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Estrogen dominance: Give Your Hormonal Imbalance A Name

What is estrogen dominance?

Estrogen dominance is a condition in which we have increased estrogen levels relative to our progesterone level.

Several scenarios can be classified as estrogen dominance:

  1. High/high normal estrogen level + normal progesterone level

  2. High/high normal estrogen level + low/low normal progesterone level

  3. Normal estrogen level + low/low normal progesterone level

As you can see, what makes estrogen “dominant” is not the absolute level of estrogen or progesterone but rather, the ratio and the relative level between estrogen and progesterone.

To ensure optimal function of our endocrine system, our estrogen and progesterone need to be in balance and fall within a specific range of ratio. When this balance is off, various health conditions can be triggered.

Health impacts of estrogen dominance

Estrogen dominance is associated with many female hormone-related conditions, including:

  • PCOS

  • Endometriosis

  • Ovarian cysts

  • Uterine fibroids

  • Fibrocystic breast

  • Uterine cancer

  • Breast cancer

  • Ovarian cancer

  • Infertility

Estrogen dominance can also contribute to chronic health conditions like autoimmune conditions, diabetes, heart disease, and fibromyalgia.

Estrogen dominance is also associated with symptoms like

  • Fatigue

  • Brain fog

  • Mood swings, anxiety, depression

  • Premenstrual symptoms (PMS) – e.g. acne, mood swings, breast tenderness

  • Menstrual issues like irregular menses, menstrual cramping, or heavy bleeding

  • Weight gain, water retention

  • Poor sleep or insomnia

  • Histamine intolerance

  • Perimenopausal and menopausal symptoms

Causes of estrogen dominance

So what makes our body produce too much estrogen or too little progesterone?

Too much estrogen can be a result of

  1. An overproduction of estrogen

    1. More estrogen is produced when we have excess amounts of fat tissues in our body or when we overconsume alcohol.

  2. Poor liver detoxification

    1. Estrogen is metabolized and broken down into estrogen metabolites by the liver, through Phase I and Phase II liver detoxification pathways. Estrogen metabolites are then excreted out of the body via urine and feces. When our liver’s detoxification function is compromised, there will be more estrogen accumulating in our body.

  3. Nutritional deficiency

    1. Vitamin B6, B12, and folate are cofactors of enzymes responsible for estrogen metabolism. When we don't have enough of these vitamins, estrogen metabolism will be slowed down.

  4. Poor elimination of estrogen

    1. Elimination of estrogen through urine and feces is also called Phase III detoxification. After going through Phase I and Phase II detoxifications in the liver, estrogen metabolites are packed with bile and excreted through feces. When we have intestinal dysbiosis, meaning too much harmful bacteria and/or too little beneficial bacteria in the intestines, it will actually increase the reabsorption of estrogen back into the body from the intestinal tracts.

  5. Xenoestrogens/Environmental hormones/Endocrine disruptors

    1. Xenoestrogens refer to environmental hormones that mimic estrogen in our bodies. They can disrupt the normal function of our endocrine system so they are also called "endocrine disruptors."

    2. Examples of environmental hormones would be BPA, phthalates, and paraben. Xenoestrogens are often present in disposable food containers, plastic food containers or products, and personal cleaning or skin care products.

    3. Pesticides and herbicides are also classified as environmental hormones.

    4. Xenoestrogens can also be present in contaminated water, produce, and meat products.

Too little progesterone can be a result of

  1. Mental emotional stress

    1. Stress, especially high level of stress over a prolonged period of time, will demand our adrenal glands to produce a large amount of cortisol (a stress hormone) to cope with the stress. When our adrenal glands cannot meet this high demand for cortisol, our body will “steal” progesterone to make cortisol. This is called “progesterone shunt” or “progesterone steal.” Low progesterone is therefore very commonly seen in long-term stress.

  2. Physical stress

    1. Besides mental and emotional stress, physical factors like overexertion of the body, chronic infections, environmental toxins, high blood sugar/high insulin, chronic inflammation, and chronic health conditions can also be seen as a stressor to the body. Progesterone shunt can therefore happen with these conditions as well.

Estrogen dominance in men

Just like women, estrogen dominance can also occur in men. Men can also have excess amounts of estrogen and insufficient amounts of progesterone, with the same causes. Also, since testosterone is made from progesterone, when the progesterone level declines, the testosterone level can also fall. Estrogen dominance in men often presents with high/high normal estrogen, low/low normal progesterone, and low/low normal testosterone.

Symptoms of estrogen dominance in men include:

  • Fatigue

  • Mood swings, depression, irritability

  • Poor sleep, insomnia

  • Weight gain and increased body fat (especially in the breast and around the abdominal area)

  • Water retention

  • Low libido

  • Erectile dysfunction

  • Infertility

What can we do to balance out estrogen and progesterone levels?

  1. Remove environmental hormones and toxins

    1. Live an environmentally friendly lifestyle

      1. Avoid using plastic products and plastic food containers, or use BPA-free products. (However, BPA-free products aren't always safe because some products simply use BPF or BPS to replace BPA. For more information, refer to "Are BPA-Free Products Always Safe?"

      2. Always check the ingredient lists of household products and personal care products before you purchase them.

      3. Buy foods low in pesticides and herbicides, or even better, buy organic.

      4. Buy organic and hormone-free meats and dairy products.

    2. EWG skin deep website or App is a good resource to help us identify xenoestrogens and other harmful chemicals in personal care products. Avoid chemicals with concerns of "Developmental and Reproductive Toxicity.”

    3. EWG also provides a shopper’s guide to pesticides in produce, listing 12 produce high in pesticides and 15 produce low in pesticides. (Dirty dozen and clean fifteen). Produce high in pesticides can vary depending on the country and area you're living in, so always check local resources to find out produce high and low in pesticides.

  2. Consume a well-balanced, anti-inflammatory diet. Avoid overconsuming animal meat and large-size sea fish.

    1. A well-balanced diet can help provide necessary nutrients (e.g. B vitamins, vitamin C, amino acids, and magnesium) for the liver’s detoxification pathways.

    2. While an anti-inflammatory diet is beneficial for the function of our liver and digestive tract and therefore benefits the proper elimination of estrogen metabolites from our body.

    3. Xenoestrogen as well as other environmental toxins like heavy metals tend to bioaccumulate in larger size animals with longer life cycles. When we consume large amounts of meats like beef, pork, swordfish, and shark, we also consume more environmental toxins, which will eventually affect our liver's health too.

  3. Build a healthy gut microbiome by ensuring adequate fiber intake from the diet, avoiding high sugar and high-fat diet, and addressing any underlying dysbiosis.

  4. Reduce physical and mental emotional stress.

  5. Exercise – which helps with stress and weight management.

  6. Address underlying health problems, especially underlying inflammatory conditions like high blood sugar, chronic infections, and other endocrine or immune dysfunctions.


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