From the Guidelines
Estrogen levels can be decreased through various methods, including medications such as aromatase inhibitors (anastrozole, letrozole, exemestane) and selective estrogen receptor modulators (tamoxifen, raloxifene), as recommended by the American Society of Clinical Oncology 1.
Medications
Medications like aromatase inhibitors block estrogen production, while selective estrogen receptor modulators block estrogen effects in certain tissues. Gonadotropin-releasing hormone agonists (leuprolide, goserelin) can temporarily shut down ovarian estrogen production.
Lifestyle Changes
Lifestyle changes that can lower estrogen include:
- Maintaining a healthy weight, as excess fat tissue produces estrogen
- Regular exercise, which can help regulate hormone levels
- Dietary modifications such as reducing alcohol consumption, limiting sugar intake, and increasing fiber consumption
Natural Approaches
Certain foods like cruciferous vegetables (broccoli, cauliflower, kale) contain compounds that may help metabolize estrogen. Stress reduction techniques are beneficial as chronic stress can disrupt hormone balance.
Recommendations
The U.S. Preventive Services Task Force recommends against the use of hormone therapy for the primary prevention of chronic conditions in postmenopausal women, except for the prevention of osteoporosis in certain cases 1. The American Society of Clinical Oncology recommends the use of pharmacologic interventions, including selective estrogen receptor modulators and aromatase inhibitors, for breast cancer risk reduction in women at increased risk 1.
The appropriate method for decreasing estrogen levels depends on the specific medical condition being addressed and should be determined in consultation with a healthcare provider.
From the FDA Drug Label
The growth of many cancers of the breast is stimulated or maintained by estrogens. In postmenopausal women, estrogens are mainly derived from the action of the aromatase enzyme, which converts adrenal androgens (primarily androstenedione and testosterone) to estrone and estradiol The suppression of estrogen biosynthesis in peripheral tissues and in the cancer tissue itself can therefore be achieved by specifically inhibiting the aromatase enzyme. Anastrozole is a selective non-steroidal aromatase inhibitor. It significantly lowers serum estradiol concentrations and has no detectable effect on formation of adrenal corticosteroids or aldosterone. The recommended daily dose, anastrozole 1 mg, reduced estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing. In humans, subcutaneous administration of single daily doses of leuprolide acetate results in an initial increase in circulating levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH), leading to a transient increase in levels of the gonadal steroids (testosterone and dihydrotestosterone in males, and estrone and estradiol in pre-menopausal females) However, continuous daily administration of leuprolide acetate results in decreased levels of LH and FSH. In pre-menopausal females, estrogens are reduced to post-menopausal levels
- Aromatase inhibitors like anastrozole can decrease estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogens.
- GnRH agonists like leuprolide acetate can also decrease estrogen levels by reducing the production of gonadal steroids, including estrogens, after initial stimulation. The decrease in estrogen levels can be achieved with:
- Anastrozole, which reduces estradiol levels by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing 2.
- Leuprolide acetate, which reduces estrogens to post-menopausal levels in pre-menopausal females after continuous daily administration 3.
From the Research
Factors that Decrease Estrogen Levels
- Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide acetate, nafarelin acetate, and goserelin acetate, can decrease estrogen levels by suppressing ovarian function 4, 5, 6, 7
- Leuprorelin acetate, a GnRH analogue, has been shown to decrease circulating serum 17 beta-estradiol levels after 6 months of treatment 6
- GnRH agonists can reduce estrogen production by inducing a reversible suppression of ovarian function, leading to a decrease in estrogen release 5
Mechanism of Action
- GnRH agonists work by initially stimulating the pituitary gland, leading to an increase in gonadotropin release, but with continued use, they cause pituitary desensitization and/or down-regulation, resulting in suppressed circulating levels of gonadotropins and sex hormones 7
- The reduction in estrogen levels is thought to be due to the suppression of ovarian function, which leads to a decrease in estrogen production 5, 6, 7