Excess estrogen: causes of occurrence, in which diseases it occurs, diagnosis, and methods of treatment.
Estrogens are a group of female sex steroid hormones that affect not only reproductive function but also mental processes, stimulate bone growth and have a procoagulant (clot-forming) effect through vitamin K-dependent factors of the blood coagulation system.
An increase in the amount of estrogen in both the female and male bodies leads to a violation of the fine regulation of metabolism and the development of various diseases.
Estrogens include the following hormones: estrone, estradiol, and estriol (formed in the placenta during pregnancy). Estradiol and estrone are synthesized in the ovaries during the maturation of follicles. In men, estrogens are produced in the testicles. Some hormones are produced in other tissues (for example, in the adrenal glands and skin). In postmenopausal women, the formation of sex hormones in women occurs mainly in adipose tissue and adrenal glands.
Cholesterol is the precursor of all sex hormones, which is why it is impossible to completely limit foods high in cholesterol or to abuse them.
Because sex hormones are fat-soluble substances, a significant amount of sex steroids can accumulate in adipose tissue, which should not normally be present. This increases the total concentration of estrogens and androgens in the blood, which leads to dysregulation of many processes in the body.
Varieties of increasing estrogen in the blood
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The increase in the amount of estrogen in the body occurs through two main mechanisms:
1. Increasing the number of endogenous estrogens, i.e. hormones that are produced in the body.
2. Increasing the number of exogenous estrogens, that is, introduced from the outside (with the help of medicinal tablets, injections, and in some cases – herbal remedies and food).
Possible causes of increased estrogen in the blood
The level of hormones is influenced by several factors: age, hereditary predisposition, and the amount of adipose tissue.
Hyperestrogenemia (an increase in the amount of estrogen in the blood) is observed in the following diseases and conditions:
Obesity is an important risk factor for the development of many diseases, including diseases of the reproductive system. In adipose tissue, the peptide hormone leptin is formed, which stimulates the production of releasing hormones, which in turn activates the synthesis of estrogens. In addition, the synthesis of sex hormones directly takes place in adipose tissue.
In childhood, obesity significantly affects the process of puberty and further reproductive function.
In obese girls, menarche (the first menstruation) occurs earlier, in adolescence and adulthood, various menstrual irregularities (oligomenorrhea and amenorrhea) occur, and the risk of uterine bleeding, endometrial pathology, and anovulatory infertility (when the normal formation of eggs is disrupted) increases. When pregnancy occurs, complications are more common. According to researchers, obese women have a 3 times higher risk of endometrial cancer than women with normal body weight.
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Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility and is associated with obesity, the development of diabetes, and an increase in the amount of estrogen in the blood. In most cases, there is an increase in the production of luteinizing hormone, leading to increased production of steroid hormones in the ovaries, including estrogens. An excess of hormones stimulates the growth of follicles, disrupts the process of their maturation, and leads to ovarian hyperplasia (an increase in the number of cells and tissue growth).
PCOS is manifested by a decrease in the number and volume of menstruation, infertility due to lack of ovulation, excessive hair growth (hirsutism), and obesity. Anxiety-depressive disorders and sleep and appetite disturbances are possible.
Diabetes. With the excessive synthesis of insulin, an increase in the production of sex hormones is observed through an increase in the sensitivity of the ovaries to luteinizing hormone.
Cirrhosis of the liver is a disease in which liver cells are replaced by connective tissue.
The development of cirrhosis is accompanied by a significant decrease in the functional capacity of the liver. Normally, the liver utilizes excess estrogens from the blood with the help of bile and converts estradiol into less active forms.
Hyperestrogenemia in liver cirrhosis is manifested by spider veins on the skin and reddening of the palms.
Hyperplasia of the adrenal cortex is a disease in which there is an overgrowth of the tissues of the adrenal glands and an increase in the production of hormones, including estrogen.
Adenoma of the pituitary gland, ovaries, or adrenal glands – can become a source of a sudden appearance in the blood of a large number of hormones. Signs of the disease are a rapid change in body weight, headaches, back pain, and menstrual irregularities.
Thyroid diseases – affect the formation of proteins that bind estradiol and other sex hormones, which is important during the development of menstrual and reproductive disorders. With hypothyroidism, there is a decrease in the synthesis of these proteins, and with hyperthyroidism – an increase.
In addition, there are receptors for thyroid hormones in the ovaries, so an excess or deficiency of thyroid hormones directly affects the amount of estrogen produced in the ovaries.
The intake of barbiturates and anti-tuberculosis drugs leads to a change in the metabolism of estrogens in the liver, as a result, their concentration in the blood increases.
Taking combined oral estrogen-containing contraceptives naturally leads to an increase in the amount of estrogen in the blood.
Which doctors to contact with an increase in the level of estrogen in the blood
There are signs by which one can suspect a pathological increase in the concentration of estrogens in the blood and seek medical help promptly. In women, the main reason for visiting a gynecologist with the development of hyperestrogenemia is the disappearance of menstruation, an irregular cycle, and soreness of the mammary glands. Some patients turn to a dermatologist with complaints of acne and brittle hair. One of the most common reasons for contacting an endocrinologist or therapist is an increase in body weight, even though the lifestyle and nutrition have not changed. In some cases, a psychologist’s consultation is required, because. women with high estrogen levels become irritable and overly emotional.
In men, an increase in the concentration of estrogens in the blood is characterized by an increase in body weight, mammary glands, and abdomen due to the deposition of fat, and a decrease in libido. In these cases, consultation with an endocrinologist and urologist is required.
Diagnostics and examinations with an increase in estrogen
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To diagnose hyperestrogenemia, several laboratory and instrumental studies may be required:
follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, estradiol, adrenocorticotropic hormone (ACTH), thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH).
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