Dietary Seeds and Luteal Phase Estrogen Support
No evidence-based recommendations exist for using dietary seeds to increase E1G (estrone-3-glucuronide) levels during the luteal phase (7-10 days post-ovulation), and this approach should not be relied upon for fertility optimization, particularly in patients undergoing letrozole and progesterone supplementation for fertility treatment.
Understanding Luteal Phase Estrogen Physiology
The luteal phase naturally exhibits a secondary rise in estrogen levels, with E1G reaching approximately 2-3 times higher than early follicular phase baseline values during the mid-luteal phase (7-10 days post-ovulation) 1. This physiological elevation occurs through corpus luteum function and has important metabolic effects including:
- Protein-sparing during exercise 1
- Improved glucose metabolism 1
- Increased lipid oxidation 1
- Enhanced muscle strength and bone mineral density 1
Critical Considerations for Your Clinical Context
Letrozole's Impact on Estrogen Levels
Your current letrozole treatment fundamentally contradicts the goal of raising estrogen levels. Letrozole is an aromatase inhibitor that:
- Suppresses estradiol concentrations by 58% during the follicular phase and 39% during the luteal phase 2
- Maintains estrogen levels near physiologic levels even during ovarian stimulation 3
- Results in serum E2 levels of approximately 650 pg/mL compared to 2451 pg/mL without letrozole 4
Progesterone Supplementation Effects
Your progesterone supplementation may already be providing adequate luteal support. Evidence shows:
- Vaginal progesterone may increase clinical pregnancy rates (RR 1.44,95% CI 1.04 to 1.98) with oral stimulation protocols 5
- Progesterone supplementation improves corpus luteum function 2
- The combination of letrozole and progesterone creates a complex hormonal environment where attempting to independently raise estrogen through dietary means is unlikely to be effective 5
Why Dietary Seeds Are Not the Solution
No clinical guidelines or high-quality research support using seeds (flax, sesame, pumpkin, or others) to meaningfully increase E1G levels during fertility treatment. The evidence base focuses on:
- Pharmaceutical interventions for hormonal optimization 3
- Controlled ovarian stimulation protocols 2, 4
- Luteal phase support with progesterone 5
Any phytoestrogen effects from seeds would be:
- Minimal compared to endogenous hormone production
- Potentially counterproductive given your letrozole therapy
- Unquantifiable and unreliable for fertility optimization
Recommended Clinical Approach
Discuss with your reproductive endocrinologist whether your current letrozole protocol is appropriate for your stage 3 rectocele and fertility goals. Consider:
- Whether letrozole is necessary given it suppresses the very estrogen you're trying to increase 2, 4
- Timing of progesterone supplementation relative to your cycle 5
- Alternative ovarian stimulation protocols if estrogen optimization is clinically indicated 3
The focus should be on evidence-based pharmaceutical management rather than unproven dietary interventions, particularly given the complexity of your concurrent letrozole and progesterone therapy.