What Is Estrogen Dominance? Women’s Guide

Have you been feeling sudden mood swings and are more irritable than usual lately? Maybe you've noticed your PMS comes with a vengeance and results in heavy periods. Or perhaps you're struggling with weight gain even though your dietary patterns and exercise routine haven't changed.

As you experience these symptoms, you decide to surf the internet and find that your symptoms suggest you may have "estrogen dominance." Is this real? It turns out that estrogen dominance is not an accepted medical diagnosis per se…but that doesn't mean it doesn't exist.

If that sounds confusing, that's because it is! According to Life Extension's Education Specialist, Dr. Crystal M. Gossard, DCN, the concept is complicated because some of the symptoms that are labeled estrogen dominance can also be an expected part of a woman's transition into menopause—or, they could be a sign of something else altogether. "Theoretically, estrogen dominance can occur, but it's not as simple as saying, this patient is experiencing these symptoms; it must be estrogen dominance," she said.

Fortunately, Dr. Gossard is here to help us navigate estrogen dominance—plus, she's got some wellness tips for maintaining estrogen levels—and keeping other hormones in check.

What is estrogen dominance in women?

As Dr. Gossard explained, estrogen dominance is a term coined by integrative and functional medicine practitioners to describe a type of hormonal "one-sidedness" where estrogen levels are higher relative to progesterone. It doesn't always mean the body has high levels of estrogen, but there's an imbalance between the sex hormones estrogen and progesterone, where there is high estrogen in relation to progesterone levels. This indicates that the estrogen available to cells is "unopposed."

What does unopposed estrogen mean? Estrogen attaches to receptors in your cells, sending the message for tissue to grow; progesterone balances estrogen's influence on the body. "When we say estrogen is 'unopposed,' it means there is too low progesterone available and it's not enough to counteract the effects of estrogen's activity," add Dr. Gossard. As a result, you can end up with annoying symptoms such as the lining of the uterus getting too thick (resulting in those infamous heavy or infrequent periods).

In contrast, when you have hormone balance, estrogen and progesterone work together, creating homeostasis in the body (or biological equilibrium). With healthy hormone levels, not only are you less likely to deal with problematic menstrual periods, but your mood, energy levels, sleep, satiety levels and more are more likely to be in balance.

What causes estrogen dominance?

There isn't a lot of medical literature on estrogen dominance, and because it's not clearly defined, it cannot be definitively diagnosed by any sort of testing. Moreover, everyone's biology is unique, and hormone balance will vary from one woman to another.

However, here are some possible causes for high estrogen levels:

• Medications

  —Estrogen-only hormone replacement therapy without progesterone—such as birth control medications, commonly used to treat polycystic ovary syndrome.

• Chemicals from the environment

  —Some of these are thought to mimic estrogen and have estrogen-like effects, disrupting the endocrine system and impacting your health.

• Excess body fat

  —In obese postmenopausal women, fat tissue becomes a source of estrogen production.

• Sluggish metabolism

  —Your metabolism is how your body gets energy from the foods you eat; when it's slow, you can face challenges with your energy levels, your weight and more.

• Biological transitions

  —This doesn't just refer to menopause. Because of their menstrual cycle, women experience hormonal changes throughout their reproductive years and could experience a hormone imbalance.

What are the effects of estrogen dominance?

The estrogen-to-progesterone hormone imbalance can result in unpleasant symptoms. These include irregular menstrual cycles (or it can increase irregularity), breast tenderness, heavy periods; it can cause sudden weight gain and more, explained Dr. Gossard. "Excess estrogen can affect reproductive health and aggravate conditions like fibroids, immune diseases and breast cancer."

Pro tip: Estrogen-healthy nutrients can help support your body's natural hormone balance. These formulations don't contain estrogen; instead, they offer specific nutrients that have an estrogen-like effect on the body.

Does estrogen dominance cause low testosterone?

No. As Dr. Gossard explained, estrogen dominance doesn't cause low testosterone levels.

However, she noted, "excess estrogen can indicate that there's also an imbalance between these two sex hormones." Testosterone is a precursor, or starting molecule, for estrogen production.

Research suggests that testosterone levels in women decline in the fourth decade. During postmenopause (after menopause), testosterone concentrations in women average about 15% of their premenopausal levels—and with this decline, women may experience dips in energy, sex drive and other changes. "The data suggests there may be a therapeutic role for testosterone hormone replacement for menopausal and postmenopausal women," Dr. Gossard added. "Although, careful assessment of and monitoring of symptoms should be considered so that the optimal dose of testosterone can be selected."

Can you have estrogen dominance after menopause?

"Theoretically speaking, yes," said Dr. Gossard. But menopause symptoms result from too little estrogen, not too much—that being said, if your progesterone levels fall off more than your estrogen levels, it's possible that you could have excess estrogen levels during menopause.

Dr. Gossard pointed out that it's actually normal for your hormone levels to drop and adjust during this transition—and the weight gain, hot flashes and mood swings, while manageable and potentially avoidable, are often part of this life experience for many women.

How do I know if I have estrogen dominance?

Evaluating your hormone levels is the first step in finding out if you have high levels or excess estrogen. Doing so will help you understand what's really going on in your body and point out areas in your lifestyle that can be addressed to improve your hormone balance. Speak with your doctor or nutritionist to discuss estrogen-related strategies you can implement into your routine.

8 ways to prevent estrogen dominance

Once you know your hormone levels, you have a better picture of how your lifestyle is impacting your health. While bioidentical hormone replacement therapy may be one way to address imbalances in your hormones, it's not the only way. Here are 8 ways women can tweak their lifestyles to help stave off estrogen dominance—and other imbalances of their hormones.

• Choose healthy, balanced meals

  —Explore the produce section at your grocery store. Choose colorful, nutrient-dense foods like beets, red bell peppers, and cruciferous vegetables like broccoli, brussels sprouts and purple cabbage (cruciferous vegetables are excellent for maintaining breast health). Add adaptogens like ashwagandha and turmeric; and phytoestrogens like flax seeds and soy; get wild-caught fish, lean and grass-fed meats, healthy fats and whole grains. Pro tip: Following dietary patterns like the ones in the Mediterranean Diet can help you ensure you're making balanced food choices.

• Eat mindfully

  —Honor your mealtime by paying attention to the flavors and sensations of your food as well as your satiety instead of answering emails or catching up on Netflix while you eat. Eating intuitively helps you develop a healthy relationship with food, so you learn to recognize when you're hungry vs. full and avoid grazing, which can lead to overeating.

• Bridge nutritional gaps

  —Even when your meals are balanced, it's not easy to meet the daily requirement of vitamins, minerals and other nutrients your body needs. That's where having a strategic nutritional plan to find women's nutrients that complement your diet goes a long way. 

• Find time for fitness

  —Daily body movement supports cognition and mood; it's excellent for healthy weight loss and regulating body fat, which supports hormone balance. Aim for 30-minutes a day, at least five days a week and include weightlifting and resistance training to tone and maintain muscle mass.

• Cultivate mental well-being

  —Health is multidimensional, which means that everything you do daily impacts whole-body health. Take a step back and observe (not judge) your daily habits. Think of how you start your mornings and end your days; are most days a go-go-go blur, or do you make time to decompress and relax? Here's where meditation, yoga, dancing, or any activity that helps you manage stress and cortisol levels come in—the secret is to find something you enjoy and can commit to doing consistently.

• Revisit your medications

  —Speak with your healthcare provider about any medicines you're taking that could be causing your symptoms to ensure the pros outweigh the cons. Important safety note: If you're battling conditions like breast cancer or immune diseases, speak with your doctor before making any changes to your treatment.

• Clean out your cleaning products

  —Ok; this one is weird, we know. But some products may have xenoestrogens, compounds that act as endocrine disruptors; these chemicals can have estrogen-like effects in the body. There are other cleaning products that will still keep your kitchen countertops clean and shiny without exposing you to these xenoestrogens.

• Get those ZZZs

  —Prioritize quality, restful sleep, which is important for maintaining a healthy weight, memory and mood, as well as hormone balance. And not just any shut-eye will do; you'll need at least seven-to-eight hours of uninterrupted sleep to maintain optimal balance.

References

• Cleary, P. Margot et al. "Obesity and Breast Cancer: The Estrogen Connection." Endocrinology, June 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689796
• Horstman, M. Astrid et al. "The Role of Androgens and Estrogens on Healthy Aging and Longevity." J Gerontol A Biol Sci Med Sci., November 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636678/
• Seema, Patel et al. "Estrogen: The Necessary Evil for Human Health, and Ways to Tame It." Biomed Pharmacother., June 2018, https://pubmed.ncbi.nlm.nih.gov/29573619/
• Valdes, Amanda, Tushar Bajaj. "Estrogen Therapy."StatPearls, July 2022, https://www.ncbi.nlm.nih.gov/books/NBK541051/
• "Estrogen Dominance." Whole Health Library. U.S. Department of Veterans Affairs, https://www.va.gov/WHOLEHEALTHLIBRARY/tools/estrogen-dominance.asp