Overload

Estrogen imbalance

Category: Illness or disabilities

Type

Involuntary

Introduction and description

The photos on this page have been chosen to add beauty to an
otherwise quite sad subject
 

Estrogen or oestrogen is a hormone. They are present in both men and women, but are usually present at significantly higher levels in women of reproductive age.

  • In women - They are responsible for development and regulation of the female reproductive system and promote the development of female secondary sexual characteristics, such as breasts.  They are also involved in the thickening of the endometrium and other aspects of regulating the menstrual cycle.
  • In males - estrogen regulates certain functions of the reproductive system important to the maturation of sperm and “may be necessary for a healthy libido”.

A full description of estrogen, its endogenous and exogenous ligands, the essential role that cholesterol plays in its synthesis in the body, and all estrogen’s functions is provided in the suppression section.  We suggest that you read this page first in order to understand imbalance.

Symptoms

 

There are two types of estrogen imbalance:

  • Hyperestrogenism – too much estrogen in your system, this can be temporary or a more permanent problem
  • Hypoestrogenism – too little estrogen in the system.  Again this can be temporary or a more long term problem

The imbalances affect men and women differently, but both have their effects on both sexes.

Hyperestrogenism

Hyperestrogenism (elevated levels of estrogen) may be a result of exogenous administration of estrogen or estrogen-like substances, or may be a result of physiologic conditions such as pregnancy or even the menopause as the levels fluctuate up and down. Too much estrogen can lead to:

Weight gain – in some papers the weight gain is called obesity and associated as a risk factor, but it is an end result of the estrogen imbalance not a cause [note that the polyps mentioned in the following paper can also result from hyperestrogenism:

A total of 89.5% (n = 355) of our patients had profile factors associated with the increased incidence of endometrial polyps and hyperestrogenism (diabetes mellitus, hypertension and overweight); 89.5% (n = 355) of patients were overweight; 34% had grade I obesity. PMID:  25783652

Mental confusion – and effects on mental performance.  The following paper assumed that more estrogen might mean better performance, but overdosing on estrogen simply made the brain malfunction, causing confusion.

Despite presumed hyperestrogenism, women with PCOS demonstrated impaired performance in terms of speed and accuracy, on reaction time and word recognition tasks. These findings are intriguing given the well-documented roles of estrogen and testosterone in cognitive function. PMID:  17659845

Oleg Oprisco

Liver disease – the following research group undertook a study to try to find out the reasons why postmenopausal women were abandoning HRT – which can produce hyperestrogenism. 

In a cross-sectional study, were included 261 menopausal women between 40 and 60 year old who attended their disease control at the Gynaecological Endocrinology serving in the National Medical Center Northwest in Obregon City, Sonora, Mexico during 2010-2011. ….A total of 21 women discontinued treatment …. The reasons for abandonment included, 42.9% gynecological reasons (23.8% breast disease, 14.3% and 4.8% cervical condition ovarian pathology). Liver disease and vascular occurred in 28.6%.  PMID:  24483042

And here we have a specific case study that shows that overdosing on estrogen can produce ‘fatty liver’ disease

A 46-year-old woman in surgical menopause was transferred due to persistent abdominal pain and nausea after cholecystectomy in the setting of long-term hyperestrogenemia. She denied recent use of hormone therapy. Significant findings included biliary dyskinesia, hypertriglyceridemia and focal nodular hyperplasia of the liver with fatty infiltration. Laboratory findings were significant for hyperestrogenemia with markedly suppressed gonadotropin levels and undetectable inhibin level. The patient eventually disclosed receiving serial implants of estradiol-17beta and testosterone pellets by another provider……Lack of standardized dosing parameters for this nonregulated product likely contributes to the chance of hyperestrogenemia. Despite bypassing first-pass metabolism, supraphysiologic levels of these hormones can cause significant metabolic and gastrointestinal impairments.  PMID:  20337216

Oleg Oprisco

Liver cancer – this study appeared to suggest that the liver cancer mostly affects men or as they put it ‘humans with male dominance’

Liver cancer is the fifth most common cancer in humans with male dominance. Sexual dimorphism of liver cancer is conserved from rodents to humans, which was firstly found in mice in late 1930s and female mice were resistant to liver cancer. Sex hormones were found to affect the incidence of liver cancer in rodents. Estrogen receptor alpha (ERα)-mediated estrogen signaling or androgen receptor-mediated androgen signaling prevents or promotes the growth of rodent liver tumors, respectively. PMID:  25661537

Immunological reactions – the immune system appears to get out of balance.  Many so-called auto-immune conditions may be a direct result of estrogen imbalance, for example

The choice of an optimal contraceptive method (OC) therapy is a significant problem in female SLE [Systemic lupus erythematosus ] patients. In view of the influence of sex hormones on the evolution of SLE, oral contraceptive (OC) therapy has to be efficient, reversible and safe, without aggravating disease activity and causing metabolic and vascular side effects. Ethinyl estradiol-containing preparations, even at 30 micrograms/day, have been shown to trigger a crisis or unmask SLE, and they exert adverse metabolic and vascular effects. PMID: 1695073

In other words by adding estrogen into the system, immunological reactions result.

Oleg Oprisco

Thrombosis – and ‘thick blood’.  Thrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system.

Strokes - The estrogen-alone substudy of the WHI reported an increased risk of stroke and deep vein thrombosis (DVT) in the women they studied who were in effect overdosing on estrogen by taking 0.625 mg of Premarin conjugated equine estrogens (CEE)

Pulmonary emboli – another finding from the same study mentioned above.

Heart problems - Based on a review of data from the WHI, on January 8, 2003 the FDA changed the labeling of all estrogen and estrogen with progestin products for use by postmenopausal women to include a new boxed warning about cardiovascular risks.  The estrogen-plus-progestin substudy of the WHI mentioned above reported an increased risk of myocardial infarction, stroke, and postmenopausal women taking estrogen supplements.

Breast cancer - The estrogen-plus-progestin substudy of the WHI mentioned above reported an increased risk of invasive breast cancer from those using products such as  PremPro, which is 0.625 mg of CEE with 2.5 mg of the progestin medroxyprogesterone acetate (MPA).  This is an overdose of estrogen.  It should be noted that this affects men and women, although the causes may be different, for example

Lesions of the male breast are rather rare. The most frequent lesion is gynecomastia followed by breast cancer. Gynecomastia is well known but male breast cancer is a rather rare tumor. It occurs in less than 1% of all cancers in men and of breast cancers. The mean age is high with a median of 68 years. Predisposing factors appear to be associated with hyperestrogenism….. PMID:  16892548

 

Endometrial cancer – for example the labeling of estrogen-only products in the U.S. includes a boxed warning that unopposed estrogen (without progestogen) therapy increases the risk of endometrial cancer.  And

Endometrial Cancer is the most frequent tumor in western world nations, with 142,000 new cases each year and 42,000 casualties. This form of cancer typically affects women between 55 and 65 years of age, and ranks fourth among female tumors. Endogenous predisposing conditions to endometrial cancer development are: late menopause, early menarche and hyperestrogenism, while hormone replacement therapy and alcohol, …. are the exogenous factors. PMID:  20937028

Uterine cancer – for example

Cancers of the uterine corpus, substantially represented by endometrial cancers, represent the fourth leading cause of cancer in women in France. Risk factors include hyperestrogenism with early age of menarche and late menopause, …..PMID:  25090759

Hypoestrogenism

The results of hypoestrogenism seem better understood than those of hyperestrogenism.

Amenorrhoea – no periods

In premenopausal women, the most severe menstrual dysfunction is amenorrhoea, which is associated with chronic hypoestrogenism. PMID:  15294009

And following on from this……

Infertility, osteoporosis , endothelial dysfunction, depression, anxiety and sexual problems – all summed up well in this paper

Functional hypothalamic amenorrhea (FHA) results from the aberrations in pulsatile gonadotropin-releasing hormone (GnRH) secretion, which in turn causes impairment of the gonadotropins (follicle-stimulating hormone and luteinizing hormone). The final consequences are complex hormonal changes manifested by profound hypoestrogenism.
Functional hypothalamic amenorrhea is related to profound impairment of reproductive functions including anovulation and infertility. Women's health in this disorder is disturbed in several aspects including the skeletal system, cardiovascular system, and mental problems. Patients manifest a decrease in bone mass density, which is related to an increase in fracture risk. Therefore, osteopenia and osteoporosis are the main long-term complications of FHA. Cardiovascular complications include endothelial dysfunction and abnormal changes in the lipid profile. FHA patients present significantly higher depression and anxiety and also sexual problems compared to healthy subjects.  PMID: 25201001

Premature ovarian insufficiency (POI) -  the cessation of ovarian function under the age of 40 years

POI is characterized by amenorrhea, hypoestrogenism, and elevated serum gonadotrophin concentration (FSH). PMID:  20680310

Glaucoma, cataracts, macular degeneration

Hormonal withdrawal has been considered among risk factors for diseases such as glaucoma, diabetic retinopathy and age-related macular disease (AMD), ……. Sex hormones and aging have been also suggested to drive the incidence of ocular surface diseases such as dry eye and cataract. …. Focusing on the estrogenic retina, we here review our knowledge on local 17β-oestradiol (E2) synthesis from cholesterol-based neurosteroidogenic path and testosterone aromatization, and presence of estrogen receptors (ERα and ERβ). The first cholesterol-limiting step and the final aromatase-limiting step are discussed as possible check-points of retinal functional/dysfunctional E2. PMID:  26265586

 
 

Dental problems – estrogen plays an important part in bone formation and ‘skeletal maintenance’.  If there is not enough estrogen then osteoporosis may follow.  There is currently an hypothesis – and it is only an hypothesis, although a well founded one – that since estrogen also acts through estrogen receptors in the cells of the periodontal ligament, it may also affect dental health.  In effect any reduction in estrogen may cause dental caries or loose teeth

The purpose of this manuscript is to review the literature for evidence to support an association between estrogen and periodontal disease in adult women, as well as bone mineral density, and to help clarify the mechanism of action. We found in our review of all pertinent databases, including Cochrane, that there are few peer-reviewed clinical studies that examine the relationship between estrogen deficiency and periodontal disease, and bone mineral density (BMD) and periodontal disease. Thus, future research is needed to investigate these associations so that at-risk patients can be identified earlier to avoid functional and esthetic sequellae of periodontal disease.  PMID:  24933771

Apocryphally, my Mum lost all her teeth at the time of the menopause and I also had terrible problems during the menopause – although I was helped by the use of all the new developments with crowns etc.

Psychosis – we have provided a number of observations that link low oestrogen levels with various forms of psychosis, but this paper is interesting, because it shows a direct drug induced link:

This paper describes the laboratory discovery and clinical testing of the first nonsteroidal antiestrogen, MER-25 (ethamoxytriphetol). The compound blocks estrogen action in all species tested and has only slight but transient estrogenic effects. No other antisteroidal actions are noted. MER-25 is antiestrogenic in primates and was investigated in the clinics … Unfortunately toxic side effects (hallucinations, etc.) precluded further investigation. PMID:  2194650

Male infertility

Oestrogen is considered to be the 'female' hormone, whereas testosterone is considered the 'male' hormone. However, both hormones are present in both sexes. Thus sexual distinctions are not qualitative differences, but rather result from quantitative divergence in hormone concentrations and differential expressions of steroid hormone receptors. In males, oestrogen is present in low concentrations in blood, but can be extraordinarily high in semen, and as high as 250 pg ml(-1) in rete testis fluids, which is higher than serum oestradiol in the female. It is well known that male reproductive tissues express oestrogen receptors, but the role of oestrogen in male reproduction has remained unclear. Here we provide evidence of a physiological role for oestrogen in male reproductive organs. We show that oestrogen regulates the reabsorption of luminal fluid in the head of the epididymis. Disruption of this essential function causes sperm to enter the epididymis diluted, rather than concentrated, resulting in infertility. This finding raises further concern over the potential direct effects of environmental oestrogens on male reproduction and reported declines in human sperm counts.  PMID:  9393999

Causes

Aside from the natural and most obvious cause of stages in a woman’s life when disruption occurs naturally – at puberty and during the menopause, the other external causes of imbalance can include the following

Phytoestrogens

Few people appear to realise how many phytoestrogens there are and how many we actually consume.  We can actually be making ourselves hyperestrogenic from food and drinks alone.  The current fashion for soy based milks and foods, the move towards vegetarian diets or even vegan diets has considerably increased the amount of estrogen in our diet.

Phytoestrogens, polyphenolic compounds derived from plants, are more and more common constituents of human and animal diets. In most of the cases, these chemicals are much less potent than endogenous estrogens but exert their biological effects via similar mechanisms of action. The most common source of phytoestrogen exposure to humans as well as ruminants is soybean-derived foods that are rich in the isoflavones genistein and daidzein being metabolized in the digestive tract to even more potent metabolites—para-ethyl-phenol and equol. Phytoestrogens have recently come into considerable interest due to the increasing information on their adverse effects in human and animal reproduction, increasing the number of people substituting animal proteins with plant-derived proteins. Finally, the soybean becomes the main source of protein in animal fodder because of an absolute prohibition of bone meal use for animal feeding in 1995 in Europe. The review describes how exposure of soybean-derived phytoestrogens can have adverse effects on reproductive performance in female adults.[ International Journal of Endocrinology:  Volume 2013 (2013), Article ID 650984]

If you are not taking HRT or contraceptives, and are not taking any cholesterol lowering drugs,  then a simple change of diet may suffice to solve the problems.

Nutritional deprivation

There were significantly lower serum concentrations of luteinizing hormone, estradiol and testosterone in rats fed a zinc-deficient diet. ….. The findings indicate that zinc deficiency reduces circulating luteinizing hormone and testosterone concentrations, alters hepatic steroid metabolism, and modifies sex steroid hormone receptor levels, thereby contributing to the pathogenesis of male reproductive dysfunction.  PMID:  8613886

And female.

Toxins

 

Principally Endocrine disruptors.  There has been some interesting research on whether toxins in water supplies or the sludge from sewerage spread on fields is a source of estrogens of various sorts.  The answer appears to be, it depends on the source of the water and the processing of the sludge.  This paper shows it can happen, though in this case the amounts were small, but other papers show that our water supplies are being polluted with endocrine disrupting chemicals in a major way and it may return to us via the food chain

This paper presents the study of the occurrence of 10 endocrine-disrupting compounds (EDCs) in 60 water samples using a method for simultaneous quantification and confirmation of the presence of these emerging compounds ….. Several natural and synthetic hormones (17-β-estradiol, ethinylestradiol, estriol, estrone, progesterone, mestranol, and diethylstilbestrol) and some industrial products (4-n-nonylphenol, 4-tert-octylphenol, and bisphenol A) were chosen for this survey. The analytical limits were calculated for each compound and were used in the identification and quantification of these target compounds in EPAL's water supply system. In this study, several samples were taken from the main intakes of water (surface and groundwater) used for production of water for human consumption and from different sampling points of the drinking water distribution system (piping, nets, and reservoirs). Some target compounds, such as estriol, 4-tert-octylphenol, mestranol, and nonylphenol, were found in trace amounts in several water samples. However, the studied endocrine-disrupting appeared in very low concentrations when compared with the assessed analytical limits. PMID:  25712629

This sounds reassuring, but one should not be reassured.  It shows it can happen and does happen.  It also very effectively lists just how many synthetic hormones there now are.

Cosmetics

Some hair shampoos on the market include estrogens and placental extracts; others contain phytoestrogens. In 1998, there were case reports of four prepubescent African-American girls developing breasts after exposure to these shampoos.

Fungal infection

There appear to be a number of fungi that can have an effect on estrogen levels.  In some cases the effects are actually positive and fungi have been used to prevent breast cancer, but this is not always the case. 

Zearalenone (ZEA) is a mycotoxin produced mainly by fungi belonging to the genus Fusarium in foods and feeds. It is frequently implicated in reproductive disorders of farm animals and occasionally in hyperoestrogenia in humans. There is evidence that ZEA and its metabolites possess oestrogenic activity in pigs, cattle and sheep. ………Moreover, ZEA has also been shown to be hepatotoxic, haematotoxic, immunotoxic and genotoxic. The exact mechanism of ZEA toxicity is not completely established. …... ZEA is commonly found on several foods and feeds in the temperate regions of Europe, Africa, Asia, America and Oceania. …….PMID:  17045381

Surgery

Oleg Oprisco

Estrogen is made from cholesterol, cholesterol circulates in the blood.  If we are in imbalance, we may get either high cholesterol or low cholesterol.  It will be noticeable that several sorts of cholesterol will be present in the blood stream to help with the manufacture of the hormone. 

Cholesterol is also increased in the bile to provide a store from which to make the hormone. 

This makes removal of the gall bladder seem a somewhat unwise activity if we still want the estrogen.  In effect removal of the gall bladder can cause hypoestrogenism.

Pharmaceuticals

Statins and lipid lowering drugs - As cholesterol is a needed precursor to the synthesis of estrogen, any medication that affects the production of cholesterol will have a very detrimental effect.  The two obvious candidates are thus statins and lipid lowering medications.

HRT and contraceptives - The two additional and obvious types of medication that may affect estrogen levels are HRT and contraceptives based on estrogen.

 

Unfortunately there appears to be some sort of widespread myth that the menopause only results in hypoestrogenism and this is why women are given HRT, but the real problems of the menopause are the fluctuations as the body tries to find a new balance.

No one has actually considered the fact that in the end the body may adjust simply to redistribute the supply centres for estrogen elsewhere – other than the ovaries.   After menopause, the predominant type of estrogen changes and these different types are produced in smaller amounts by other tissues such as the liver, adrenal glands, and the breasts. This may be why older women sometimes develop such massive breasts.  These secondary sources of estrogens are especially important in postmenopausal women. Fat cells produce estrogen as well.

The shape changes in older women to reflect the fact they don’t need to look like sex goddesses anymore, but nature still looks after them with enough estrogen to keep the bones rigid and the skin reasonably supple – as long as we let nature do her job.

HRT does not use this form of ‘mature woman’ estrogen.  It is based on trying to turn back the clock and the body is fairly obviously going to rebel.

Antipsychotics

Hyperprolactiaemia causes decrease of bone mass density (BMD). High serum prolactin levels lead to increase of the risk of osteopenia or/and osteoporosis. Decrease of BMD results from hypoestrogenism induced by hyperprolactinaemia and also by the direct negative influence of prolactin on bone. ….Important group of patients threatened by osteoporosis and bone fracture is constituted by women which use antipsychotic drugs (which induce hyperprolactinaemia). PMID:  26319389

Others

Using the eHealthme site and the Adverse drug reports submitted by doctors to the FDA and SEDA in the USA, it is possible to find out which drugs are implicated in all the variations of estrogen imbalance.  There is no entry on eHealthme labelled 'estrogen imbalance', because it it a cause and not a symptom and the eHealthme site concentrates on symptoms; but we can take the various symptoms of estrogen imbalance and provide lists for each.  The links below should take you to the symptom.  Scroll down and you will find an  entry for 'Drugs which cause'.  If you press think link you will get an up to date list of all the pharmaceuticals implicated in that symptom:

  • Premenstrual syndrome - follow LINK - As of October 2016, about 250 pharmaceuticals were in this list
  • Polycystic ovary syndrome - follow LINK - As of October 2016, about 400 pharmaceuticals were in this list
  • Precocious puberty - follow LINK - As of October 2016, about 100 pharmaceuticals were in this list
  • Delayed puberty - follow LINK - As of October 2016, about 50 pharmaceuticals were in this list
  • Premature menopause - follow LINK - As of October 2016, about 200 pharmaceuticals were in this list
  • Amenorrhoea - follow LINK - As of October 2016, about 650 pharmaceuticals were in this list
  • Infertility - see LINK - As of October 2016, about 200 pharmaceuticals were in this list
  • Irregular menstruation - see LINK - As of October 2016, about 17 pharmaceuticals were in this list
  • Menstruation - painful - see LINK - As of October 2016, about 750 pharmaceuticals were in this list
  • Menstruation - delayed - see LINK - As of October 2016, about 300 pharmaceuticals were in this list
  • Ovarian disorder - see LINK - As of October 2016, about 250 pharmaceuticals were in this list
  • Ovarian failure - see LINK - As of October 2016, about 100 pharmaceuticals were in this list

 plus more.  There are some more links provided in the section on Reproductive system disease.

Parasites

Cysts are often the sign of parasitic infection.  Although bacteria and viruses may also be encysted, the formation of a cyst is a frequent mechanism used by the immune system to entomb an invader.  Unfortunately the cyst itself can disrupt the endocrine system particularly if it is in the ovary or on any endocrine glands.  The very presence of a cyst may also indicate parasites as yet not encysted that are also doing damage.  Both can thus do damage in both directions – hyper and hypo estrogenism.

In this review we report the literature about ovarian function of young women with McCune-Albright Syndrome and describe our personal experience in the follow-up of a small cohort.  Collectively, the existing data demonstrate that ovarian hyperfunction with ovarian cysts and hyperestrogenism persists in those women who had precocious puberty. ….. The persistence of estrogen hypersecretion causes menstrual disturbances and hypofertility. PMID:  17982390

All sorts of parasites have been implicated.  The following example is that of the Echinococcosis, also called hydatid cyst, caused by tapeworms of the Echinococcus type.

We report a case of 48-year-old woman with multiple hydatid cysts in pararectal region and right paraovarian localization with an unusual sonographic and computed tomographic presentation mimicking a pelvic endometriosis. During laparotomy, multiple pararectal and right ovarian cysts resembling endometriosis were resected. Pathologic examination gives the diagnosis of hydatid cysts. PMID:  23456529

Viruses

Oleg Oprisco

A number of viruses are implicated in causing estrogen imbalance by infecting the ovaries and endocrine system in general.  One of these is the herpes simplex virus:

The goal of this work was to study the capacity of the herpes simplex virus (HSV) of infecting ovary with disease in case of the intravaginal experimental animals. The results of the study demonstrated that the ascending HSV infection in mice lead to modification of all the cells of the ovary, including follicular cells synthesizing estrogen and progesterone…Estrogens provide the protective effects against the virus. Progesterone does not modify the body sensitivity to HSV, but reduces the effectiveness of the antiviral immunity, resulting in increased mortality of animals. We demonstrated that infection of oocytes in ovarian follicles of female mice during infection with HSV modified the process in vitro and for the first time demonstrated the detection of viral antigens in mature oocytes in patient with infertility. During the intracytoplasmic sperm injection into the infected oocytes (ICSI), the failure of fertilization was observed. These results are of interest, because there is no available literature on whether HSV infection of oocytes can have a direct negative impact on the process of fertilization in humans.  PMID:  25065146

It may of interest that Human papillomavirus (HPV) is widely accepted as the main cause of cervical cancer. However, the presence of HPV DNA does not inescapably lead to the development of the cancerous phenotype of the infected cell. Therefore, it is considered that the induction of full cancerous expression of HPV requires additional cofactors. One of those co-factors appears to be estrogen imbalance.  [Ref PMID:  21491087]

Treatment

Find the cause.

How it works

Although overdosing on estrogen can cause some mental confusion, we found no observations showing it resulted in psychosis or hallucinations.   This does not mean it is not possible, simply that there were no observations we could find.

 In contrast the connection between insufficient estrogen – hypoestrogenism - and various forms of mental illness are quite marked.  Anxiety and depression are quite common, but spiritual experiences are also present – hallucinations especially.  Rather alarmingly this has often been diagnosed as bipolar disorder or schizophrenia, when it is simply an hormonal imbalance and could be corrected via the diet.

There also seem to be indications, however, that in the long term very large spikes of estrogen, though causing no hallucinations or similar experiences at the time, result in brain damage.  And brain damage does cause hallucinations

Attempts at causal therapy are focussed on searching for the substances that can prevent the formation and toxicity of beta-amyloid (droloksifen, estrogens, agonists of muscarinic receptors M1), PMID:  11059261

In the end therefore the cause of hallucinations is brain damage – hopefully temporary, but if maintained for too long, permanent.

References and further reading

Oleg Oprisco

Papers

Association of polymorphisms in estrogen receptors (ESR1 and ESR2) with male infertility: a meta-analysis and systematic review.  Ge YZ1, Xu LW, Jia RP, Xu Z, Li WC, Wu R, Liao S, Gao F, Tan SJ, Song Q, Xin H.  1Department of Urology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China.

Diverse Effects of Phytoestrogens on the Reproductive Performance: Izabela Wocławek-Potocka,1 Chiara Mannelli,1,2 Dorota Boruszewska,1 Ilona Kowalczyk-Zieba,1 Tomasz Waśniewski,3 and Dariusz J. Skarżyński1; 1Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 2Department of Life Sciences, Doctoral School in Life Sciences, University of Siena, 3Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Warmia and Masuria, Poland

H. W. Bennetts, E. J. Underwood, and F. L. Skier, “A breeding problem of sheep in the south- west division of western Australia,” Journal of Agriculture, Western Australia, vol. 23, pp. 1–12, 1946. [red clover and phytoestrogen effects on sheep fertility]

Psychosomatics. 2012 May-Jun;53(3):285-8. doi: 10.1016/j.psym.2011.08.008. Epub 2012 Feb 3.  A case of repeated brief psychotic episodes secondary to discontinuation of non-prescription estrogen replacement therapy.  Findley JC1, Joshi KG.  PMID:  22305488

 Photos

Some of the photos on this page are by Oleg Oprisco, whose work can be found extensively all over the site, as his photos are stunning - heavenly!

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