1980s

Duck duck GOOSE! Do you know this game?  That’s how I’m feeling with oestrogen – high-high-high-LOW!-of late. Likely similar to your experience, the majority of my female clients battle with oestrogen dominance, therefore I get so used to looking for it, expecting it: the high Cu, the profoundly elevated SHBG, maybe a raised ESR.  So much so that sometimes the low ones can catch you out, especially of course when it happens in women way way before menopause.

We’re so resolved to hear bad press about oestrogen and to be armed ready to saturate our patients with broccoli extracts of the highest order – do we remember the clinical features and markers of an oestrogen deficit and know what to do with those women who simply don’t have enough?

Sometimes when I talk with other practitioners about the positives of oestrogen I feel a bit 1980s.  A bit daggy, a bit outdated, a bit off trend.   And then I go back to the literature about the incredible protective role oestrogen plays on the actual anatomy of the brain and in cognition and mood and think…boy we’re missing a key opportunity to improve women’s lives if we don’t pay heed to the low oestrogen state.  Or better still I ask my friend and colleague, Angela Hywood, “Hey Ang what do you reckon, am I really seeing mood, memory and energy problems as a result of low oestrogen in these premenopausal women?” You betcha! she says and much to my relief, tells me not to throw out the ’80s’ just yet 😉

Ever wanted a tangible take home about oestrogen’s potency on the brain?  Just ask any woman who experienced the ‘ovarian withdrawal effect’ at white knuckle speed post-partum or post-menopause. Discombobulation in action.

So I was pleased to see ‘Estrogen and Brain Health: Exploring estrogen’s vital role linking the brain, the gut microbiome, and the immune system’ on the program for the upcoming ACNEM Brain Health for Better Life Outcomes Conference in Melbourne in May. So among all our incredible local talent (read Sarris, Berk, Jacka, Fenech), Dr Felice Gersh (US) will present on this important aspect of mental wellbeing that speaks to our ‘other’ patients.  I’m also just generally excited by 2 days of dedicated brain health content by leading researchers – mito dysfunction by Berk, dietary interventions for depression by Felice, some basic biochemical testing (Ross Grant) and gene profiling (Denise Furness) in cognitive decline…can’t wait!

Maybe I’ll see you there?  I’ll be the one wearing my ‘Wake me up!’ t-shirt and a single flouro glove 🙂

Often female patients present with health problems that don’t directly scream, “high oestrogen!” but their condition absolutely could be being compounded by this background imbalance – think thyroid & other autoimmune conditions for example. In this Update Rachel brings together her 10 quick tips in this UU30 podcast, on how to recognise either high oestrogen and/or the potential underpinning reason behind the excess, in a range of easily accessible markers.  A great refresher and synthesis of ideas on this important aspect of diagnosis and clinical management of oestrogen imbalance.