In PART 1, I covered the basics: cycle / period length, quality, female hormones, and PMS. Now, let’s focus on the role of the liver, our primary detox organ, in balancing female hormones. An imbalance of the progesterone to estrogen ratio, specifically the condition of Estrogen Dominance (or relative Progesterone Deficiency), is at the root of a majority of female troubles surrounding periods. Too much or not enough of any hormone (regulatory messenger) interferes with its end organ function. 

  • Dysmonorrhea: pain during menstruation (painful periods), i.e., menstrual cramps usually centred around the pelvis or lower abdomen
  • Oligomenorrhea: infrequent menstrual periods in women of childbearing age, i.e. Cycle length regularly >35 days
  • Polymenorrhea: frequent menstrual periods, i.e. Cycle length regularly <21 days
  • Irregular cycles: Cycle length varying >8 days compared to other periods
  • Menorrhagia: menstrual periods with abnormally heavy or prolonged bleeding (e.g., needing >1 sanitary product every 2 hrs., layering multiple sanitary products, clots >1”, etc.)
  • Metrorrhagia: uterine bleeding at irregular intervals (e.g., bleeding between cycles)
  • Menometrorrhagia: heavy or prolonged uterine bleeding at irregular and frequent intervals 
  • Anovulatory cycle: menstrual cycle with varying intervals (e.g., heavy bleeding due to insufficient progesterone can mimic a period); an absence of ovulation / a luteal phase

Estrogen Dominance (ED) can begin early, even in menarche. Young women with ED often experience very difficult periods (see above terms), with irregular / heavy uterine bleeding that may be accompanied by moderate – severe PMS (mood swings, depression, anxiety, fluid retention, cravings / changes in appetite, etc.) and cramps, and are often prescribed birth control pills to manage the severity and frequency of flow. ED also develops later in life due to dietary / environmental / lifestyle factors, liver impairment and other conditions, medications (e.g., hormone replacement therapy), and anovulatory cycles. Other common conditions related to / affected by ED include: PCOS (insulin resistance, ovarian cysts), Fibrocystic breast changes, Breast cancer, Migraines, Adenomyosis, Endometriosis, Uterine Fibroids, and many more. 

Anything that interferes with proper liver function, particularly detoxification (the process of removing toxins), will promote the retention and recirculation of excess estrogens. Below are some suggestions on how to help the liver stay on top of the onslaught of everyday toxins, so it can metabolize hormones more efficiently. Other detox organs (emunctories) that will also benefit from these actions include: kidney, lymph, and skin. While our bodies are designed to be self-cleansing, the toxic burden of our modern world requires a helping hand. For additional ideas on how to promote liver health, please read Dr. Carin’s article: A Kink in the Hose: Unblocking the Liver for Optimal Digestion

Stress & Exercise

Not only does prolonged stress decrease progesterone production in favour of cortisol (the “stress hormone”), but adrenal steroids like cortisol are also converted to estrogen by enzymes in fatty tissue, especially abdominal fat (as seen in fatty liver disease). 

MAKE TIME for EXERCISE, which allows one to “blow off steam” while helping mobilize the toxins stored in fat. Further, physical activity massages your internal organs and promotes regular ( ≥1 / day) well-formed bowel movements. 

Environmental Toxins: Xenoestrogens & Heavy Metals

1) SAY NO to XENOESTROGENS—synthetic substances that mimic the effects of estrogen (e.g, PCBs, phthalates, and persistent DDT)—which are found in plastics (even BPA-free ones), pesticides, and personal care products. They are stored in fat, since the body has no way of eliminating these foreign toxins. 

  • Search your go-to products in The Environmental Working Group (EWG) Skin Deep Database ( to see if repeated exposure to any of the ingredients raise a significant level of concern 
  • The Environmental Defense also has a Toxic 10: Skincare Guide (
  • Use the EWG’s Dirty Dozen and Clean Fifteen ( (updated every year) to guide when you should invest in organic produce. Liver-friendly spinach and kale sadly top the “Dirty” list  

2) CHELATE HEAVY METALS (e.g., mercury, lead and cadmium, etc.). Many can be bound and removed by foods as simple as chlorella and cilantro, which leads to my next point: 

Diet & Supplements

This is a big area, which I will expand on next time. Generally speaking, one should have a steady supply of high quality protein (plant or animal) and increase consumption of alkalizing / bitter foods, including leafy green / cruciferous vegetables, phytoestrogens, and insoluble fibre (more further below). 

Vitamin B12 is primarily stored in the liver; it facilitates the conversion of amino acids into needed hormones and aids in clearance of excess hormones via methylation. Those with a vegan lifestyle, cirrhosis, or late-stage liver disease would especially benefit from supplementation, due to lower intake and absorption, respectively. 


An imbalance of good vs. bad gut bacteria inhibits the conversion of estrogen into a water-soluble form that can be eliminated. SUPPLEMENT with PREBIOTICS and / or PROBIOTICS and screen for infections, especially candida overgrowth, SIBO, and parasites. 

All prebiotics are fibre but not all fibre is prebiotic. Don’t forget to INCREASE consumption of INSOLUBLE FIBRE (e.g., whole grains, bran, non-starchy vegetables, berries, beans and legumes, etc.) to help sweep toxins from your gut AND FIBRE-RICH PREBIOTICS (e.g., garlic, onion, cabbage, asparagus, leeks, chicory, Jerusalem artichoke (sunchokes), oats, lentils, chickpeas, and soybeans, etc.) to encourage the growth of healthy gut bacteria.  

The final instalment of this 3-part series on menstrual health will be available mid-March, the perfect time to do a Spring Detox Cleanse! Did you know that abrupt occurrences of allergies and asthma are other symptoms of ED?

In health,
Dr. Vanessa