Estrogen Dominance? - Printable Version
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Estrogen Dominance? - bryony - 17-03-2013
Folks,
help me out here. I've seen the phrase "estrogen dominance" bandied about a lot here, but I can't see how it is relevant...
I tried searching in the .gov domain and found a court document that says this:
(I found this in a legal brief to the FTC complaining about a mail order progesterone vendor)
------------------------------------------------------------------------------------------------
“Estrogen dominance” is a term coined by Dr. John R. Lee. It describes a
condition where a woman can have deficient, normal, or excessive estrogen but
the body has little or no progesterone to balance its effects. Signs and symptoms
of estrogen dominance include:
* * *
Breast cancer
* * *
Uterine cancer
* * *
Pre-menopausal bone loss
--------------------------------------------------------------------------------------------------
then Wikipedia:
Estrogen dominance is a theory about a metabolic state where the level of estrogen outweighs the level of progesterone in the body. This is said to be caused by a decrease in progesterone without a subsequent decrease in estrogen. The theory is popular among natural health practitioners, but is generally not recognized by mainstream medicine.
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So I went to Dr John Lee's website. First off, he died in 2003, arguably a bit before great strides were made in "liberating" transsexuals, which may be why I found nothing on his website for TS or TGs.
There was a bit about something he wrote about estrogen dominance in men, but it appears to be about getting a right balance with estrogen testosterone and progesterone for "normal"men, and in this respect, he appears to use progesterone to counter estrogen.
Dr. Lee's concern appeared to be with regard to xenoestrogens. His website says"
THE CAUSES OF ESTROGEN DOMINANCE
Strictly speaking, it's possible that we are all -- men, women and children -- suffering a little from estrogen dominance, because there is so much of it in our environment. You would have to virtually live in a bubble to escape the excess estrogens we're exposed to through pesticides, plastics, industrial waste products, car exhaust, meat, soaps and much of the carpeting, furniture and paneling that we live with indoors every day. ..."
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I next looked at .gov sites for progesterone in men and found this: http://www.ncbi.nlm.nih.gov/pubmed/15669543
"Surprisingly, we know little about the physiology, endocrinology, and pharmacology of progesterone and progestins in male gender or men respectively, despite the fact that, as to progesterone secretion and serum progesterone levels, there are no great quantitative differences between men and women (at least outside the luteal phase)."
With all that in mind, I have to ask what it means for transgender people?
1) it is a theory with precious little, if any, research that I could find on Google Scholar.
2) there is very little known about the effects of progesterone naturally occuring in men
3) the major concerns stated are with regard to female physiology that we don't have (apart from breasts)
4) the theory doesn't really apply to men who are deliberately introducing large amounts of estrogen to their systems; if anything this forum RELIES on Estrogen Dominance! We all want our estrogen to outbalance our testosterone
If the theory holds, to my mind the only way to achieve balance is either to get it right for male levels, or for female levels. The former means no breast enlargement, and the latter is only achievable with an orchiectomy and serious blood work.
So help me out here folks... what's going on? Is it all anecdotal?
After all, if we are talking anecdotal, there is at least one doctor who advises against using progesterone for breast develoment at all.
It seem to me that there are at least as many bad anecdotes about using progesterone too early in breast development as there are for this estrogen dominance theory.
I'd be happy to be corrected though.
B.
RE: Estrogen Dominance? - AbiDrew85 - 17-03-2013
Well, there is a lot of what would be considered anecdotal evidence for the theory, but you are largely right about it all be very theoretical.
I suppose it at least partially depends on just how femininely "wired" your brain is (or how female your soul is if you subscribe to such spiritual explanations for the way we are).
The more female your brain is, the more benefit it'll get from having a female balance and cycle of hormones regardless of the rest of your genetics and physiology.
Or at least, that's my theory, with strong anecdotal support, and I'm putting my money where my mouth is on this one and running a program based on it.
I'm not sure really if anyone in the "official" medical RESEARCH community has much bothered themselves with this sort of concept... I do know of at least one other TS than myself who AFAIK has never visited nor seen this site, who shares my theory and also puts HER money where our mouths are. She is in the medical community in some function, though I've not really asked her to elaborate.
There's also your natural progesterone levels to take into account. Male levels range from lower than female basal levels to about half female peak levels. Through trial and error since I lack access to proper testing, I have determined mine to be pretty much right on-target for female basal levels. But since I'm pumping myself with an extra high level of estrogen, I also need to raise my average level of progesterone.
RE: Estrogen Dominance? - bryony - 17-03-2013
hmmm... but it is kind of guesswork isn't it?
After all the guy who proposed the theory was an MD, so, to an extent, was basing his theory on medical tests of, in the main, female hormone levels.
What I don't get is how this applies to someone with a pair of testicles (sorry to be crude). If it is all about balancing hormones, well, people like us don't provide much of a sample to work on. People like Dr Lee who are probably working hard to get their theory accepted by mainstream medical orthodoxy aren't going to have a lot of time to be examining the blood work and associated symptoms of blokes who are pumping either Premarin / and/ or Estradio / and /or/ some kind of phytoestrogen into their bodies.
How the heck would you decide on the right amount of PG anyway? Rub some on until you feel better? What about the placebo effect?
Like I say, unless an orchiectomy is involved, it's going to make very little difference how much progesterone is used, the mix of hormones is still going to be "wrong." How would anyone work out the perfect balance of estrogen, progesterone, and testosterone for an MTF TS/TG? For one thing, the estrogen/progesterone balance varies in GGs with a monthly cycle which we don't have, but even trying to simulate it (hard without a blood lab), what about the HUGE imbalance of testosterone?
Honestly, I'm getting the impression that worrying about estrogen dominance is the last of our problems...
Again, I don't mind being corrected!
B.
RE: Estrogen Dominance? - AbiDrew85 - 17-03-2013
(17-03-2013, 09:26 PM)bryony Wrote: hmmm... but it is kind of guesswork isn't it?
After all the guy who proposed the theory was an MD, so, to an extent, was basing his theory on medical tests of, in the main, female hormone levels.
The original concept, yes. Though that's not really so much theory anymore but accepted in general practice by most MD's, regardless of what area of practice. When it comes to GG's.
(17-03-2013, 09:26 PM)bryony Wrote: What I don't get is how this applies to someone with a pair of testicles (sorry to be crude). If it is all about balancing hormones, well, people like us don't provide much of a sample to work on. People like Dr Lee who are probably working hard to get their theory accepted by mainstream medical orthodoxy aren't going to have a lot of time to be examining the blood work and associated symptoms of blokes who are pumping either Premarin / and/ or Estradio / and /or/ some kind of phytoestrogen into their bodies.
This is true...
(17-03-2013, 09:26 PM)bryony Wrote: How the heck would you decide on the right amount of PG anyway? Rub some on until you feel better? What about the placebo effect?
Well, for me, since I CAN'T afford tests, it's guesswork. But if I COULD afford tests, I'd be doing regular testing throughout a cycle for a few cycles until it was gotten right. Right being most likely upper range for both the low and the high to compensate for my extra estrogens.
(17-03-2013, 09:26 PM)bryony Wrote: Like I say, unless an orchiectomy is involved, it's going to make very little difference how much progesterone is used, the mix of hormones is still going to be "wrong." How would anyone work out the perfect balance of estrogen, progesterone, and testosterone for an MTF TS/TG? For one thing, the estrogen/progesterone balance varies in GGs with a monthly cycle which we don't have, but even trying to simulate it (hard without a blood lab), what about the HUGE imbalance of testosterone?
Huge imbalance of testosterone? Sorry. But the goal is to block that off almost entirely, to low end of female norm if at all possible, high end at minimum. For those who are TS anyways. And I dunno how effective my herbals are for this, but it IS possible to pull off, for sure using pharma, if not using herbals.
As to the rest... yeah, it's hard to do without a lab, but I seem to be at least close. If I could afford the lab I might just be able to perfect it.
(17-03-2013, 09:26 PM)bryony Wrote: Honestly, I'm getting the impression that worrying about estrogen dominance is the last of our problems...
Again, I don't mind being corrected!
B.
Last? Nah. I wouldn't be so bold as to classify ANY of our balancing problems as "last". They're all pretty danged important. Yes. Most doctors prescribing hormones and anti-hormones for TS patients do seem to consider it "last" if at all. Shoot. Many don't even consider it for GG's.
RE: Estrogen Dominance? - flamesabers - 17-03-2013
(17-03-2013, 09:26 PM)bryony Wrote: How the heck would you decide on the right amount of PG anyway? Rub some on until you feel better? What about the placebo effect?
Like I say, unless an orchiectomy is involved, it's going to make very little difference how much progesterone is used, the mix of hormones is still going to be "wrong." How would anyone work out the perfect balance of estrogen, progesterone, and testosterone for an MTF TS/TG? For one thing, the estrogen/progesterone balance varies in GGs with a monthly cycle which we don't have, but even trying to simulate it (hard without a blood lab), what about the HUGE imbalance of testosterone?
It would be convenient to have all the answers on this subject. As you mentioned though, it's a bit of guesswork until scientists develop a comprehensive explanation.
My thoughts on this issue is finding the right amount of PG to balance estrogen is more of a spectrum than either or. I suspect the body tries to compensate and reach an equilibrium, no matter whether the person is taking pm and using PG.
RE: Estrogen Dominance? - MonikaT - 18-03-2013
Here's my two cents. Take it for what you will. From some of the reading I've done, the overwhelming majority of doctors treating MtFs do not believe PG is necessary, regardless of whether or not she has had an orchiectomy. It is claimed it had no effect on breast growth and development. Yet, there are a small number of doctors who do use it as part of their standard TS protocol so they must see some benefit to it.
In a male who wants to remain male, is not trying to grow breasts, and has no GD, etc., estrogen dominance is a little harder to pin down. Male hormone regulation today is mostly uncharted waters. Honestly, they know more about hormone regulation for the MtF than they do for the average male. I'm having one hell of a time trying to convince doctors that it isn't just about T, but also about the ratio of T to E. They accept that in genetic females, there needs to be a balance of hormones, but in men, it's all about T and nothing else. In this respect, compared to female hormone balance, males are in the 1930s. So, yes, about all a male can do is treat with PG until symptoms ease, if he has symptoms of estrogen dominance which can be quite similar to symptoms of low T.
Doctors tend to be extreme in their approach to things. Until something is hugely wrong, it isn't a problem. Look at things like the recommended daily allowance of vitamins and minerals. Until very recently, they were set to the minimum level necessary to prevent the signs of deficiency such as scurvy, rickets, or beriberi. This wasn't a level necessary to promote good health, just the barest minimum necessary to keep you from dying or turning to jelly or losing all your teeth or something. What about the person who gets nothing but the minimum levels of nutrients but seems to catch every cold or flu that goes around, is weak, and looks pretty unhealthy? He just has a weak constitution. Could it be that if he consumed more than just the bare minimum, he might feel better? I suspect so. Well, this is where things stand today for male hormone regulation. Until something is markedly wrong, it is too subtle a problem for doctors to recognize with any certainty, and those who claim to see it are considered heretics and whackos. They are labeled as "natural practitioners" who use vague, undefined terms like "estrogen dominance" or "adrenal fatigue." I guess in a male, estrogen dominance would be a more subtle form of T deficiency just as adrenal fatigue is a more subtle form of adrenal insufficiency. Doctors officially recognize the latter two conditions because they have blood tests with defined ranges and agreed-upon guidelines. The former two conditions require more of a gut feel to diagnose and treat because the person's blood work is probably within the wide range of normal, but they don't feel well, and their levels are probably near the bottom (or top, depending) of the normal range, or the ratio of different things is off, but both values are in the normal range.
On a final note, when it comes to T, one cannot forget about the adrenals and the role they play. I know a MtF who had an orchiectomy many years ago, but last I knew still had not had SRS due to cost. She still has to take spironolactone because her T is too high, and they attribute it to her adrenals.
RE: Estrogen Dominance? - sfem - 18-03-2013
First a complaint, then some on topic thoughts.
I am seeing an increase in this information age disease which I do not know the name for (Baffler's Syndrome anyone?), but is characterized by the presenting of surmise and guesswork as if it were fact as then using it as the basis for further speculation, deduction, and argument support. It drives me nuts. It turns otherwise trustworthy and worthwhile individuals into background noise over time. If you believe something to be true, but don't know it for a fact, please say so. The suggested syndrome acronym is significant and a label no-one wants to acquire. I'm not pointing this at anyone, but I have recently crossed my threshold for ignoring it.
For myself, I am becoming interested in progesterone because I am at a stage of boobie development where I am wondering if it may be beneficial. In past posts on this forum there have been comments made that progesterone is useful in the final stages of breast maturation. These comments seem to be linked to the idea that progesterone becomes more significant in women as they change during pregnancy, and therefore is implicated in the last stages of breast development. I don't want to lactate but I do want the last stages of shape and nipple development. I probably can't have it both ways, but I haven't given up hope. I'm quite unsure of the details on this likely because I wasn't near that stage when these posts were made. Quite possibly I even saw them on the old network54 site, I just don't recall. So anyway I have been trying to gather a bit of information about whether I should try it. I know we are generally big fans of "give it a try and let us know" in this group but I still want to know a bit more about it first if I can find anything solid. So I have been asking a bit for anecdotal evidence here and doing some light searching online for information of a credible nature. I thought this thread might indeed be a good one for me because Bryony is usually good at stirring the pot to get the discussion mixing and to call bullshit where it is found. But so far there doesn't seem to be much real information forthcoming, just our usual speculations and hints of Baffler's Syndrome. So here goes my results of an admittedly limited amount of research on progesterone. Please remember I am not an academic, and it is up to you to evaluate the validity of the info in these links. I do not want anyone to think I have read these from cover to cover, or even understood everything I did read in them. But I think they have relevant info in them and their references may be helpful although many of them are surprisingly aged.
Progesterone inhibits DHT in men to some extent.
http://www.cenegenicsfoundation.org/library/library_files/Inhibition_of_Testosterone_Conversion_to_Dihydrotestosterone_in_Men_Treated_Percutaneously_by_Progesterone.pdf
Progesterone may lower libido and reduce anxiety in men.
http://thinksteroids.com/articles/contrarian-endocrinology-estrogen-men/
Progesterone is used as part of a chemical castration agent for men.
http://www.nejm.org/doi/full/10.1056/nejm199704033361420
"progesterone causes increased terminal duct lobular unit cell division in the luteal phase" - http://www.ncbi.nlm.nih.gov/pubmed/8405201
"prolactin has gynaecomastia-inducing properties" - http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0272.2011.01240.x/abstract
And there are many more that aren't tedious to find, but maybe these can get us started. Also, more than you ever wanted to know about the breast can be found in Rook's Textbook of Dermatology - http://onlinelibrary.wiley.com/doi/10.1002/9781444317633.ch70/summary if you are desirous of tmi.
The King vs. Leder studies comparison suggests to me that maybe we are missing a bet by not trying taking our entire shot of PM at once daily, first thing in the morning. Does anyone else think that might be rational? Anyone tried that approach with a large dose (>1g) long enough (more than a week) to tell if it makes a difference?
RE: Estrogen Dominance? - Misty0732 - 18-03-2013
(18-03-2013, 05:24 PM)sfem Wrote: The King vs. Leder studies comparison suggests to me that maybe we are missing a bet by not trying taking our entire shot of PM at once daily, first thing in the morning. Does anyone else think that might be rational? Anyone tried that approach with a large dose (>1g) long enough (more than a week) to tell if it makes a difference?
I believe Abi uses that approach, and she has some scientific data to back it up.
Misty
RE: Estrogen Dominance? - PattiJT - 18-03-2013
Thanks a bunch, sfem.
Heretofore, I thought I was in a relatively good over-all condition of health. Now, with the discovery of "Bafflers" syndrome, I realize I have indeed contracted it's counterpart, "Baffled" syndrome. Is there a cure, or even a treatment? I have let all the estro dominance talk go in one ear and out the other, but now, I don't know if that was the right approach. I'm soooo confused. (Baffled).
RE: Estrogen Dominance? - sfem - 18-03-2013
ROFL, PattiJT!