What is Estrogen Dominance and How to Treat It

August 14, 2023

Hormones are miraculous messengers in the body.  Estrogen’s benefits are numerous.  By the early 1990s, well documented in the medical literature was 50 years of evidence supporting the amazing benefits of estrogen.  “Estrogen not only successfully controlled menopausal symptoms in most women but also significantly reduced the risks of heart disease, hip fractures, colon cancer, and Alzheimer’s.”

What happens when there is an imbalance of estrogen and progesterone?  Estrogen dominance is referred to as one of the most common hormone imbalances in women.  What is estrogen dominance?  What are the signs of estrogen dominance?  What exactly does it mean?  What can you do if you have it?

What is Estrogen Dominance?

Estrogen gets a bad reputation from the term estrogen dominance.  Estrogen dominance does not simply mean excess estrogen; it means there is a pattern of elevated estrogen and/or estrogen activity relative to progesterone levels in the body.  This pattern can present 3 different way ways:

  1. Estrogen levels are in a healthy range but progesterone levels are decreased. Hence this case is caused by a lack of progesterone or a decrease in the function of progesterone.
  2. Estrogen levels are elevated and progesterone is in a healthy range.
  3. Estrogen levels are in a healthy range but the body is more sensitive to the existing amounts of estrogen.

All patterns result in a relative excess of estrogen compared to progesterone.  It is this imbalance between estrogen and progesterone that leads to the symptoms of ‘estrogen dominance’.  The symptoms of estrogen dominance are also the same symptoms as low progesterone.  Think of a teeter-tooter that is balanced and becomes unbalanced.  It is the balance of estrogen to progesterone that is tipped higher for estrogen.  As one end goes up the other goes down.

Signs and Symptoms of Estrogen Dominance

  • Uterine fibroids
  • Cyclical breast tenderness or fibrocystic breasts
  • PMS-related headaches and migraines
  • PMS-related mood swings, anxiety, depression
  • Cyclical acne
  • Irregular, heavy or painful periods
  • Weight gain
  • Low libido
  • Hot flashes
  • Recurrent UTI or vaginal yeast infection
  • Endometriosis
  • PCOS
  • Bloating
  • Brain fog and fatigue
  • Insomnia
  • Anxiety
  • Depression

Identifying the Underlying Cause of Estrogen Dominance

The next question is why do you have an imbalance?  Are your estrogen levels in a healthy range but progesterone is not or are your estrogen levels high while progesterone is in a healthy range?

You can identify your personal hormone pattern by questionnaires, blood work, and/or doing a month-long, at-home hormone test called the DUTCH Test.

There are various underlying causes of estrogen dominance; it is imperative to identify the cause in order to treat it:

  • Poor gut and/or liver health
    • Estrogen travels to your liver for processing where it is broken down and sent to the gut for elimination.  Liver function and balanced gut bacteria are important for this process.
    • You may have a COMT or MTHFR gene mutation making it difficult to detox through your liver properly on your own.
  • Environmental toxins
    • Endocrine disruptors such as xenoestrogens resemble estrogen and can lead to imbalance.  Toxins such as pesticides, BPA and other plastics, chemicals, heavy metals and mycotoxins contribute to hormone imbalance.
  • Prolonged use of birth control
  • Unhealthy BMI
    • Estrogen is stored and secreted by fat cells. The more fat you have, the higher amounts of estrogen are produced.
  • Chronic stress
    • Chronic stress affects the adrenal glands and cortisol production which can contribute to imbalance.  Cortisol is made from progesterone so as cortisol goes up it depletes the progesterone disrupting the estrogen/progesterone balance.

Are There Long-Term Risks of Estrogen Dominance?

Long-term health risks associated with or exacerbated by estrogen dominance are:

  • Breast and uterine cancers
  • PCOS
  • Fibroids
  • Endometriosis
  • Autoimmunity
  • Thyroid disease.  All hormones affect another hormone.  Estrogen naturally suppresses thyroid production/function so as estrogen increases, thyroid hormones decrease.

What Can I Do If I Have Estrogen Dominance?

Bioidentical hormone replacement therapy using progesterone is often used to help balance relative excess estrogen.

Estrogen dominance/low progesterone is probably the cause of most depression and anxiety in women.  An easy, more natural remedy for estrogen dominance is to add progesterone to correct the imbalance.  It acts within an hour and can be a much better solution than SSRIs for depression as it is addressing the cause and is much more fast acting that SSRIs.

Sometimes estrogen dominance/low progesterone is treated by putting women on oral contraceptive pills which deliver synthetic estrogens and progestins to override hormone imbalances.

There are other measures imperative in correcting estrogen dominance:

  • Eat a clean diet:
    • Eat organic as nutritional values are higher. Eat a variety of foods.
      • Eat quality proteins such as grass-fed only red meat.
    • Eat Foods promoting estrogen metabolism: cruciferous vegetables such as cabbage, broccoli, cauliflower, brussels sprouts, flaxseed
    • Eat a high-fiber diet as fiber decreases the amount of estrogen absorbed and increases the amount of estrogen excreted
    • Use olive oil or avocado oil and/or take omega 3s to support hormone balance
  • Drink green tea
  • Reduce stress and get enough sleep
  • Take supplements to promote estrogen metabolism through the liver:
    • DIM (diindolylmethane) 150mg once or twice a day: a plant nutrient found in cruciferous vegetables that aids in estrogen balance
    • Indole-3-carbinol 300 mg a day: another compound from cruciferous vegetables
    • Methylated B vitamins: B vitamins aid in the breakdown and elimination of estrogen.  Methylation support is important especially if you have COMT or MTHFR gene mutations. Vitamin B6 is essential for production of progesterone.
    • Magnesium is necessary for progesterone function and will help balance excessive estrogen production
    • Calcium D-glucarate helps your body eliminate excess estrogen and prevents reabsorption
  • Detox: eliminate toxins, heavy metals, mold, ditch plastics, chemicals and toxic household and skincare products
  • Avoid excessive alcohol as alcohol inhibits estrogen detoxification and increases estrogen
  • Heal your gut: Eat a clean diet and add support with prebiotics, probiotics and digestive enzymes
  • Exercise: Engage in moderate exercise every day to help maintain a healthy weight

Conclusion

Estrogen is a powerful hormone with an abundance of benefits.  When there is a relative excess of estrogen compared to progesterone, many suffer the symptoms of estrogen dominance, one of the most common hormone imbalances in women.  The imbalance is reversible and can be corrected with bioidentical hormone replacement, lifestyle changes and supportive supplements.

Have an awesome day!   Dr. D and Drew Chernisky, PA

Posted in Estrogen, Estrone Levels