Estrogen Replacement......The Good, The Bad and The Ugly!

All estrogens are not created equal. Some are good, some are bad and some are just downright ugly! Below is a short synopsis about these and what you can do to keep your good estrogen up and your bad estrogens down.

 1. E1 (estrone)- this is the main estrogen made in menopause. It is also the most potent estrogen. Increased levels of E1 increase the risk of breast cancer, thus the reason we see more breast cancers in postmenopausal women. E1 is further subdivided in the section below.

2. E2 (estradiol)- this is the estrogen that serves over 400 functions in the body.

3. E3 (estriol)- this estrogen is 80 times weaker than E2, but is very protective against breast cancer and protects the ovaries as well.  It does not however afford protection to the brain, bones or heart. Estriol is so beneficial to breast tissue that in Europe it is used to treat breast cancer!


When E1 is metabolized in the body there are three main "estrones" it becomes. There is 2-hyroxyestrone (2-OH estrone), 4- hydroxyestrone (4-OH estrone) and a 16-hydroxyestrone (16-OH estrone). Not only are the levels of each important, but also their ratios.

2-OH estrone is good in that it does not cause breast cells to proliferate and therefore helps protect against breast cancer. It is the main estrogen in premenopause.  To increase this estrone you need a good intake of omega-3 fatty acids like fish oil, moderate exercise, broccoli derivatives (I3C, DIM), B6, B12, folate, rosemary, turmeric, flax seed, kudzu, Vitamin D and high protein diets.  However too much 2-OH estrone can lead to osteoporosis.

4-OH estrone is the ugly one. It damages DNA leading to breast cancer and causes uterine fibroids. Synthetic estrogens, like Premarin, metabolize to 4-OH estrone. Synthetic estrogens are made from the urine of pregnant horses! There are over 40 different estrogens in them, none of which the body can metabolize properly.  And this is the reason I won't prescribe synthetic hormones and I sure don't want them in my body! Betaine supplements will lower 4-OH estrone. 

16-OH estrone is bad but not quite as ugly as 4-OH estrone. Obesity, hypothyroidism, pesticides and increased omega-6 in the diet without enough omega-3s can elevate 16-OH estrone levels leading to increased risk of breast cancer. 

Bio-identical hormones like those in the HTCA pellets are the exact same chemical structure you are born with therefore they do not increase your risk of breast cancer, or if you're a man, prostate cancer. They also are cardioprotective meaning they actually protect against heart disease and stroke, and do NOT increase the risk of disease like synthetics. In North America bio-identical hormones like our HTCA pellets are made of yams (in the south we call those sweet potatoes). In other areas of the world pellets are made from yams and soy, but in the U.S. it's almost impossible to find non-GMO soy. Understand that natural hormones are NOT the same as bio-identical. Synthetic hormones, sometimes referred to as "natural hormones" by pharmaceutical companies, are only chemical substitutions. They are not the same in function nor structure to our own bodies' hormones. Oral synthetic estrogens also increase the risk of blood clots, gallbladder disease and abnormal lipids. 

I hope this has given you a little insight into the complexity of our hormones. I didn't even touch on progesterone, progestins, testosterone, DHEA, pregnenolone, androstenedione and many other sex hormones in our body. It's very important NOT to put synthetic hormones in your body and important to consult a physician who deals with bio-identical hormones on a daily basis. Hormone levels, metabolites and your symptoms should be monitored. Don't add any medication or supplement to your regimen without first checking with your physician.

Call today for your consult with Dr. Trussell regarding HTCA bio-identical hormone replacement pellet therapy. Start feeling better and start being healthier! 501-228-6237