What Is Estrogen Dominance? Signs & Natural Treatments

What-Is-Estrogen-Dominance--Signs-&Amp;-Natural-Treatments

What Is Estrogen Dominance?

Estrogen dominance, also known as high estrogen, is an imbalance between estrogen and progesterone, the key female sex hormones. It’s most common in women over 35 but can happen at any age.

There are three types of estrogen hormones I’ll refer to collectively here as just ‘estrogen:’

  • Estrone (E1) — primarily produced during and after menopause
  • Estradiol (E2) — primarily produced during reproductive years
  • Estriol (E3) — primarily produced during pregnancy

This hormone imbalance can be caused by excessive estrogen production, altered estrogen metabolism and excretion, or significantly higher estrogen compared to progesterone levels.

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While fluctuations in estrogen are normal during a woman's menstrual cycle (low during menstruation and peaking before ovulation), estrogen dominance can disrupt this cycle and impact reproductive health. Progesterone plays an important role in balancing and neutralizing excess estrogen, so progesterone resistance frequently contributes to estrogen dominance.

Too much estrogen is a significant issue in women's health, affecting periods, PMS, and menopause, and can also occur in men due to their naturally lower levels of estrogen.

Estrogen dominance is often linked to chronic inflammation, contributing to various diseases. (1)

I see patients dealing with estrogen dominance even when their hormone levels are within the ‘normal’ lab reference range. Estrogen dominance is generally a condition that occurs when your sex hormone balance is somewhat out of whack, but not to the point where you can be diagnosed with estrogen excess.

Estrogen excess is associated with a very high risk of blood clots, stroke, and hormonal cancers (like breast cancer). (2) Untreated estrogen dominance may lead to this condition when left untreated.

Symptoms

The signs of high estrogen can look different for every person and differ between genders. Most people with estrogen dominance experience a handful of the following symptoms of estrogen dominance and/or related conditions: (3)

In women:

  • Bloating
  • Rapid weight gain
  • Severe PMS
  • Breast tenderness
  • Mood swings
  • Heavy, painful, and/or irregular periods
  • Premenstrual dysphoric disorder (PMDD)
  • Decreased sex drive/libido
  • Anxiety
  • Depression
  • Migraine headaches
  • Insomnia/difficulty sleeping
  • Brain fog
  • Fatigue
  • Hair loss
  • Infertility
  • Polycystic Ovary Syndrome (PCOS)
  • Endometriosis
  • Uterine fibroids

In men:

  • Infertility
  • Erectile dysfunction (ED)
  • Gynecomastia (enlarged breasts)
  • Low libido
  • Fatigue
  • Hair loss

In addition to these symptoms and related conditions, estrogen dominance may increase the risk of autoimmune disease and breast, ovarian, and uterine cancer. (4)

Causes

There are several root causes of estrogen hormonal imbalances. If you’re struggling with estrogen dominance, you may need to address multiple of these to relieve your health concerns.

1. Excess Body Weight

Fat secretes estrogen, which is why higher amounts of body fat and insulin resistance are associated with high estrogen levels. (5)

2. Medications

Certain medications like birth control pills (oral contraceptives) and hormone replacement therapy (HRT) can boost estrogen levels to an unhealthy level. (6)

3. Stress

Chronic stress can lead to chronically high cortisol, which actively depletes your body’s estrogen-balancing hormone, progesterone. (7)

@drwillcole This #FunctionalMedicineFriday topic is about the top hormone imbalances I see in my patients with autoimmune diseases. To learn more about each of these, I have loads of free resources on my website including podcast episodes, articles, quizzes, books, and more. Link in bio. #functionalmedicinedoc ♬ original sound - Dr. Will Cole

4. Xenoestrogens

Xenoestrogens, also called synthetic estrogens or exogenous estrogens, are chemicals that act like estrogen. The most common of these are BPA (bisphenol A) and phthalates. Frequent exposure to xenoestrogens may contribute to estrogen dominance. (8)

Exogenous estrogens can be found in everything from household cleaning supplies to plastic to beauty products. Not only do they increase your estrogen levels, but the constant onslaught of these chemicals can make it difficult for your body to break down and eliminate any excess estrogen effectively.

5. Liver Dysfunction

Your liver is one of your body’s main organs responsible for detoxification. However, if your liver isn’t functioning properly, it won’t be able to break down estrogen, causing it to accumulate in your body. (9)

6. Poor Ovulation

When the body releases eggs, progesterone levels increase. If you don’t ovulate regularly and progesterone levels stay lower, high estrogen levels can result. (11)

7. Alcohol

Drinking alcohol is associated with increased estrogen production during perimenopause. (12) It’s unclear if this extends to premenopausal women, but this does seem to be one reason alcohol drinking may increase the risk of some cancers.

8. Gut Dysbiosis

The balance of gut bacteria that makes up your microbiome has a direct impact on estrogen levels. (12) Dysbiosis, or an imbalance of commensal (health-promoting) to pathogenic (disease-causing) bacteria in your gut, may lead to estrogen dominance.

Diet And Lifestyle Changes To Correct Estrogen Dominance

To address estrogen dominance, you must first know why it’s happening. Your healthcare provider might recommend these lifestyle changes to help your body better balance estrogen levels:

Follow An Estrogen Dominance Diet

Your diet plays a major role in the balance of hormones in your body. There’s no single dietary pattern to reverse this problem, but following these estrogen dominance diet tips can help: (13)

  • Drink less alcohol. There’s no solid evidence that drinking any type of alcohol (even wine) has a net positive impact on your health. When it comes to estrogen dominance, alcohol consumption can definitely make things worse. Consider going completely sober or limiting your alcohol intake to 1-2 drinks per week for better hormone balance.
  • Eat nutrient-dense, lower-sugar foods. Whether you prefer a carnivorous diet or tend towards fruits and vegetables, do your best to fill your plate with whole foods that are rich in vitamins and minerals and low in sugar, especially processed or added sugar.
  • Get plenty of fiber. Dietary fiber from vegetables is consistently linked to better health, including gut health (which has a huge impact on estrogen production). Aim to get at least 25-30 grams of fiber every day. (For comparison, the average American gets about 15 grams daily.)
  • Limit your intake of processed foods and sugar. Less sugar and processed food ingredients will be part of any healthy diet. Shop the outside of your grocery store and be very selective when choosing foods that are sold in a box.
  • Eat more healthy fats. Fats are considered the building blocks of your hormones. A high-fat, low-carb ketogenic diet has been shown to help balance HPA-axis function and hormones. (14) Even if you don’t go full keto, try incorporating more wild-caught salmon, avocados, hemp seeds, and coconut oil into your diet. These are some of the foods common to the Mediterranean diet, which is also associated with positive hormone balance. (13)
  • When you can, eat organic. Buying organic foods for everything you eat is unnecessary, but certain organic foods will help reduce your pesticide exposure. Fruits and vegetables with thin skins that you eat and meat are the two biggest targets I recommend to my patients when boosting their organic food intake (especially if budget is an issue).
  • Try seed cycling. This simple plan involves eating flaxseeds and pumpkin seeds during the follicular phase of your cycle (days 1-14) and sesame and sunflower seeds during the luteal phase (days 15-28). Seed cycling helps to balance hormone levels for women, especially those with existing imbalances like those seen in PCOS. (15)

Read Next: 15 Best Foods And Supplements To Increase Estrogen Naturally

Try Estrogen-Balancing Supplements

Certain dietary supplements support optimal estrogen levels, including:

Weight Loss

While it’s not easy with hormonal imbalances, decreasing your body fat can significantly improve overall hormone levels and fix some of what causes imbalances to happen in the first place.

For instance, many features of PCOS can worsen estrogen dominance, such as anovulation and increased body weight — but losing 5-10% of your total body weight may reverse many of these symptoms.

To lose weight when you’re estrogen-dominant:

  • Eat foods rich in nutrients (including fiber), low in sugar, and with as few ingredients as possible — the more whole foods, the better
  • Practice moderate-intensity aerobic exercise, but don’t overdo it
  • Cut your xenoestrogen exposure from BPA, other plastics, pesticides, and conventional beauty products
  • Talk to your healthcare provider about bioidentical hormone replacement therapy (bHRT), especially if you’re nearing or in menopause

Reduce Stress Levels

Easier said than done, yes. But decreasing your overall exposure to stressful situations can reduce cortisol production and, in turn, may help to balance estrogens. Acute stress is associated with an increase in estrogen levels. (17)

Meditation and mindfulness practices like spending time in nature and journaling can help. Take stock of your workload and personal relationships, and set up healthy boundaries where needed.

Cut Xenoestrogen Exposure

Whenever you can, eliminate xenoestrogens from your household. This might mean replacing the BPA plastics in your home, purchasing hormone-free meats, and even changing the pesticides you use for your lawn.

Try swapping conventional cleaners, perfumes, candles, air fresheners, and beauty products for essential oils and plant-based, non-toxic household cleaners and personal care products. The Environmental Working Group has a great list of non-toxic household products and personal care items.

Increase Your Physical Activity

Exercising more frequently can reduce the amount of estrogens circulating in your blood, and it’s not totally due to weight loss. (18) Be careful not to over-exercise, as too much at once (especially if you’re starting from a sedentary lifestyle) can also disrupt hormones.

Support Your Liver

If your liver isn’t breaking down estrogen well, the other efforts you make aren’t going to move the needle as much as you’d like. Here are a few ways to promote proper liver function and natural detoxification:

  • Milk thistle is an herb that has been used for hundreds of years to help support optimal liver function. (19) It works to restore liver cells that have been damaged from increased toxin exposure. You can take milk thistle as a supplement or drink it as tea.
  • Omega-3 fatty acids, often in the form of fish oil supplements, are fantastic for overall health and optimal liver function. (20) You can even skip the supplements altogether and get plenty of these healthy fats by eating wild-caught fish products and other omega-3-rich foods.
  • Vitamin E supplementation can support a healthy liver.
  • Zinc supplements are a safe, effective way to promote better liver function, especially if you’re zinc-deficient. (21)

Promote Optimal Methylation

Methylation is a biochemical process that happens more than 1 billion times a second in your body to keep you alive and healthy. It works alongside your liver, as one of its primary purposes is detoxification. Many people with immune problems have genetic methylation impairments, such as MTHFR gene mutations, which makes it difficult to detox on your own.

B vitamins act as fuel for methylation and help boost your body’s ability to detox and break down estrogen. (22) Dandelion tea, dark leafy greens, broccoli, Brussels sprouts, and cauliflower are all packed with B vitamins.

Try Adaptogens

Adaptogens are a broad family of herbs and plant medicines that are generally safe for everyone, help your body handle stress, and support optimal hormone health. (23) This is because adaptogens have a balancing effect on the hypothalamic-pituitary-endocrine (HPA) axis and positively interact with estrogen receptors.

This delicate dance between your brain and hormone system includes your brain-adrenal axis, brain-thyroid (HPT), and brain-gonadal axis (HPG). You need all these communication systems working in perfect harmony for a healthy mood, metabolism, energy, immune system, and sex drive.

Some of my favorite adaptogens for estrogen dominance include ashwagandha, licorice root, shilajit, and Schisandra.

Improve Your Sleep Habits

Ideally, everyone should be getting between 7-8 hours of sleep a night as recommended by the CDC. This is important for many reasons, but it’s especially important for your hormone health.

This is because your body uses this rest time to regulate hormones, including the stress hormone cortisol. In fact, studies have shown that a lack of sleep can lead to chronically elevated cortisol, which negatively impacts estrogen levels. (24)

I recommend cultivating a nighttime routine that fits your lifestyle, helps you wind down, and prepares your body for sleep. This can include shutting off electronics an hour or two before bed, a 15-minute mindfulness practice, or sleeping with a weighted blanket.

Other Treatments

If natural methods aren’t enough to address your estrogen dominance, there are some medical treatments you may need to discuss with your doctor, including:

  • Medications: The most common pharmaceutical treatments for estrogen dominance are aromatase inhibitors (which prevent your fat cells from producing estrogen) and GnRH agonists (which prevent your ovaries from releasing estrogen).
  • Surgery: Surgery is a last resort for patients with ovarian or breast cancer who have persistently high estrogen levels. In these cases, an oophorectomy (removal of the ovaries) may be recommended to prevent excess estrogen production.

FAQs

Yes, it is possible to get pregnant with estrogen dominance, but it may be more difficult. Chronically high estrogen levels can cause disruptions in your fertility window and are sometimes associated with infertility in both women and men. There is no evidence that high estrogen has a negative effect on pregnancy outcomes. (25)

There are no quick fixes for flushing estrogen. However, following the diet and lifestyle changes I outlined above — a nutrient-dense, low-sugar diet, weight loss, stress reduction, and cutting alcohol, in particular — can help your body regulate estrogen levels naturally.

For some women, estrogen levels may be regulated in as few as two weeks when following diet and lifestyle changes to address estrogen dominance. For many others, this process may take 2-6 months, especially depending on your unique situation, body composition, and lifestyle.

Processed foods (deli meats, non-organic red meat, heavily processed boxed foods, etc.) and foods high in sugar are the worst foods to eat for estrogen dominance. Both of these food types have a significantly negative impact on your body’s natural hormone balance.

Next Steps

All the systems in your body are interconnected, and if you have estrogen dominance, it will affect other areas of your health. Working with a functional medicine expert can help you determine if estrogen dominance is a factor in your case and recommend the best steps to rebalance your levels.

In my telehealth functional medicine clinic, we look at all aspects of your health to incorporate these wellness tools and others based on your unique situation.

If you suspect that you are struggling with estrogen dominance, schedule a consultation to learn more about how you can alleviate your symptoms naturally with functional medicine.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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BY DR. WILL COLE

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.

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