How Your Gut Health Impacts Estrogen
The health of our gut microbiome, the collection of microorganisms that live in the gut, can impact everything from weight, immune system health, skin, concentration and… you guessed it, hormonal health!
Looking at the gut is one of the key pieces of the puzzle when looking at PCOS, endometriosis, fertility and many other hormonal conditions. Read on for a 101 on how our gut can impact our hormonal health, specifically estrogen, and how we can support healthy balanced hormones through the gut.
GUT HEALTH & HORMONES
Our gut health plays a pretty important role when it comes to the health of our hormones, through mechanisms such as:
- Helping the synthesis and regulation of hormones and neurotransmitters
- Plays a key role in the immune system
- Contributes to the regulation of estrogen levels within the body
- Facilitates the absorption of macro and micro nutrients
THE ESTROBOLOME
The estrobolome is the name for the group of bacteria in the gut that are responsible for metabolising and modulating the body’s estrogen.
Microbes in the estrobolome work to produce beta-glucuronidase, an enzyme which reverts estrogens into its unconjugated form that can then potentially be absorbed back into the bloodstream, impacting estrogen related physiological functions. Therefore, the more beta-glucuronidase that your gut-microbes are producing, the less estrogen will be excreted from the body.
When your gut microbes are unbalanced (dysbiosis), beta-glucuronidase activity is altered which may result in enzyme activity changes. This dysbiosis can result in a lack of estrogen, or an excess of estrogen, which may cause an imbalance between estrogen and other hormones, potentially leading to the development of estrogen-related disorders or other chronic conditions.
DYSBIOSIS AND HORMONES
Gut dysbiosis is often down to an imbalance of commensal versus non-commensal bacteria. If there is an overgrowth of certain strains of bacteria (such as Eschericia coli, Bacteroides species and Clostridium perfringens) that produces beta glucuronidase, this can revert estrogen back into its unconjugated active form, where it is then absorbed back into the bloodstream, potentially resulting in estrogen dominance.
Elevated beta glucuronidase levels have been associated with conditions such as:
- Obesity
- Endometriosis
- Infertility
- PMS
- Mood disturbances
- Heart disease
The fragile balance of the microbiome and estrobolome can be impacted by numerous different factors such as genetics, age, weight, diet, alcohol, antibiotics, pollutants and more.
ESTROGENS
There are three different forms of estrogens which are necessary for our overall health. These are made in the ovaries and adrenal glands.
Role:
- Can help to regulate body fat
- Essential for reproductive function, cardiovascular health, bone health and brain function
- Regulates menstruation
- Menopausal symptoms
- Mood stabiliser
- Libido
- Energy levels
- Skin health
Estrogen also supports the following organs to function optimally:
- Ovaries: Estrogen helps to stimulate the growth of the egg follicle
- Vagina: Estrogen helps maintain the thickness of the vaginal wall and promotes lubrication
- Uterus: Estrogen enhances and helps maintain the mucous membrane that lines the uterus, whilst regulating the thickness and flow of uterine mucus secretions
- Breasts: Estrogen is used for the formation of breast tissue, whilst also helping to stop the flow of milk after weaning.
In men, estrogen is particularly known as estradiol, and is key for male sexuality. We all know that testosterone is the most significant male sex hormone, however estrogen is required to stay in balance with testoterone for numerous bodily functions listed below. Testosterone naturally decreases as men age, and estrogen increases:
- Support the maturation of sperm
- Maintain an individual’s libido
- For erectile function
- Maintenance of puberty and growth
- Energy
- Maintaining muscle mass
- Focus
When an individual’s gut microbiome is in a healthy state, the estrobolome is producing the perfect levels of the enzyme beta glucuronidase. Beta glucuronidase is also key for breaking down complex carbohydrates, and for the absorption of bilirubin and flavonoids.
However, when there is too much bad bacteria in the microbiome, or an imbalance, oestrogen levels may become imbalanced.
Therefore a healthy, balanced gut microbiome which includes a whole variety of diverse bacteria is key for hormonal balance.
WAYS TO IMPROVE GUT HEALTH AND HORMONAL BALANCE
DIET:
Our diet has an influence on almost every element of our health, and plays a particularly important role in the health of our gut and the way we produce and clear our hormones. Incorporate the below as regularly as possible, and tolerated!
Antioxidants: Oxidative stress can overpower the body’s antioxidant defences which may cause damage to the gut. Dietary polyphenols in colourful plant foods can improve antioxidant balance to support gut health and hormonal balance.
Polyphenols are a form of prebiotic that can work to feed the bifidobacteria in the gut, therefore increasing the population of good bacteria, promoting our overall gut health, they have also been known to help treat inflammatory gut disease.
Try adding foods such as berries, 70%+ dark chocolate, hazelnuts and pecans, broccoli, beetroot, green tea and artichokes into your diet routinely.
Fibre: Fibre travels to the large intestine, where your gut bugs ferment this fibre for energy, therefore providing fuel for your gut cells to function.
Aim to include nuts and seeds, cruciferous veggies, berries and wholegrains daily to reach the desired 35 g of fibre per day. I like to add a sprinkling of chia and flax seeds on my breakfast, salads and soups as a booster.
Be careful if you suffer from IBS as too much or too little fibre can trigger symptoms. Certain types of fibre may be better tolerated than others, and working with a professional can help you understand which types of fibre are best for you.
Live fermented foods: Live foods, also known as fermented foods, contain live microorganisms that can help to balance your healthy gut bugs. Aim to consume a source of live, fermented foods at least 3-4 times a week, these can include kefir, sauerkraut, kimchi and miso.
Prebiotic rich foods: prebiotics are the fuel that live bacteria feed on, and are a form of fibre that support overall gut health. When our gut bugs consume these prebiotics, they can produce short chain fatty acids (SCFAs). Studies have shown the correlation between a higher intake of plant foods and increased levels of short-chain fatty acids in stool. (1) SCFA’s can contribute to everything from inflammation, immune function, energy and mood.
In addition to SCFAs being crucial for gut health, they also stimulate the production of serotonin and other gut hormones.
Think cooked onion, asparagus, jerusalem artichokes and raw chicory root.
If you suffer from IBS, FODMAP containing prebiotics may worsen symptoms. Therefore it is advised to stick to minimal portions as smaller volumes of prebiotic fibre may be better tolerated.
SLEEP:
Research has shown that there is a significant relationship between sleep quality, gut microbe balance and cognitive function. (2) Ideally, we should be aiming for 8 hours of uninterrupted sleep each night, to support many aspects of our health.
Sleep quality may have the ability to impact estrogen levels, but low estrogen levels can also impact our sleep. Both estrogen and progesterone can impact the electrical activity of the brain during stages of both sleep and wakefulness. Women who have lower levels of estrogen have also been shown to experience less deep sleep and even if they do get 8 hours of sleep, they wake feeling tired. (3)
Here are a few ways to optimise your sleep:
- Aim for 7-9 hours of sleep each night
- Go to sleep and wake at the same time each day, to train your body to know when it should be sleeping
- Keep blue light technology and artificial light away from the bedroom and try to avoid it for 1 hour before bed
- Ensure your bedroom is well-ventilated and a cool temperature
- Consider tracking your sleep on an oura ring to find out why or where you may be losing good quality sleep
EXERCISE:
Exercise has been shown to benefit our gut health by improving diversity and overall development of healthy bacteria. Regular, moderate intensity exercise can also reduce levels of circulating estrogens in the body. Exercise has also been shown to reduce levels of the stress hormone cortisol, which may negatively impact our sex hormones. (4)
The amount we move our body can have a big impact on our hormonal responses. Small changes such as an increase in heart rate and the activation of our nervous system can cause the brain to release numerous hormones, which can control how our peripheral organs respond.
A week of workouts should be planned to be hormone friendly and to positively impact your hormone health. Different workouts at different intensities can all contribute to hormone fluctuations.
- HIIT: Can contribute to increased strength and fitness levels, but it only takes a couple of intervals to experience your body’s increased levels of energy, which is impacted by a fluctuation on hormones, especially cortisol. If you enjoy HIIT workouts, consider adding them into your routine 1-2 times per week and remember the importance of embracing rest to support your hormones. (5)
- Cardio (walking/ running)- can help to increase dopamine and serotonin for a sense of mood elevation.
- Low intensity exercise: Can help to reduce cortisol and support your hormone levels. One study found that women who did pilates, yoga or light dance 3 times per week for 60 minutes developed stronger balance, muscle strength and estrogen levels. (6)
It’s important to be mindful here, everyone is individual when it comes to exercise, a high intensity workout may work for some, but not be right for others. Lower intensity exercise such as yoga and pilates can help the body tick into “rest and digest” mode which is highly beneficial for our hormone health.
ENVIRONMENT:
Synthetically manufactured estrogens are called xenoestrogens, that can act as hormone disruptors, and can be commonly found in household products such as pesticides, fragrances, body products and plastics. Xenoestrogens can be absorbed into the body where they are then stored in the liver and fat cells, and can act alongside estrogens to impact the production and normal levels of our own hormones.
It can be challenging, but try to reduce your exposure to toxic substances as much as possible as they are often the driver of a hormonal imbalance.
Studies have suggested that endocrine disrupting chemicals may also affect the gut microbiome. Dietary exposure may lead to a reduced diversity of gut microbiota composition, especially Akkermansia, a bacterial strain that is key for maintaining normal intestinal barrier function. These bacterial changes corresponded to heightened endotoxin levels, and increased liver inflammation (7).
Tips to reduce endocrine disrupting chemicals at home:
- Eating organic when possible, download the current dirty dozen list here in the UK which shows the fruit and veg with the highest pesticide content.
- Use a water filter, my favourite glass water bottle with filter is here
- Avoid using plastic and opt for a glass water bottle (see linked above) and tupperware.
- Remove your shoes when in your home as they can bring in contaminated dust, pesticides, bacteria and viruses.
- Opt for BPA free tins, I like Mr Organic and Biona.
- Use a high quality air purifier- use code CLARISSA100 for £100 off the air doctor here
ALCOHOL:
Alcohol consumption can impact the health of our gut microbiome and may also impact the liver’s ability to detoxify circulating estrogens and endocrine-disruptors.
One of the most damaging effects of alcohol on the body is its impact on the liver. The liver processes alcohol and other substances to remove damaging toxins from the body. However, very extreme alcohol use can overwhelm the liver and prevent it from performing essential processes that keep the body functioning optimally.
The liver is also responsible for metabolising estrogen, but when consuming a high volume of alcohol this can increase circulation of androgens and estrogens, predisposing an indiviudal to potential estrogen dominance. (8)
In addition, high alcohol intake may inhibit your body’s production of digestive enzymes and juices, which can impact your gut bacteria’s fermentation process. Over fermentation can lead to bloating, gas and stomach pain. It may also cause inflammation in the gut and hyper intestinal permeability which in turn can lead to increased inflammation.
Therefore, be mindful when drinking alcohol, and aim to not consume over 14 units per week with a minimum of 4 alcohol free nights per week.
GUT TESTING
In the Clarissa Lenherr Nutrition clinic we use numerous forms of testing that can give us a much clearer idea of what is going on inside your gut:
Gut microbiome testing can be conducted through a stool test to get a closer look into what’s going on in your microbiome and to provide an analysis of your gastrointestinal system. It will look into diseases-related microbial markers such as bacteria, yeast and parasites along with host health markers which may be contributing to your symptoms. This test can also test for beta-glucuronidase.
A DUTCH test is the test we use in clinic to take a comprehensive assessment of your sex and adrenal hormones and their metabolites. This is done by collecting a number of urine samples over a 24 hour period. Measuring your estrogen and androgen metabolites gives us the opportunity to be more precise in clinical diagnosis of hormonal imbalances.
Overall, supporting your gut health is the root of balancing your hormones. Aim to keep your gut healthy and thriving so it doesn’t have a knock on effect when it comes to your overall health. If you think your gut may need some support, I am taking on new clients for my GUT HEALTH PACKAGE from November- email my team to find out more info@clarissalenherr.com
REFERENCES:
https://pubmed.ncbi.nlm.nih.gov/26416813/ (1)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779243/ (2)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718648/ (3)
https://pubmed.ncbi.nlm.nih.gov/18787373/ (4)
https://pubmed.ncbi.nlm.nih.gov/34022085/ (5)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934971/ (6)
