You’ll often hear people talk about “detox” as if it’s a cleanse or a quick reset. In medicine, what we’re really talking about is how your body processes, transforms, and clears hormones and other compounds—and your liver is a major hub for that work.
This matters in midlife because hormone levels are already shifting (especially estrogen and progesterone). If hormone processing and clearance isn’t keeping up with what your body needs, some people experience more noticeable hormone-related symptoms.
What The Liver Actually Does With Hormones
Your liver helps metabolize and package hormones so they can be safely eliminated. One big way it does this is through conjugation—attaching molecules (like glucuronic acid or sulfate) to make hormones more water-soluble, so they can be excreted in bile or urine. PMC+1
Estrogens, in particular, are commonly processed through pathways like glucuronidation and sulfation before leaving the body. PMC+1
Why Estrogen Can “Recirculate”
After the liver packages hormones, some hormone metabolites are sent into the digestive tract through bile. From there, they’re intended to leave the body in stool.
But the gut microbiome can influence what happens next.
Certain gut bacteria produce an enzyme called β-glucuronidase, which can deconjugate (un-package) estrogen metabolites—potentially allowing some estrogen to be reactivated and reabsorbed through what’s called enterohepatic circulation. PMC+1
This is one reason gut health and liver clearance are often discussed together: the liver packages hormones, and the gut environment can influence whether they’re eliminated efficiently or partially recirculated. PMC+1
When “Detox Pathways” Feel Sluggish
When people say “detox pathways are sluggish,” they usually mean: your body’s processing and clearance systems may be under extra strain, or missing key supports.
Common influences include:
- Genetics (your enzymes can run faster or slower depending on your inherited patterns)
- Nutrient gaps (clearance pathways rely on nutrient cofactors)
- Gut issues (microbiome imbalance, constipation, or digestive dysfunction can affect elimination)
- Inflammation (systemic inflammation can change metabolic signaling and burden detox systems)
- Stress load (chronic stress can shift sleep, cravings, digestion, and inflammatory tone)
- Toxic load/exposures (the liver is also processing medications, alcohol, and environmental exposures)
This doesn’t mean your liver is “failing.” It often means your body is doing a lot at once—especially during midlife transitions.
Symptoms That Can Overlap With Estrogen Clearance Patterns
If estrogen is being recirculated more than your body prefers (often alongside other midlife physiology shifts), some people report symptoms such as:
- PMS-type symptoms
- Heavy bleeding or more intense periods
- Breast tenderness
- Irritability
- Weight changes
- Hot flashes
Important nuance: these symptoms are not specific to “estrogen recirculation.” They can also be caused by other common midlife patterns (thyroid shifts, insulin resistance, sleep disruption, perimenopause changes, uterine fibroids/polyps, etc.). If you have heavy bleeding or bleeding pattern changes, it’s worth a proper evaluation rather than assuming it’s only a detox issue. ACOG
Why Supporting Liver Pathways Matters In Midlife
During perimenopause and menopause, hormone signaling can feel more sensitive, and symptom thresholds can be lower. Supporting healthy processing and elimination can be an important part of a comprehensive plan because it connects to:
- Hormone metabolism and clearance PMC+1
- Gut-microbiome activity (including β-glucuronidase) PMC
- Inflammation and stress physiology (which can intensify symptoms)
This isn’t about extreme cleanses. It’s about understanding your physiology and removing bottlenecks that may be amplifying symptoms.
How Peace And Calm Health Functional Medicine Can Help
At Peace and Calm Health Functional Medicine in Lakewood, CO, we look at hormone symptoms through a whole-systems lens—especially the liver–gut–stress–metabolism connections that can amplify midlife symptoms.
If you’re dealing with PMS, heavier bleeding, breast tenderness, irritability, weight changes, or hot flashes, we can help you:
- map symptom patterns across your cycle and life stressors
- evaluate gut function and elimination patterns that can affect clearance
- consider targeted labs when appropriate (hormones, thyroid, metabolic markers, inflammation)
- build a personalized plan that supports your physiology (not a one-size-fits-all “detox protocol”)
To explore next steps, book a Clarity Call here:
https://www.drjenniferhorton.com/work-with-me
You can learn more about wellness programs here:
https://www.drjenniferhorton.com/wellness-programs
Science Section (Selected References)
- Gut Microbial β-Glucuronidases Can Reactivate Estrogen Glucuronides (Mechanism For Potential Estrogen Recirculation)
- Enterohepatic Circulation And Estrogen Conjugation (Glucuronidation/Sulfation; Biliary Excretion)
- Glucuronidation As A Major Phase II Pathway (Detox/Conjugation Concept For Endogenous Substances Including Hormones)
- ACOG: Perimenopausal Bleeding And Bleeding After Menopause (When Bleeding Changes Need Medical Evaluation)
Medically reviewed by Dr. Jennifer Horton, DO, ABFM, IFMCP
This content is for educational purposes and does not substitute personalized medical advice.
