Swimming in a sea of oestrogen

Women of all ages are increasingly struggling with hormonal imbalances due an overexposure to environmental oestrogen, writes Dr Sly Nedic.

As this ‘sea of oestrogen’ in which women are swimming grows, so too does our responsibility as practitioners of functional medicine to raise public awareness of how to minimise the harmful effects related to a systemic overload of oestrogen.

Harmful effects of oestrogen overload:

Premenstrual syndrome (PMS and PMDD)
Fibroids
Endometriosis
Infertility
Anxiety, irritability, mood swings
Menorrhagia (heavy menstrual bleeding)
Weight gain and an inability to lose weight
Anti-thyroid effect – sluggish metabolism
Increased risk of thrombosis and stroke
Breast cancer
PCOS

This oestrogen explosion is in large part due to an excess of environmental oestrogens. Among the concerning results is the increased incidence of precocious puberty in young girls. If we don’t act on this environmental oestrogenic load, we will soon have a young generation of girls who are not psychologically mature enough to accept the changes that precocious puberty brings, uncovering a host of further problems for general public health. It’s clearly time to start worrying!

The most common presenting symptom of oestrogen overload is usually PMS. This results in painful periods, irritability, mood swings, anxiety and an inability to lose weight. PMS has become the ‘norm’, going hand in hand with monthly menstruation. In previous generations, PMS was a rarity.

This has created a vicious cycle, whereby birth control pills have been over-prescribed as a PMS treatment, which has only added to the environmental oestrogen burden. How so? Well, these pharmaceuticals are dissipated into our soil and water, meaning we come into greater contact with them. This even affects our male population, which faces an elevated risk of prostate cancer. South Africa has among the highest rates of birth control prescriptions, which is an obvious concern.

Research has also demonstrated that environmental oestrogen could mimic our very potent oestrogen called estradiol (E2), activating the E2 receptor in the vaginal tissue, thereby increasing the risk of developing thrush (Candida albicans) by up to 800%. This is even occurring in pre-pubescent girls. This cannot effectively be tackled by prescribing anti-thrush pharmaceuticals but rather by decreasing environmental oestrogens.

A compound issue

Beyond environmental oestrogens, inadequate detoxification within our bodies causes our own oestrogen to become ‘trapped’. An individual’s detoxification process is influenced by their genetics, nutrition and their interaction with environmental toxins.

Inadequate detoxification exacerbates many of the listed symptoms and creates an internal hormonal imbalance.

During detoxification, our body creates oestrogen metabolites, some of which are beneficial and non-harmful, while others are incredibly harmful. These harmful metabolites increase the body’s oestrogen burden, leading to a state of oestrogen dominance.

Fortunately, when it comes to the genetics, unfavourable markers are easily detectable through testing. This is the first step in personalising treatment for women suffering from oestrogenic overload. Poor genomic pathways of oestrogen detoxification are often why two individuals living in the same environment develop different responses to environmental oestrogens.

Depleted levels of vitamins B6, B9 and B12, as well as magnesium, zinc and quality protein, among others, further hinder oestrogen detoxification. While our liver is key in this process, the gut is just as important.

When oestrogen passes through our gut, ready to be excreted, unhealthy gut flora can interrupt this process, contributing to the reabsorption of our oestrogen, putting it back into circulation (known as enterohepatic recirculation). This problem hugely contributes to the oestrogen-dominant state that sees women in their reproductive years suffering from PMS and PMDD, fibroids, endometriosis, anxiety, irritability, mood swings, heavy menstrual flow, weight gain, etc. It’s clear how problematic this recirculation of oestrogen is.

Functional medicine interventions for helping the gut are just as crucial as facilitating liver detoxification in these individuals. Besides the appropriate detoxification, oestrogen should also be balanced with progesterone. Inadequate progesterone, as is common with in chronic stress or periods without ovulation, further increases oestrogen dominance. We often see this in perimenopausal women with heavy bleeding, which may lead to unnecessary hysterectomies – again an overly common medical intervention in South Africa.

Danger all around

There seems to be a lack of acknowledgment from conventional medicine about the harmful effects of environmental oestrogens. Constant exposure and the excessive use of certain substances make the situation challenging for women struggling with oestrogen dominance diseases. This alarming situation is best described by the presence of 288 environmental toxins found in the umbilical cords, meaning that these are found in babies too. Of these toxins, 180 cause cancer in humans or animals and 217 are toxic to the brain and nervous system.

There are three well-known environmental oestrogens: xenoestrogens, mycoestrogens and metalloestrogens.

The largest group and the hardest to control are the xenoestrogens, which are all-pervading in our environment. Examples of these are pesticides, petroleum-based plastic compounds, organophosphates, industrial chemicals, phthalates, parabens and much more. Patients receive a complete list from functional medicine doctors to help facilitate their elimination. Highly compliant patients in eliminating environmental oestrogens have been shown to improve significantly faster.

Xenoestrogens act as endocrine disruptors and can alter hormonal functioning in sensitive tissues, including the breast, uterus, cervix and prostate. Decreasing the expression of certain ‘bad’ genes is an important aspect of the functional medicine approach.

Then there are the mycoestrogens, which were recently found to act as full oestrogen receptor stimulators, binding to oestrogen receptors with high affinity, increasing oestrogen overload. Many mycoestrogens are found in dairy products, especially cheese.

Metalloestrogens that bind to oestrogen receptors include aluminium, antimony, arsenite, cadmium, copper, lead, mercury and nickel, among others. The potential for these metalloestrogens to add to excessive oestrogen signalling within the human breast is being investigated. Some patients cannot detoxify these metalloestrogens sufficiently due to their specific genetic makeup and that should always be checked.

Take-home message

We really need to think beyond just hormones and more about the total environmental oestrogenic load, which can trigger oestrogen responses in any part of the body where oestrogen receptors exist. In this surrounding sea of oestrogen, taking a functional medicine approach can significantly aid in ensuring positive outcomes and better general health.

www.8thsense.co.za

All references are available on request.