Why Tackling “Estrogen Dominance” is Key for Endometriosis (+ How To Support via Diet)

Endometriosis is a painful condition where the tissue that is similar to the lining of the uterus tissue grows in other parts of the body, leading to symptoms like extreme period cramps, leg, hip, and sciatic pain, heavy bleeding, GI discomfort like bloating, infertility and much more. One significant factor seen in the presentation of endometriosis is estrogen dominance. Estrogen stimulates endometrial growth, period – which is why an overabundance of this hormone leads to the painful tissue growth that occurs outside of the uterus.

Estrogen dominance is a hormonal imbalance that occurs when levels of estrogen in the body are higher than they should be (either alone in the context of normal progesterone, or in comparison to low levels of progesterone) and “dominate” the delicate estrogen:progesterone ratio. 

1. For some women, estrogen itself is simply too high, even though their progesterone levels are just fine. 
2. For others, estrogen is in the normal range, but it is still “dominant” as their progesterone levels are far too low. 

It’s important to know where you fall within this framework so that you may either:

(a) support your body in its metabolism and detoxification of estrogen and/or limit your exposure to “xenoestrogens,” or 

(b) support your body in making more progesterone, whether by eating and supplementing nutrients known to support progesterone production (like Vitamin C and B6), or by managing stress via lifestyle and adaptogenic botanicals that free up the body’s resources so that normal progesterone production can resume.

A functional lab test, such as the Dutch Test, can give you a full picture of your estrogen and progesterone levels via urine sample, which is far more comprehensive and accurate than a traditional blood test where levels often falsely appear ‘normal.’

WHAT CONTRIBUTES TO ESTROGEN DOMINANCE?

1. External factors, like exposures to the “xenoestrogens” mentioned above, can contribute to estrogen dominance. These xenoestrogens, or ‘false estrogens’ are not true hormones but rather estrogen mimicking compounds which are not produced by our body. These compounds mimic the structure or function of our very own human estradiol (E2) and bind to our estrogen receptors with varying degrees of strength. We’re usually exposed to them through our air, water, or food supply, and the major players include pesticides, heavy metals, and especially plastics. Food packaged in plastic or water sitting in plastic for long periods of time pose the greatest risk, and are most important to avoid. While it may be challenging to avoid all sources of xenoestrogens, being mindful of product choices, such as using organic tampons and minimizing exposure to environmental toxins, can help reduce the overall estrogen load.

2. Internal factors related to estrogen dominance include sluggish liver detoxification, which can stem from inadequate intake of protein, fiber, and essential micronutrients required for phase II detoxification. Because part of the liver’s job is metabolizing and excreting excess estrogen (via bile, then ultimately the bowels), it needs adequate amounts of highly specific nutrients and amino acids to be able to properly perform this important function. 

Nutrients and amino acids required for healthy phase II liver detoxification include glycine, glutamine, choline and inositol (found in protein such as meat, bone broth, egg yolks, and foods like blueberries and cantaloupe). Cruciferous vegetable intake is also key, as they contain sulfur metabolites that fuel our liver’s sulfation pathway. Adequate protein intake in general cannot be stressed enough, as this is where we get the majority of amino acids that not only help the liver with phase II estrogen metabolism, but also help the liver make its master antioxidant, glutathione. Certain herbs can also support phase II liver detoxification, such as Milk Thistle, Dandelion Root and Burdock Root.

Once the liver is supported with adequate nutrients for detoxification, there must be enough fiber consumed in one’s diet to ensure any estrogen released thanks to the liver and gallbladder via bile, has something to bind to in order to be safely escorted out of the body through the bowels. If there’s not enough fiber present in the digestive tract, and bile containing estrogen (and other toxins) is released into the intestines, those toxins will have nothing to cling onto and ultimately be reabsorbed through the intestinal wall, only to add an extra load to the liver and be processed once again. Alternatively, if fiber intake is adequate (at least 25g/day for women), toxins and hormones like estrogen released via bile have something to cling onto and essentially ‘ride’ out of the body through bowel movements. Fiber and liver detox-supporting herbs and nutrients go hand in hand, and when implemented together, make a world of difference.

Ultimately, supporting the liver’s vital estrogen-metabolizing function through a nutrient-rich, fiber and protein-rich diet, plus incorporating liver-supporting herbs like Milk Thistle and Dandelion Root can help promote proper hormone elimination.

MORE ON FIBER

Foods rich in fiber, such as legumes (beans), flaxseeds and chia seeds, all aid in eliminating excess hormones from the body through the stool. When enough fiber is present in the gut, toxins and estrogen released through bile have something to latch onto and can be safely excreted, reducing excessive estrogen levels. Including these fiber sources in your diet is one of the easiest and quickest things you can do to reduce estrogen dominance. These fiber-rich foods also increase gut microbiota diversity and feed healthier gut bacteria over time. One of our favorite ways to sneak a solid dose of fiber into meals or as a snack is Olivia’s High-Fiber Chia Pudding linked here.

Additional helpful dietary strategies include:

• Eating more fermented foods such as sauerkraut and kimchi to help rebalance the gut microbiota and increase bacterial diversity.
• In addition to eating your probiotics, take a probiotic that contains Lactobacillus strains. Lactobacillus acidophilus, for example, can help crowd out the bacteria that produce beta-glucuronidase and ultimately reduce estrogen recirculation. Our probiotic formula is rich in Lactobacillus strains, as well as enzymes and prebiotic fiber that promote a healthier gut environment.
• Consume prebiotic foods such as asparagus and plantains (green bananas) that are rich in fructo-oligosaccharides or inulin. These foods feed your good bacteria, increase your gut diversity, and again – help crowd out the ‘bad guys.’
• Bump up the cruciferous veggies such as broccoli, cauliflower, cabbage, and kale. The liver’s phase II detoxification pathway called the ‘sulfation’ pathway requires sulfur-rich foods in order to function properly and metabolize various toxins and hormones. And of course, these foods are also rich in fiber for our beneficial gut bacteria.

KEY HERBS TO INCLUDE IN YOUR DIET

The liver is responsible for metabolizing and detoxifying excess hormones like estrogen from the body. Many women with endometriosis are estrogen dominant, meaning they have excess estrogen levels in relation to progesterone. Liver-supporting herbs like Milk Thistle and Dandelion Root found in Liver Juice can be supportive for both phase I and phase II detox pathways. Limiting your exposure to xenoestrogens found in things like plastics and pesticides is also important to reduce the burden on your liver. 

Pro Tip: Take your liver-supporting herbs, such as Liver Juice, 30 minutes after eating a healthy serving of fiber-rich foods. Because herbs like Dandelion Root activate our detoxification pathways and prompt bile release, the timing works out to your advantage. With fiber readily available in your intestines, the bile will readily have something to bind to!

To learn more about other root causes of estrogen dominance and how to support your body in detoxing excess hormones, click here for a deeper dive into endometriosis.