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Taking Charge of Your Health


Hello everyone, my name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a special focus
in mental health and hormones, especially women’s hormones. So, today I’m going to talk about an article
I wrote about a year and a half ago that gotten a lot of activity online and it’s called “Let’s
Talk Mirena: Anxiety and Hormone Imbalance”. I wrote the article because I was seeing a
few patients who had the Mirena IUD and a series of similar symptoms. So, anxiety, panic attacks, and just a general
sense of hormone imbalance. And when we ran their labs, when I looked
at the levels of progesterone in their blood, they had very low progesterone. So I wrote an article about this and about
the phenomenon of “estrogen dominance” that we naturopaths talk about a lot. And I got this resounding response online,
so even today, sometimes, I’ll get a couple emails a day of people expressing their experiences
and their agreement with the article and their confusion and frustration and anxiety around
some of the symptoms that they’ve been experiencing since getting the IUD. So, the reason I wrote the article is not
because I don’t agree with the Mirena IUD. I’ve written another article called “Having
a Healthy Birth Control Experience” in which I state that as a form of contraception, a
hormonal birth control and a hormonal implant such as the IUD can be really great measures
against unwanted pregnancy, because their efficacies are very very high—I think the
Mirena IUDis about 99%pregnancy avoidance— and you don’t need to think about it, you
don’t need to take a pill every day, so for some women this is ideal. The issue is that a lot of women are being
prescribed the Mirena IUD as a solution for Estrogen Dominance. And so what I find in my clinical practice,
and I’ll talk more about estrogen dominance in the course of this video, but what I find
in my clinical practice is, because it doesn’t address the underlying cause, and because
it’s hormonal in and of itself, and it adds more hormones to the body, in a specific location,
the uterus, and because it doesn’t address the underlying imbalance, it either worsens
or ignores the condition of estrogen dominance, causing symptoms to get worse and women to
feel frustrated and lost and then write to me. Mirena is often prescribed to women with heavy
and painful menstrual bleeding. So, this could be a diagnosis of endometriosis,
or ovarian cysts, or just symptoms that they’re experiencing. So a lot of them might be experiencing iron
deficiency because of the heaviness of the bleeding and a lot of women are out of commission
for a couple of days every month because their period is so heavy and uncomfortable and they
feel weak and they’re in pain and maybe they deal with really intense PMS. Some of my patients deal with PMS for 2 weeks
out of the month, which is crazy and super uncomfortable. Conventional medical doctors prescribe the
Mirena IUD to combat these symptoms because with birth control and the IUD, one of the
side effects is really light periods and some people don’t even get their period at all
on Mirena and so you can imagine, if you’re period is this time of the month where you
can’t go to work and you’re just basically hemorrhaging from the insides, then it would
be a massive relief to not have to deal with a period anymore for 5 years, which is how
long the hormones last in Mirena. But one of the issues is that we need to look
at the cause of these symptoms. Oftentimes these symptoms are caused by a
difference in estrogen and progesterone, so these are two of the main female sex hormones. One of the things that happens in conditions
like endometriosis or heavy and painful periods is that the estrogen is high in relation to
the progesterone in the body. And so this is really apparent in a condition
like endometriosis where there’s often high estrogen and also fibroids. So both of those cause terrible periods, and
they need to be ruled out when periods are heavy and uncomfortable. And then there’s ways that we can deal with
that as naturopaths. But even without an underlying health condition,
just primary dysmenorrhea, that’s not caused by another diagnosis is often the result of
estrogen dominance. And so the Mirena, because it’s made of only
progesterone, can help with the uterine symptoms of estrogen dominance, which would be the
heavy and painful periods. However, we have estrogen and progesterone
receptors all over our body, not just in our uterus, and so when we’re putting hormones
in one part of the body, and they’re not ending up in the rest of the body, we start to worsen
that deficiency, or that relative deficiency in progesterone. So women will mention, and one of the most
common symptoms is anxiety and panic attacks, because progesterone this kind of calming
effect on the central nervous system, on the brain, so it kind of chills you out and helps
you handle stress. Estrogen is a hormone that causes women to
ovulate, so it’s a pro-ovulatory hormone and it also helps build up the uterine lining. So the more estrogen we have, the thicker
the lining and therefore when we shed the lining during our period, the more we have
to shed. So, more estrogen, the thicker the lining,
the heavier and, by proxy, more painful the period. Progesterone is a hormone that, in terms of
reproduction, it helps us maintain the lining (of the uterus). So, if you ovulate and then that egg gets
fertilized by sperm, then the egg gets implanted in the uterus and progesterone starts to increase,
so pregnancy is a very progesterone dominant condition and one of the signs of a low progesterone
state is when women who have been pregnant say that that’s the most balanced they’ve
ever felt because progesterone is naturally higher in pregnancy. Progesterone starts to rise when you become
pregnant and that maintains the lining throughout the 9 months and then, after the 9 months,
you have your baby. If the egg doesn’t become fertilized then
progesterone rises for the last 2 weeks of the cycle and then it falls, along with estrogen,
you shed your lining and then you have a period. And for some women, they sail right into their
periods. They have no PMS symptoms, they might feel
a little bit bloated a couple of hours before and then they go to the washroom and go, “ok,
look, there’s blood I’m having my period.” And for other women, it’s not the case, they
get warning signs, like i said, before two weeks, so pretty much from ovulation to when
their period happens. So, half of their life: 2 weeks out of every
month. And so, what happens with a lot of women is
that there’s higher estrogen in relation to progesterone. So we call this “Estrogen Dominance”. And there can be three possibilities in this
state. One is that estrogen is abnormally high and
progesterone is normal, or optimal. Another is that estrogen is normal or optimal,
progesterone is low, and a third option is that you have both at the same time: so estrogen
is high and abnormal and progesterone is low and that’s more common than you think in a
lot of women who are dealing with really severe symptoms, that divide between the two hormones
is really off. And, as I mentioned before, prescribing birth
control pill or Mirena IUD are not solutions because they’re not correcting the underlying
imbalance. They’re not looking at the cause of why this
imbalance is happening in the first place. Instead, they introduce foreign, fake or synthetic
hormones into the system to try and correct the balance, but our body has a delicate balance
and a delicate ecology and so when we try and shift that balance artificially sometimes
we pay the price and we don’t necessarily feel balanced. So, why does this occur? Why do people get estrogen dominance and how
do you fix it? So, when it comes to the first situation,
high estrogen, and normal progesterone, there’s a couple of reasons why estrogen might be
high. So the first is exposure to foreign estrogen,
or excess estrogens in the environment. And, so many of you may have heard of these
“xenoestrogens”, or toxic estrogens, from sources such as BPA, so the lining of tin
cans, or those plastic water bottles or baby bottles that everyone was throwing out and
replacing with glass and stainless steel, which is a great idea. So, we’re in contact with these in the environment
through the cosmetics, cleaning products, and some of the plastics that we hold and
interact with on a daily basis. And paper receipts have this as well. So cashiers and people that handle receipts
regularly are in contact with BPA. And it’s absorbed through the skin. So just this exposure to these toxic estrogens
can activate estrogen receptors and it increases estrogen in the body. And that’s problematic. We know that these can also set the stage
for hormonal cancers, like breast cancer, you might have heard of estrogen-receptor
positive breast cancer, or ovarian cancer and endometrial cancer and cervical cancer. So these are all kind of these foreign estrogens
influence the body’s hormones in a negative way causing growths. The second reason why estrogen might be high
is the reduced ability of the body to detoxify estrogens. So, when we’re done using the estrogen that
we need, our liver cleans our blood of estrogen, then we dump the estrogen biproducts into
the colon and then we eliminate them by having a bowel movement. And this is a normal process in lowering the
toxic estrogen or the estrogen metabolites, the estrogen we don’t need anymore. And so when this process is either over-burdened
by too many xenoestrogens, so those plastic estrogens, or limited in some way because
our liver is trying to detoxify other things, such as alcohol, or tylenol, or some of these
over-the-counter drugs, the liver just can’t handle the burden and so, in terms of treatment
we need to bolster the liver’s detoxification abilities. And a lot of the time those two things exist
at the same time: you’re getting too many foreign estrogens, we need to clean up the
environment and the diet and make sure everything you’re getting is promoting a healthy estrogen
metabolism. And then, why progesterone might be low, which
is the other arm or possibility of this estrogen dominance condition that I’m speaking of is
stress, mainly. So, when we’re stressed out, and we’re dealing
with a lot our body produces a hormone called cortisol and that’s the “stress hormone” that
helps us deal with high amounts of pressure and stress. And a lot of the time stress is not perceived
so, just this feeling of being tired and wired, disrupted sleep, sugar cravings around 3-4pm,
having a difficult time getting up in the morning, feeling a little bit stretched thin,
maybe feeling a drop in motivation, are all signs of chronic stress. So what happens is our adrenal glands, these
pyramid-shaped endocrine glands that sit on top of the kidneys, they make cortisol. And when our body has more cortisol than it
needs, or when it needs to make progesterone, it takes the cortisol and it makes progesterone
with it. So it’s kind of like leftover cortisol that
it’s not using gets made into progesterone. After ovulation, the ovaries also produce
progesterone, but part of the progesterone production in the body come from the adrenal
glands. So you can imagine: if you’re stressed out
and you’re spending all of your adrenal function on making cortisol you’re not going to have
enough time or resources to make progesterone. So a lot of bringing up progesterone balance
is by either lowering environmental stress or increasing adrenal function. We also look a nutrient deficiencies and we
can also look at bringing pituitary balance by using an herb called vitex, which can help
balance hormones and kind of right that estrogen-progesterone imbalance that might be going on. So what happens when you give the Mirena,
or you give an oral contraceptive to deal with this? Well, what happens is, there’s an imbalance
and you induce another imbalance kind of over top. So, the body is still not making enough progesterone,
there’s still too much estrogen, toxic estrogen, and what you’re doing is giving synthetic
progesterone, which doesn’t have the same effects, progestins, synthetic progesterone,
it doesn’t have the same effects as regular progesterone and often doesn’t work on the
brain, so it doesn’t have that low anxiety effect, that calming effect, and it doesn’t
prevent the estrogen-dominant cancers, it doesn’t help with ovarian cysts, it doesn’t
manage endometriosis, other than stopping your periods, perhaps, if you’re reacting
to it. And then you’re also, if you’re doing a combined
oral contraceptive pill, you’re introducing more xenoestrogens to the body that your liver
then has to clear out and that are going to cause more of those estrogen-dominant symptoms. And, in the colon we know that oral contraceptives
can cause a bacterial imbalance, so a dysbiosis in the gut and potentially constipation and
so that throws off our whole system. I’ve talked about how important that gut bacteria
is for mental health and mood and just digestion and everything. So, more cells are in our gut than in the
rest of our body. So our gut microbiome is super important to
our health and well-being. So, how does a naturopathic doctor address
estrogen dominance? This is a big part of my practice especially
because I see a lot of women with month-long PMS, acne, polycystic ovarian syndrome, so
irregular periods, or missed periods, or they have a family history of hormone-dominant
cancers and they’re trying to prevent these things from happening down the line, or they’re
just having terrible periods. They’re having weight gain, or bloating, or
anxiety that’s related to the period or really bad PMS, so mood swings, depression around
their period or a condition called PMDD, which is really really severe depression right before
the period. So the first thing I do is order labs. And so your medical doctor might have done
labs, gotten your estrogen and progesterone measured in your blood and your doctor might
have said, “oh, it’s fine, it’s normal”, and this is true to the extent that when your
medical doctor is evaluating your labs, they’re looking at massive reference ranges. So our reference ranges are a bit more narrow
because we’re trying to look at the optimal levels for fertility and for feeling like
your optimal, amazing self. We’re looking at, “is your estrogen within
an optimal range, is your estrogen on the high side, and therefore, could be brought
down? And does that match your symptom picture? Do you have estrogen dominance symptoms and
a relatively high estrogen level? Is your progesterone lower than optimal to
maintain a uterine lining in pregnancy, to not have a miscarriage in the first trimesters,
etc. etc.” So we look at labs, and then we, using our
natural therapies, we prescribe diet, supplements, and some lifestyle changes to help re-establish
that hormonal balance. So, if you have any more questions, just send
me an email, at [email protected] or check out some of the articles that I mentioned
in this video.

8 thoughts on “Estrogen Dominance: Balancing Hormones, Mood, Birth Control + The Mirena IUD

  1. Does the copper iud affect hormones as well? I know it doesn’t release any hormones but I don’t understand if adding copper to our body could change some kind of “balance”..

  2. Thank you for this video!! So many questions answered. I’m not on birth control but have very heavy periods, anemia, severe depression before periods, feeling weak and crappy and anxious constantly. I had a feeling a hormonal imbalance may have been the cause of my symptoms but had no idea where to look. My doc just suggested me going on the pill but I’ve been hesitant. Thanks for this info! Wish I lived in your area as I’ve been seriously considering seeing a naturopath.

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