Estrogen Dominance Starter Guide: Causes, Symptoms, Nutrition and Metabolism

What is Estrogen Dominance?

Estrogen dominance is exactly as it sounds. An excess level of estrogen compared to your other hormones, specifically your progesterone. These hormones are crucial for so many functions in the body beyond trying to grow a baby. They influence your mental health, physical appearance, metabolism and so much more.

This imbalance is actually quite common, in fact it is one of the most common hormonal irregularities that a woman may experience throughout their lifetime and could explain why you may be having irregular periods, are struggling with weight loss or can’t seem to concentrate.

The good news is that with some lifestyle and targeted dietary changes, you can take control of this hormone imbalance and lower excess estrogen in your body!

What are the types of estrogen?

There are three types of estrogen that the body produces that are important to know about.

Estrone (E1)

Sometimes referred to as the “not so good” estrogen but that depends on how it is metabolized in the body. This type is often concentrated in the breast tissue and is often seen after menopause. It can be made in the adrenal glands, fatty tissue or converted into estradiol (the “good” estrogen). 1 This type of estrogen can also dominate in cases of hormone imbalance such as PCOS.

Estradiol (E2)

Great for your bones and heart health, is the most biologically active estrogen for women and made primarily in the ovaries. This type of estrogen is found most often in premenopausal women.1

Estriol (E3)

This type of estrogen is great for the health of your uterine lining and skin and is dominant when a woman is pregnant. Estriol can be made from the not so great estrone. 1

*To clarify, all three types of estrogen can be present at the same time, one type may dominate in certain situations.

Fully understanding the difference between these three and how they are metabolized in the body is a great first step to creating your targeted approach to balance your hormones. They all act differently and have different pathways of breaking down which can be influenced by certain nutrients, vitamins, minerals and lifestyle choices.

What role does estrogen play in the body?

Here is the good news. Estrogen, when balanced, does beautiful things for your body. It gives you those curves, keeps your skin youthful, hair full, and mind clear. Estrogen is the highest during the first half of your menstrual cycle and can support boundless energy with the ability to Get.Things. Done. Naturally produced estrogen is essential for your heart health, bone health and virtually every tissue in the female body. 2

BUT when in excess, things can start to go ary. Extreme levels of anything in your delicate ecosystem can disrupt the balance it is constantly trying to achieve. Some of the symptoms you may be experiencing is a sign from your body that it is trying to compensate and act on this imbalance to protect itself. Although annoying, disruptions in sleep, headaches, blood clots in your period and mood swings are your body’s way of warning you that something is not right. In a way, this is insanely helpful for the role of prevention and alerting you to make some changes before things get worse.

What role does progesterone play in the body?

Progesterone, on the other hand, peaks during the second half of your period to support the growth and development of a baby. Even if pregnancy is not your goal, having adequate amounts of this hormone is crucial to help you maintain your sanity and help you feel calm. If you ever feel anxious, all over the place, unable to sleep or just feel plain off before your period it could be a sign that your progesterone levels could be low. 2 It also plays a role in your metabolism, especially fat storage and the regulation of your thyroid.3,4 Low progesterone could be one of the factors that is making weight loss an issue.

What are the symptoms of estrogen dominance?

This is a long list of symptoms that in the past were not put together to really mean anything. In fact, estrogen dominance is not considered a diagnosis or condition by many doctors. But now with further understanding of hormone imbalance these can be connected to a pattern related to estrogen dominance.

You are not crazy and if you experience more than a few of these it may be a good idea to work with a practitioner to test your hormone levels to see what could be going on.

Memory problems
Night Sweats
Low thyroid function
Anxiety
Cold hands and feet
Hair loss
Period clots
Cyclical acne
Fibrocystic breast tissue
Hormonal weight gain
Luteal phase insomnia
Brain fog
Irregular periods
Fatigue
Breast tenderness
Chronic UTIs
Heavy/painful periods
Fibroids
PMS
Depression
Low Sex drive
Bloating
Mood swings
Menstrual headaches

What happens to your period with estrogen dominance?

Your period is a great indicator for what is going on in your body. If you have noticed a pattern of change in the past 3 period cycles, there could be a few things that could be going on. So many things influence not only the length but also the color and how heavy it is if it comes at all. Things like stress are a huge factor along with hormonal changes, your dietary habits, exercise and nutrient deficiencies.

When talking about estrogen dominance, these are the things that typically show up:

High estrogen and normal progesterone levels

Blood clotting and heavy periods
Painful periods with strong PMS symptoms beforehand
Brown spotting before and after period
Very dark in color, deep red, purple or even blue

Why this could be happening : Estrogen is a building hormone and when in higher levels, there is a chance that your uterine lining is thicker than usual causing heavier shedding when your period comes. As for the brown spotting, this is often referred to as stagnation in Chinese medicine and may indicate the need for supporting blood flow and liver health.

Normal to high estrogen with low progesterone levels

Heavy periods
Mid cycle spotting
Irregular or missed periods
Brown spotting before and after period

Why this could be happening : Very low progesterone levels cause irregularities with shedding of your uterine lining. Again the brown spotting can indicate that there is stagnation and you may be holding onto old tissue until your next period.

High estrogen & high testosterone with low progesterone

Irregular timing between periods, could take up to 35 days between each period
Heavy bleeding and clotting
Can be seen with Polycystic Ovary Syndrome (PCOS)

Why this could be happening : This imbalance can lead to skipped ovulation and present itself as an estrogen dominant problem because without ovulation, progesterone levels are not fully released.

These are not hard and fast rules. Every woman’s body is different and in a lot of cases, there is not just one hormone imbalance happening. There could be irregularities with your adrenal health causing issues with cortisol levels or your thyroid that could be influencing your period as well. That is why with my approach with estrogen dominance, your whole body and endocrine health comes into play.

What are common conditions with high estrogen?

Polycystic Ovary Syndrome (PCOS)
Endometriosis
Fibrocystic breast tissue
PMS
PMDD
Menstrual headaches
Uterine fibroids
Low Thyroid function or hypothyroidism
Hormone related cancers

What are some of the root causes of estrogen dominance?

Although there are many reasons for hormone imbalance to occur, there are two root causes that I focus on in my programs for addressing estrogen dominance, they are:

Issues with detoxification and excess estrogen exposure
Stress and burnout

Let me break this down a little further.

Root cause one can be caused by issues with breaking down and eliminating estrogen properly in the body. This is often seen in cases where estrogen is very high and progesterone is normal to low. There are 3 big phases of detox for estrogen and multiple pathways that estrogen can go through. They are phase 1 and 2 of your liver detox process where phase 1 is great for the first defense breakdown while phase 2 modifies substances to be more easily eliminated by the body. Phase 3 is where your gut health comes into play.

Luckily, all three can be addressed through simple interventions such as targeted nutrition, specific supplements, herbal support and lifestyle changes. The key is knowing where the blockage is happening and taking steps to reverse or address the issue. This is where testing can come into play.

The second part of root cause one is your estrogen load. Is your body overproducing estrogen? Are you getting exposure to hormone disrupting chemicals in your daily environment (this is way more common than you may think) or is there an issue with heavy metals causing your body to use up key nutrients that are crucial for hormone regulation?

Root cause number two has more to do with your adrenal and thyroid health and how these are influencing your progesterone production. In this scenario you can have normal estrogen levels but very low progesterone causing the ratio to skew towards estrogen dominance. Progesterone and your stress hormone cortisol compete against each other when being created. Essentially progesterone becomes cortisol when your body is in a stressed state. The more stressed you are the lower your progesterone levels may be. This is why I have fallen in love with lifestyle design, working in tune with your natural rhythms such as your menstrual cycle and focusing on personalized techniques to lower stress levels.

Both of these root causes are addressed in my upcoming course The Fertility Cleanse for Estrogen Dominance. I breakdown exactly what you need to do to address these through your nutrition, supplements and daily routines so that you can finally start feeling more in tune with your body and lower your symptoms of hormone imbalance.

Does birth control increase estrogen levels?

Hormonal birth control is very effective for preventing pregnancy and has given women the freedom to pursue what they want in life before they are ready to start a family. I get it! I was on birth control for 7 years while trying to control my adult acne, heavy periods, pms, mood swings and go after what I wanted for my career, especially since I got married at a young age. And for a while it worked. My symptoms were virtually nonexistent but the pill also masked what was really going on in my body and by adding synthetic hormones to the mix and skipping my natural menstrual rhythms I was creating more imbalance in my body than before I got started on the pill. This caused my symptoms to come back tenfold when I was ready to get off of birth control. Essentially, I experienced post birth control syndrome.

What I wish I knew before getting on the pill were other methods for tracking my fertility, understanding what was causing my imbalances and ways to work with my cycle to avoid pregnancy during my twenties. I would have saved many years of the hormone roller coaster had I taken this approach but I course-corrected and now want to be the guide for you to naturally balance your hormones in a shorter amount of time.

One of the things that birth control can also do is contribute to estrogen dominance which was what I was experiencing for the majority of my menstruating life. If you are already having trouble clearing excess hormones from your body then introduce an external source of more hormones, a buildup is bound to happen.

The additional hormones also lower the communication between your brain and ovaries so that you do not ovulate thus preventing pregnancy. When you come off the pill this communication may take some time to get back on line and can put a strain on your liver, thyroid and adrenals, all key organs that support hormone regulation.2

Can postpartum lead to estrogen dominance?

After pregnancy, your body is depleted. You just did an extraordinary multi-hour marathon that your body was designed to do but in the process your hormones drop dramatically after delivering your baby. In some cases they return to somewhat normal levels soon after but there is a real possibility of having ongoing low progesterone with high estrogen depending on your situation. This can show up as low mood and anxious thoughts that are on a constant loop.

You have also been providing key nutrients from your own bones, brain, blood and other tissues to keep your baby healthy not to mention providing the nutrients needed to produce breast milk and sustain life. Without fully restoring your body and giving it time to recover between pregnancies, your ability to regulate your hormones can become compromised. Giving your body at least six months to recover is key before starting to intervene on potential imbalances. If you continue to see irregularities in your mood, are not menstruating or have other symptoms of hormone imbalance at this point then testing can come in handy to determine what could be going on here. In some cases the results can look similar to estrogen dominance.

Why can perimenopause cause estrogen dominance?

If you are in your 40s, you may have experienced changes in your menstrual cycle such as heavy periods, PMS, skin breakouts and menstrual headaches. This could be an indication of perimenopause happening which could take a few years to fully go through before menopause occurs. During this time, progesterone levels tend to drop leading to symptoms of estrogen dominance. Working to balance the ratio of estrogen to progesterone during this time and supporting your natural methods for estrogen elimination can be a great way to lower the symptoms you may experience later when menopause occurs.

Can estrogen dominance affect fertility?

Estrogen dominance is a factor for infertility. Having a healthy balance of hormones that regulate your ovulation and support an environment to grow a baby are crucial in your ability to get pregnant. While there are many potential causes of infertility, starting with how well your body is regulating your estrogen to progesterone levels is a great place to start. That is why I created The Fertility Cleanse for Estrogen Dominance. Doing a cleanse like this months before working to conceive can give your body and baby a great opportunity to thrive and lower the exposure to not only toxins such as heavy metals and endocrine disruptors but also supports your body’s store of nutrients to give your baby a healthy beginning.

Click Here For Your Free Fertility Diet Cookbook

What are normal estrogen levels?

Instead of a set number to achieve in a lab, there is a range for your hormone levels and these can vary depending on your unique biochemistry. These levels also ebb and flow throughout the month causing higher estrogen levels at the beginning of your cycle and higher progesterone closer to your period. That is why I love using the DUTCH test which works with your cycle fluctuations and walks through the ratio of estrogen to progesterone which is more important than a specific number of estrogen.

How do I know my estrogen and progesterone levels?

Beyond looking at your symptoms and checking them off a list, there are a few test options available to get an idea of where your hormones are. As mentioned previously in this article, I like to use the DUTCH test to get an in depth review of what pathways could be causing hormone imbalances. While I do not diagnose, I can help you determine what natural interventions you can start using today based on your unique results. You can also work with your provider to order testing through your insurance, they will be able to give you a diagnosis and determine what other testing may be needed. Lastly there is an at home kit called Mira that gives you a quick peek at where your hormones are at any point in your cycle. This helps you see the bigger picture of what your menstrual cycle looks like while detecting small changes in hormone levels.

How long does it take to reverse estrogen dominance?

Everyone is different but with each menstrual cycle, you have the potential to make significant strides in the regulation of your hormones. This is especially true when switching products you use on a daily basis that have been active as endocrine disruptors (chemicals/compounds that interfere with the daily activity of your hormone regulation) and going organic with your food to eliminate exposure to insecticides, preservatives and additives. Certain supplements can even start influencing your estrogen levels in as little as two weeks!5

How is estrogen metabolized?

Estrogen goes through three major pathways of metabolism, these include phase 1 of liver detox, phase 2 of liver detox and finally phase 3 which includes elimination via the gut microbiome. All three phases work to break down estrogen to be used and eliminated properly, however, there are multiple things that can interfere with the activity of these phases.

A great analogy I have heard many times is to look at these phases like filling up a tub of water then draining it. In phase 1 the water is filling the tub. How quickly is the tub filling up and is it the right type of water? This is equivalent to toxins and hormones that are sent to your liver to be broken down. In phase 2 this is where the drain comes in. How open is the drain, is it wide enough to quickly drain the water so that the tub does not overflow? This is similar to phase 2 of your liver trying to break down the material to be eliminated. The last phase is the dirty water being sent away from your house, in the body this is equivalent to your gut packaging the results from your liver to be eliminated from your body.(6)

Here are the main things that can interfere with each phase:(6)

Phase 1: Liver detox (6)

Genetic irregularities affecting the CYP enzymes that are actively breaking down toxins and hormones
Iron deficiency
Smoking
Advanced glycation end products (AGEs) made from things like charred meats in BBQ
Environmental toxins like xenoestrogens or PCBs

Phase 2: Liver detox (6)

Issues with methylation
Being estrogen dominant
A genetic mutation with COMT
PCB and bisphenol exposure
Excess serotonin seen with SSRI use
Certain medications

Phase 3: Gut 6

Infections in the intestines
Parasites
Certain medications
Chemicals and toxicants
Overgrowth of not so friendly bacteria
Inflammation
Ongoing heartburn
Issues with the gallbladder
Issues with bile production
Compromised cell membranes from heavy metals and unhealthy fats

When working with clients, my goal is to focus on these three major phases and see what could be interfering with your ability to fully break down and eliminate the excess hormones and other materials that are interfering with your hormonal health. In The Fertility Cleanse for Estrogen Dominance, there is a whole section that covers the many ways these three phases can be addressed to support your body’s natural ability to detox.

How is insulin resistance connected to estrogen dominance?

Having a high amount of glucose circulating the body with a lowered ability to regulate insulin to combat this excess can lead to many disruptions within the body due to your inflammatory response, immune response and hormonal response to this overload. When it comes to estrogen dominance specifically, high insulin causes a decrease in the activity of a protein that works to bind free excess hormones in the body and directs them to tissues that need it called sex hormone binding globulin (SHBG).7 When this is lowered, estrogen is in a higher concentration in your body which can lead to symptoms of estrogen dominance.

This can also become a cycle that feeds itself leading to symptoms of estrogen dominance. Since your cells are not hearing the signals from insulin to bring glucose into the cell to be used, you may feel fatigued and crave things like refined carbs and simple sugars to give you energy. This in turn can lead to more weight gain, specifically an increase in the density of fat cells which is also where estrogen can be produced and can contribute to your overall estrogen load. 8 This is why focusing on your blood sugar is such an important step in supporting your hormone health!

What foods decrease estrogen dominance?

Cruciferous vegetables ( broccoli, kale, cauliflower, arugula etc)
Broccoli Sprouts
Beta-carotene rich foods (orange, yellow and leafy green foods such as carrots, spinach and sweet potatoes)
Berries
Healthy fats ( Extra Virgin Olive Oil, Avocado oil, avocados, nuts, seeds, fatty fish, coconut oil, grass fed butter, ghee)
Grass fed, free range meat
Cage free eggs
Wild caught seafood
Beans and legumes
Whole grains
Fermented foods

What foods increase estrogen dominance?

Processed soy
High fructose corn syrup
Refined carbs
Excess simple sugars
Conventional meats and dairy products
Packaged and processed foods
Fried foods
Alcohol
Excess caffeine

What herbs support estrogen dominance?

Curcumin/turmeric
Silymarin (milk thistle)
Dandelion root
Red raspberry leaf
Ashwagandha
Berberine
Chaste tree (Vitex agnus-castus)
Nettle Leaf

What supplements support estrogen dominance?

Before taking a ton of supplements, it is important to know what pathways may interfere with your estrogen and progesterone balance. Some of the supplements such as DIM are heavy hitters for estrogen clearance and if you fall into the camp of normal estrogen but low progesterone, this supplement may not be appropriate for you causing your estrogen levels to dip. This is where working with a practitioner can be helpful.

DIM
I3C if you have adequate stomach acid
Alpha Lipoic Acid
Magnesium
B-vitamins
CoQ10
Resveratrol
Calcium-d-glucarate
Pre and probiotics

For a review of my favorite supplements, check out my hormone loving supplement boutique

Supplement Boutique

How do you reverse estrogen dominance naturally?

Eat a plant centered diet similar to one like the mediterranean diet
Hydrate!
Determine what pathway is blocked through testing and use targeted support with supplements, herbs and foods
Eat plenty of fiber
Focus on your circadian rhythm and work towards restful sleep
Exercise for at least 30 minutes a day
Include cruciferous vegetables daily
Include yellow, orange and leafy green produce in your daily diet
Start switching your daily cleaning, hygiene and other personal items to non-toxic versions
Stick with organic food as much as possible

This three month program focuses on my three phase method for supporting estrogen dominance. The program starts with a 2 week reset to kickstart your results, a one month deep dive into your natural detoxification abilities and a one month masterclass series on using your menstrual cycle to achieve the results you desire.

Disclaimer: I am not a doc and this blog is meant for informational purposes only.

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Dallas King-WallisApril 26, 2023