Balancing Your Hormones Goes Beyond Estrogen

Interviewer: We hear so much about estrogen and estrogen dominance. How much of a concern are other hormones in terms of their balance and things like that?

Dr. David Zava: When you talk about estrogen dominance, you're referring to what I've said before. It's too much estrogen in your body. 

Interviewer: Mm-hmm.

Dr. David Zava: It could be from lack of exercise. It could be from stress. It's how your adrenals are functioning. It can be from taking too much estrogen, exogenous estrogen from therapy. It could be from, I said diet, but too much meat, not enough fiber in your diet so the estrogen recirculates in your system. There are a number of different things. But it's not just the estrogen. 

It could be the lack of those things that balance estrogen too, which could be, for example, as I mentioned before, progesterone. 

Interviewer: Mm-hmm.

Dr. David Zava: Progesterone is needed as a balance because they're made in equal amounts throughout the menstrual cycle. So if you have a physiologic level of estrogen, you need to have a physiologic level of progesterone to balance it. 

Interviewer: Mm-hmm.

Dr. David Zava: But there are other hormones that come into play that help balance the estrogen too. Testosterone is an . . . 

Interviewer: Mm-hmm.

Dr. David Zava: . . . anti-estrogen in a sense, but it has its own important functions the body. 

Interviewer: Mm-hmm.

Dr. David Zava: So there are many different things. Cortisol and estrogen tend to be stimulating and they're working in concert. So if you're overstressed, the estrogen is going to be more the bad estrogen . . .

Interviewer: Mm-hmm.

Dr. David Zava: . . . than the good estrogen. So there are many different things. Thyroid comes into play in terms of how it regulates estrogen, because thyroid is going to stimulate the liver to make sex hormone bonding globulin that holds onto the estrogen and doesn't allow it to be as bioavailable. So if your thyroid is low, then you're going to have more problem with bioavailable estrogen. It's going to get into the tissues.

Interviewer: Mm-hmm.

Dr. David Zava: It's going to be more active if you don't have that balance. So there are many different things that are coming into play. 

Interviewer: Mm-hmm.

Dr. David Zava: It's your lifestyle and it's your own hormonal milieu. It's not just estradiol by itself. It could be some genetic component. You may have a propensity to make more estrogen out of precursors. Estrogen comes from the androgens. If you have more aromatase. If you have more fat tissue in your body, you're going to have more aromatase. Cortisol stimulates the aromatase activity in the fat tissue. So now you're eating too much. You're overweight. 

Interviewer: Mm-hmm.

Dr. David Zava: Now you have a lot more aromatase because you have more fat tissue. You're going to make more estrogen. That's why heavier set people tend to make more estrogen. Both men and women. So guys who are overweight have more fat tissue. They have more capacity to make estrogen, so their estrogen/testosterone ratio is going to change. In a guy, testosterone is here and estrogen is here. That's normal. But as we get older and we get fatter, and we get less healthy, that begins to shift. 

Interviewer: Mm-hmm.

Dr. David Zava: So we can grow breasts. We probably calm down. We're not going to be super athletes that the testosterone going to make of us. We're losing muscle mass.

Interviewer: Mm-hmm.

Dr. David Zava: We get softer. We probably get nicer. Nicer than a 16-year-old. So we can talk about the 16-year-olds . . . 

Interviewer: Yeah.

Dr. David Zava: . . . and they've got it all figured out. 

Interviewer: Oh, yeah.

Dr. David Zava: They're going to solve all the problems of the world . . .

Interviewer: Mm-hmm.

Dr. David Zava: . . . so it's under control.