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Let’s talk about hormones! Part 3: Estrogen and Progesterone

If you’ve been reading the “Let’s talk about hormones!” series, you’ll have seen that the hormone system is rather incredible with its complexity, control and elegance.  We tend to think about things in very simple terms, that one hormone does one thing, and increasing or decreasing the hormone level directly controls that one thing. However, as we’ve discussed, hormone systems have target roles and then they affect lots of different processes to achieve that role, with many many different checks and balances along the way.

The classic “female” hormones, Estrogen and Progesterone, are prime examples of this complexity. At the most basic level Estrogen and Progesterone levels cycle in a specific way to control the menstrual cycle and ovulation.  But on a grander level, Estrogen and Progesterone supports most aspects of fertility and pregnancy.  Estrogen levels are controlled by the brain and, when its levels peak, it signals for ovulation. In situations that aren’t ideal for pregnancy (high stress, or low body fat), the body downregulates Estrogen, effectively shutting down ovulation and preventing pregnancy.  During a pregnancy, the caloric needs greatly increase, both to support the mother’s needs but also those of a growing fetus and so Estrogen also affects storage of fats into the lower tummy, hips, breasts and thighs.   Estrogen affects cholesterol and insulin resistance, supports vaginal secretions and uterine lining thickness, and has a positive effect on emotional and physical arousal.  Along with progesterone, estrogen prevents excess calcium and bone loss.

Progesterone is more of a pregnancy hormone, and it is primarily produced by the egg released at ovulation and then by the placenta during pregnancy.  It affects the body by loosening joints, and altering other hormone functions and body systems for the optimal conditions for growing a baby and preventing a miscarriage.  Progesterone also works in balance with Estrogen, sensitizing the body to Estrogen but also protecting against its effects.  This protects the uterus from cancer growth, improving cholesterol profiles and protecting against the insulin effects.  Progesterone is also helpful for mood support and for helping with sleep disturbances.  These hormones fluctuate dramatically during the cycle and increase even further during pregnancy.  A key point is that the Estrogen and Progesterone levels are kept carefully balanced together and with Testosterone (especially in later life). When those ratios are out of balance, then you may see a variety of symptoms from libido changes, hair loss, or fatigue, to heavy menstruation and migraines.

As usual, we chat about testing to evaluate the hormones.  We can test these hormones with saliva tests or blood tests.  Both choices have their merits and difficulties.  Dr George Gillson MD,  the President and Medical Director of Rocky Mountain Analytical Labs, talks about our testing methodology as being woefully primitive for such a wonderfully complex system. He says “Trying to figure out what is going on inside the cell from blood, urine or saliva tests is like trying to read a newspaper on the sidewalk, from the 15th floor”.  After discussion with my patients, I usually choose to order a panel of saliva tests, even knowing they aren’t the most accurate, because they do give me enough clinical information to make good choices about treatment options.

In the next post, we’ll talk a little about some of the common female hormonal complaints and basic naturopathic therapies.  As always, please feel free to email me or post a comment if you have any questions or topics you’d like to see in the future.

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