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Medically Reviewed by Dr. Shalaka Samant, B. Pharm. Sc., PhD
Estrogen dominance or excess estrogen is one of the primary causes
of recurring yeast infections. My hope is that this page will help you
understand how this can happen; what it can lead to, and how to fix it.
Excess estrogen will literally feed Candida growth because estrogen controls vaginal glycogen levels. This is why birth control pills and estrogen replacement therapy put women at a greater risk of developing Candida yeast infections.
Short of testing, we can take a look at the symptoms of premenstrual syndrome and determine if you suffer from estrogen dominance.
Dr. Katharina Dalton of the U.K., a leading specialist who first used the term "premenstrual syndrome" defines it as the presence of recurrent symptoms before menstruation with the complete absence of symptoms after menstruation.
PMS differs from all other disorders because the diagnosis does not depend on the type of symptoms you suffer from, but when your symptoms appear and disappear.
Doctors have identified at least 150 symptoms
that occur in PMS, but fortunately, because all of us are different, no
one has all of them! Among the most common are bloating, headache,
backaches, severe grouchiness, depression, breast tenderness, loss of
libido and fatigue.
Do these symptoms sound familiar? They are symptoms of estrogen dominance!
If you suffer from PMS every month, you are probably estrogen dominant. Either your estrogen levels are too high or your progesterone levels are too low, which has the very same effect because progesterone offsets the effects of estrogen. Your menstrual cycle, if your hormones were in balance, should sneak up on you with very few, if any, symptoms.
In a scientific study done in 1999 by Paul L. Fidel Jr., Jessica Cutright, and Chad Steele of Louisiana State University, and published in the American Society of Microbiology in 2000, they found that progesterone has no effect on vaginal Candida in mice but excess estrogen promoted its growth. They also found that excess estrogen reduced the ability of vaginal epithelial cells to prevent colonization of Candida on the vaginal walls.
A study published in June 2015 in Current Infectious Disease Reports talks about pregnancy-related factors such as excess estrogen, increased vaginal glycogen levels, and reduced immune function increasing the yeast infection rate of pregnant women. 1
This study in 2006 done by Georgina Cheng, Kathleen M. Yeater, and Lois L. Hoyer with Department of Pathobiology at the University of Illinois, found that elevated estrogen levels and the incidence of vaginal candidiasis are positively associated. The study noted; "The addition of 17-β-estradiol or ethynyl estradiol to Candida albicans cells caused an increase in the number of cells. The transcriptional profile of estrogen-treated C. albicans cells showed increased expression of CDR1 and CDR2 across several strain-estrogen concentration-time point combinations, suggesting that these genes are the most responsive to estrogen exposure".
A study in 2000 by Xiaoqian Zhang, Michael Essmann, Edward T. Burt, and Bryan Larsen at the Infectious Disease Research Laboratory in Des Moines Iowa, determined that higher estrogen levels lead to increased growth and survival rates of Candida yeast, which proves that once Candida yeast colonizes the vagina, it becomes hormone-dependent. In addition, estrogen increased the amount of multi-drug resistant Candida rna compared with cells not treated with estrogen.
What can cause our hormones to be imbalanced? STRESS!
Stress makes the adrenal glands go into overdrive, which causes the body to divert progesterone to the adrenals to support cortisol production. This process reduces progesterone levels and because progesterone offsets estrogen, the body may experience estrogen dominance, i.e. PMS, hot flashes, night sweats, migraines, fibroids, heavy bleeding, breast tenderness, weight gain, etc.
The adrenal gland contributes about 35 percent of premenopausal female hormones and compromised adrenal function profoundly affects hormonal balance.
Excessive cortisol blocks your progesterone receptors, further contributing to low progesterone and progesterone is the primary material for producing cortisol. When progesterone levels go down, estrogen levels rise. Its a big intertwined circle. These two imbalances, excessive cortisol and low progesterone, lead to estrogen dominance. Restoring adrenal function is a required for hormonal balance.
Excessive estrogen levels have been linked to breast cancer and reduced function of the Thymic gland. The Thymic gland helps immune system t-cells that are grown in the bone marrow mature. At a certain stage of t-cell growth in the bone marrow the t-cells migrate to the Thymic gland to mature. Upon maturity of the t-cells, the Thymic gland releases them into the body. So excessive estrogen also affects T cell maturation and immune response.
Chronic low blood pressure can be a key symptom of adrenal exhaustion as well as extreme fatigue or Chronic Fatigue Syndrome, irritability, inability to concentrate, frustration, insomnia, addictions to either sweet or salty foods, allergies, nervousness, depression, anxiety, PMS, sensitivity to cold, diabetes and headaches.
The continued stress and resulting release of cortisol eventually burns out the adrenals and levels quite often crash in the mornings. This study published in 2005 by Ehrström SM and Associates from the Department of Obstetrics and Gynecology in Stockholm Sweden, determined that these low cortisol levels definitely contributed to recurrent vaginal candida yeast infections.
Individuals who suspect adrenal exhaustion can determine whether the body is producing healthy levels of adrenal hormones through proper testing. Cortisol levels can be measured with a saliva test that measures cortisol levels at four different times of the day. If the test shows low cortisol then your adrenals are exhausted and this must be corrected before you can balance all other hormones.
Adrenal exhaustion can lead to Hypothyroidism, which is defined as a low performing thyroid. The most common symptoms are unwanted weight gain, depression, low energy, cold intolerance, thinning hair, sleep disturbance, fatigue, mood swings and a low sex drive.
In his book, What Your Doctor May Not Tell You About Menopause, Dr. John Lee discusses how it became apparent that the taking of thyroid supplements among his women patients was especially common in those with too much estrogen. This is because, when estrogen is not counter balanced with progesterone, the estrogen builds up and blocks proper thyroid function creating hypothyroidism.
If you suffer from PMS you can also test your thyroid yourself to get a better idea if you have too much estrogen or not. What you do is take your temperature first thing in the morning before you get out of bed. If it is under 97.5 your thyroid is under performing and it could be because of too much estrogen.
Excess mercury can also lead to adrenal and thyroid
to mention the effect it has on the production of yeast. Mercury is a
hormone disruptor and will have an effect on all your hormones. Its also
been found that candida yeast is 67% more prevalent among people with
amalgam dental fillings than those without.2
You can test your mercury levels yourself with an in home Mercury Test Kit.
If your levels are to high, you will have to be treated by following the directions on the Treatment for Mercury Poisoning webpage.
If you suffer from the symptoms of PMS then most likely you have to much estrogen or not enough progesterone.
However, the best way to determine estrogen levels of course is to take a saliva hormone test to detect estrogen dominance.
Saliva hormone testing is the most accurate test with the least amount of false positives. If the test result reveals a low progesterone - estradiol ratio, then you are estrogen dominant.
Please See the Recurring Yeast Infection Webpage to understand how to treat high estrogen levels if you don't have an adrenal or mercury problem.
If you suffer from to much stress which may have caused all these problems to begin with, please see the How To Relieve Stress webpage so you can get it under control.
The information provided in the above article about estrogen dominance, its impact on other hormones, and its association with a greater risk of developing vaginal candida infections is accurate.
Vaginal candida infections are an important concern amongst all women of child-bearing age, with as many as 75% women having reported at least one episode (1) of such an infection during their lifetime. Although several factors, such as, excessive antibiotic use, immunosuppression, and diabetes are known to increase susceptibility to candida infections, the prevalence of candida colonization of the vagina has been observed to increase during pregnancy (2).
Several studies have found that pregnant women were more likely than non-pregnant women to experience a symptomatic infection caused by Candida species. Pregnancy-related factors, such as decreased cell-mediated immunity, increased estrogen levels, and increased vaginal mucosal glycogen production are believed to be responsible for providing a conducive environment for the infectious growth of Candida species.
Candidiasis appears to occur more often in the setting of increased estrogen levels (3), such as oral contraceptive use (4) (especially when estrogen dose is high), pregnancy, and estrogen therapy. Increased estrogen facilitates adherence of yeast (5) to vaginal mucosal epithelial cells. In addition, estrogen promotes hyphae formation and enzyme production in Candida, which are important virulence factors (6) further enhancing colonization. Therefore, elevated estrogen appears to be an environmental signal (7) for enhancing yeast virulence thereby favouring recurring yeast infections.
Estrogen controls critical functions such as glucose homeostasis, lipid homeostasis, bone metabolism, brain function, follicular growth, skeletal growth, and ovulation among a myriad of other functions. Estrogen is a master regulator, (8) and it interacts with a spectrum of other hormones, and enzymes to mediate its versatile functions. Therefore, both hyper and hypo level of estrogen sets off a diverse array of diseases i.e. autoimmune, metabolic, neural, and gender-specific, among others.
Put simply, estrogen dominance is a state in which the body contains too much estrogen and too little progesterone. Excess estrogen can stem from increased estrogen production, increased estrogen exposure in the environment, or improper breakdown of estrogen. These days our environment and diet have multiple estrogen mimics that increase exposure to this hormone. Poor gut and liver health due to an inappropriate diet diminish our ability to adequately breakdown estrogen. And to compound matters further, stress increases our production of the hormone cortisol, which then slows down our ability to get rid of estrogen.
Thus, there are many possible reasons for why a woman is estrogen dominant, as well as multiple factors that can exacerbate estrogen excess. Testing for estrogen dominance followed by diet and lifestyle changes may help achieve the desired hormonal balance and also potentially ward off recurring yeast infections.
If you have any questions about estrogen dominance or anything else, you can contact us through the contact page of this website.
Dr. Samant's References
1. Vaginal colonization by bacteria and yeast. Galask, Rudolph P. American Journal of Obstetrics & Gynecology, Volume 158, Issue 4, 993 - 995. April 1988
2. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015 Jun;17(6):462. doi: 10.1007/s11908-015-0462-0. https://www.ncbi.nlm.nih.gov/pubmed/25916994
3. Candida vulvovaginitis. Author: Jack D Sobel, MD. Section Editors: Robert L Barbieri, MD, Carol A Kauffman, MD Deputy Editor: Kristen Eckler, MD, FACOG. Oct 12, 2016.
4. The impact of oral contraception on vulvovaginal candidiasis. Contraception. 1995 May;51(5):293-7.
5. Vulvovaginal candidosis. Sobel JD1. Lancet. 2007 Jun 9;369(9577):1961-71.
6. The epidemiology, pathogenesis, and diagnosis of vulvovaginal candidosis: a mycological perspective. Crit Rev Microbiol. 2011 Aug;37(3):250-61. doi: 10.3109/1040841X.2011.576332. Epub 2011 May 20.
7. Xiaoqian Zhang, Michael Essmann, Edward T. Burt, Bryan Larsen, Estrogen Effects on Candida albicans: A Potential Virulence-Regulating Mechanism, The Journal of Infectious Diseases, Volume 181, Issue 4, April 2000, Pages 1441–1446
8. Estrogen: The necessary evil for human health, and ways to tame it. Biomed Pharmacother. 2018 Jun;102:403-411. doi: 10.1016/j.biopha.2018.03.078. Epub 2018 Mar 22.
1. Curr Infect Dis Rep. 2015 Jun;17(6):462. doi: 10.1007/s11908-015-0462-0. Vulvovaginal candidiasis in pregnancy.Aguin TJ1, Sobel JD.
2. Med Arch. 2012;66(6):415-7 The relationship between oral hygiene and oral colonisation with Candida species. Muzurovic S1, Babajic E, Masic T, Smajic R, Selmanagic A
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