Estrogen is the surname for a family of three similar hormones – Estrone (E1), Estradiol (E2) and Estriol (E3). Women who are on bio-identical hormone replacement therapy may be familiar with the different estrogens by name but not really know the differences between them. Understanding the role each form of estrogen plays in the balance of our hormones and addressing dietary and lifestyle issues that support healthy estrogen metabolism gives us the ability to be proactive in keeping hormones balanced.
Estrone (E1) is the major form of estrogen made by a woman’s body in menopause. Estrone is made primarily in the liver and fat cells. As the ovaries age and the production of estradiol decreases, estrone levels increase to make up for the loss of estradiol. One of the complaints that women have during perimenopause is the development of belly fat. This increase in fat supports the body’s ability to make estrone. This also may be why women who are overweight tend to have higher estrogen levels and higher estrogen-related problems such as gall bladder disease, fibroids, uterine hyperplasia and fibrocystic breasts.
Most of our estrogens metabolize into some form of estrone. There are three major estrone metabolites – 2-hydroxyestrone, 4-hydroxyestrone and 16-hydroxyestrone. 2 hydroxyestrone is more protective because it asserts a mild anti-estrogenic effect while
4-hydroxyestrone and 16-hydroxyestrone are considered mutagenic which is to say that they potentially promote cancer growth. Genetics, liver function, diet and lifestyle determine which metabolite will be formed. Some women simply have inherited the genetic predisposition to faulty estrogen metabolism. If this is the case, it is very important to keep weight down, support healthy liver metabolism and eat a diet rich in cruciferous and sea vegetables.
Estradiol (E2) is the most potent of the estrogens. It is the major hormone made by the ovaries before menopause. It is the hormone that makes us feel womanly by enhancing sex drive, moisturizing all mucous membranes in the body including skin, lips, eyes and vagina. It strengthens bones, skin and hair, and can help lessen the fine lines that occur around the eyes and mouth as we get older. Estradiol also raises serotonin levels which is why women feel calmer and more focused when they have enough estradiol. Estradiol is metabolized to one of the three estrones as determined by genetics, diet and lifestyle.
Estriol (E3) is the weakest of the circulating estrogens and the one that is highest during pregnancy when it is made by the baby’s placenta When women are not pregnant, this hormone is primarily made in the liver and breast cells from 16-hydroxyestrone. It provides similar benefit as estradiol but in a much weaker potency being about one-eighth as strong. It is theorized that the role of estriol is to modulate and balance the effect of the more potent estradiol since they bind to the same receptors. Much of the current beliefs about the effect of estriol come from its potential effects during pregnancy. Some studies have shown that exposure to high estriol levels during pregnancy decreases a risk for breast cancer later in life.
Now that you have met the estrogen family, you are probably wondering what to do to make sure your estrogen metabolism is healthy. Estrogen metabolites can be measured in a 24 hour urine test ordered through your doctor. With that, you can assess the ratio of 2-hydroxyestrone to 16-hydroxyestrone. You can also assess the level of 4-hydroxyestrone and estriol. If the ratios are not where they should be, there are supplements and dietary changes that can help to bring them back into balance.
To increase 2-hydroxyestrone, eat plenty of cruciferous vegetables, berries, iodine-rich foods, flaxseeds, grapefruit and rosemary. Get plenty of exercise and make sure that thyroid function is optimal. Supplements that increase 2-hydroxyestrone are indole-3-carbinol (I3C) and diindolylmethane (DIM). Both of these products are isolates of plant compounds found in cruciferous vegetables. Keep the diet low in excess carbohydrates (grains, sugars), and include adequate amounts of quality protein (lean, organic meats, chicken and fish), essential fats (fish oils, flax oil, nuts and seeds), and plenty of vegetables.
A healthy diet and lifestyle improves every aspect of health and must be the cornerstone of every program designed to address illness and imbalance. We can’t get around this one! Food, sleep, stress, alcohol consumption, medications and toxic exposures have a profound effect on our health. Each of us has our genetic weaknesses and that will ultimately determine the type of illness we may develop as a result of poor diet and lifestyle. Take control where you can! You may never know what you avoided as a result of your good choices so choose good health everyday.