~Female Hormone Modulation, Part 5

Hormone Modulation: Supportive Lifestyle and Nutrients

Every hormone discussed in this protocol is influenced by both environmental and nutritional factors.

The following are some of the most important factors:

  • Stress: There are strong correlations between excessive stress and problems such as adrenal insufficiency, lack of menstrual cycle, PMS, vaginitis, urinary incontinence, bone loss, and infertility.
  • Smoking: The link between cancer and smoking is well documented. Less well known is connection of smoking with bone loss, cervical dysplasia, and miscarriage.
  • Exercise: The obvious connection of exercise is to osteoporosis, but lack of regular exercise plays a role in adrenal disease, cardiopulmonary disorders, loss of libido, and menstrual problems, as well as leading to insulin resistance and consequent diabetes and/or weight gain, which results in more estrogen dominance.
  • Obesity: Some menstrual disorders are more often found in overweight women. In fact, a diet that lowers body fat may lower estrogen levels as well.
  • Nutrition: The following are some areas in which dietary supplements play an important role in the development and treatment of hormonally related diseases:
    • Vitamin E: Research at Johns Hopkins Medical School demonstrated that 600 IU/ day of vitamin E raised both estriol and progesterone levels in a group of women with fibroid breast disease. Both estriol and progesterone help to protect against estrogen's possible tumor-creating effects (London et al. 1981).
    • Calcium, magnesium, and vitamin D3: Women should supplement their diet with at least 1000-1500 mg of elemental calcium in the form of calcium citrate or calcium bisglycinate to ensure the best absorption, 400 mg of elemental magnesium, and 400 IU of vitamin D3 daily. A product such as Bone Assure contains the necessary amounts of these nutrients. For more information on this topic, please refer to the Osteoporosis protocol.
    • Antioxidants: The addition of such antioxidants as vitamin C, vitamin E, CoQ10, grape seed-skin extract (proanthocyanidins), and alpha-lipoic acid may be of great assistance when preventing a number of the disorders in this protocol, including cardiac problems and cancers.
    • Fats: Diets high in saturated fats lead to heart disease, cancers, and an imbalance in the eicosanoid hormones (an important factor in fibroid cysts). In contrast, diets high in essential fatty acids help to balance eicosanoids. Omega-3 essential fatty acids are unsaturated fats from cold water fish (e.g., salmon, tuna, mackerel, and herring) and perilla and flaxseed oil. Evening primrose and borage oil provide gamma linolenic acid (GLA), an important anti-inflammatory fatty acid. A good portion of your diet should come from soybeans. Other links to eicosanoid imbalance include uterine cramps, pelvic pain, and breast pain. Supplements are available that provide both the essential fatty acids from fish oil (DHA-EPA) and GLA.
    • High-potency B-complex vitamins: Various B vitamins have been examined by researchers. Abraham (1983) found vitamin B6 to be helpful in reducing menstrual cramps. Mills et al. (1999) showed that in women with endometriosis, supplementing the B-complex group produced a significant decrease in symptoms.
    • Bioflavonoids: Supplements of this member of the vitamin C complex appear to actually inhibit excessive estrogen synthesis (Kellis et al. 1984).


The need to modulate the relative levels of the primary female hormones is of critical importance throughout life. Proper hormone replacement therapy not only alleviates menopausal symptoms, but also helps prevent common disorders such as PMS, endometriosis, several types of cancer, sexual dysfunction, fibroid tumors, osteoporosis, and possibly Alzheimer's disease. Many diseases are linked to either excessive or deficient estrogen levels, particularly compared to the amount of progesterone available. Not only should hormones be modulated regularly, but natural sources for hormone supplementation should be used. Synthetic and nonhuman analogue hormones carry with them unwanted, even deadly, side effects. Hormone modulation requires individualization and works best when carefully monitored through laboratory testing. Both lifestyle and nutritional variables play an important role in hormone modulation.

Estrogen is an antiaging hormone that provides many beneficial effects throughout the body. However, the major drawback to conventional estrogen replacement therapy is the increased risk of certain cancers, and in combination with conventional progestin, estrogen may increase the incidence in heart disease. FDA-approved estrogen drugs have other adverse side effects that preclude many women from effectively using them. Natural plant extracts provide the body with safe and possibly more effective estrogen replacement.

Menopause is not just an estrogen deficiency. Numerous hormone imbalances threaten the health of menopausal women. The published literature has identified several plant extracts that favorably modulate hormone balance in aging women.

The decline in progesterone production is correlated with increased bone loss and increased risk of cancer. Many of the effects associated with normal aging can be attributed to a progesterone deficiency; therefore, progesterone replacement therapy may be another missing link to solving the human aging process. The beneficial effects of natural progesterone have now been shown in women and men. Progesterone protects against many of the detrimental changes of aging, and the only downside is that too much can cause sleepiness or even euphoria. Please note that it usually takes 2-4 weeks for topically applied progesterone to build up to sufficient levels in the body to cause noticeable effects.

Individual symptomatic improvement and blood analysis of estrogen, progesterone, testosterone, prolactin, luteinizing hormone, and follicular stimulating hormone (FSH) by a physician can help determine how well natural hormone modulation therapy is working.

The proper intake of hormone-modulating plant extracts, phytoestrogens, DHEA, natural progesterone, and other natural hormones may provide significant health benefits to the aging female.

A woman approaching menopause or postmenopause should consult her physician before commencing any hormone replacement therapy program. The following nutrients, drugs, and blood tests can be taken to restore hormone balance in aging women or women with symptoms of an imbalance:

  • Natural Estrogen (multi-ingredient phytoestrogen formula containing soy isoflavones, black cohosh, licorice root extract, Dong Quai, and vitex extract): Take one capsule, two times daily.
  • DHEA: Take one 15-mg or one 25-mg capsule daily in the morning on an empty stomach. Some women may require 50 mg each morning. Refer to the DHEA Replacement Therapy protocol for specific information.
  • Soy extract: Take one 135-mg (40% isoflavones) capsule twice daily. This is not required if Natural Estrogen is taken.
  • Melatonin: Take 300 mcg to 6 mg only at bedtime.
  • Indole-3-carbinol (I3C): Take 200 mg, twice daily. Women weighing over 180 pounds require higher amounts.
  • Vitamin E: Take 400 IU daily along with a supplement that provides at least 200 mg of gamma tocopherol.
  • Vitamin C: Take 2.5-6 grams daily as a prophylactic dosage.
  • Vitamin D3: Take 400-1500 IU daily.
  • Vitamin B complex (including folic acid): Take three capsules of Life Extension's Complete B Complex daily in divided doses.
  • Alpha lipoic acid: Take two 250-mg capsules early in the day.
  • Calcium: Take 1000 mg daily; magnesium: take 400 mg daily in a combined dose to prevent bone loss.
  • Ipriflavone may be considered to prevent bone loss in a dose of 200 mg, 3 times daily.
  • CoQ10: Take 100-300 mg daily (those over 40).
  • Essential fatty acids help to maintain eicosanoid balance and healthy hormonal receptor sites. Omega-3 and omega-6 essential fatty acids from cold water fish and plant derivatives should be considered as follows:
    • Omega-6 fatty acids providing at least 900 mg daily of gamma linolenic acid may be obtained from borage oil or evening primrose oil.
    • Omega-3 fatty acids may be obtained from perilla oil, 6000 mg daily, or flaxseed oil, 6000 mg daily. Super EPA/DHA contains an omega-3 formulation rich in EPA and DHA from fish oil concentrate.
  • Consider estriol, Bi-est, or Tri-Est drugs if menopausal symptoms are not alleviated by nonprescription therapies. Blood or saliva testing may also indicate the need for additional estrogen or proges-terone. Blood or saliva testing after 60-90 days is mandatory to verify that you are taking the proper dosages. These drugs are available from compounding pharmacies, but require a physician prescription.
  • Blood, saliva, or 24-hour urine tests can evaluate a woman's need for modulation of hormones such as estrogen, progesterone, testosterone, DHEA, etc. Testing can greatly assist a knowledgeable physician in balancing a woman's hormone profile. These tests can be ordered by calling 1-800-208-3444.
  • The 2/16a Estrogen Metabolite Ratio urine test measures the ratio of 2-hydroxy- to 16-hydroxyestrone (2/16). Only one urine specimen is required and the results come with an interpretation, such as consuming indole-3-carbinol and eating more cruciferous vegetables if levels of the bad estrogen metabolite (16a-hydroxyestrone) are too high or if levels of the good estrogen metabolite (2-hydroxyestrone) are too low. The optimal time to measure the 2/16a ratio is in the follicular or preovulatory phase of the menstrual cycle (Bradlow et al. 1995a,b, 1996) To inquire about this simple urine test, call (800) 208-3444.

Editor's note: Significant portions of this protocol were contributed by Michele Morrow, D.O., F.A.A.F.P. and Edward Leyton, M.D.

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