#209: Why Does My Estrogen Fluctuate?

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So welcome.

All right.

I am here to answer, why does my estrogen keep fluctuating? I keep getting this question, so let's tackle it. I'm here to tell you this episode is for every woman because you're going to deal with this at some point. Estrogen normally fluctuates each month. That is something really important for you to understand. That is one reason why so many doctors don't know how to test hormones and to interpret lab results efficiently, because your estrogen level does change every day of the month depending on where you are in your cycle and what is happening. So let me just quickly explain the basic rundown of your 28-day cycle, okay? So cycle day 1 is actually the first day that you start bleeding. That is where we call day 1. Most women bleed like 5-ish days, 5 to 7, and they have a 28-day cycle. That is like the standard that we term, you know, base everything off of. So our FSH level is a little bit higher those first 5 to 7 days. days, and then it starts to decline. Around day 8, 9, 10, estrogen starts to increase. And what's happening is we're done shedding or bleeding off that uterine lining. That's called the endometrium. That's what grows every month from estrogen. We've bled that off. It's thin. So we have what we call a thin endometrial stripe and a thin lining on ultrasound. Then estrogen starts to be produced by the ovaries in response to that FSH, and we start to grow a new lining. And we're growing, growing, growing. Around day 13, our estrogen starts to decline and we get something called an LH surge. This luteinizing hormone increases drastically, and that triggers the ovary to actually release an egg. called ovulation. And once that process happens, what's left over where the egg was inside this tiny follicle is called the corpus luteum, and that starts to produce progesterone. So then your progesterone starts to slightly increase after ovulation. It heats— hits a peak of maybe around day 21, day 22. So oftentimes we'll tell you if we're looking for progesterone production or evidence of ovulation will have you get your labs drawn between cycle days 18 and 22 to see what those progesterone peak levels look like. Estrogen is also increasing again during this time to grow that lining and to maintain that lining because your body thinks that egg is possibly going to be fertilized, and then it needs to implant into that lining and grow. And so estrogen and progesterone are both increasing again during this luteal phase, during the second phase, and then they start to decline. And these are smooth levels. They, they rise smooth and they drop smooth. And once they drop really low because your egg didn't get fertilized and didn't get implanted into the endometrial lining and trigger a chemical reaction, When those hormones drop, that triggers your endometrial lining to be shed and bled off. So then you start back over at day one and have your bleed. Okay, so it's really important to understand that estrogen increases and peaks 2 times of the month. So it is going to look different every day of the month. We try to check it either Earlier in the phase, around cycle day 10 or 12, to see that first peak. Then we want to look again during the luteal phase, during that second peak of day 21, somewhere in there, and see what those levels look like. But here's the kicker, you guys. That is for a healthy, normal cycle that ovulation has happened. And so if ovulation isn't happening, that sends a totally different message to the brain. And there's a constant communication going on between your hypothalamus, your pituitary gland in your brain, and your ovaries. There's also crosstalk from the thyroid and the adrenals that are all in the conversation together. These are called axes. There's the HPO axis. The HPA axis, the HPT axis, and they determine how much estrogen your ovaries make. So if you don't ovulate regularly every month because you have blood sugar issues, you have PCOS diagnosis, you're a major athlete, and you're affecting your periods that way, if you have thyroid. issues like hypothyroidism, um, or severe adrenal dysfunction, those can all impact your ability to ovulate and have a regular period, and that will shift your hormones. The last reason is perimenopause, period. Like, in general, once you start getting north of 40, you are naturally running out of eggs to ovulate each month. Mm-hmm. And environmental issues can cause you to run out of eggs earlier because they, they can die. And so they don't ovulate. And so if you have a high toxic burden, you've had radiation, you've had heavy metal exposures, you've had lots of illnesses, especially viral illnesses, you might have fewer eggs to ovulate and you might go into this premature space of not ovulating, not making progesterone. That in turn causes what we say an estrogen dominance picture for a while, but it shifts your estrogen production. And so I don't want you to be frustrated if you're north of 40 and you feel like you're working with a provider, you maybe even got an estrogen replacement because your estrogen was low for a little while, and then you find you no longer need it. That is because your ovaries are still Trying to produce estrogen, even though they're not ovulating, they're not producing progesterone, they're not doing all those pieces. They're still trying to squeeze out the last bit of estrogen and function they possibly can. And sometimes that looks like estrogen spikes. It's not a smooth rise and decline. Sometimes it's like, oh, just let me squeeze some estrogen out these few days, and then it's not sustained. And it drops again. And I explain this to patients like, if you fall off a 1-story building onto the ground, it hurts. You're probably okay. If you fall from a 10-story building, you're gonna break something or get severely injured, and it's gonna hurt really bad. That's what happens with our hormones. If your estrogen is really, really high right before your period, It has to drop from a much higher level. You're going to be way more symptomatic. You're going to have more PMS, more discomfort, more hot flashes, night sweats, all the things, irritability, fatigue, crankiness, food cravings, all the PMS things. And it's going to be more severe if you were dropping from a higher level of hormones. Or if you really didn't have any progesterone, you don't even need a super high level of estrogen to feel those effects of estrogen because you don't have progesterone keeping it in check. And I talk about this in other episodes way back at the beginning of my podcast a couple years ago. I went deep dive into the hormone cycle and everything that's going on with your hormones in those 28 days. And that would be a great thing for you to go back and listen to, because you should understand what the heck is happening in your body as a woman. And know that it goes through different not only cycles through different things every day of the month, but different seasons of your life. And perimenopause is a season of transition. It normally. Is about irregularity. So don't freak out that your hormones are irregular, that your periods are a little bit wonky. This is a normal transition time. But I did a whole episode on perimenopause where I talked about the fact that perimenopause used to only be a few years before the menopausal transition, around age 51 or 52. But because of everything we're exposed to in this day and age, perimenopause is lasting more than 5 years, even upwards of 10 years. Women are just having way more hormonal imbalances because of toxic burdens, all the plastics in our environments, the fragrances, all those things. Gut issues cause hormone imbalances. Chronic stress. We're doing too much in this day and age as women, and we're not managing our stress. Like so many reasons. So just know that this is all changeable. We can get a grasp on it. There's so much intervention that we can do, and you actually have so much control of what the heck your hormones are doing. I promise you something as simple as fasting. I have women telling me probably once a week. That they're getting pregnant just doing my Fast to Faith program, doing my Healthy Her program, like dialing in these diet and lifestyle changes that actually balance their hormones out. And their ovaries are coming back online. That connection between the brain and the ovaries is working again. Their hormones are being produced. They're ovulating. So many amazing good things. So there is support. There's answers. We don't actually regulate your periods with birth control. If you're still being told that by your doctor, please listen to my birth control episodes where I debunk all of that. It's all lies. Okay, I know I went really deep into this, but I want you to understand that estrogen does fluctuate. We want it to fluctuate, but we don't want it to be unopposed. We want estrogen or progesterone to keep it in check, to keep it balanced, and we should feel really good. Estrogen is our feel-good hormone. It, it makes us thrive. I love having a good level of estrogen. It like makes everything go so much smoother. Okay, so I hope this helped you a little bit. Let me know What other questions you have from this episode? I'm here for you. This is all figureoutable. I promise you. Just stick with me. I have all the answers you're looking for. So go have an amazing week. Love you.