Can Broccoli Help My PMS?

Premenstrual syndrome (PMS) is essentially a catch-all for the laundry list of symptoms that come along with monthly menstruation – mood swings, irritability, bloating, constipation, diarrhea, acne, breast tenderness, muscle aches, fatigue – if you’ve ever menstruated, you know what I’m talking about. Fluctuations in hormones and neurotransmitters play a big role in the severity of PMS, and high levels of circulating estrogen are associated not only with PMS, but with longer, heavier, and generally more unpleasant periods. The good news is that we can give our bodies a helping hand when it comes to estrogen detoxification, just by eating with intention!

Demystifying Estrogen Detoxification

When I refer to detoxification, I’m not talking about juice cleanses, laxative teas, or special restrictive diets that promise to clear your body of toxins and help you lose weight in the process. You don’t need to stop eating to detoxify your body – in fact, you should not stop eating to detoxify your body! Your body is already equipped with its own detoxification system – your liver! And your liver requires fuel to keep chugging along! You can, however, mindfully and intentionally choose foods that support your liver in the great work it’s already doing.

So, what is detoxification? It’s the process of taking toxins like drugs, pesticides, alcohol, supplements, hormones, and other potentially harmful substances and turning them into less harmful substances for excretion. Detoxification happens into three phases: Phase I (loading the dishwasher), Phase II (starting the dishwasher), and Phase III (draining the dishwasher).

In Phase I, estrogen is converted into three metabolites: 2-hydroxyestrone (2-OH), 4-hydroxyestrone (4-OH), and 16-hydroxyestrone (16-OH). This process is like loading your dirty dishes into the dishwasher. Dirty dishes are no longer piling up in your sink, but they’re still not clean and ready to be put away.

Phase II is like starting your dishwasher and putting the dishes away. In this phase, 2-OH, 4-OH, and 16-OH are converted into less toxic metabolites and attached to molecules of glucuronic acid for excretion. If the enzymes in Phase II are not working properly, only some of your dishes get cleaned, and the others might start to grow mold and stink up your kitchen. Similarly, after estrogen goes through Phase I of detoxification, the resulting metabolites need to be metabolized further in Phase II, or they start to cause health problems like cancer, PCOS, PMS, and endometriosis.

In Phase III, we excrete all of the gunk we got off of the dishes. This is when the dishwasher drains away all of that dirty water. We excrete either through our kidneys (to then be peed out) or our gut (to then be pooped out). We wouldn’t want to put dishes back in our cabinets that are still dirty, right? Well, if your Phase III detoxification isn’t working right, that’s exactly what can happen. For example, if you can’t properly excrete your estrogen, it can be recirculated into your system, leading to a whole host of less than ideal symptoms, listed below.

Okay, So What Does This Mean For My Health?

Just as some dirty dishes are cleaner or greasier than others, these estrogen metabolites have different risks for causing health problems. 2-OH is considered the “good” type of estrogen because it exerts only a weak estrogenic effect and is not likely to result in health problems if levels are high. Like a plate used for toast, the crumbs wipe off easily and no harm is done. 4-OH, on the other hand, is like a pot used for macaroni and cheese that your partner left on the counter for a week. You can scrub it in the sink, but if it doesn’t get a thorough cleaning in the dishwasher, it can start to cause some major problems. 16-OH is less predictable than its sister metabolites. 16-OH is great for proliferation (meaning cell growth), which is wonderful for bone health but obviously not a good thing for cancer cells. Studies have linked high levels to the development of breast cancer, but recent research has shown that a number of other factors influence its effects.(2,4)

Without lab testing, it can be hard to know if your estrogen detoxification system is working properly, but there are some signs and symptoms to look out for:

Cyclical breast tenderness
Increased symptoms of PMS
Heavy periods
Periods lasting over 5 days
Heavy clotting
Irritability, mood swings
Weight gain in hips/butt/thighs
Decreased desire for sex

If you suspect you may have high estrogen, a DUTCH test can tell you not only what your total estrogen level is, but how much of each metabolite your body is making. In the example below, you can see that 4-OH is on the high end of the spectrum. Each metabolite has a dial like a gas tank and when the needle is farther to the right, you have more gas. If your DUTCH test looks something like this, you could benefit from adding some detox superstars into your diet.

Using Food as Medicine

It might seem obvious to say that nutrition is an important factor in our health, but it really can’t be overstated. You’re probably aware that what you eat influences your risk for developing chronic diseases like obesity, high blood pressure, type 2 diabetes, and high cholesterol, but you might not have known that it also impacts sperm motility, morphology, and number, as well as egg quality, uterine thickness, cervical mucus production, and hormone metabolism – AKA your fertility!

When you and your partner have been TTC for over a year and it seems like natural conception just isn’t in the cards, most clinicians will refer you for IUI or IVF. These are incredibly empowering tools and have helped millions of couples conceive and carry to term, but it feels like modern fertility healthcare is missing a step in between. The Fueling Fertility Tribe is all about pinpointing modifiable lifestyle factors like sleep, exercise, stress, and nutrition that can be putting our bodies in “no place for a baby mode,” and turning them to our advantage. While more invasive treatments like surgeries and medications certainly have their place, we need to take a good long look at the basics first. Just as babies need to crawl before they walk, we need to start back at the roots of fertility by examining what we eat.

Cruciferous Vegetables and Estrogen Detoxification

Move over chocolate, broccoli is here to stay. Ok, broccoli may never replace chocolate, but it should be added to your menstruation menu, your flow fare, your period provisions, whatever fun name you like to call your period comfort foods. Why? Because broccoli, along with brussels sprouts, cauliflower, kale, cabbage, arugula, collard greens, bok choy, and several others, is a cruciferous vegetable containing magical compounds called sulforaphane and diindolylmethane (DIM).

Acrucif-what?

Cruciferous veggies belong to the Cruciferae (or Brassicaceae) family and are high in vitamins C, E, and K, folate, fiber, and carotenoids. They also contain phytonutrients called glucosinolates, indoles, and isothiocyanates that support liver enzymes involved in detoxification.

Sulforaphane is the superstar of isothiocyanates because it is one of the most potent natural inducers of Phase II detoxification. It also increases your body’s antioxidant activity, which reduces oxidative stress, relieves inflammation, and reduces the risk for cancer. If you remember from my recent post on Fertility Nutrition 101, oxidative stress and inflammation can reduce the quality of both egg and sperm, so consuming antioxidants is essential!

Sulforaphane also promotes 2-OH formation over 4-OH and 16-OH, which basically means it can grab the estrogen that is going down that super dirty-dish 4-OH pathway and put it on the easier-to-clean-dish 2-OH pathway. And it supports GST, an important enzyme that neutralizes the carcinogenic effects of 4-OH.(5)

Get the most out of your cruciferous vegetables!

Sulforaphane is only released when cruciferous veggies are chopped or chewed, and cooking can destroy the enzymes that make the magic happen. You can eat some cruciferous veggies raw, but others are best when cooked. For these veggies, chop them and let them sit for 5-10 minutes to let the enzymes do their thing before cooking.

DIM is an indole that induces Phase I detoxification and inhibits testosterone from converting to estrogen.(3) This conversion is a normal and healthy part of your physiology, but when you have high estrogen levels, reducing conversion can help bring your hormones back into balance.

Do I Need to Supplement?

Adding cruciferous veggies into your diet is a great way to support your liver’s natural processes, but women with high estrogen might also benefit from taking these nutrients in a more concentrated form. You’d need to eat something like six pounds of cruciferous vegetables a day to get the therapeutic doses used to influence estrogen detox pathways, which is a bit ambitious. However, whole foods contain countless other phytonutrients, vitamins, minerals, and fiber that are extremely beneficial for our overall health and fertility, so don’t underestimate their value!

Common estrogen detox supplements include DIM and indole-3-carbinol (I3C) (Phase I superstars), sulforaphane (Phase II superstar) and calcium d-glucarate (Phase III superstar). Since I3C is the parent molecule of DIM, I recommend skipping the extra step of converting I3C to DIM in your stomach and simply taking DIM instead. Because DIM is a Phase I inducer, it’s important to ensure that Phase II is running at the same capacity, or you could end up with a full dishwasher that just can’t run fast enough.

So if you’re taking DIM, I recommend supplementing with sulforaphane as well as calcium d-glucarate. Calcium d-glucarate works in the stomach to ensure that detoxified estrogen stays attached to glucuronic acid and gets excreted. In other words, it helps put the clean dishes away.

But the best thing you can do to figure out what supplement regime is best for you is to TEST NOT GUESS, which I would love to do for you.

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What Else Can I Do?

Reduce your exposure to xenoestrogens. Xenoestrogens are man-made chemicals in the environment that mimic estrogen in your body and interfere with hormone synthesis and metabolism. Common xenoestrogens include:

Parabens (personal care products like shampoos, lotions, soaps, face washes)
Phthalates (soft plastics, personal care products)
BPA (metal cans)
Weed killers with atrazine(1)

Reduce your exposure to other toxins like alcohol, drugs, and pesticides. If your liver is already overburdened with other toxins, resources may be diverted away from estrogen detoxification, allowing estrogen to recirculate rather than be excreted.(6)

Eat more lignans. Lignans are a type of phytonutrient found in fiber-rich plants that increases the production of sex hormone-binding globulin, the protein that binds estrogen and prevents it from exerting effects on your cells.

Foods high in lignans include:

Legumes
Berries
Whole Grains
Flaxseeds
Sesame Seeds
Cashews
Broccoli
Brussels Sprouts

Eat dark chocolate. I know, this is a really tough one 😉 Dark chocolate contains a phytonutrient called resveratrol that neutralizes the harmful metabolites of 4-OH and helps reduce the production of these metabolites in the first place. If you’re not a fan of dark chocolate, you can also increase your resveratrol consumption by eating peanuts, red-skinned grapes, blueberries, and pistachios.