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Winning the weight battle after menopause

Lifestyle changes may not always be enough to control biologically driven body changes.

Published: August, 2019

You spend hours in the gym every day. You eat nothing but grilled chicken, fish, and salads. Yet the numbers on the scale don’t budge — or worse, they slowly creep up, along with your waist measurement.

Welcome to menopause.

“The change” actually does bring changes for many women, including weight gain that can resist even the most diligent efforts to reverse it, says Dr. Fatima Cody Stanford, instructor in medicine at Harvard Medical School.

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Signs of Estrogen Dominance — and How to Fix It

  • Estrogen dominance is essentially too much estrogen. There’s no set number that indicates estrogen dominance. It’s the amount of estrogen you have relative to your other sex hormones.
  • Estrogen is crucial for day-to-day functioning. Without it, you end up with vaginal changes that lead to painful sex and urination, hot flashes, moodiness, wonky periods, brain fog, and more.
  • Too much estrogen can wreak absolute havoc on your whole body. It can cause things ranging from fatigue and anxiety to fibroids, endometriosis, abnormal menstruation, and breast cancer.
  • Conventional medicine tends to prescribe hormonal birth control to alleviate symptoms of estrogen dominance, which can have a lot of side effects and make the problem worse in the long run.
  • There are things you can do that not just alleviate symptoms, but get rid of the problem at its core.

It seems like female problems come in groups. Patients will learn they have fibrocystic breasts, then get treated for endometriosis or fibroids. A woman with a lifetime of heavy periods will end up at the fertility clinic. A man with a more womanly shape up top may find himself with sexual dysfunction down the road.

It all points to estrogen dominance, which is high estrogen levels. There’s no set number that indicates estrogen dominance. It’s the amount of estrogen you have relative to your other sex hormones (progesterone in women and testosterone in men).

Low estrogen symptoms (i.e., why you need estrogen)

Estrogen is crucial for day-to-day functioning. It regulates menstruation, hunger and satiety, insulin sensitivity, it helps you metabolize cholesterol, it contributes to bone density, and more. Without it, you end up with symptoms of menopause, like vaginal changes that lead to painful sex and urination, hot flashes, moodiness, wonky periods, brain fog, and more.

But, too much of a good thing causes biological chaos, in the case of high estrogen.

Symptoms of estrogen dominance:

Women:

  • PMS
  • Weight gain (particularly in hips, midsection, thighs)
  • Fibrocystic breasts
  • Fibroids
  • Endometriosis
  • Abnormal menstruation
  • Fatigue
  • Reduced sex drive
  • Depression
  • Anxiety
  • Bloating
  • Breast tenderness
  • Mood swings
  • Brain fog
  • Insomnia

Men:

  • Enlarged breasts (gynecomastia or man boobs)
  • Sexual dysfunction
  • Infertility

If you have a few high estrogen symptoms going on, you might want to open up a conversation with your functional medicine doctor about estrogen dominance. Read on to find out where these symptoms are coming from and what to do about them.

Hormonal birth control

One of the main reasons there has been a noticeable rise in estrogen dominance is because hormonal birth control is so popular. It’s a common scenario that doctors prescribe the pill to young women to regulate periods or to control heavy bleeding, and these women will stay on hormonal birth control for years without fully understanding long-term effects.

Hormonal birth control creates the perfect storm of hormone imbalance. Erratic periods and heavy bleeding are likely a result of estrogen dominance to begin with. Prescribing the pill to treat it just stacks more estrogen on top of excess estrogen. Second, hormonal birth control releases synthetic progesterone, which suppresses your natural progesterone production. Progesterone balances the effects of estrogen, and without enough, you end up with symptoms of estrogen dominance.

You don’t even have to be a lifetime Pill user to end up with hormone balance problems. If you used hormonal birth control and have symptoms of estrogen dominance after only a few cycles, the culprit could still be the exogenous hormones.

Personal care products

Thousands of man-made products contain xenoestrogens, which means they mimic estrogen and disrupt your hormone balance. There’s a long list of chemicals that mimic estrogen. Here’s the short list of the more common ones you’ll see:

  • Parabens. Manufacturers use this well-known xenoestrogen as a preservative.
  • Phthalates. You’ll find phthalates in plastics and as an emulsifier and stabilizer in topical products.
  • Benzophenones. This additive alters estrogen and testosterone production. Most often, you’ll find it in sunscreens.
    Triclosan. Manufacturers use triclosan as an antibacterial agent. Researchers found that it measurably acts on estrogen receptors. For example, it increased the size of uteri and grew breast cancer cells in rats.

Another rule of thumb is that if it has a strong chemical or perfume smell, there’s a good chance it’s messing with your hormones. The exception is products fragranced with essential oils, which can smell strong but won’t disrupt your hormones. It’s best to avoid products with “fragrance” on the ingredients list.

You absorb a substantial portion of the things that come into contact with your skin, so it makes sense to be conscious about what’s in the products you use. Whether you switch out your products as you run out, swap one thing a month, or go nuclear on your shelves, you’ll need to pay attention to your personal care products to reduce your estrogen load.

Related: Natural Beauty Products That Won’t Wreck Your Hormones

Estrogen in the food you eat

Whether the food you eat comes from plants or animals, it has an effect on your estrogen levels. The pesticides most widely used in large-scale farming contains endocrine disruptors, and researchers associated the most common herbicide in the world, glyphosate, with female cancers which point to estrogenic and endocrine-disrupting effects. In one example, glyphosate caused human breast cancer cells to grow in vitro.

It’s common practice for factory farmers to administer hormones to animals for faster growth, which end up in your meat (particularly the fat) and dairy.

Carefully sourcing your food matters. Small-scale, naturally-minded farmers do not pump animals full of hormones for quick turnaround, and they do not have hundreds of acres of crop-dust with dangerous herbicides. Choose organic for high-residue foods when you can.

Related: The Sneaky Place Glyphosate Is Hiding in Your Food

Estrogen in water

The Environmental Working Group identified 45 hormone-disrupting chemicals in public drinking water.

As a consumer, that presents a problem. You can decide to forgo certain types of foods or check ingredients on your personal care products, but you can’t skip water. If you’re drinking water from a public source, you’re probably dosing yourself with things that mimic estrogen and disrupt your hormones. Bottled water is equally problematic. Estrogenic chemicals in plastic bottles leaches out into the water. Canned drinks lined with BPA are no better.

The cleanest water you’ll get is regularly tested well water that’s not close to factory farms, mines, or any sort of industrial complex that will contaminate it. Obviously, that’s not accessible for everyone. For the rest of us, the combination of a public water source with a high-quality filter will give you clean water that won’t change your bra size. Look for a triple-stage filter: a sediment filter, a ceramic filter (to block viruses), and an activated charcoal filter.

Slow digestion

What does the way you digest your food have to do with how much estrogen you have pumping through your system? Since your digestion points to how efficiently you get rid of waste that hangs around in your intestines, it has everything to do with how much estrogen is in your bloodstream.

One major way your body eliminates estrogen is through pooping. If you have slow elimination, you don’t get rid of estrogen through the digestive tract. If estrogen hangs around your intestines and moves inefficiently, it has plenty of opportunity to be reabsorbed into the bloodstream. Stack that on top of the normal estrogen your body releases at ovulation and around period time, and your estrogen levels will climb month over month.

There are hundreds of things that might affect your intestinal motility, but two you can take control of are low stomach acid and gut bacteria imbalance.

  • Low stomach acid. If you don’t have enough stomach acid, your food doesn’t break down enough for a smooth move through the intestines. When food moves slowly, bacteria have the chance to feast and reproduce, which throws off the balance of your gut microbes.
  • Gut bacteria imbalance. When your gut bacteria is off, owing to low stomach acid, antibiotics, heavy metal exposure, or a million other causes, it can affect the nerves that tell your intestines to contract and relax and move things along. So, an imbalanced gut both causes things like IBS and SIBO, and makes them worse.

Finding the root cause of these things can be frustrating, but if you suspect you have acid or microbiome imbalances, ask your functional medicine doctor about supplementing with betaine HCl or digestive enzymes.

Toxic load

Whether it’s heavy metals, a moldy house, or eating processed packaged foods, toxic load contributes to estrogen dominance by burdening your detoxification and elimination systems. Your detox systems — particularly your liver and kidneys — can only handle so much over the course of a day. If your body is constantly dealing with heavy metals, mold toxins, plastics, cleaning products, fragrances…all of those things and more compete with estrogen for its place in the elimination line.

Toxin-free environments do not exist. Even digestion releases by-products that your body has to neutralize and excrete. The key here is to minimize toxins when you can, which leaves room for your body to deal with the toxins that you can’t control.

Being overweight and high estrogen

Your body produces estrogen in the adrenal glands, brain, and in your ovaries or testes, depending on your equipment. Another place both men and women produce estrogen is in adipose (fat) tissues.

As expected, the more fat cells you have, the more estrogen you will make. The more estrogen you make, the more fat you store. And then you make even more estrogen, and store more fat, and so on until you have more estrogen and fat than you know what to do with.

Does stress cause estrogen dominance?

If you have a handful of symptoms of estrogen dominance, evaluate your stress levels before you do anything else. Stress has a massive impact on the production of your sex hormones, and chronic stress will throw off your hormone balance and contribute to estrogen dominance if you don’t get a handle on it.

The reason for this is because we have a multi-tasking hormone, pregnenolone, that is a precursor to both stress hormones and sex hormones, and it will go wherever the demand is.

When everything is fine, pregnenolone helps make progesterone and just enough cortisol. When you’re stressed, your body snaps up the pregnenolone that it would otherwise use to make progesterone, and instead makes a substantially more stress hormones like cortisol. That means progesterone comes up short.

Progesterone keeps estrogen in check, so if you don’t have enough of it, estrogen can go haywire. That’s when you end up with weight gain, PMS, and the other symptoms of estrogen dominance.

A stressful event here and there is fine, and your body can handle that. It’s chronic stress that causes problems with your hormones and frankly, your whole body.

What to do about too much estrogen

  • Quit birth control. Talk to your functional medicine doctor about non-hormonal birth control options.
  • Swap out your personal care products. There are non-toxic versions of just about everything nowadays, and they perform just as well or better than the nasty stuff.
  • Choose organic. It might be tough to go all organic, all the time, but you can at least opt for organic meats and choose organic of the most high-residue foods.
  • Filter your water. Obviously, you can’t forgo water. A high-quality filter is an expense up-front but will pay for itself if you were buying bottled water, not to mention medical costs down the road.
  • Talk to your doc about stomach acid. Functional or integrative medicine doctors do stomach acid better. Conventional medicine doctors will prescribe you things that will make problems worse if your acid is too low.
  • Reduce toxic load and support detox pathways. Natural herbs and supplements like milk thistle, dandelion root tea, dandelion greens, glutathione, and calcium d-glucarate support the liver and help get rid of excess estrogen and all the other day-to-day yuck we run into. Here’s a fascinating article on why calcium d-glucarate is an amazing detoxifier. (Spoiler: it metabolizes estrogen as well as tamoxifen, a prescription medication for excess estrogen).
  • Lose weight. You know who you are. You can start by using our 30 Day Upgrade guide to clean up your diet while crushing cravings.
  • Meditation, yoga, gratitude. Start a de-stressing practice that will free up that pregnenolone for progesterone.

When people try to get help from a doctor or other practitioner, they are often told this is genetics, it’s just the way you are, that you have to deal with it. It’s simply not true. Just because there’s no magic pill (or there is a pill but it has awful side effects) doesn’t mean you’re at a loss. There are things you can do that not just alleviate symptoms, but get rid of the problem at its core.

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13 Signs Your Body Is Producing Too Much Estrogen

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions will remain anonymous. This week’s topic: signs your body is producing too much estrogen.

Q: I’ve been experiencing some weird symptoms. I recently noticed that I was gaining weight, which is unusual for me. And my brain is feeling fuzzy, like I can’t concentrate that well. I’m also getting really bad PMS, when I never used to before. I called up my mom’s best friend, who’s a doctor, and she said that I’d have to get tested but it sounds like it could be that I have too much estrogen. How is that possible? Is it something I can fix?

A: For those of us with female reproductive systems, estrogen is extremely important for driving our monthly menstrual cycle. Throughout the month, it spikes and dives, orchestrating ovulation and helping trigger our period. Estrogen levels vary widely between people, but basically, it’s all about balance! Your body is always making estrogen, but you could end up making too much if you have a lot of excess weight, have diabetes or high blood pressure, are pregnant, have a tumor, or are stressed. Environmental causes include drinking lots of alcohol (because your liver is what metabolizes this hormone and alcohol can mess with your liver so it is unable to do that job), being exposed to estrogen-like toxins in the environment, or eating certain foods that have estrogen-like compounds in them.

If your estrogen levels are high compared to your other hormones, that’s often called estrogen dominance — because that one hormone is dominating the others. In particular, it’s high relative to the hormone progesterone, the other hormone that helps orchestrate your menstrual cycle. (Note: I’m going to limit this article to high estrogen in folks with female reproductive systems, but high estrogen can cause difficulties in people with male reproductive systems too. The symptoms are different and there isn’t enough space to go into them here.)

So how do you know if your doctor should be monitoring your estrogen levels? Let’s look at the ways your body might be tipping you off that its estrogen cup overfloweth.

1. You’re Gaining Weight

One of the main symptoms of too much estrogen is weight gain, particularly in the hip area. If you have too much estrogen, you might end up gaining weight. You might also experience bloating, and/or difficulty getting rid of extra weight. This is because your estrogen actually needs to be balanced in order for your body to be able to lose weight and maintain weight loss over time.

2. Your Breasts Are Swollen Or Tender

Your breasts are extremely sensitive to hormone changes, which you may already know since many people experience breast changes every month during their cycle. If you notice that your breasts are more swollen than usual or are feeling sore, it could be due to high estrogen levels. Look in particular for soreness on the front of your breast and around your nipples.

3. Your Breasts Are Fibrocystic

Fibrocystic breast changes are when the quality of your breast tissue changes, becoming more lumpy or rope-like. Your breasts may also be painful or tender to the touch (usually on the top or side of your breast). This happens because of high estrogen and low progesterone levels — aka estrogen dominance. Specifically, this balance (or rather unbalance) of hormones causes the connective breast tissue to grow more than usual, creating the ropey or bumpy quality of tissue we call fibrocystic.

4. Your Period Is Irregular

There are tons of reasons why your period could show up early or late. High estrogen is just one, but it is a potential culprit, so it’s good to know about if you’re worried about your hormone levels. Your period is orchestrated carefully and gloriously by the complex dance of multiple hormones. So if one hormone is elevated, the whole operation can be thrown out of whack.

5. You Period Is Heavier Than Usual

Also good to know is that high estrogen levels can cause your period to be heavier. That’s because this hormone is responsible for thickening the lining of your uterus — so if you have more of it, your lining will be more, um, plentiful.

6. You Have Mood Swings

Estrogen doesn’t just impact your period — it is also very important for your emotions and mental state. To illustrate this point, consider the monthly mood rollercoaster that is your menstrual cycle. All those changes and swings are because of what your hormone levels are doing.

If you have high levels of estrogen, your mood is likely to tend toward anxiety, panic attacks, and depression. One doctor specifically calls the feeling lots of people with high estrogen get “agitated depression,” because people with elevated estrogen often experience a mix of anxiety and depression at the same time.

7. Your Sex Drive Is Lower Than Usual

You may have heard that your sex drive can diminish when your estrogen is lower, like when you start going through menopause. However, many people with high levels of estrogen also notice that their sex drive is diminished. There still isn’t much research on the subject, unfortunately.

8. You’re Getting Headaches

Did you know that humans with female reproductive systems are more likely to get headaches and migraines? The hormone levels in our systems are a big factor in headaches. Fluctuations in estrogen levels (like what happens to you every month as your body goes through ovulation to menstruation) are one reason why you could be getting headaches. Also, it turns out that pretty much everyone gets a headache when they have more estrogen than progesterone in their systems.

9. Your Hair Is Falling Out

If you have too much estrogen, your hair can start to thin. Specifically, if you have estrogen dominance and as a result your progesterone is lower than it should be, you can end up shedding more hair than usual. Over time, this can result in hair loss.

10. Your Hands And Feet Are Always Cold

The reasons for this aren’t very well explained, but many people with high estrogen levels also have poor circulation and as a result get cold hands and feet. We do know that estrogen has something to do with circulation, but more research needs to be done in this area as well.

11. Your Memory Isn’t Great

Low estrogen has been associated with Alzheimer’s and other memory loss. However, doctors have found that if you have high estrogen, you’re also likely to have difficulty remembering things. More research has to be done to explain why this is happening. (You noticing a pattern yet?)

12. It’s Hard For You To Sleep

Estrogen is an exciting hormone — it gets your body hyped. If you have a lot of it, it’s going to be hard to sleep. Progesterone, in contrast, is the hormone that helps you chill out. So if you notice that you’re having a hard time winding down, estrogen dominance could be the culprit.

13. You’re Exhausted

This stems directly from the item above. If you’re not sleeping, it would make sense that you’re going to feel more fatigued than you usually do. Lots of things make us tired, particularly in this face-paced world we’re living in, so exhaustion could be because of a long list of things. But if you’re noticing that you’re tired more often than usual AND you have some of the other symptoms on this list, that could indicate that you have high estrogen.

What Can I Do About It?

Sure, some of these symptoms suck, but is having high estrogen a potentially scary thing? It turns out it can be — because having more of this hormone puts you at risk for medical conditions you don’t want. These include breast, uterine, and endometrial cancer, high blood pressure, endometriosis, ovarian cysts, and depression.

To know if your estrogen levels are too high, you have to go to your doctor to get tested — probably more than once, so your doctor can monitor trends in how your levels rise and fall across your cycle. A single number isn’t going to cut it because the normal amount of estrogen someone has in their body is always fluctuating. She may put you on hormone replacement therapy so you can get back in balance and start feeling better.

There are also a lot of things you can do on your own to help! Cutting back on drinking alcohol is a big one, since we now know that if your liver is messed up it can’t process estrogen out of your system. Eating organic can help you cut out any pesticides or other chemicals you may be eating that are acting like estrogen once you have them in your system. It can also be helpful to eat weak phytoestrogenic foods, like pomegranates, flax seeds, berries, oats, and barley, which actually counteract estrogen’s effects. (Steer clear of soy, which does just the opposite.) Exercising can help you cut excess weight that may be causing your estrogen imbalance. Sleeping enough each night is important, because if you don’t get enough sleep your body doesn’t make as much of the hormone melatonin, which helps you maintain healthy estrogen levels. Finally, managing stress is critical, because the stress hormone cortisol is actually made in part by progesterone. So if your body is making lots of that hormone, it’s using up your progesterone stock, making your estrogen levels higher by comparison.

Either way, there’s no way to know what’s going on without a doctor’s help, so if these symptoms sound like you, go and get checked out so you can start feeling better!

Images: ; Giphy

Maintaining proper weight is a challenge for people of all ages. However, the older you get, the more difficult it can be. It has been found that 90% of women experience weight gain between the ages of 35 and 55, not coincidentally, during perimenopause and menopause. While nutrition, exercise and lifestyle are critical elements to weight loss, balancing your hormones after the imbalance that perimenopause and menopause caused, is vital to your success in maintaining a healthier weight. Hormones and weight gain are closely related, if your hormones are not balanced, you can gain weight, especially with too much cortisol or too little progesterone, testosterone or estrogen. Bioidentical hormone therapy may tip the scales in your favor.

The average weight gain is gradual, about 10 to 15 pounds starting in perimenopause and averaging to about a pound a year. However, women who experience early menopause as a result of surgical menopause (hysterectomy) tend to gain the weight at an even more accelerated pace. Menopause weight gain, thanks to the androgen hormone, tends to be located on your abdomen as opposed to your hips, thighs, or rear.

Hormones and Weight Gain; What Causes Menopause Weight Gain?

The hormone fluctuations in perimenopause and menopause directly impact your appetite, fat storage, and metabolism. Hormones and weight gain go hand in hand. So, menopause weight gain is actually hormone weight gain.

Estrogen: It is common for estrogen levels to diminish during menopause causing cessation of ovulation. The decreased production of estrogen by the ovaries causes a woman’s body to search for other sources of estrogen. Another source of estrogen is fat cells, so your body learns to convert more calories into fat, in order to increase estrogen production. This means weight gain.

Progesterone: It is also common for progesterone levels to decrease during menopause. Progesterone’s role in weight gain is more deceiving; low levels of the hormone do not actually cause you to gain weight, but instead cause water retention or bloating. This annoying side effect makes you feel heavier and makes your clothes fit tighter.

Testosterone: Testosterone in a women works to build and maintain muscle mass among other things. These muscle cells work to burn calories in your body and cause a higher metabolism. Levels of this hormone decrease during menopause causing the loss of muscle mass and hence result in lower metabolism. This also results in weight gain.

Other Causes: Insulin resistance and stress are also responsible for a woman’s difficulty or inability to experience weight loss during menopause. Insulin resistance occurs when a woman’s body incorrectly converts every calorie into fat; this is an extreme case of estrogen correction. Overtime, your body resists the insulin produced in your blood stream and you therefore experience weight gain.

Stress is also a contributing factor to menopause weight gain. High stress puts your body into panic mode, preventing weight loss. Basically, your body begins to store food since stress hormones, namely high levels of cortisol, are telling your body that you will not be eating again for a long time. These stored calories result in weight gain. Stress hormones and weight gain are a common problem among women.

HRT and Weight Gain

Women who use hormone replacement therapy (HRT) typically experience fewer problems with weight gain and redistribution of body fat. Estrogen enables leptin – a protein hormone that helps control the way that the body stores fat. Leptin helps by making you feel full so you eat less and increase the rate at which you burn calories. In addition to estrogen, testosterone helps maintain lean muscle mass and can also boost energy levels. Many women who supplement the hormones estrogen and testosterone with HRT are less likely experience weight gain and metabolic issues.

The Solution: Bioidentical Hormones and Weight Loss

Bioidentical hormones and weight loss are closely related. Nutrition is 70% of your health, exercise and lifestyle account for about 25%, and the hormones only for about 5%. However, when that 5% gets out of balance, the other 95% does not work well. So to combat menopause weight gain and begin weight loss, first, BodyLogicMD helps regain hormonal balance by replacing lost hormones with natural, bioidentical ones.

We then initiate customized programs to help patients eat right, exercise and maintain a healthy lifestyle.Unbalanced hormones and weight gain do not have to be a part of your life. By combining fitness, nutrition and bioidentical hormone replacement therapy you can experience success in controlling weight gain. Employ a proper nutrition and fitness plan and correct hormone imbalance with bioidentical hormones and weight loss will come naturally.

Contact the BodyLogicMD bioidentical hormone therapy physician nearest you to schedule an appointment and learn more about how hormone therapy can help control menopause weight gain.

Estrogen and Weight Gain: What’s the Connection?

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You may be asking, “What’s estrogen’s role in weight gain?” And you’d be right to ask that.

You can’t win, can you? When estrogen is high, it causes problems.

When it’s high, it’s partially to blame for things you’re likely familiar with—like irregular periods, heavy bleeding, PMS, endometriosis, fibroids, fatigue, mood changes and sometimes breast or ovarian cancer.

And when it’s low, it affects us, too.

Much of the same—missed or irregular periods, infertility, mood changes.

Ahem, anything else? There’s more, I’m sure.

Related to menopause, yes, there’s more. Weak bones, for one. Hot flashes for another. And then there’s an increase in urinary tract infections and—the elephant in the room—

Lemme guess … weight gain.

Sorry, yes, but you already knew that. Low estrogen levels can, and do, contribute to weight gain in many menopausal women.

So, what really happens?

It’s not uncommon for women to notice that they’re gaining weight or it’s more difficult to lose weight. The form of estrogen known as estradiol decreases during menopause. Estradiol helps regulate your metabolism and your body weight. Hence, the weight issues.

And why does that weight like to gather around the mid-section, rather than the hips and thighs? I’m suddenly an “apple” and no longer a “pear.”

Although more research needs to be done, some has shown that “perimenopause, independent of age, is associated with increased fat in the abdomen as well as decreased lean body mass,” according to the website menopause.org. That’s apparently where this type of fat likes to migrate.

OK, break it to me. Why is it particularly dangerous to be an apple rather than a pear?

It’s because there’s more than just meets the eye: Belly fat is not just that extra layer of padding you see below your skin (known as subcutaneous fat). It’s also visceral fat, which is the fat hiding where you can’t see it—deep inside your belly, surrounding your internal organs.

Visceral fat is linked to many health problems that are potentially dangerous, like heart disease, type 2 diabetes, high blood pressure and high cholesterol and even an increased risk of premature death (regardless of your overall weight).

What do the experts have to say?

While some blame low estrogen for weight gain, others point to other midlife factors that take place around the same time as menopause, like the fact that women become less active and more sedentary (many midlife women—including this one—beg to differ) and a natural slowing of metabolism.

Sounds like low estrogen and weight gain is a done deal.

Certainly not. There’s strong evidence that physical activity and a good, healthful diet with sensible portions can offset much of the weight gain that appears during this time of life. Read Dr. Barb DePree’s tips to help menopausal women manage their weight.

You may also have to kick it up a notch and exercise more often than you’re used to, but it’ll pay off. Make sure to include strength training in that exercise regimen, because it helps boost metabolism and increase muscle mass that we also lose with age. Learn about fighting back with exercise.

And since studies show that sitting is linked to higher levels of abdominal fat, you’ll do yourself a favor if you stay vertical when you’re able. Stand more, sit less and move around more often. (A standing desk is great for people who sit while they work; so is pacing while you’re talking on the phone.)

Oh, there’s one other thing: Aim for a good, solid night’s sleep. Sleep deprivation activates the hormones leptin and ghrelin, which are responsible for regulating your hunger and appetite.

“I’ve hit a stubborn weight-loss plateau,” writes this week’s house call, “even though I seem to be doing everything right, like eating the right foods and exercising. How can I overcome that obstacle?”

I’ve discussed different reasons for weight-loss resistance in past blogs. Many obstacles have nothing to do with what you eat or how much you exercise. Instead, they involve things like nutritional imbalances, chronic inflammation, metabolic challenges, leaky gut, changes in your microbiome, environmental toxins and your genes.

One huge but often-overlooked reason for weight-loss resistance involves hormonal imbalances.

No contest: The monster hormone that causes weight gain, inflammation and chronic disease is excess insulin. Think of this hormone as your fat cell fertilizer! My new book, Eat Fat, Get Thin, discusses how to naturally regulate insulin so you can shift your body from fat storage mode to fat-burning mode.

At the same time, insulin isn’t the only player; other hormones also affect your weight and health. Three big disruptors are: thyroid, cortisol and sex hormones. I discuss these hormones in-depth in The Blood Sugar Solution, however, let’s briefly look at each of them here.

Thyroid

Research shows hypothyroidism, or low-thyroid function, affects one in five women and one in ten men. Unfortunately, in over half of these cases, this condition isn’t diagnosed.

Many things contribute to these imbalances. In my e-book The UltraThyroid Solution, I explain how diet, nutrient deficiencies, stress and environmental toxins impact your thyroid and how to address these problems.

A common cause of hypothyroidism is gluten intolerance.

Other major culprits that interfere with thyroid function include pesticides and heavy metals. Nutrient deficiencies can also slow things down. Your thyroid needs specific nutrients to run optimally including selenium, zinc, iodine and omega 3 fats.

Most doctors don’t test for thyroid function correctly. Even when they do diagnose it, they don’t treat it effectively by optimizing thyroid function through diet, supplements and the right thyroid hormone replacement therapy.

That’s unfortunate, since thyroid function plays a vital role in maintaining a healthy weight, and hypothyroid is a major player in weight-loss resistance. Among my patients, I’ve found these four strategies can optimize thyroid function and weight loss:

  1. Get the right tests. Ask your doctor to check your thyroid stimulating hormone (TSH and free T3 and T4, as well as thyroid antibodies including thyroid peroxidase (TPO) and anti-thyroglobulin antibodies. I cover this extensively in my e-book. Some people may need to dig deeper and get a special test called reverse T3 to learn if something like heavy metals (mercury), pesticides, yeast or nutritional deficiencies like selenium, vitamin D, zinc or even iodine could block thyroid hormone function. Reverse T3 is the brake that stops your thyroid hormone from working at the right times. Unfortunately, toxins and inflammation increase levels of reverse T3. Even if regular thyroid tests appear normal, high levels of reverse T3 mean your thyroid is not working properly!
  2. Eat right for your thyroid. Limit soybeans, raw kale and other raw cruciferous veggies, which might contain thyroid-blocking compounds called goitrogens. I know this sounds confusing. After all, I usually recommend plenty of cruciferous veggies. In this scenario, I am saying it’s okay to eat them…just not raw! You should limit the kale juice and kale salad. One study in The New England Journal of Medicine looked at a woman who ate two pounds of raw bok choy a day and went into a hypothyroid coma! I know that sounds extreme, but it could happen. I also recommend wild-caught, low-mercury fish and seaweed for additional iodine, the mineral your thyroid hormones are made from. Since people eat less iodized salt, you might be iodine deficient. Over-exposure to fluoride and chlorine also create iodine deficiencies. Pumpkin seeds and oysters provide excellent zinc sources, and Brazil nuts provide selenium and iodine.
  3. Use quality supplements for thyroid health. A good multivitamin that contains the above nutrients, plus fish oil and vitamin D, makes an excellent nutrient base. Some people may benefit from iodine supplements. Just be careful not to overdose and be sure to get your iodine levels measured regularly.
  4. Replace the right thyroid hormones. Most doctors will only prescribe T4 (such as Synthroid), the inactive form of thyroid hormone your body must convert to its active form T3. Most people do better on bioidentical hormones (like Armour, Westhroid or Nature Throid) or a combination of T4 and T3. A Functional Medicine doctor who understands how to optimize thyroid balance can customize a nutrient protocol.

Cortisol

Another source of weight-loss resistance is stress. Yes, you actually can think yourself fat or think yourself thin, and science proves it. Stressful thoughts activate metabolic pathways that cause weight gain and insulin resistance.

Remember, stress is a response to stimulation that makes you feel threatened and not always provoked by real circumstances, rather a perception that you are being attacked.

Most stress isn’t real. A worry, thought, fear or projection into the future of what might go wrong can all become real stressors. While short-lived, we carry them with us and don’t know how to reset our mindset. If you have survived trauma, it can live in your body even after the original stressor is gone.

Regardless, stress is any real or imagined threat to your body or ego. While that might mean someone putting a gun to your head, it could also mean thinking your boss is mad at you (even when they aren’t).

Stress creates hormonal responses that cause weight gain and insulin resistance. Cortisol is an adrenal hormone that helps you to run faster, see further, hear better and pump fuel into your bloodstream for quick energy. It is the hormone that helps us survive in the face of true danger. It also shuts down digestion and slows your metabolism.

All of this is perfectly normal in the short term, yet if left unchecked, prolonged stress and high levels of cortisol cause high blood sugar, increased belly fat, high blood pressure, high cholesterol and muscle loss.

You can’t eliminate stress completely, but you can reduce it with meditation, yoga or deep relaxation. These activities activate pathways that promote weight loss and health.

A few simple ideas I find helpful to reset the stress response include:

  1. Fix your thinking. This is the most powerful long-term way to be happy and reduce stress. We often get into habits of thinking, beliefs and ideas that keep us stressed. Don’t believe every stupid thought you have!
  2. Practice active relaxation. That might be as simple as learning deep breathing or trying a sauna or steam bath, which elevates body temperature to help discharge stress from the body and help reduce stress hormones. Or try meditation. It can be powerful. Check out Ziva Meditation for a great online course on meditation – I did it and it changed my life!
  3. Make time to be a human being, not a human doing. Make time to love and connect with others. Taking time with family and friends to love and be loved is powerful healing medicine.

Sex Hormone Imbalances

Sex hormone imbalances, such as estrogen and testosterone, can also cause weight problems. Having too much estrogen causes weight gain whether you’re a man or a woman. Do you know how ranchers fatten steer before they go to market? They implant them with estrogen pellets.

For both genders, too much sugar, refined carbs and alcohol spikes estrogen. Keeping your gut healthy also cultivates healthy sex-hormone metabolism. Too little fiber or too many antibiotics damage the gut, triggering estrogen spikes because your body can’t properly detoxify or excrete waste. Environmental toxins thrive on pesticides called xenoestrogens, because even at lose doses, they act like estrogen in your body.

Symptoms of excess estrogen in women include breast tenderness, fluid retention, bad premenstrual syndrome, fibroids and heavy menstrual bleeding.

In men, excess estrogen can cause loss of body hair (including chest, legs and arms), a beer belly, and “man boobs.” Low testosterone in men can also accelerate aging. Lack of exercise, alcohol, stress, environmental toxins or diseases like diabesity or even pituitary problems can also lower testosterone.

Low testosterone causes men to lose muscle and gain fat, leading to sexual dysfunction, low sex drive, fatigue, mental fogginess and bone loss that can lead to osteoporosis.

Interestingly, cholesterol produces testosterone and other sex hormones. Eating a low-fat diet and taking statin drugs that block cholesterol production can negatively impact your sex hormones.

If you suspect imbalances, you’ll want to get tested for imbalances. In my free e-book, How to Work with Your Doctor To Get What You Need, I explain exactly how to test for these and other hormone imbalances. These five strategies can help get you started:

  1. Eat a hormone-balancing diet. The nutritional principles in Eat Fat, Get Thin, which is low in sugar, high in good fats, and high in fiber, can help balance hormones. My own testosterone went up 500 points when I ate more healthy fats!
  2. Bulk up on fiber. Ground flaxseeds provide optimal fiber and lignans, which balance hormones. Even two tablespoons a day to a shake or a salad can help. You’ll also want to eat fiber-rich organic fruits and veggies.
  3. Eliminate daily. Constipation is bad for your hormones. Take magnesium citrate, vitamin C, probiotics and flax seeds daily to help maintain regularity. It’s a foolproof combo for most people.
  4. Limit or remove alcohol. Excess alcohol can compromise liver and kidney function, which inhibit detoxification and create hormonal imbalances, high triglycerides and fatty liver.
  5. Get moving. Exercise helps balance hormones, reducing estrogen and increasing testosterone, which helps you lose fat and build muscle.

Conclusion

While many culprits contribute to weight-loss resistance, I find addressing these three hormonal imbalances helps many patients lose stubborn weight. Hormonal balance might require working with a Functional Medicine practitioner, yet for most patients these strategies become the ticket to ignite weight loss.

If you’ve struggled to balance your hormones, what strategy would you add to this list? Comment below or on my Facebook page. Please keep submitting your great questions to drhyman.com. Let’s continue to inspire others to balance their hormones, ignite their weight loss and get healthy!

Hormones That Take Off the Pounds

The frustration of not losing weight despite eating right and exercising is usually related to hormone imbalances. Last week I wrote about hormones that cause weight gain. Now let’s consider several hormones that can you help lose weight! Some of them increase metabolism, some build muscle, while others lower appetite and cravings plus stimulate the breakdown of fat.

Hormones That Increase Metabolism

Thyroid hormone is our main metabolic hormone, directly increasing the burning of calories. It increases the body temperature and overall energy. Thyroid helps our fuel (food) burn more efficiently and will improve cholesterol metabolism. Thyroid sensitizes other hormone receptors so they operate better. Optimizing thyroid is similar to turning up the furnace or tuning an engine – the body simply operates better

Glucagon, from the pancreas, is the opposite of insulin and works to release fat and glucose from storage to be used as fuel. Protein intake will increase glucagon while high blood sugar and high insulin levels will turn down glucagon production.

Many women are progesterone deficient and have heavy estrogen dominant menstrual cycles coupled with PMS for several weeks when their estrogen is not balanced with enough progesterone. Aside from weight gain caused by estrogen dominance, the low progesterone encourages weight gain as progesterone supports thyroid while increasing body temperature and metabolism.

Hormones That Build Muscle

Androgen hormones such as testosterone and DHEA build muscle and break down fat. They directly turn on DNA to make protein and build structure such as muscle and bone. They also “kick-start” enzymes that break down fat. The fat accumulation around the belly of aging men and women (over 40) is partly due to declining levels of these androgen hormones.

Growth hormone is touted as the “mother of anti-aging” hormones since it has so many benefits that promote health and slow aging. Made by the liver, it too will build muscle and bone while breaking down fat.

These hormones are all “anabolic” which means they build tissue. Unlike the synthetic anabolic hormones abused by sports stars these natural anabolic hormones promote strong healthy bodies. Unfortunately they normally decline with aging such that by age 50-60 most of us are starting to show the signs of their disappearance.

Hormones That Lower Appetite and Cravings

Leptin is a fascinating hormone that was only discovered in 1994 and since then has generated much interest in the area of weight loss. Leptin is made by fat cells and will signal the brain to lower our appetite and increase metabolism. Leptin increases with weight gain, which sounds good, but similar to insulin, as we gain weight and make more leptin, we become more and more resistant to its beneficial effects. When I treat someone with insulin resistance I just assume they have leptin resistance as well and treat both.

Several hormones affect our mood, sleep, and appetite. The key players are melatonin (sleep), serotonin (mood), dopamine (pleasure), and GABA (mood). Melatonin is our main nighttime hormone, helping to promote restful sleep and the production of other hormones such as thyroid and growth hormone. Melatonin levels decline by age 45-50 and many people start having sleep disturbances around this age.

Serotonin deficiency is the cause of low mood and certain foods such as sugar and high-glycemic foods will temporarily stimulate serotonin. Dopamine is our pleasure hormone being associated with cravings, appetite and activities such as sex. Stimulant drugs increase dopamine and lead to the “high” associated with them. GABA influences mood by calming the brain, balancing the effects of dopamine and serotonin, thus promoting restful sleep and a calm controlled mood. Proper support of this family of hormones will support controlled appetite and cravings.

Putting It All Together

Restful sleep has so many benefits on natural hormone production that perhaps it is our most important strategy to successful weight loss! During deep sleep we make more anabolic hormones and more leptin. Melatonin is part of the normal sleep cycle and is promoted by absolute darkness, quiet, and cooler temperatures.

Regular exercise is another way to increase anabolic hormone production and improve insulin and leptin sensitivity so that each works properly. A combination of aerobic (walking, etc) and anaerobic (strength training) is ideal. Peak intensity training, also called interval or burst training, to threshold will maximize growth hormone output.

Diet plays a major role in more than just the amount of calories consumed. The proper balance of proteins and carbohydrates is essential. The protein stimulates glucagon production and provides the amino acids necessary to make serotonin, dopamine and GABA. Protein is also necessary for good muscle development. Including anti-inflammatory fats (omega-3) is also important as fats do not stimulate insulin and help provide a long lasting energy source. Eliminating sugar and limiting high-glycemic foods and inflammatory fats (saturated, red meat) will help. Avoid high-fructose energy drinks.

We recommend many natural supplements to help with hormone production. 5-HTP will help serotonin, tyrosine will increase dopamine, and GABA supplements can be taken directly. Irvingia (from life extension) is derived from the African Bush Mango and is a great product that helps increase leptin sensitivity. These are just a few of the dozens of natural supplements that can help manage weight.

Thyroid and progesterone imbalances are often cured by recognizing the underlying cause of the deficiency and treating the root cause. Medical conditions such as leaky gut or gut dysbiosis, autoimmune disease, polycystic ovarian syndrome and others need be identified and fixed. At some point direct hormone replacement is indicated for the normal age related decline in the anabolic hormones.

Our weight loss program addresses all these issues and many others. Simply telling patients to “watch what you eat and exercise more” is not good enough! Addressing hormone imbalances is a necessary part of successful weight loss.

Author

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.

Divigel

SIDE EFFECTS

The following serious adverse reactions are discussed elsewhere in the labeling:

  • Cardiovascular Disorders .
  • Malignant Neoplasms .

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Divigel was studied at doses of 0.25, 0.5 and 1.0 gram per day in a 12-week, double-blind, placebo-controlled study that included a total of 495 postmenopausal women (86.5 percent Caucasian). The adverse events that occurred at a rate greater than 5 percent and greater than placebo in any of the treatment groups are summarized in Table 1.

Table 1: Number (%) of Subjects with Common Adverse Reaction*in a 12-Week Placebo-Controlled Study of Divigel

In a 12-week placebo-controlled study of Divigel, application site reactions were seen in <1 percent of subjects.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Divigel. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Genitourinary System

Amenorrhea, dysmenorrhea, ovarian cyst, vaginal discharge

Breasts

Gynecomastia

Palpitations, ventricular extrasystoles

Flatulence

Skin

Rash pruritic, urticaria

Eyes

Retinal vein occlusion

Central Nervous System

Tremor

Miscellaneous

Arthralgia, application site rash, asthenia, chest discomfort, fatigue, feeling abnormal, heart rate increased, insomnia, malaise, muscle spasms, pain in extremity, weight increased

Additional postmarketing adverse reactions have been reported in patients receiving other forms of hormone therapy.

Read the entire FDA prescribing information for Divigel (Estradiol Gel)

Divigel Side Effects

Generic Name: estradiol

Medically reviewed by Drugs.com. Last updated on Dec 3, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Interactions
  • Pregnancy
  • More

Note: This document contains side effect information about estradiol. Some of the dosage forms listed on this page may not apply to the brand name Divigel.

In Summary

Common side effects of Divigel include: infection, endometrium disease, and mastalgia. Other side effects include: headache, pruritus, and sinusitis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to estradiol: vaginal capsule liquid filled, vaginal cream, vaginal insert extended release, vaginal tablet

Other dosage forms:

  • transdermal gel/jelly, transdermal patch extended release, transdermal spray

Warning

Vaginal route (Insert, Extended Release; Cream)

Estrogens increase the risk of endometrial cancer; monitor for abnormal vaginal bleeding. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. Increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) have been reported. An increased risk of developing probable dementia in postmenopausal women 65 years of age or older has also been reported in women receiving estrogen alone or estrogen combined with progestins. Risks should be assumed to be similar for other doses, combinations, and dosage forms of estrogens and progestins. Estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration possible.

Vaginal route (Insert, Extended Release)

Use of unopposed estrogens increases the risk of endometrial cancer, while addition of a progestin decreases the risk of endometrial hyperplasia. Rule out malignancy if abnormal vaginal bleeding develops. Do not use estrogen alone or in combination with progestin to prevent cardiovascular disease or dementia. There is an increased risk of cardiovascular disorders (ie, DVT, pulmonary embolism, stroke, myocardial infarction) with combination therapy in women 50 years or older, and an increased risk of dementia in women 65 years or older with estrogen monotherapy or combination therapy. Combination therapy also increases the risk of invasive breast cancer. Prescribe estrogens with or without progestins at the lowest effective dose and for the shortest duration consistent with risks and treatment goals.

Along with its needed effects, estradiol (the active ingredient contained in Divigel) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking estradiol:

Less common

  • Vaginal yeast infection

Incidence not known

  • Change in vaginal discharge
  • clear or bloody discharge from the nipple
  • decrease in the amount of urine
  • dimpling of the breast skin
  • fast heartbeat
  • fever
  • hives, itching, or rash
  • hoarseness
  • inverted nipple
  • irritation
  • joint pain, stiffness, or swelling
  • lump in the breast or under the arm
  • noisy, rattling breathing
  • pain or feeling of pressure in the pelvis
  • pain, redness, or swelling in the arm or leg
  • persistent crusting or scaling of the nipple
  • redness of the skin
  • redness or swelling of the breast
  • sore on the skin of the breast that does not heal
  • swelling of the eyelids, face, fingers, lips, hands, feet, or lower legs
  • tightness in the chest
  • troubled breathing at rest
  • troubled breathing or swallowing
  • vaginal bleeding

Get emergency help immediately if any of the following symptoms of overdose occur while taking estradiol:

Symptoms of overdose

  • Dizziness
  • drowsiness
  • nausea
  • stomach pain
  • tenderness of the breasts
  • unusual tiredness or weakness
  • vomiting

Some side effects of estradiol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Back pain
  • headache
  • itching or pain of the vagina or genital area
  • thick, white vaginal discharge with mild or no odor
  • weight gain

Less common

  • Body aches or pain
  • chills
  • cough
  • diarrhea
  • ear congestion
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat

Incidence not known

  • Feeling sad or empty
  • headache, severe and throbbing
  • irritability
  • lack of appetite
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • welts

For Healthcare Professionals

Applies to estradiol: compounding powder, intramuscular solution, oral tablet, transdermal emulsion, transdermal film extended release, transdermal gel, transdermal spray, vaginal ring

Genitourinary

Very common (10% or more): Breast pain (29%)

Common (1% to 10%): Vulvovaginal pruritus, leukorrhea, vaginal hemorrhage, vaginal discharge, vaginal discomfort, menopause symptoms, breakthrough bleeding or spotting, dysmenorrhea, breast swelling, menorrhagia, metrorrhagia, endometrial hyperplasia

Uncommon (0.1% to 1%): Urinary problems

Rare (less than 0.1%): Galactorrhea

Postmarketing reports: Vaginal irritation, vaginal pain, genital pruritus, changes in bleeding pattern, pelvic pain, breast tenderness, vaginal ulceration, uterine fibroids

Gastrointestinal

Very common (10% or more): Abdominal pain (16%),

Common (1% to 10%): Flatulence, nausea, diarrhea

Uncommon (0.1% to 1%): Vomiting

Postmarketing reports: Abdominal distension

Musculoskeletal

Very common (10% or more): Back pain (11%), arthralgia (11%)

Common (1% to 10%): Leg cramps

Cardiovascular

Common (1% to 10%): Varicose veins, cardiac symptoms (e.g. palpitations)

Uncommon (0.1% to 1%): Hot flush, hypertension, venous thromboembolic disease

Rare (less than 0.1%): Arterial hypertension

Postmarketing reports: Deep vein thrombosis, changes in blood pressure

Nervous system

Very common (10% or more): Headache (18%)

Uncommon (0.1% to 1%): Vertigo, migraine

Rare (less than 0.1%): Aggravation of epilepsy

Postmarketing reports: Migraine aggravated, paresthesia, dizziness

Oncologic

Uncommon (0.1% to 1%): Benign breast neoplasm, increased volume of uterine leiomyoma

Postmarketing reports: Endometrial cancer, breast cancer

Other

Very common (10% or more): Pain (11%)

Common (1% to 10%): Edema

Uncommon (0.1% to 1%): Weight increased, asthenia

Postmarketing reports: Drug ineffectiveness, blood estrogen increase, fatigue, exacerbation of hereditary angioedema

Psychiatric

Common (1% to 10%): Depression

Uncommon (0.1% to 1%): Sleep disorders, nervousness, mood swings

Rare (less than 0.1%): Change in libido

Postmarketing reports: Vaginismus, insomnia, anxiety, irritability

Dermatologic

Common (1% to 10%): Pruritus

Uncommon (0.1% to 1%): Rash

Rare (less than 0.1%): Skin discoloration, acne

Postmarketing reports: Urticaria, erythematous or pruritic rash, alopecia, hyperhidrosis, night sweats, contact dermatitis, eczema

Ocular

Uncommon (0.1% to 1%): Vision abnormal NOS

Postmarketing reports: Visual disturbances, contact lens intolerance

Hepatic

Rare (less than 0.1%): Liver function tests abnormalities

Postmarketing reports: Cholestatic jaundice

Metabolic

Rare (less than 0.1%): Glucose intolerance

Postmarketing reports: Fluid retention

Hypersensitivity

Rare (less than 0.1%): Anaphylactic reaction (with a past history of allergic reaction)

Postmarketing reports: Anaphylactic reactions, hypersensitivity

Immunologic

Very common (10% or more): Upper respiratory tract infection (17%)

Common (1% to 10%): Vulvovaginal mycotic infection, pharyngitis, rhinitis, sinusitis, moniliasis genital

Uncommon (0.1% to 1%): Vaginitis/vaginal candidosis

Local

Common (1% to 10%): Skin irritation (topical gel)

Postmarketing reports: Application site reaction

1. “Product Information. Estradiol Vaginal Insert (estradiol topical).” Teva Pharmaceuticals USA, North Wales, PA.

2. Julian TM “Pseudoincontinence secondary to unopposed estrogen replacement in the surgically castrate premenopausal female.” Obstet Gynecol 70 (1987): 382-3

3. Nash HA, AlvarezSanchez F, Mishell DR, Fraser IS, Maruo T, Harmon TM “Estradiol-delivering vaginal rings for hormone replacement therapy.” Am J Obstet Gynecol 181 (1999): 1400-6

4. “Product Information. Climara (estradiol).” Berlex, Richmond, CA.

5. “Product Information. Estrace (estradiol).” Warner Chilcott Laboratories, Rockaway, NJ.

6. Cerner Multum, Inc. “Australian Product Information.” O 0

7. Auerbach R, Mittal K, Schwartz PE “Estrogen and progestin receptors in an ovarian ependymoma.” Obstet Gynecol 71 (1988): 1043-5

8. “Product Information. Yuvafem (estradiol topical).” AvKare Inc, Pulaski, TN.

9. Boston Collaborative Drug Surveilance Program “Surgically confirmed gallbladder disease, venous thromboembolism, and breast tumors in relation to postmenopausal estrogen therapy.” N Engl J Med 290 (1974): 15-9

10. Jick H, Dinan B, Rothman KJ “Noncontraceptive estrogens and nonfatal myocardial infarction.” JAMA 239 (1978): 1407-8

11. Barrett-Connor E, Wingard DL, Criqui MH “Postmenopausal estrogen use and heart disease risk factors in the 1980s. Rancho Bernardo, Calif, revisited.” JAMA 261 (1989): 1095-2100

12. Bui MN, Arai AE, Hathaway L, Waclawiw MA, Csako G, Cannon RO 3rd “Effect of hormone replacement therapy on carotid arterial compliance in healthy postmenopausal women.” Am J Cardiol 90 (2002): 82-5

13. Belchetz PE “Hormonal treatment of postmenopausal women.” N Engl J Med 330 (1994): 1062-71

14. Rosenberg L, Slone D, Shapiro S, Kaufman D, Stolley PD, Miettinen OS “Noncontraceptive estrogens and myocardial infarction in young women.” JAMA 244 (1980): 339-42

15. Collins P, Beale CM, Rosano GMC “Oestrogen as a calcium channel blocker.” Eur Heart J 17 ( Suppl (1996): 27-31

17. Crane MG, Harris JJ “Estrogens and hypertension: effect of discontinuing estrogens on blood pressure, exchangeable sodium, and the renin-aldosterone system.” Am J Med Sci 276 (1978): 33-55

18. Barrett-Connor E, Bush TL “Estrogen and coronary heart disease in women.” JAMA 265 (1991): 1861-7

19. Schwartz J, Freeman R, Frishman W “Clinical pharmacology of estrogens: cardiovascular actions and cardioprotective benefits of replacement therapy in postmenopausal women.” J Clin Pharmacol 35 (1995): 1-16

22. The Writing Group for the PEPI Trial “Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial.” JAMA 273 (1995): 199-208

23. Wren BG, Routledge DA “Blood pressure changes: oestrogens in climacteric women.” Med J Aust 2 (1981): 528-31

24. Cohen L, Coxwell WL, Melchione T, Koltun W, Gibson E, Gupta N, Roberts M “Low-dose 17-beta estradiol matrix transdermal system in the treatment of moderate-to-severe hot flushes in postmenopausal women.” Curr Ther Res Clin Exp 60 (1999): 534-47

25. Steiger MJ, Quinn NP “Hormone replacement therapy induced chorea.” BMJ 302 (1991): 762

26. Palmer JR, Rosenberg L, Clarke EA, Miller DR, Shapiro S “Breast cancer risk after estrogen replacement therapy: results from the Toronto Breast Cancer Study.” Am J Epidemiol 134 (1991): 1386-95

27. Colditz GA, Hankinson SE, Hunter DJ, et al. “The use of estrogens and progestins and the risk of breast cancer in postmenopausal women.” N Engl J Med 332 (1995): 1589-93

28. Obrink A, Bunne G, Collen J, Tjernberg B “Endometrial cancer and exogenous estrogens.” Acta Obstet Gynecol Scand 58 (1979): 123

29. Kaufman DW, Palmer JR, de Mouzon J, Rosenberg L, Stolley PD, Warshauer ME, Zauber AG, Shapiro S “Estrogen replacement therapy and the risk of breast cancer: results from the case-control surveillance study.” Am J Epidemiol 134 (1991): 1375-85

30. Gapstur SM, Morrow M, Sellers TA “Hormone replacement therapy and risk of breast cancer with a favorable histology: results of the Iowa women’s health study.” JAMA 281 (1999): 2091-7

32. Gordon J, Reagan JW, Finkle WD, Ziel HK “Estrogen and endometrial carcinoma. An independent pathology review supporting original risk estimate.” N Engl J Med 297 (1977): 570-1

34. The Writing Group for the PEPI Trial “Effects of hormone replacement therapy on endometrial histology in postmenopausal women.” JAMA 275 (1996): 370-5

35. Gray LA Sr, Christopherson WM, Hoover RN “Estrogens and endometrial carcinoma.” Obstet Gynecol 49 (1977): 385-9

36. Thomas DB, Persing JP, Hutchinson WB “Exogenous estrogens and other risk factors for breast cancer in women with benign breast diseases.” J Natl Cancer Inst 69 (1982): 1017-25

37. Spengler RF, Clarke EA, Woolever CA, Newman AM, Osborn RW “Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases.” Am J Epidemiol 114 (1981): 497-506

38. Oppenheim G “A case of rapid mood cycling with estrogen: implications for therapy.” J Clin Psychiatry 45 (1984): 34-5

39. Conter RL, Longmire WP Jr “Recurrent hepatic hemangiomas. Possible association with estrogen therapy.” Ann Surg 207 (1988): 115-9

40. Aldinger K, Ben-Menachem Y, Whalen G “Focal nodular hyperplasia of the liver associated with high-dosage estrogens.” Arch Intern Med 137 (1977): 357-9

41. Molitch ME, Oill P, Odell WD “Massive hyperlipemia during estrogen therapy.” JAMA 227 (1974): 522-5

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about Divigel (estradiol)

  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • Pricing & Coupons
  • 10 Reviews
  • Drug class: estrogens
  • FDA Alerts (2)
  • FDA Approval History

Consumer resources

  • Divigel
  • Divigel 0.75 mg/packet for use on skin
  • Divigel Transdermal (Advanced Reading)

Other brands: Estrace, Estradiol Patch, Climara, Vivelle-Dot, … +17 more

Professional resources

  • Estradiol (AHFS Monograph)
  • … +1 more

Related treatment guides

  • Postmenopausal Symptoms

6 Ways Progesterone Helps With Weight Loss!

  • Posted on: Jan 18 2019
  • By: Dr Shel

Maintaining your ideal body weight can be a frustrating and difficult task. You may have heard or suspected that your hormones have something to do with your inability to lose weight and that may absolutely correct, especially if you a woman after childbirth or have taken birth control pills for several years. For women, hormone balance involves two hormones: progesterone and estrogen. When both of these are in the body at adequate levels, the body will run optimally, however, it’s when estrogen becomes too high (or progesterone get’s too low), a woman will find herself in a state of “estrogen dominance,” which can wreak havoc on several bodily functions. One of which is the body’s ability to maintain its ideal weight.

The 6 Big Reasons Why Estrogen Dominance (Low Progesterone) Can Greatly Inhibit Your Ability to Lose Weight & Keep it Off:

  1. Excessive Estrogen Can Cause Belly Fat

    Let’s just look at the dairy industry for a second. Traditional dairy farmers will pump their cows full of estrogen for the simple task of fattening them up (yikes, right?!). A workaround to this system is to purchase milk and meat locally or organically, however, keep in mind that a cow’s milk is also designed to grow a calf. Yet, to make matters worse, fat cells in the body produce estrogen, so with excess fat, you may find yourself in a vicious fat/estrogen cycle and unable to keep hormones balanced and lose that layer of fat in your mid-section. In some women, it can even cause more weight gain. An obvious solution to this is to limit excess estrogen consumption as much as possible but to balance the estrogen in the body, it may also be necessary to supplement with natural, bio-identical progesterone (remember… the key is to have the two hormones balanced).

    You may also consider the use of a natural phytonutrient (plant nutrient) found in cruciferous vegetables called Diindolylmethane (DIM). This nutrient is very effective in helping to achieve a healthier estrogen metabolism. Learn more about DIM.

  2. Progesterone For Weight Loss Helps Your Thyroid Hormones Function More Efficiently.

    When you have low levels of progesterone, your liver produces excess amounts of a protein called Thyroid Binding Globulin (TBG). This TBG binds to the thyroid hormones your body, inhibiting the hormones from being utilized properly by your body. The net effect of this is a form of Hypothyroidism that some refer to as Type 2 Hypothyroidism, which does not show up on blood tests since the problem is within your cells rather than in your blood.

  3. Progesterone Lowers Insulin Levels.

    Insulin is affected by hormone imbalance, and estrogen dominance can lead to the release of excess insulin. Increases in insulin can lead to sugar cravings that can be hard to control. This is why many women crave chocolate or other sweets during PMS. This can also contribute to weight gain. It’s all making sense now, isn’t it?

  4. Progesterone is a Natural Anti-Inflammatory.

    Reducing inflammation also helps your brain to receive another hormone called Leptin, which helps to regulate your appetite. Balanced hormones make it easier to eat in moderation and lose weight.

  5. Progesterone is a Natural Sleep Aid.

    This is because progesterone has a calming effect on the brain. Estrogen, on the other hand, has an excitatory effect on the brain. Because of this, women with estrogen dominance typically sleep very restlessly. Sleep deprivation is also associated with disrupting the hormone that regulates your appetite (Leptin). Lack of sleep has been linked to both increased calorie consumption and reduced energy expenditure (more calories in and fewer calories out).

  6. Progesterone Reduces Fluid Retention.

    When Estrogen levels are not balanced out by adequate levels of progesterone, women tend to retain more fluid than usual. Progesterone is a natural diuretic and can greatly reduce bloating and swelling.

Progesterone vs. Progestins

It is critically important to understand the differences between bio-identical progesterone and the drugs called progestins. Bio-identical progesterone is molecularity identical to what your body makes, which allows it to be easily recognized and utilized. There is a connection between bioidentical progesterone and weight loss. Not all progesterone creams are the same. It is best to purchase a progesterone cream that is made for your body, unlike the synthetic versions.

Progestins, on the other hand, do not have the same molecular structure and are not treated the same way by your body. The reason progestins are not the same as what your body makes is due to the fact that a drug company cannot patent progesterone. In fact, drug companies cannot patent any thing or substance that is naturally occurring in nature. What does this mean for the pharmaceutical industry? It’s easy… No patent = no money.

Not only do Progestins (synthetic progesterone) not relieve the symptoms of Estrogen Dominance, but they can actually worsen or even be the cause of the problems in the first place. The negative effects of progestins are exacerbated by the fact that they actually shut down your body’s production of its own progesterone. This is why when women use birth control pills, which contain progestins, they tend to cause weight gain, retain fluid and exhibit the other symptoms of estrogen dominance. An interesting fact about birth control pills is that the original research conducted to develop birth control pills were conducted with natural progesterone, but was later altered so that it could be patented. You can read more about the differences between bio-identical and synthetic progesterone here.

Biodentical progesterone and weight loss is one of the reasons that many people will turn to a bioidentical doctor who will take different steps to help them with their hormonal imbalance. These doctors can also give you progesterone cream for weight loss when needed. Progesterone side effects can cause weight gain, but that is not always the case. Every person’s body is different and reacts differently to progesterone.

What Steps Can I Take to Correct Hormonal Imbalance?

Estrogen dominance can be safely and effectively treated with the use of bio-identical progesterone. Lab testing, preferably saliva testing, allows us to see the levels and balance of estrogen and progesterone in your body and develop a treatment plan to supplement the progesterone you have with enough to adequately balance out your estrogen. By simply replacing the missing progesterone in your body with bio-identical progesterone, you can get your hormones back into balance. The benefits of hormonal balance can include better sleep, improved moods, increased energy, better mental function, improved libido, and yes, even weight loss!

If you suspect you have a hormonal imbalance, you can Test Your Symptoms for Free. You can also request a Free Consultation and find out how we can help you get to living your best life possible!

Posted in: Bioidentical Hormone, Birth Control, Estrogen Dominance, Hormone Imbalance, Hypothyroidism, Weight Loss, Wellness, Women

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Estrogen and weight gain

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