A woman’s concerns about her endocrine health will be on her mind each month from age 12. Indeed, hormonal cycles will always lead to a complex symphony of what we consider women’s health. Nevertheless, nutrition compounds often play the part of building blocks of the orchestra conductors called hormones. Therefore, if one is the other’s precursor, there must be a combination that leads to a harmonious symphony.

A woman’s health is a barometer of her environment. It is modeled and shaped according to her evolution in the womb and the social, cultural, and ecological environment of her childhood. – Dr. Mark Hyman.

Women’s health

Women’s health and endocrine function are complex. Indeed, women are commonly exposed to many symptoms that they already grew accustomed to them. On the contrary, functional medicine experts are trying to change the idea and realizing that these symptoms are related to chronic low-grade inflammation, an unhealthy diet, stress factors (uncontrolled stress hormones and their effects), and lack of exercise are triggers of these phenomena. Besides, they conclude that women can make a small shift in the lifestyle that will promote hormonal balance and improve their quality of life.

 

Common symptoms and risk factors

Premenstrual syndrome – Monthly weight fluctuation – Edema, swelling, puffiness, or water retention – Feeling bloated – Headaches – Mood swings – Tender, enlarged breasts – Depression – Feeling unable to cope with ordinary demands – Backache, joint or muscle pain – Premenstrual food cravings (sugar or salt)

• Irregular cycles, heavy bleeding, light bleeding • Infertility • Use of birth control pill or other hormones • Premenstrual migraines

• Breast cysts or lumps or fibrocystic breasts • Family history of breast, ovarian, or uterine cancer • Uterine fibroids • Peri-menopausal or menopausal symptoms

– Hot flashes – Mood swings or depression or anxiety – Night sweats – Insomnia – Loss of libido or sex drive – Dry skin, hair, and vagina – Joint pains – Palpitations – Trouble with memory or concentration – Bloating or weight gain around the middle – Facial hair

• Exposure to pesticides (food, water, air)

Hormone synthesis:

It is fundamental to know that women’s hormones are synthesized through their main precursor, Testosterone that is dependent on cholesterol. Indeed, this last information confirms that diet contributes to the formation, receptor activity, and detoxification patterns on hormonal metabolism.

As stated above, estrogen synthesizes from testosterone. This synthesis is part of a complex metabolic route in which enzymes are dedicated to aromatase, oxidize, reduce, sulfonate, hydroxylated, and methylate to provide estrogen function and structure. The term estrogen refers to the 4 known types of estrogen:

Types of estrogen:

• Estrone (E1).
• Estradiol (E2).
• Estriol (E3).
• Estretol (E4).

In their synthesis route, Estrone and Estradiol are formed from testosterone and androstenedione with an enzyme called aromatase. Additionally, they can E1, and E2 can be interconverted via 1 7B- hydroxysteroid dehydrogenases. On the other hand, estriol is synthesized by estrone via Cytochrome P450, which first forms 16A-hydroxyestrone and becomes estriol. Estrogen can also be stored in some tissues as estrone sulfate, estrogen sulfotransferase, which catalyzes this action. Finally, estrogens are first hydroxylated and then sulfated and glucuronidated to be eliminated from our body.

 

 

Nutrition and Diet:

Past studies have shown that diet plays an essential role in the modulation of estrogen synthesis. Conversely, the commonly reported hyperinsulinemia in patients with hormonal disturbances, promotes testosterone production and reduces sex hormone-binding globulin. Besides, alcohol has been associated with low estrogen detoxification, which increases the risk of developing breast cancer. On the contrary, the ingestion of a high fiber diet can reduce unconjugated estrogens and enterohepatic circulation.

Conversely, a reduced glycemic load diet is recommended to balance hormone levels. The combination of this diet with N-3 fatty acids is found to elevate hydroxylation estrogen, promoting its elimination. Also, probiotics supplementation shows a strong association with reducing B glucuronidase-producing bacteria leading to a production of enterolactones.

An overload of estrogen can lead to different kinds of cancers. This is associated with a decrease of 2-OH estrogens. Indeed, for estrogen to be metabolized and excreted, they have to be hydrolyzed at -2, -4, and -16 carbon position. Afterward, this hydroxylation allows this compound to be sulfated and glucuronidated, and ready to be excreted.

Phytonutrients and antioxidants:

Nevertheless, the integration of cruciferous vegetables to the diet has shown an impactful effect, increasing the hydroxylation at the -2 carbon. Furthermore, foods like legumes, clover, flax seeds, seed oils, vegetables, and kudzu root containing high levels of phytonutrients and soy isoflavones can improve the hydroxylation -16 carbon. In addition to their hydroxylation benefits, soy isoflavones modulated the action NF-kB. This translated to reducing IL-16 expression and therefore prevented tumorigenesis associated with breast, colon, prostate, lung, and ovary cancers.

Curcumin increases the action of glutathione and glutathione S- transferase. Conversely, this increase of glutathione reduces the oxidation of catechol estrogen that can potentially turn into quinones.

Women’s hormonal health depends greatly on hormonal balance. Different environmental factors can mediate a hormonal imbalance, which allows us to treat them from different points of view.  As a woman, I rather think about hormonal disbalance as the way that Dr. Hyman explains it: hormones are the birds in the coalmine, modulators in our body. Therefore, if something is wrong with the bird, we have to look at the environment and change, prevent, and modulate the factors that affect it. Indeed, women’s endocrine health can be strongly modulated by the nutritional improvement of their diet, physical exercise, and stress management. Use this as a guide to include new foods and supplements to improve your health outcomes and look for professional guidance. The partnership between healthcare professionals and patients will provide an extra layer to the patient’s support system.- Ana Paola Rodríguez Arciniega. Master in Clinical Nutrition

Thomas, Mark P., and Barry VL Potter. “The structural biology of estrogen metabolism.” The Journal of steroid biochemistry and molecular biology 137 (2013): 27-49.

Hyman, Mark A. “The life cycles of women: Restoring balance.” Alternative therapies in health and medicine 13.3 (2007): 10-17.

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