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Perimenopause and COMT
Hi B. I saw this question on Dr Lynch page and it got so many likes and replies that they are interested to know. And my sister next to me jumped and said she’s wondering the same. So let me throw it here if that’s ok.The woman asking said she’s perimenopause and has a hit low progesterone and low/borderline oestrogen. The dr prescribed compounding progesterone cream from Yam.
She said she use to take DIM and D glucarate to detox estrogen but now she’s afraid. And she hit sore breast when on her period.So. If a woman has already COMT mutation and needs to detox oestrogen regularly, once started perimenopause what to do here? So borderline progesterone and oestrogen still holding in low side as well.
Can DIM and calcium D glucarate be taken, still? Will it only take care of bad oestrogen or or it will lower total oestrogen further?If it can’t be taken, so how to detox bad oestrogen in this case?
And what if oestrogen got low and needs bio-identical oestrogen therapy? How to deal with COMT in this case? -
2 Replies
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Hey ,
With perimenopause, estrogen can go up and down quite a bit. I would focus on reducing the ‘bad estrogen’, but probably not with DIM since it lowers estrogen out of circulation which is fine when estrogen is high… but once estrogen drops it could cause complaints.
DIM also helps the first part of estrogen detoxification (also called phase 1 detoxification). I would mainly focus on phase 2 detoxification and reducing the ‘bad estrogen’. We do by the way have a handout for that right here that give you some suggestions to support phase 2 detoxification as well.
I usually would recommend NAC and/or sulforaphane. They both reduce the risk of DNA damage. Sulforaphane also helps with phase 2 detoxification but doesn’t lower estrogen like DIM can do.
As to the second part of your question, I would probably only consider bioidentical estrogen therapy if I like what I see happening downstream. And only with someone who has the right background to prescribe bioidentical estrogen. If I see elevations in 4OH metabolite with low estrogen, I wouldn’t consider adding estrogen until I addressed that.
With SNPs on COMT I would support a mindful way of living (since COMT is needed to break down adrenaline and noradrenaline) and I would also support the complete methylation cycle by making sure there is enough B2, B6, methyl-folate and methyl B12 present in the diet either through foods or supplements. Magnesium is also important to support COMT and the supplement SAMe can help COMT as well.
I hope this answers your question!
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thanks Daniel. All makes sense. I saw a reply from Dr Lynch to support liver to be able to detoxify bad oestrogen.
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