Estrogen Balance, Metabolism and Stress

September 17, 2013

Estrogen Balance, Metabolism and Stress 

 Reference:  A4M Advanced Endocrine Module with Eldred Taylor 

 Just about the most common complaint women tell me when they get to be 55 and postmenopausal is, “Why can’t I sleep and why is all this stuff showing up around my middle?  My waist is expanding and I’m gaining weight.  What’s going on?” The simple answer is never simple and never accurate. But the more nuanced answer might be all about stress.  Mid life adults have lived through a lot, and like 57 Chevys, have accumulated their share of nicks, dents, and life traumas. The accumulated effects of those traumas remain in our pysches and play out in our stress response.  

Last week we talked about how mindfulness meditation can lower your cortisol level.  Well, the reason to do that is that just about all of us, men and women have elevated cortisol and stress response as we age.  Lowering it is important.  The relationship of cortisol to estrogen metabolism is one of the key reasons to lower it.   Here is the short list why. Elevated cortisol has a profound effect on the way your body handles estrogen.  It effectively upsets the whole pathway.  First, it decreases sex hormone binding globulin, the protein that binds estrogen which means you increase the estrogen pool. It also makes you insulin resistant to that you have higher insulin, stimulate your “thecal cells” and make more testosterone.  

Then, cortisol makes you have “leaky gut”  and increases your “enterohepatic circulation” of estrogen – so the estrogen your liver handled once and excreted gets reabsorbed and back into circulation in your body.  (If you have had gall bladder surgery or have stones, your enterohepatic system is on overdrive and signals you have poor detoxing going one.)  It also causes dysbiosis in your gut which means your gut isn’t working.   You don’t absorb the nutrients you need to detox Phase I and Phase II.  You also have more oxidation.   That increases the pathway that metabolizes estrogen to dangerous estrogens.  AND, because you have increased SHBG and insulin, you have increased aromatase in your fat tissue and that increases estrogen.  

Because you are going down the cortisol pathway instead of the mineralocorticoid pathway, you waste magnesium which is a critical co-factor for COMT, the enzyme that excretes estrogen.   Ouch, ouch, ouch and ouch.  Five coordinated means by which cortisol conflicts with estrogen.  You simply aren’t in balance. Did you get all that?  The problem is the cortisol and stress level, and the coordinated, global, synergistic effect by which virtually every arm of estrogen metabolism and excretion is messed up.  

To clear up your estrogen metabolism, you have to start with cleaning up your cortisol. To clean up your cortisol, you have to deal with your stress.  To deal with your stress, you have at address your “story”. What is the stressful event that triggered it all?   Modern medicine says that stress is all in your head and there is no connection between stress and dysfunction?!!!  We are now beginning to understand the link, and be able to measure the nuance.  It’s not black and white, it’s gray added upon gray added upon stress.  You have to see the pattern and start with the simple premise that excessive stress is dangerous. 

 WWW. What will work for me.   Dealing with stress might be the first thing we have to think about when we want to be well.  Wellness isn’t just medical.  The good news is that with measurement, we can now assure ourselves that we are making progress.  What is so fascinating is watching seemingly remote things, like estrogen metabolism and waist size respond.   How can you reduce your stress?

Column Written by Dr John E Whitcomb,Brookfield Longevity, Brookfield WI