Also see:
Quotes: Thyroid, Estrogen, Menstrual Symptoms, PMS, and Infertility
Ray Peat, PhD on the Menstrual Cycle
Estrogen Related to Loss of Fat Free Mass with Aging
Fat Tissue and Aging – Increased Estrogen
Estrogen Levels Increase with Age
Ray Peat, PhD on the Benefits of the Raw Carrot

Consult a medical professional regarding all things related to your health.

Despite popular opinion, PMS isn’t normal. It’s akin to a check engine light that goes off monthly. If you’re looking to have an easy menopause, don’t ignore PMS. If you’re looking for easier weight management, it’s recommended to remedy the hormonal imbalances and metabolism suppression associated with PMS. This blog discusses the underlying issues of PMS and provides insight into correction. Correction won’t involve birth control.

The Menstrual Cycle
The menstrual cycle encompasses 26 to 30 days involving cyclical rises in certain hormones. The two steroidal hormones responsible for creating the menstrual cycle are progesterone and estrogen. Both are made from cholesterol in various female tissues but mostly the adrenal glands and ovaries. Fat cells in the overweight are also a chronic source of estrogen. Progesterone and estrogen are antagonistic hormones, each with their own function, that create PMS-free menstrual cycles when balanced.

Estrogen has tightly controlled functions during the cycle and stimulates the release of the egg. Estrogen rises to its highest levels at ovulation which occurs between days 12 to 16. Estrogen in healthy women should only be dominant for a few hours each month. The modern diet, birth control, poor lifestyle, stress, inadequate liver function, gut toxicity, and IUDs are causing women to be estrogen dominant 24/7.

Estrogen is very dangerous if not checked by its opposing hormone, progesterone, which surges from the corpus luteum after ovulation and lowers estrogen and its effects by eliminating it from cells. When progesterone is available, it destroys the estrogen receptor and inhibits the enzymes (sulfatase, aromatase, and glucuronidase) that stimulate estrogen production. Progesterone is very strongly anti-estrogen.

Progesterone stimulates the making of the lining of the uterus. If the egg is fertilized, this "progestational hormone" (progesterone) is produced in very large amounts in healthy mothers to oxygenate the fetus and protect it from stress.

Progesterone is one of the most protective substances the body makes allowing us to handle stress, create energy, offset estrogen, and regulate blood sugar and salt metabolism without the need to produce cortisol and aldosterone respectively. When progesterone is high, it minimizes the stress inducing effects of estrogen, cortisol, and aldosterone.

When progesterone is high after ovulation, PMS doesn’t exist or is minimal at worst. In a progesterone deficient (also know as estrogen dominant) state, the effects of estrogen are unopposed resulting in the common symptoms of PMS – bloating, cramping, heavy bleeding, breast tenderness, acne, mood changes, food cravings, back pain, migraine, fluid retention, etc. The progesterone deficient state is also associated with irregular periods, infertility, and miscarriage as these are the unfortunate effects of unopposed estrogen. So the question is what are some of the factors that lead to this progesterone deficient state?

Thyroid Deficiency and Progesterone
Not many know that the thyroid has a nickname – "the third ovary" – due to its role in producing hormones involved in fertility and the menstrual cycle. High cholesterol was historically used as a diagnostic marker for hypothyroidism. When thyroid is low, cholesterol turnover into bile salts and steroids falls resulting in a rise in serum cholesterol.

The thyroid deficient state is an important factor in estrogen dominance. Thyroid and vitamin A are needed for the conversion of cholesterol into pregnenolone; deficiency in any of these substances decreases steroid synthesis. Pregnenolone is the precursor to both progesterone and DHEA. Progesterone is a protective hormone that offsets or opposes the effects of estrogen (and aldosterone). Low thyroid function, low cholesterol, and/or a vitamin deficiency (particularly Vitamin A) results in a low progesterone. The hypothyroid have a difficult time converting carotene to Vitamin A sometimes resulting in orange calluses on the hands and feet which further feeds the progesterone deficiency. Vitamin A in liver, pastured eggs, and dairy are recommended.

A progesterone deficiency contributes to the overproduction of cortisol and serotonin which further feeds the stress state associated with estrogen dominance. Cortisol is associated with the accumulation of back and belly fat. Until the progesterone deficient state is addressed, weight loss in these areas will prove difficult. Supplemental progesterone from day 14 until the first day of menstruation helps remedy PMS symptoms and sometimes gets rid of them completely. Ultimately though, the health of the thyroid is paramount to improving progesterone production. Anything that contributes to thyroid deficiency will work against your efforts to correct PMS (and fat loss). If progesterone doesn’t help, estrogen removal, nutrition, and thyroid health will have to be ramped up.

"Thyroid is needed to keep the cell in an oxidative, rather than reductive state, and progesterone (which is produced elsewhere only when cells are in a rapidly oxidizing state) activates the processes that remove estrogen from the cell, and inactivates the processes that would form new estrogen in the cell." -Ray Peat, PhD

Thyroid Deficiency, Bile Salts, and Bowel Regularity
Bile salts are another substance made from cholesterol in the liver and stored in the gallbladder. Bile salts are used to remove toxins and old hormones, excrete excess cholesterol, and breakdown dietary fats that enter the small intestine.

Bile salt production, like steroid synthesis, falls when the metabolic rate decreases. Bile is vital for the removal of estrogen and other toxins through the bowel that have been readied for excretion by a healthy, nourished liver. A toxic bowel can negatively affect this process (glucornidation) if glucoronic acid is stripped off the estrogen leading to estrogen re-absorption back into the body. Bamboo shoots and raw carrots lower gut bacteria and support estrogen removal.

Bowel regularity is needed to reduce estrogen and exposure to endotoxin (lipopolysachharides). A sluggish bowel results in the re-absorption of estrogen back into the bloodstream (enterohepatic recirculation) and increases exposure to endotoxin putting further strain on the liver. Thyroid deficiency is historically related to constipation so once again the health of the thyroid is a vital component to prevent or reverse estrogen dominance. Salt and sugar lower cortisol, adrenaline, and aldosterone and improve gut motility as does a diet that contain foods digestible by humans.

Birth Control
Early in the 20th century, natural dessicated thyroid had been used to correct infertility, menstrual irregularities, delayed or premature onset of puberty (or menopause), and premenstrual syndrome. The medical community at large has forgotten this valuable information and now chooses to poison women of all ages by giving them birth control.

The effects of birth control are due to excess estrogen which inhibit pregnancy. Estrogen has been known as the hormone that causes miscarriage, infertility, and spontaneous abortion. This effect in birth control is intentional and harmful as it manipulates hormones in such a way which promotes age-related degeneration. Did you know that the "morning after pill" is a very high dose of estrogen? For twenty years, this same pill was previously said to "prevent abortions" by the synthetic estrogen industry. The industry was and still is confused about estrogen.

Excess estrogen is associated with osteoporosis, cancer, stroke, heart disease, and serves as a prime player in accelerated aging. Dementia, migraine, chorea, and scleroderma are more dysfunctions promoted by estrogen dominance. Progesterone and high thyroid are protective against all of these.

In much the same way birth control is poisoning younger women, hormone replacement treatment (HRT) is poisoning post menopausal women as the medical community falsely teaches that this population lacks estrogen. Menopause is the prolonged exposure to estrogen. The Women’s Health Initiative Study (2002) was a major showcase of the tragic flaw in allopathic medicine’s methodology. Instead of showing the wonders of estrogen, the study lead to premature death in the estrogen treated group. Gary Null, Phd et al. discusses this in "Death by Medicine."

"Synthetic hormone replacement therapy (HRT) does not prevent heart disease or dementia, but does increase the risk of breast cancer, heart disease, stroke, and gall bladder attack.

As many as one-third of postmenopausal women use HRT. This number is important in light of the much-publicized Women’s Health Initiative Study, which was halted before its completion because of a higher death rate in the synthetic estrogen-progestin (HRT) group." -Gary Null, PhD

Menopause occurs not due to lack of estrogen as the estrogen industry would have us believe. The fall in the metabolic rate as aging occurs leads to a fall in progesterone production which leaves estrogen unopposed which further suppresses metabolism, stimulate the pituitary, and promotes stress and aging. The inability to cyclically make progesterone leads to ceasing of menstruation. Progesterone is the hormone that is lacking in menopause NOT estrogen. Pharma’s synthetic progesterone (progestins) acts more like estrogen and cause cancer.

"Since the Women’s Health Initiative study involved the use of Prempro, the emphasis of the industry has been to divert attention from the toxic effects of estrogen, by blaming everything on "progesterone." An intense campaign is underway to assign all of estrogen’s harmful effects to progesterone." -Ray Peat, PhD

"Estrogen can be produced in so many different tissues, there’s no deficiency condition that has ever been defined factually. Menopause is exhaustion of the nerves that regulate the pituitary, caused by overexposure to estrogen. Thus, menopause is the result of prolonged exposure to estrogen. In addition to the estrogen produced by many different tissues, other estrogenic substances and xenoestrogens, which are not measured, exacerbate the estrogen dominance condition. These include soy products and other phyto (plant) estrogens (such as black cohosh, sage, pennyroyal, etc.), all unsaturated oils, synthetic estrogens in commercial meat and pesticides." -Ray Peat, PhD

Menopause and post-menopause is an estrogen dominant state so everything described here for the PMS sufferer would benefit the menopausal woman. This thought makes sense when you consider the dysfunctions associated with menopause like increased risk of osteoporosis, stroke, heart disease, and cancers of the breast and uterus which are all highly correlated with estrogen excess. Progesterone and high thyroid, once again, protects against these conditions. The medical community appears to have the situation backward.

Polyunsaturated Fatty Acids (PUFA)
Digestible seeds don’t stand the test of time. Part of seeds’ and seed oils’ (as well nuts, bean, grains, above ground vegetables) defense mechanism against being eaten is they contain polyunsaturated fatty acids which poison the digestion of the animals that consume them.

In addition to poisoning protein digestion, PUFA promote the production of estrogen in the human body, and estrogen promotes the release of free fatty acids (PUFA) into the blood which block glucose oxidation (Randle Effect) creating a metabolism with an over reliance on fatty acids, which has a myriad of negative effects. Women are more likely to get diabetes as a result of this chronic elevation in free fatty acids. Birth control, because of its estrogen content, has been shown to have this effect.

PUFA and estrogen both block thyroid function at multiple points, decreasing progesterone production, and harming liver function. Because estrogen and PUFA promote each other and both have a metabolism lowering effect, trying to lose weight in an estrogen dominant state can prove very difficult as can correcting hormonal imbalance. Saturated fats, like coconut oil and butter, help offset the affects of PUFA.

One of the effects of excess PUFA on the liver is that it reflexively withholds cholesterol. For those that see cholesterol as harmful, this is a positive effect. However, because cholesterol itself is anti-stress and is the raw material for all of the steroids, vitamin D, and bile salts, this action serves as just another toxic effect. The withholding of cholesterol affects bile salt and steroid synthesis contributing to poor estrogen detoxification and progesterone production.

Liver Health
Digestible proteins from animal-based sources (NOT vegetable sources) are important as they are needed by the liver to detoxify estrogen and other toxins. A healthy liver will destroy all estrogen (and PUFA) that passes through it. A protein deficiency results in thyroid deficiency as estrogen, which is strongly anti-thyroid, is allowed to accumulate. There is a negative feedback loop that occurs here as thyroid hormone activates liver metabolism, but it’s being suppressed due to estrogen accumulation and high free fatty acids in the blood which further lowers thyroid function and thus liver function allowing more estrogen to accumulate.

Remember that PUFA poison the proteolytic enzymes responsible for protein digestion so you can be "eating well" and still have the symptoms of protein deficiency. B vitamins are also a needed component for a healthy liver. Fruit sugars are liver friendly and allow it to store energy (glycogen) for use in detoxification or during times of low blood sugar.

Much of the active thyroid hormones, triiodothyronine (T3), is made in peripheral tissues not the thyroid itself. T4, or thyroxine, is an inactive hormone that cells cannot use and must be converted to T3 to be used. Approximately 70% to 80% percent of this conversion happens in the liver and requires glucose and selenium for the enzymes (deiodinases) involved in the conversion to function. The health of the liver is paramount to correcting hormonal imbalances and maintaining or improving the metabolic rate.

Tryptophan and Serotonin
As the precursor to serotonin, excess dietary tryptophan can be dangerous. Food rich in tryptophan are egg white, muscle and organ meat, and some fruits like kiwis, prunes, plums, pineapple, and bananas. The body can convert tryptophan to vitamin B3 or serotonin, but during stressful times, aging, and malnutrition the preferred pathway is to serotonin. Tryptophan, serotonin, PUFA, and estrogen contribute extensively to age-related degeneration and slowing of the metabolic rate.

Serotonin lowers the metabolic rate and body temperature and has a clear role in hibernation in animals as a function of these effects. Serotonin’s interference with energy metabolism, particularly in the brain, serves as a catalysts for a cascade of anti-thyroid, pro-degeneration effects that involves the production of more inflammatory mediators. It is these harmful anti-metabolic and inflammation promoting effects that cause the adverse symptoms in some SSRI and tryptophan using individuals.

Stress, low metabolism, and aging lead to a rise in the hormone cortisol. Cortisol’s role is to break down proteins from skeletal muscle and other tissues to be made into glucose in the liver to provide the fuel the body needs to meet the demands of the stressor. Skeletal muscle contains high amounts of tryptophan and other anti-thryoid amino acids. Muscle tissue breakdown during times of stress under the influence of cortisol results in high serotonin just as it does when taking SSRIs. Serotonin unfortunately promotes the production of cortisol leading to perpetuation of the issue. Cortisol inhibits the production of T3 in the liver, further suppressing the metabolic rate.

A PUFA-rich diet encourages the production of serotonin as well. PUFA increases the entry and formation of serotonin in the brain; serotonin liberates PUFA from stored fat creating another negative feedback loop. Reductions in the dietary intake of PUFA and tryptophan prolong the healthy life span. Estrogen promotes the release of serotonin (and histamine and prolactin) so it’s imperative that substances that offset the excitatory, stress-promoting effects of estrogen are maximized in order to prevent a serotonin dominant physiology.

PMS symptoms are exacerbated by excess serotonin so reducing dietary tryptophan intake during the entire cycle or during the second half can help diminish or stop unwanted side effects. Optimizing sodium (salt) intake helps lower the production of serotonin, lower adrenaline, improve body temperature, and raise the metabolic rate. Saturated fats, unlike polyunsaturated fats, do not encourage the production of serotonin or its entry into the brain and represent a major part of a protective nutrition plan. Carbohydrate choices like fruit juice, milk, and ripe fruits help spark the thyroid, provide important vitamins/minerals, and balance blood sugar. Carbon dioxide, light exposure, thyroid, caffeine, aspirin, progesterone, and high altitude helps antagonize the anti-metabolism effects of excess serotonin release. Temperature and pulse will provide further insight into whether your metabolism and health enhancing strategy is proving fruitful.

Salt and Sugar
Salt and sugar are your friend. Cravings for salty and sugary treats can occur during the menstrual cycle particularly during and after ovulation. Salt improves circulation, helps improve CO2 production and the elimination of intracellular calcium, lowers stress mediators like cortisol and aldosterone, and assists with cycle-related water retention and puffiness. The hypothyroid tend to lose excess sodium in the urine. Magnesium found in coffee, ripe fruits, and bone broth helps with sodium retention and T3 helps with magnesium retention. Sugars (ripe fruits, milk sugars, and sucrose) also lower cortisol as well as adrenaline, support T3 production, allow the liver to store glycogen, and keep PUFA in storage where their anti-thyroid and degenerative affects described above are not realized. A word from Ray Peat on the matter:

"Many young women periodically crave salt and sugar, especially around ovulation and premenstrually, when estrogen is high. Physiologically, this is similar to the food cravings of pregnancy. Premenstrual water retention is a common problem, and physicians commonly offer the same advice to cycling women that was offered as a standard treatment for pregnant women–the avoidance of salt, sometimes with a diuretic. But when women premenstrually increase their salt intake according to their craving, the water retention can be prevented.

Blood volume changes during the normal menstrual cycle, and when the blood volume is low, it is usually because the water has moved into the tissues, causing edema. When estrogen is high, the osmolarity of the blood is low. (Courtar, et al., 2007; Stachenfeld, et al., 1999). Hypothyroidism (which increases the ratio of estrogen to progesterone) is a major cause of excessive sodium loss." -Ray Peat, PhD

Excess estrogen stimulates insulin making individuals in such a state prone to low blood sugar (hypoglycemia) and overeating which isn’t ideal with a low metabolic rate. Higher amounts of saturated fat maybe be needed initially in an estrogen dominant state to help balance blood sugar.

Exercise
Exercise is a slippery slope for those with hormonal imbalances. When one cannot lose weight, he/she instantly goes the more, more, more exercise route to lose the weight. This strategy can and will backfire in the stressed individual. More stress means more estrogen because the actions of aromatase enzymes, which convert androgens to estrogens, increase under such conditions. The more you try, the worse it gets. Those will excess fat tissue are even more susceptible to such effects because remember that fat cells are a chronic source of estrogen. Exercise can deplete progesterone because of the increased need for cortisol from exercise. Female athletes are known to get amenorrhea or other menstrual disorders because of the chronic depletion of progesterone from training.

Exercise can lower thyroid hormone. Active thyroid hormone (T3) production tends to halt with exercise. This is likely due to a combination of a decrease in blood sugar, increase in free fatty acids in the blood, and rise in adrenaline and cortisol. A healthy person can restore T3 production following exercise, but the stressed person remains hypothyroid. Low thyroid leads to low progesterone production further feeding the presenting hormone imbalance. Hyperventilation (excessive loss of carbon dioxide) and a rise in lactic acid are two other parameters that can promote cellular stress and synergize with dietary polyunsaturates and estrogen in creating oxygen deficiency, promoting inefficient glycolytic metabolism.

The mindset should switch from "lose weight to get healthy" to "get healthy and correct the underlying imbalances to lose weight."

Summary
The correction of hormonal imbalances is multifaceted. The body is a systems of systems with each system dependent upon the function of the other. Manipulating one system affects all others. It’s the combination of the right moves within this system that synergistically can make the unit function optimally. PMS and a difficult menopause are signs that your systems are not working well. Will you make the right moves in diet, lifestyle, and in some cases supplementation to help correct the underlying issues at hand?

Synopsis of corrective measures for estrogen dominance
1. Decrease PUFA in the diet. Eat more saturated fat.
2. Support liver health – animal based proteins and B vitamins (beef liver, egg yolks).
3. Bowel regularity is very important.
4. Support thyroid function for improved cholesterol turnover and reduced bodyfat.
5. Supplement with progesterone at the appropriate times if needed.
6. Use sodium, sucrose, milk, OJ and fruit sugars appropriately.
7. Decrease consumption of tryptophan rich foods to decrease serotonin production.
8. Use friendly fibers like carrots and bamboo shoots to assist in decreasing bowel toxicity and estrogen removal.
9. Balance blood sugar – don’t eat protein alone, don’t eat carbohydrate alone.
10. Reduce stress and be very careful with exercise.

Consult a medical professional regarding all things related to your health. FPS coaches a 12 to 16 week nutrition course based solely on the methodology of Ray Peat, PhD. Please click here for more information.

References:
Salt, energy, metabolic rate, and longevity by Ray Peat, PhD
Death by Medicine by Gary Null, PhD et al.
Tissue-bound estrogen in aging by Ray Peat, PhD
Radio Interview – Progesterone v. Estrogen – EastWest Healing Blog Talk
Serotonin, depression, and aggression: The problem of brain energy by Ray Peat, PhD