What happens to excess Estrogen after Endometrial Ablation?

[Suett]

Hi All,

I had an Endometrial Ablation with a D&C a few days ago due to anemia from heavy menstral bleeding. I am 51 years old and have 2 cm cyst on left ovary and .9 cm on right which will be monitored. A small polp was excised from my uterus duing the operation, too.

I  have  liver processing issues which do not process Estrogen too well due to a CYP3A4 and CYP1B1 mutations.

Is it true that the Liver will now process the Estrogen more because the endrometrial lining will not grow any longer?

Also, will the breast tissue be more at risk for too much estrogen, too causing fibrocystic breasts and /or cancer?

In other words . .  what are some of the negatives from the ablation in regards to hormones since the ovaries will still be producing them.

Thank you kindly,
suett

[Machelle Seibel, MD]

A. The fact that you had an ablation will not have any effect on how your liver will metabolize estrogen. Estrogen, and every other hormone, works on tissues that have special receptors for that particular hormone. It works like a lock and key; the estrogen is the key and the tissue (endometrium) has the receptor. When the key goes to the tissue with the lock it turns on the effect that the hormone is able to have on that particular tissue. So estrogen can affect your bones, uterine lining, breasts and other tissues with estrogen receptors.  But estrogen has no effect on tissues that don’t have the receptors for estrogen.  By having a uterine ablation, your body cannot use estrogen on the uterine lining because it has been destroyed, but it will not have any impact at all on how estrogen will affect other tissues, or how much estrogen is available.

Machelle M. Seibel, MD

[peekawho]

I don't think that ablation has any relationship to estrogen production at all.  I'm not sure I totally understand your question, though. It seems as though you think that if you have no endometrium, that your body is somehow getting to much estrogen?  

Endometrial ablation simply reduces the endometrium, which does not produce or process estrogen in any way.  It is simply the lining of the uterus that is shed each month if conception has not occured.  You will not have over production of estrogen from not having an endometrium to shed.

[Suett]

Hi Peekawho,

The estrogen needs either be used or secreted instead of being used by the endometrium . . so where is it going now(what is it being used for)since the ovaries are still working normally?

The liver always detoxes hormones and my point was there may be more for the liver to deal with since the endrometrium is not being bulit up and shedded each month any longer.

I am not saying that there is anymore estrogen being produced, just the normal amounts from before the ablation.

Hope with helps clarify my questions.

Thank you, Suett

[peekawho]

The endometrium does not "use" any of the estrogen in any event.  Whatever estrogen was in your body before the ablation, the amounts are unchanged after the ablation.  It is irrelevant whether the lining is shed or not, estrogen wise.

[Suett]

Then why is it sometimes said that if you are estrogen dominant that you grow a thick endometrial lining?

[peekawho]

Just because it might influence the endometrial lining to be thick, the endometrium doesn't in any way "use" the estrogen up in any way.  It's just AFFECTED by estrogen.  Now that you don't have as much of an endometrial lining, it doesn't mean there is extra estrogen floating around looking for something to do.

You have the same amount of circulating estrogen, endometrium or no endometrium.  

[Suett]

Thank you for your responses, but just wondering are you substituting for the MD response?