At menopause (around age 55) estrogen production declines by 40-60% depending on your body fat content. However, Progesterone levels drop to zero at menopause. Thus most menopausal women are even more estrogen dominant than perimenopausal women. This is one of the reasons that women’s risk of breast cancer goes up with each year of life. It does not decline after menopause. So why do some women have sufficient estrogen levels after menopause, but have estrogen deficiency symptoms? In order to respond to estrogen you must have adequate estrogen receptors on your cells (sort of like satellite dishes on your roof). You do not make adequate estrogen receptors without progesterone. Thus, many menopausal women are estrogen-dominant, but relatively estrogen-resistant. The medical establishment, not realizing this, often treat menopausal symptoms with high doses of synthetic estrogen (such as Premarin) which override the defective receptors. Now these women become REALLY estrogen-dominant. While on the subject of synthetic estrogens such as Premarin, it is worth mention that the dominant estrogen in this product is Equilin (obviously of horse origin). One dose of Equilin takes almost two weeks for your body to eliminate. It is easy to see how daily oral administration could lead to very high tissue levels over time.
There are three human estrogens: Estradiol, Estrone, and Estriol. Estradiol is the strongest and some of it converts into Estrone. Estrone has a mid-range strength, but is felt by some authorities to have more cancer causing attributes than Estradiol. Estriol is the weakest estrogen and is more water soluble than the others. It has the least propensity for cancer stimulation and some experts feel that it decreases breast cancer risk. It used to be thought that Estriol was produced only during pregnancy but recent studies show it is produced at high levels throughout the menstrual cycle.
Testosterone is produced in women and men. Men produce ten times more than women and thus it is usually called a male hormone. Testosterone is anti-inflammatory and vital for men and women. I do not believe that Testosterone is the cause of prostate cancer. Prostate cancer is related to elevated systemic inflammatory change and the increased conversion of Testosterone into Estradiol by the aromatase enzymes found in excess visceral fat (especially beer/wheat belly). Testosterone is responsible for muscle mass, ambition, sex drive, and positive outlook, for example.
Following childbirth some women lose some of their Testosterone production from the interstitial cells of the ovary. Most hormonal contraception causes suppression of Testosterone. This can lead to fatigue, depression, and decreased sex drive. The usual explanation for these symptoms is stress and depression related to child rearing, marriage, work etc. The most common treatment suggested is counseling or antidepressant therapy with meds that can often cause more sexual dysfunction, weight gain, and fatigue. While stress issues are very real in our society, testosterone deficiency (and hypothyroidism) is very real and should be evaluated before blaming stress.
In my next blog, I will discuss how I use these “Tres Amigos” to treat perimenopausal and menopausal women who suffer from symptoms of hormonal imbalance.