s Wort. There are no known contraindications for DIM supplementation. It may affect blood sugar levels so make sure you’re keeping an eye on this if you have diabetes or issues with hypoglycemia.

Sulforaphane 

Sulforaphane is a compound found in broccoli sprouts. It is a potent Phase 2 liver detox facilitator, acting on the sulfation pathway. It helps aid in the body’s detoxification, as well as exert long-lasting antioxidant effects. It is also a powerful anti-inflammatory. As a result, sulforaphane has also been linked to being anti-carcinogenic in estrogenic cancers.

Sulforaphane aids hormone balance in several ways: 

• Liver detoxification: Sulforaphane is directly involved in supporting liver detoxification, which is important not only for liver function but for the rest of the body as well. It targets biological pathways that both modulate Phase I enzymes and elevate Phase II enzymes. This allows for full and proper detoxification of unsafe chemicals along with problematic estrogens.
• Anti-carcinogen and detoxifier: Research shows when it comes to supplementing with sulforaphane, premenopausal breast cancer risk was decreased with higher broccoli consumption. It can increase the activity of detoxification enzymes, it’s effective in reducing thyroid cancers, and it raises 2-OH estrone, which is the less carcinogenic form of estrogen.

Find a sulforaphane supplement that guarantees 3 to 7 grams of sulforaphane (not just glucoraphanin), provides myrosinase, and preferably contains vitamin C.

If you are taking medications that the liver metabolizes, check with your pharmacist before taking sulforaphane. Sulforaphane impacts the liver and these medications may act too fast or have side effects.

Calcium D-glucarate 

Calcium d-glucarate helps the elimination of excess estrogen and other toxins and protects against re-absorption. It supports the Phase II (methylation via COMT gene), glucuronidation pathway detox. This supplement inhibits beta-glucuronidase, which is an enzyme that reduces the liver’s detox ability, allowing toxins and estrogen metabolites to re-enter the blood. Beta-glucuronidase is produced by some gut bacteria and imbalances of microbes can increase levels. A GI Map test will assess this.

Additionally, Calcium d-glucarate removes the harmful metabolites of estrogen that may be responsible for conditions. These conditions include fibrocystic breasts, breast lumps, ER+ breast cancers, thyroid nodules, thyroid cancer endometriosis, fibroids, infertility, mood swings, and PMS.

Finally, Calcium d-glucarate can speed up the metabolism of toxins and decrease the effectiveness of medications metabolized by the liver. If you are taking any medications, please speak to your pharmacist before adding Calcium d-glucarate.

Which Products Should I Start With?

The answer to this question depends on your health and where you need support. Some women metabolize estrogen beautifully but aren’t ovulating routinely. After looking at a DUTCH test (which gives you ALL of this information), I’ll often recommend vitex and Vitamin C first if there aren’t any issues with Phase 1 or 2 metabolism. If constipation is a problem, managing that is the first step. If there are issues with metabolism, but not levels, I may start with DIM and/or Calcium d-glucarate.

Supplements or Food?

You know I’m a big believer that food is the foundation of our hormonal health. However, if you are highly symptomatic from estrogen dominance and need rapid relief, I recommend starting with the supplements because they will relieve many of your symptoms. Then, continue with an anti-estrogenic diet.