Have you noticed your metabolism slowing, more belly fat or changes in your cycle? There is a complex interplay between sex hormones and hormones that control metabolism, like insulin and your thyroid. Understanding the enzyme aromatase may help to explain these connections and bring solutions to some common symptoms. 

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“There is a complex interplay between sex hormones and hormones that control metabolism, like insulin and your thyroid. Understanding the enzyme aromatase may help to explain these connections and bring solutions to some common symptoms.” 

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In today’s article, you will learn: 

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● What is aromatization? 

● How to balance aromatization. 

● Why it’s important to address insulin resistance first.

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Let’s jump in! 

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What is Aromatase and Aromatization? 

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All estrogen starts out as testosterone. It’s true! Aromatization is the process by which testosterone converts into estrogen, specifically estradiol or E2, and the enzyme that facilitates this conversion is called aromatase. 

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“All estrogen starts out as testosterone.” 

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This is a normal, natural, biochemical reaction that happens in both men and women. But when aromatase is happening too much, (or not enough), in certain cells of the body, it could lead to hormonal imbalance such as estrogen dominance or high or low testosterone. 

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When estrogen levels are high, but testosterone levels are low, we must consider high aromatase, or over conversion of estrogen to testosterone. This might be the case when under stress, as the hormone cortisol makes aromatase work faster. 

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The most common imbalance that I see in my clients is the opposite: high testosterone with low estrogen. The main driver here is insulin resistance or metabolic syndrome, where insulin levels are high which presents with symptoms such as excess belly fat, high blood pressure, elevated blood sugar, elevated triglycerides or low HDL cholesterol. 

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When it comes to female hormones, insulin resistance can also drive high testosterone and polycystic ovarian syndrome, or PCOS, in women. 

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Here is how it is related to aromatase. 

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The theca cells in the ovary produce androgens, including testosterone which then converts to estrogen via aromatase. In the case of insulin resistance, when insulin levels are high, different cells respond in different ways. The ovaries are interestingly the only cells in the body that do not become insulin resistant. And insulin, go figure, is an aromatase inhibitor. This means that when insulin is high, the ovaries have a hard time making the much-needed estrogen and the result is rising levels of testosterone (and all those unwanted symptoms). 

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In cells that are resistant to insulin, like fat cells for example, more aromatase activity may occur, increasing estrogen levels. This is a contributing factor for high estrogen levels in women, and (men too)! 

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Insulin resistance and high testosterone is a classic pattern of PCOS. It may also inform us of other symptoms of high testosterone including: 

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- Male pattern baldness 

- Male pattern hair growth 

- Acne 

- Anovulatory cycles 

- Fat storage in the midsection 

- Fertility problems

- Metabolic disorders 

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How to Prevent Too Much Aromatization 

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The dominant conversation around aromatization is about decreasing it by inhibiting aromatase. However, this thought may be overly simplistic. Female hormone balance in women is more nuanced. It matters where the aromatization is happening and what the hormonal pattern looks like. 

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Too much aromatization could be a factor in estrogen dominance. In women, we also want to consider the other factors that may be playing a role in this hormone imbalance, such as:

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● Exposure to environmental estrogens 

● Low progesterone 

● Issues with estrogen detoxification 

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In PCOS and other cases of elevated testosterone in women, there may already be a lot of aromatase inhibition in the ovaries from insulin itself so we may not want to inhibit it further. 

The number one solution for bringing aromatase back into balance is addressing the underlying insulin resistance. 

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Natural Aromatase Inhibitors 

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“Each woman is different, which is why it is critical to test and not guess about hormones.” 

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Each woman is different, which is why it is critical to test and not guess about hormones. We want to evaluate: 

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● Estrogen levels 

● Testosterone levels 

● SHBG levels 

● Insulin levels and other metabolic markers 

● Stress and cortisol 

● Progesterone levels 

● Regularity of cycles 

● Positive and robust ovulations 

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These are important questions to ask before jumping to inhibit aromatase. We need to understand the underlying hormonal landscape for each woman. 

That said, addressing insulin resistance is key. Here’s how: 

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● Balance blood sugar. Consider food first and work to include whole foods, eaten at regular intervals, that allow daily blood sugar to look more like rolling hills instead of peaks and valleys.

This means ditching processed food and refined carbs. If it comes in a box or a bag, skip it. Choose fruits, vegetables, tubers, and legumes instead, and pair them with protein and fat. 

Some research points to higher protein diets controlling aromatase. While I don’t advocate for a high protein diet, ensure you are meeting your basic needs by including predominantly plant protein at every meal and smart sources of animal and seafood protein to round out your real food diet. 

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● Supplement smart. Then consider supplements. Supplements to improve insulin sensitivity include: 

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o Fiber 

o Cinnamon 

o Berberine 

o Alpha lipoic acid 

o Magnesium 

o NAC 

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Depending on your hormone levels you may also consider supplements to balance testosterone or supplements to balance estrogen. 

In Part 2 of this series, I’ll discuss more about testing and solutions to address high testosterone, while you work on the lifestyle changes needed to improve insulin sensitivity. 

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References 

1. Blakemore, J., & Naftolin, F. (2016). Aromatase: Contributions to Physiology and Disease in Women and Men. Physiology (Bethesda, Md.), 31(4), 258–269. 

2. Chen, J., Shen, S., Tan, Y., Xia, D., Xia, Y., Cao, Y., Wang, W., Wu, X., Wang, H., Yi, L., Gao, Q., & Wang, Y. (2015). The correlation of aromatase activity and obesity in women with or without polycystic ovary syndrome. Journal of ovarian research, 8, 11.