Hormones and the Estrobolome

Written By Ceda Jarick

I often chat in clinic about the ‘organ systems’ in East Asian Medicine, that are important in hormonal regulation. In Chinese Medicine, menstrual cycle regularity is usually related to the function of Kidney (from a modern scientific perspective, this includes the Ovaries & Adrenals, HPA/HPO axis), Digestion (Stomach, Spleen-Pancreas and digestive enzymes) and the Liver-Gall Bladder. These, according to symptoms and signs, will factor heavily into Herbal and Acupuncture treatment of hormone issues in Puberty, Hormone Imbalance, Period problems, Fertility optimisation and Peri/Menopausal transition.

In the last 15 years, thanks to DNA sequencing of intestinal bacteria, we are expanding our knowledge of how Oestrogen is excreted or recycled, from a biological perspective.

The Estrobolome is a collection of bacteria in the gut that support the oestrogen levels in the body. Your liver breaks down oestrogen and sends it, via the bile, through the Gall Bladder, into the intestines. From here, the Estrobolome influences whether the oestrogen is either excreted (removed) through the stool, or it’s reabsorbed back into the blood stream.

SUPPORTIVE FRAMEWORK FOR THE ESTROBOLOME:

  1. Eat a fibre rich, diverse diet (look at the idea of eating 30 plants per week)

  2. Include cooked Brassica family vegetables (broccoli, cabbage, Brussels sprouts, cauliflower, asian greens like Gai Lan and Bok Choy) as these help oestrogen metabolism in the Liver

  3. Include fermented foods regularly (yoghurt, kefir, sauerkraut, kimchi etc)

  4. Maintain regular bowel motions (optimally every day)

  5. Exercise consistently, add some resistance or strength training

  6. Manage stress (meditation, exercise, Acupuncture, spend time in nature and with friends)

  7. Avoid cigarettes and drink alcohol moderately

  8. Aim for 7-9 hours sleep per night.

  9. Aim for at least 1.5L of pure water each day. Herbal teas count (but I don’t count tea and coffee)

  10. Avoid unnecessary use of anti-biotics

  11. If you are post-menopausal, look to foods that contain phytoestrogens (soybeans, tofu, tempeh, flaxseeds)

WHEN AND WHY DOES THIS MATTER?

PUBERTY

During puberty, oestrogen rises dramatically, leading to breast development, establishment of the menstrual cycle, as well as other effects. A healthy microbiome at this time may help with hormone signalling and immune response.

Feeding the good bacteria with the suggestions above, and avoiding ultra-processed foods, refined sugar, emulsifiers and additives will contribute to a healthy microbiome.

Puberty can shift the natural Circadian Rhythms, which can further affect insulin sensitivity and blood sugar regulation, gut health and hormone regulation.

These lifestyle tweaks may be particularly important to a teen who has painful periods, PMT or heavy periods, which seem so incredibly unfair.

PERIMENOPAUSE

As Ovarian Estrogen production becomes erratic in Peri-menopause, the estrobolome may be helpful to Oestrogen regulation. Potential signs include the obvious things like hot flushes and mood changes, but there are many more (read more here)

There are a few dietary tweaks that I see as being really beneficial during this time (all of the list above, and specific information here!). However, that might feel a little overwhelming to start with. So, what if I narrowed it down to 3?

  1. Increase your fibre intake to 25-35g per day (read more here) but do this gradually to allow the microbiome to catch up

  2. Do 20-30 minutes of ‘exercise that raises your heart rate’ each day. Make 2-3 sessions per week weight bearing or resistance (ie weight training, pilates, yoga).

  3. Increase your protein intake to around 1.2-1.5g per kg of ideal body weight. For most Woman, this is around 30g per meal. For more information, see the article on protein.

MENOPAUSE

After menopause (ie no periods for more than 12 months), Women still have oestrogen in their system. (read more here) Before Menopause, the Ovaries are the major producer, with the Adrenals and Adipose (fat) tissue contributing a little and the Estrobolome has a supporting role. After Menopause, the main sources are:

  • The adrenal glands (on top of the Kidneys, mediators of the stress response) make the precursors to oestrogen (DHEA, DHEA-S and Androstenedione), which are then converted to oestrogen. An important consideration here is stress (read more here), as the Adrenals are a part of the stress response, and this may disrupt the production of these precursors.

  • The Adipose/Fat tissue contains Aromatase that converts the adrenal precursor to the E1 type of oestrogen. Women with lower body fat tend to have lower oestrogen levels after menopause. Women with higher body fat often have higher levels of Oestrogen. This may contribute to the tendency to gain weight at Menopause.

  • The Estrobolome recycling of Oestrogen becomes more important post-menopausally.

From a Chinese Medical perspective, symptoms or signs that you might need to work on your “Spleen Qi” or digestion include:

  • Fatigue, Low energy

  • Poor appetite, Sweets cravings, picky eating

  • Bloating after eating

  • Loose stools, diarrhoea, constipation without dry stools or with incomplete bowel motion

  • Feeling heavy or weak in the limbs, lowered muscle mass

  • Pale complexion

  • Brain fog and dizziness

  • Bruising or bleeding easily

  • Heavy periods, prolapse

    This might be impacted by the ‘Liver Qi stagnation’, often as a result of stress.

  • Irritability, sighing

  • Irregular bowels

  • Irregular periods, period pain

Thanks for reading!

Ceda Jarick
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