Webinar Replay

Estrogen Metabolism 101:
A Practical Guide to Understanding and Measuring

Presented by Hilary Miller, ND

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This webinar focuses on estrogen metabolism, an often-misunderstood aspect of hormonal health. Most people know that estrogen can be the culprit in hormone-related symptoms, and that several women’s health concerns are impacted by estrogen directly, such as endometriosis and breast cancer. Estrogen symptoms and risks can also be impacted by how it is metabolized by the body. This is a practical guide through the phase I and phase II pathways, where key players like P450 and methylation enzymes will be explored.

Starting phase I with 2-OH, known for its stability and neutral impact, to 16-OH with a stronger estrogen receptor activity, to the unstable and potentially damaging 4-OH. In phase II, catechol estrogens undergo methylation, another crucial step that impacts estrogen’s actions in the body. Not only can these pathways be measured in urine, but this guide will explain how to interpret them, emphasizing the significance of ratios over absolute levels. New and experienced learners will find these pathways clarified and gather useful tools for exploring detox and long-term hormonal health.


About the Speaker

Hilary Miller, ND is a clinical educator at Precision Analytical with nine years of clinical experience in women’s health and fertility. Dr. Miller got her Bachelor of Science in biology from Portland State University. She completed her medical training at the National College of Natural Medicine (NUNM) in 2014. At NUNM she focused on advanced gynecology and women’s health and spent one year shadowing ND midwives. Her clinical experience focuses on women’s health including fertility, mental health, weight management, menopause, and anti-aging. Dr. Miller has been a clinical educator at Precision Analytical since 2016. 


Key Moments

  • 1:35 Introducing Dr. Hilary Miller 
  • 2:30 Webinar Outline 
  • 3:36 What does estrogen do? 
  • 4:57 Estrogen and Breast Cancer 
  • 6:58 Estrogen and High Estrogen Conditions in Females 
  • 7:42 Assessing Estrogen 
  • 10:26 Phase I Estrogen Metabolism 
  • 14:08 2OH Pathway 
  • 17:00 16OH Pathway 
  • 22:51 2:16 Ratio 
  • 24:38 4OH Pathway 
  • 29:14 Phase II COMT Methylation 
  • 33:46 Estrogen Metabolism Overview 
  • 35:13 What affects estrogen detox? 
  • 36:41 How do we measure estrogen metabolism? 
  • 40:23 DUTCH Estrogen Metabolism Testing - DUTCH Report Examples 
  • 51:44 Treatment Considerations 
  • 54:42 Webinar Summary