Questions that always crop up in my clinic time and time again are: 
How can I balance my hormones?  
Regulate my menstrual cycle? 
Enhance fertility? 
Help me sail through the peri/menopause and beyond? 
Oestrogen is sometimes called The Goldilocks Hormone – we don’t want too little or too much of it. It needs to be “just right”. Balanced oestrogen levels, whether we are in our 20s, 30s, 40s, 50s, 60s and beyond is key to our vitality and general health and wellbeing. 
Oestrogen may be the most misunderstood hormone and often gets blamed for many symptoms. Oestrogen has over 400 different jobs in the body and it is the hormone that defines us as a woman. It gives us hips and breasts, buffers our mood, fires up our brain, helps us sleep and all things related to our fertility. 
There are oestrogen receptors (like docking stations) all over the body, not only in the ovaries and breast tissue but also in skin, bone, liver, adrenal glands and even the brain. This explains why, when oestrogen levels are not in balance, the symptomatic fallout can be felt all over the body. 
Signs of imbalanced oestrogen include: 
Bloating and digestive upset 
Brain fog 
Weight gain 
Sluggish metabolism 
Decreased sex drive 
Periods that are heavy, painful or irregular 
Severe PMS 
Breast pain or tenderness 
Headaches and migraines 
Water retention 
Food cravings 
Hot flushes 
Mood swings 
Irritability and depression 
Polycystic ovarian syndrome (PCOS) 
Fertility issues 
It’s important to know that when we talk about oestrogen – this is not just one thing. Oestrogen is a general term that refers to many different “types” of oestrogen such as: 
Estone (E1) is the main oestrogen in menopausal years (and is also made by fat cells) 
Estradiol (E2) is the main oestrogen in reproductive years 
Estriol (E3) is the main oestrogen during pregnancy 
Estrogen breakdown products (metabolites) – some of which could have an unfavourable effect on the body 
Ethinylestradiol from oral contraceptives 
Xenoestrogens from chemicals (pesticides, preservatives, perfumes etc) 
Once “oestrogen” (E1, E2, E3) has worked it’s magic in your body, the majority of it goes to your liver to be broken down, and these break down products of oestrogen (oestrogen metabolites) can be an even bigger driver of unwanted symptoms as they can still have a very active and unfavourable role in the body. 
If you have ever had your oestrogen levels measured in blood and they come back “normal”, but you are suffering from any of the symptoms described above, your symptoms could be due to how your body is clearing oestrogens. 
So, proper oestrogen clearance from the body is key to balancing your oestrogen. This applies to females of any age group and especially if using HRT. 
There are 2 main organs involved in clearing oestrogens: 
The Liver 
Your liver clears used up oestrogen via 2 detox pathways called Phase I and Phase II. During these phases your liver could be favouring pathways that drive “unfavourable” oestrogen metabolites, causing symptoms and health problems. 
So how can you support your liver to detox oestrogens? 
A daily portion of cruciferous veg helps support liver detox. Choose from cabbage, broccoli, Brussels sprouts, kale, bok choy, cauliflower, rocket and watercress 
Manage your stress overwhelm as stress impairs detox 
Ensure you have adequate magnesium, zinc and B vitamins – as these nutrients are required for good clearance 
Limit your consumption of fried foods, alcohol, sugar, caffeine and give up smoking 
The Gut 
Once your liver has packaged up the detoxed oestrogen in bile, it then sends it to your gut for what is known as Phase III detoxification. 
Here, you have a special team of gut microbes called the estrobolome – a special subset of bacteria that help to eliminate the detoxed oestrogen out of the body, via an enzyme called beta-glucuronidase. The estrobolome keeps oestrogen levels “just right”. 
If the estrobolome is unbalanced, for example it lacks diversity or there is an overgrowth of unfriendly bacteria then too much beta-glucuronidase is produced and this causes the package of oestrogen to be unpicked and recycled back into the body leading to high oestrogen levels, which can then cause undesirable symptoms. 
A healthy balanced estrobolome thrives on fibre (veggies, nuts, seeds, legumes, beans), fermented foods (kimchi, sauerkraut, kefir) but is adversely affected by alcohol, sugar and refined foods. 
You can use the DUTCH test to help clarify your hormone levels and how your body is clearing oestrogen. This is a simple do-it-at-home urine test and the results can then be used to work out a bespoke plan to address any imbalances. 
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