To understand disorders of hormonal dysfunction, we must first understand the normal order of hormonal function. While hormonal imbalance has been around since women have experienced menopause, more women today seem to be experiencing these debilitating symptoms earlier than ever before. There are many theories for this including food additives, endocrine disruptors, environmental toxins, and increased stress and demands of our modern life.
Infant females are born with between one and two million eggs or follicles, but about 11,000 die or undergo atresia each mouth until they reach puberty at which time they are left with approximately three to four hundred thousand eggs. From becoming a teenager until menopause, there is a loss of about one thousand eggs per month. Whenever a woman runs out of eggs, her ovaries cease to produce enough estrogen and she begins to experience menopause.
During the reproductive phase of a woman’s life, her body selects one or more eggs for fertilization usually on a monthly basis. This is a complex process beginning in a portion of the brain called the pituitary that sends chemical messengers called hormones Follicle Stimulating Hormone (FSH) and Luteinizing hormone (LH) through the blood stream to stimulate the ovaries to release the egg and subsequently the hormones estrogen and progesterone.
Estrogen is dominant during the first half of the cycle and sends messages to tissues like the breast and uterine lining called the endometrium to grow. Once ovulation occurs during mid-cycle, estrogen levels drop slightly and the egg ruptures through the surface of the ovary and is retrieved by the fallopian tube to be transported to the uterine cavity. If fertilization occurs while in transit, pregnancy may occur.
Progesterone then becomes the dominant hormone blocking any further growth effect of the estrogen on the breasts and endometrium and essentially creating maturation of tissue and balancing the other adverse effects of estrogen. It also alters the endometrial tissue lining creating a succulent nutrient bed if fertilization occurs. If fertilization does not occur, the level of progesterone begins to fall around cycle day 25 causing the endometrium to slough off resulting in menstruation.
Life is all about balance and the hormonal balance of the menstrual cycle is no exception. At no time do hormones act independently under normal circumstances. Estrogen and progesterone are antagonists. While estrogen performs the valuable purpose of increasing cell proliferation, creating tissue and organ growth such as breast and uterine tissue growth and development, progesterone performs an equal or even greater purpose of inhibiting cell proliferation, balancing the otherwise uncontrolled growth effect of estrogen and differentiating (maturing) the developed tissue and organs. Uncontrolled continuous growth without balance or boundaries is the definition of cancer. A simple analogy of this process would be observing our children grow into teenagers. They may grow physically to their adult size by the time they are 16 or 18, but unless they recognize their boundaries by maturing mentally, intellectually, emotionally and socially by the time they are true adults, potentially disastrous consequences may occur.
This hormonal pattern continues throughout a woman’s reproductive life but the normal ratio of progesterone to estrogen balance begins to change after age 35. Although pregnancy is still possible, the significantly declining levels of progesterone decreases fertility explaining nature’s natural selection process which prefers to select the healthiest eggs earlier in life. Although estrogen production does decline, it does not decline as precipitously as progesterone creating a significant imbalance in favor of estrogen called estrogen dominance. Eventually, progesterone production ceases except for a small amount secreted by the adrenal glands.
The imbalance of progesterone to estrogen is further compromised by the fact that as women age, the production of estrogen switches from the ovaries to the adrenal gland and fatty tissue which converts testosterone into estrogen which further exacerbates the imbalance between progesterone and estrogen especially in women who become overweight. This resulting estrogen dominance can lead to many of the symptoms women experience later in life including increasing the risks for breast and uterine cancer, decreasing emotional stability, increased breast tenderness, menstrual bleeding disorders, altering brain function, and decreasing energy, sleep, and libido.