Estrogen Dominance Symptoms
Worse with TCM herbs

by Tiffany

Hi Amelia,
I believe that my estrogen dominance symptoms are worse since I started TCM herbs. Back in early December of 2010 I did another "Ask Amelia" titled "Questions About Me, My Acupuncturist, and Herbs". Basically, you had stated because of the extreme stress I had undergone and my symptoms that I had estrogen dominance. It may help you to read that over so that I'm not repeating myself again.

Basically, I again wanted to get your input on my problems I am still experiencing. I am still continuing with the acupuncture and have recently been off all my herbs for about 3 weeks. Weirdly, my estrogen dominance symptoms that include spotting, cramping, and breast tenderness have gotten worse since taking the herbs - meaning instead of the spotting/cramping and having the breast tenderness about a week before I start my period, I am now experiencing these symptoms much sooner. Instead of experiencing my symptoms about 7 days before my period starts, I am now experiencing them 10-12 days beforehand. In addition, I started growing this "peach fuzz", including a few course hairs around my chin area. I have NEVER in my life experienced ANY abnormal facial hair.

I have informed the TCM herbalist about these estrogen dominance symptoms worsening. The only reason I can come up with is that some of the herbs that may contain estrogen. The herbalist has informed me that they really don't look at hormones in TCM, which makes me wonder???

I am still "stressed", probably more emotionally stressed than anything, especially since my symptoms have gotten worse, which is probably not helping my situation. I have also been told and have read that if your liver (the organ itself) is "congested" from stress, toxins, etc., it can cause hormonal imbalances such as the ED that I am experiencing. If my liver isn't metabolizing the excess estrogen that I am producing (possibly from stress, and then adding these estrogenic herbs, my symptoms become worse.

I mentioned in my previous "Ask Amelia" question that I already eat a clean diet which contains whole grains, greens, chicken, etc. which contain no pesticides and no hormones. I will say to that the my acupuncturist has diagnosed me with a bad liver qi stagnation along with a few other things. From the way he explained it, my liver energies were stagnated. After a while of this continuing without correcting this stagnation, it can eventually affect the function of the actual liver, even though your "liver function blood test" can come back "normal". What do you think about all of this?

I wanted to ask you as well about your response in my previous question. You had stated that my ovarian cysts are the follicles that are continuing to develop post ovulation. I am questioning if that means that I AM OVULATING, (which according to my basal body temperature, I am ovulating. I wanted to also mention that before I started with my herbs about 9 months ago, my temperature would rise after ovulation, but would go way down once the spotting/cramping started that exact day (about 7 days before I started my period). Now, when the spotting/cramping begins, my temperature continues to stay elevated until about 1 day or sometimes even the day that I start my period, it will drop down.

I'm confused about this. I don't understand why my temperatures are staying elevated until towards the time my period starts, but I'm still having the cramping/spotting? I thought I wasn't producing enough progesterone, hence the body temperature declining early, but now it stays elevated almost the entire luteal phase? Could you explain this? Also, wanted to mention that my temperatures during the follicular phase is between 97.2-97.5, then jumps to 98.2 after ovulation. During the luteal phase it fluctuates from 98.1-98.5, but usually stays at 98.2 most days.

I also wanted to give you a quick run down of what I usually experience each cycle. I do get the "egg white cervical fluid" around ovulation, and since all this hormonal imbalance, I started to experience tenderness (not pain) around the nipple area. This continues and increases in tenderness all the way up until my "entire" breast tenderness, spotting, and cramping starts.

Once all that starts, the tenderness in the nipple area slowly fades away, then the breast area tenderness starts. What is this nipple tenderness...part of the hormonal imbalance? Also, I feel like I can sometimes feel ovulation (like a very dull ache) for several days BEFORE ovulation and I think it's going to stop after ovulation, but it continues. Are these the "cysts" that keep growing??? And, I just don't understand why these follicles continuing to grow? Is it because (like you stated previously) I'm not making a strong dominant follicle, which again brings me to the above question...am I ovulating, even if my temperatures rise after "ovulation"???

I apologize for all the info, and realize that I have questions "scattered" throughout. If you could please answer all these questions I would greatly appreciate it. I think that if I can understand what's really going on with me, I can start to "heal", especially emotionally. It's the "unknown" that causes me even more stress. I just can't understand why this is continuing, and have done everything to try to get rid of this ED, including exercise, etc. Can me being so emotional depressed/stressed over this keep me from fixing this issue, in addition to what I mentioned about my liver qi stagnation?

One last thing to mention to you is that I recently saw a homeopath doctor who doesn't specialize in fertility, but is checking my hormones again to see where I'm currently at since my symptoms are worse. I don't see him until about 2 weeks from yesterday regarding the results. If there is something that comes back really out of whack, can I just "reply" to this "Ask Amelia" to update you?

Thanks,

Tiffany

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Worse with TCM herbs

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Estrogen Dominance Symptoms - Part 1
by: Amelia Hirota

Hi Tiffany,
I'm sorry to hear about the worsening estrogen dominance symptoms. Estrogen dominance (ED) basically means that excess estrogen is being secreted during the luteal phase. Hormonal balance in menstruating women is when estrogen is dominant to progesterone during the follicular phase and progesterone is dominant to estrogen in the luteal phase. In your case, the ED symptoms that you're experiencing from just after ovulation until the period tell us that there is too much estrogen in the luteal phase.

The peach fuzz and course hairs on the chin are usually due to excess testosterone, which often coincides with ED and with PCOS.

Some herbs can be phytoestrogenic and this can be fine if they are properly prescribed. Soy is an example of a phytoestrogenic food. In TCM, we sometimes think of Yin tonics as herbs that support the production of estrogen by the body. These herbs are often given during the follicular phase to support egg recruitment and cervical mucus production.

In your case, I think that addressing the hormonal imbalance directly may be the best idea. I think that you need to work with a practitioner that speaks your language and addresses what is going on in your body. Some acupuncturists and herbalists are not trained to understand female hormones in a Western sense. I think that you would be better served to find someone that has this training, since the TCM herbal approach hasn't seemed to help your condition.

Liver Qi Stagnation often accompanies ED and can result from stress. If left untreated, Liver Qi Stagnation can cause multiple problems down the road, so I do agree with your acupuncturist about this. The liver has to be severely compromised for elevated liver enzymes to come back on a blood test. It sounds like your acupuncturist is trying to prevent this from happening.

The only way to definitely test if you're ovulating or not is to have your progesterone tested 6 days after ovulation. This is a 6 DPO (days past ovulation) test. Some doctors just call it a Day 20 progesterone, because it's often assumed than all women ovulate on Day 14. If the value is over 3, you have ovulated. A good level of progesterone that would support pregnancy is over 10. Therefore, a number under 10, but over 3 indicates that ovulation has occurred, but that there is a progesterone deficiency.

From your BBT, it sounds like the Chinese herbs have improved the quality of your luteal phase and hence, progesterone production. We want to see temps immediately rise after ovulation and then remain high until the period comes. I'll continue my answer in Part 2.

Sending Healing and Peace,
Amelia Hirota

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Estroen Dominance Symptoms - Part 2
by: Amelia Hirota

Hi Tiffany,
You're right in your observation of the contradiction between your improvement in lasting high temperatures up to the period and the earlier onset of the cramping and spotting. I can't know for sure, but I would assess this as the herbs helped make a better corpus luteum, but ongoing development of follicles into the luteal phase created ED. And this is why I'm using less Chinese herbs in my clinic these days when ED is the primary culprit. Chinese herbs are great at tonifying Yang and improving progesterone production during the luteal phase, but I don't find them helpful when ED is presenting. By the way, your temps are great! I like to see the luteal temps break through 98.0.

From your temps and your symptoms, I would guess that you are ovulating, but you're not ovulating a dominant follicle that has the 2 necessary attributes necessary for conception to take place successfully. First, you want your dominant follicle to cause the remaining follicles to break down and stop secreting estrogen. Secondly, you want to make a good quality corpus luteam that secretes adequate amounts of progesterone.

Breast and nipple tenderness happen for a number of reasons. In early pregnancy, the breasts are getting ready for nursing and as the ducts are opening up, the breasts can feel especially tender. In ED, the excess estrogen stimulates the estrogen receptors in the breasts and this creates tenderness. Also, excess prolactin can cause breast tenderness. Excess prolactin is associated with elevated testosterone and PCOS.

Stress more than likely is at the root of some of these issues. When the body is stressed, the steroid hormones are shunted from the reproductive pathway to the adrenal stress pathway. The body preferentially deals with the stress by secreting cortisol and adrenaline and this is at the expense of making good reproductive hormones.

If I can give you a little advice, I would strongly recommend a daily meditation practice. Also, the book, The Presence Process by Michael Brown includes a daily breath work practice that I find incredibly helpful with my fertility patients. Adding cooked cruciferous vegetables like cauliflower, broccoli, kale, cabbage and brussels sprouts to your diet will help to clear the estrogen metabolites from the gut that contribute to estrogen dominance. Lastly, I would work with a practitioner that is well versed in female hormones and can communicate clearly with you. I feel your pain and frustration. Please feel free to reply to this post and update us on your progress.

If you haven't signed up for my newsletter yet, I recommend that you do so soon, as I'm launching a number of helpful programs.

Sending Healing and Peace,
Amelia Hirota

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Hormone Panel Results
by: Tiffany

Hi Amelia,

I informed you that I recently had a hormonal panel done and fortunately was able to retrieve the results sooner than expected. I wanted to add this info to my original "Ask Amelia" question, but obviously they were not completed at the time.

Anyway, I had the below tests done on day 23 (7 days past ovulation) of my cycle. I most likely ovulated on the 16th day of my cycle. (I realize that most tests are done on day 3, with the exception of the progesterone and possibly a few others, but the Dr wanted to see where my numbers fell at this point. Below, I will give you the result and the labs reference range.

DHEA 280 (31 - 701)(Oddly, this came down from 939 to 280 in only two in a half years.)

TESTOSTERONE 38 (8 - 48)

LH 4.7 (1.0 - 11.4 for luteal phase)

FSH 1.9 (1.7 - 7.7 for luteal phase)

PROLACTIN 17.2 (4.8 - 23.3)

PROGESTERONE 8.1 (1.7 - 27.0 for luteal phase) *I know, this is low.*

SEX HORMONE BINDING GLOB. 89.6 (26.1 - 110.0 for
17 - 50 years of age)

FREE ANDROGEN INDEX 1.5 (0.4 - 8.4)

ESTRADIOL 251.8 (43.8 - 211.0 for luteal phase)

TOTAL ESTROGENS 312 (156 - 350 for cycle days 21-30)

Thyroid panel all came back within normal range.

I wanted your opinion on the results and to see if they coincide with your conclusion about the spotting/cramping that I am experiencing in my luteal phase, hence the ED.

I'm pretty sure most of this is all related to the extreme stress that I experienced a few years back and still going through, since I've never had problems with my cycles before all this. I have also been diagnosed with adrenal fatigue in the past too.

I'm just really wanting to know if this spotting/cramping I experience before my period is mainly do to the ED? It feels like I'm always "getting ready" to start my period once this starts about 4-5 days into the luteal phase, but it doesn't come until about 14 days after ovulation.

Thanks so much for your input.
Tiffany







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Hormone Panel Results
by: Amelia Hirota

Hi Tiffany,
Thanks for adding your hormone panel results. Overall, the hormone values look good. I really find that salivary panels that are done throughout your cycle give us the best overall view of what is going on hormonally. Blood tests that are done on one day only give us a snapshot of the entire menstrual cycle with its intricate dance of hormones.

Your DHEA may have been high before when you were having acute stress. With prolonged stress, DHEA becomes depleted and this may be why you're 280 now.

Yes, the progesterone is a little low at 8.1. You've ovulated, but your corpus luteum wasn't producing a lot of progesterone this cycle. This makes it easy for slightly elevated estradiol levels to overtake progesterone in the luteal phase. Your estradiol level of 251.8 is slightly elevated and combined with the 8.1 progesterone level indicates probable estrogen dominance.

I agree with you that the extreme stress that you experienced is what threw your cycles out of balance. The body will preferentially deal with stress by attending to the adrenals at the expense reproduction. Finding effective stress management techniques, sleeping at least 10 hours a night and nourishing your body and your adrenals will help to bring your adrenal glands back to optimal function.

The adrenal glands are the foundation of the endocrine system and they are paramount in conception, pregnancy and labor.

Tiffany, be sure to sign up for my Newsletter. My educational video series will be coming out soon. I think that you'll be interested in the Diagnostic Testing Video, where I'll be explaining salivary hormone testing and hair tissue analysis. These are the diagnostic tests that I use in the clinic.

I really admire your perseverance in getting down to your personal diagnosis. I wish you the very best in your quest for a healthy pregnancy. Please let us know when you're successful.

Warmest regards,
Amelia

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Can you still ovulate without making a dominant follicle?
by: Tiffany

Hi Amelia,
This question is in regards to the previous post. (I'm sorry, but wasn't sure if I could add a comment/question to the response who have given me a while back ago, or if I needed to purchase a new question.) If so, just let me know.

Anyway, you had stated in this post that it sounded like I wasn't making a 'dominant follicle', which was possibly causing the ongoing ovarian cysts or follicles to continue to grow, hence the spotting and cramping. My question is...does that mean that if you DON'T make a dominate follicle, you DON'T ovulate? Can you still ovulate without a dominant follicle?

I definately see a rise in my temp mid cycle (assuming I ovulated - although I know I don't ovulate every month). I ask because my hormones are finally getting back in balance, and my temps stay high throughout the luteal phase, but the cramping/spotting is still there, but not as bad.

The way I understand your post is that it's possible that the ovarian cysts are causing my symptoms, in which I'm still trying to dissolve naturally. So far, it is getting better, but I assume it can take awhile for multiple cysts to diminish.

Thanks in advance, and like I said, just let me know if you want me to 'purchase' a new question.

Thanks!
Tiffany


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Liver, Estrogen Metabolites and Stress
by: Edie

Acupuncture and herbs are great. However, if your liver and large intestine are congested, no amount of acupuncture or herbs will resolve it. Check out Andreas Moritz- Amazing Liver Flush- book or Youtube.

Once the liver stones removed with liver flushes and the colon is cleansed and functional, then the herbs can be properly metabolized and the estrogen excreted. Stagnant liver chi can not move through the congested organ.

Of course poor diet and high levels of stress can cause liver chi stagnation again, so not only the acuuncture and herbs need to be kept up, but the stress effectively dealt with and the colon cleanses and liver flushes maintained for best results.

Liver heat will affect the lowe dan tien's reproductive organ's function. Also, the blasting heat from the liver will affect the heart and the breasts.

HTH,
Edie

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Estrogen Dominance
by: Tina

Great post. Thanks for sharing this with us.

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Do Non-Dominant Follicles Ovulate?
by: Amelia Hirota

Hi Tiffany,
You ask a great question. Yes, non-dominant follicles can ovulate and you can see a temperature surge from the corpus luteum producing progesterone.

The problem is that because the follicle isn't a great dominant follicle, the progesterone produced isn't adequate to balance out the estrogen produced by the lingering cysts. That's why you still have some cramping and spotting.

The good news is that the cramping and spotting is going down. That means that you're making better and better follicles and clearing the cysts. It can be slow going, but if you're symptoms are going down, you're moving in the right direction. That is really good work!

Please check out my upcoming webinars for more information. I'm covering this topic in detail in webinar #1 and #7. I hope this is helpful to you. I admire you for your perseverance.

Sending Babydust Your Way,
Amelia

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