Coined from the Greek term ‘to egg on’, hormones have always played a central role in how we feel and how we respond to the world around us. Although a number of hormones can affect our physical appearance, excess estrogen stands out as the only hormonal imbalance that can be seen from a distance. In this regard, I refer to the commonly-seen ‘pear shape’.
Estrogen, often dubbed the ‘female hormone, is responsible for the difference in shape between men and women. Particularly active during puberty, it triggers the growth of breast tissue as well as sealing the epiphiseal plates, which halts bone growth (explaining the average height differential between men and women). However, it is also active in adulthood and, when in excess, can cause increased fat storage.
This fat storage occurs most prominantly in estrogen-sensitive areas: beneath the arms (“bingo wings”), around the buttocks and the thighs. As you might imagine, this results in the ‘pear-shape’ whereby the lower half of the body is much weighter than the top. It is fair to assume that every women who notices this pattern is suffering from estrogen dominance.
Naturally, this sounds like estrogen is an evil plague, afflicted on humans to give them difficulty finding dresses that fit. This is an unfair slight on the hormone, which provides a number of beneficial effects. Estrogen is responsible for the expression of excitatory neurotransmitters in the brain, explaining why the average woman can multitask more effectively than her male counterpart, and sensitizes the brain to the effects of dopamine and serotonin. These neurotransmitters are important for feeling good and maintaining a sense of calm, respectively. If their action is blunted, the woman will not feel motivated during the day and will not get good sleep at night. Beyond that, estrogen also exerts a cardioprotective effect and supports bone health.
Clearly, it’s not a bad hormone, simply bad in excess. And while fat retention at the thighs invariably causes concern, this is not the only issue associated with estrogen dominance. When this hormone is unopposed by progesterone, the risk of estrogen-sensitive issues such as endometriosis, fibrocystic breasts and some cancers (mainly breast and uterine) are increased. Problems such as PMT are almost guaranteed, while poor sleep and migraines are more likely. This is why many (but not all) pear-shaped women will also notice heavier and more painful periods, PMT and bloating before their period is due, spots, irritability and poor quality sleep (although, if this has always been the case, most will not actually be aware of the latter two).
It’s clear that excessive estrogen is worth addressing. The first step is to get your hormones tested. The test I most commonly order is a blood test for the most potent estrogen, estradiol, alongside other heavyweight steroids such as progesterone and testosterone and well as SHBG (sex hormone binding globulin). It’s vital that you measure this last one as this liver protein holds onto the steroids in the bloodstream and stops them from running amok; if this is not measured, you have no idea how much of the hormones are ‘free’ to actually affect the cells. I also suggest that you undergo this test in the luteal phase of your cycle (typically days 13-27), where imbalances are more obvious. The test should set you back less than £100.
The results of the test will let you know what you are dealing with. Sometimes, it is a case of estrogen being too high, like this:
There are other times, a lack of progesterone is the root cause, in which case the results will look more like this:
Sometimes, they are both low which allows small fluctuations between the menstrual cycle to reak havoc. Differing levels of testosterone and sex hormone binding globulin will also contribute to the situation. Obviously, these different situations will require different treatment. Occasionally, the progesterone status looks good in the bloodstream but is negatively affected by low thyroid action; thyroid hormones are required to activate progesterone receptors.
(The above results are from case studies published previously. Click here to see the two case estrogen dominance case studies).
Only when you have the results of this test should you take action. It’s vital you do not embark on self-treatment before doing so. I know plenty of women who have plunged straight into progesterone treatment without testing; sometimes this works well, other times is works very badly. In any case, you do not want to be crossing your fingers and hoping when it comes to hormones.