Estrogen Dominance and How to Fix It
What is estrogen dominance?
Estrogen dominance is a non-medical term that is commonly used by practitioners to describe situations where estrogen levels are disproportionately high in the body. This surplus of estrogen can occur when the body makes too much estrogen, when the pathways for getting rid of extra estrogen aren't working well, or when the hormone progesterone is too low.
How to know if you are "estrogen dominant"
Estrogen dominance can be identified in a few ways.
Since hormones are complex, it is generally not recommended to rely only on signs and symptoms to diagnose high estrogen. That said, the following signs and symptoms can all be due to estrogen imbalance:
Lab testing can also help identify if estrogen is too high. There are two main ways I test estrogen levels in my practice. For detailed information, I use DUTCH testing by Precision Analytical, or the Hu-Map by Doctors Data, both of which offer a detailed breakdown of all types of estrogen metabolites (as well as detailed information about all the other sex hormones). For many women, basic blood work done at two different points in a menstrual cycle can provide good information about whether estrogen may be too high relative to your other hormones. I typically order estrogen on day 3-5 of the menstrual cycle, and progesterone on day 19-21 of a 28-day menstrual cycle.
- If you experience any of the symptoms below, you might already suspect estrogen dominance.
- Your doctor might suspect estrogen dominance after conducting an in-office health assessment during which they will ask you many questions about your health symptoms and history.
- Estrogen dominance can be confirmed through lab testing.
Since hormones are complex, it is generally not recommended to rely only on signs and symptoms to diagnose high estrogen. That said, the following signs and symptoms can all be due to estrogen imbalance:
- Irregular menstrual cycles
- Heavy menstrual bleeding and blood clots
- PMS symptoms
- Breast tenderness and swelling
- Weight gain (especially around the hips and thighs)
- Mood swings, anxiety, and depression
- Low libido and fatigue
- Endometriosis
- Uterine fibroids
- PCOS
Lab testing can also help identify if estrogen is too high. There are two main ways I test estrogen levels in my practice. For detailed information, I use DUTCH testing by Precision Analytical, or the Hu-Map by Doctors Data, both of which offer a detailed breakdown of all types of estrogen metabolites (as well as detailed information about all the other sex hormones). For many women, basic blood work done at two different points in a menstrual cycle can provide good information about whether estrogen may be too high relative to your other hormones. I typically order estrogen on day 3-5 of the menstrual cycle, and progesterone on day 19-21 of a 28-day menstrual cycle.
What causes estrogen dominance?
There are many things that can cause estrogen to be disproportionately high, and it's not always obvious what's causing it. But the good news is by reviewing lifestyle, past and present exposure to toxins, and running various lab tests, you can identify likely causes and choose the appropriate treatment. Even if you don't know why estrogen is high, there are many treatments you can use to help regulate your hormones.
1. Chronic stress can lead to high estrogen
Chronic stress causes your adrenal glands to produce high amounts of the hormone cortisol (referred to as the "stress hormone"). High levels of cortisol cause a drop in production of progesterone. Since progesterone helps balance out high estrogen, this reduction in progesterone can result in symptoms of estrogen dominance.
2. Poor liver function can cause high estrogen
Your liver plays a crucial role in hormone balance, actively filtering out excess hormones your body doesn’t need. If your liver is overwhelmed by toxins, a poor diet, medications, or other factors, it may struggle to break down and eliminate excess estrogen efficiently, leading to elevated estrogen levels.
3. Xenoestrogens may be to blame
Xenoestrogens are synthetic or naturally occurring estrogen-like substances present in plastics, personal care products, and pesticides (to name a few sources). Xenoestrogens can mimic or block estrogen by binding to estrogen receptors in the body. Exposure to xenoestrogens can lead to reproductive issues and certain types of cancer.
4. Obesity
Estrogen can be produced by fatty tissue. An enzyme called aromatase in fat cells converts androgens (testosterone-like hormones) into estrogen. A vicious cycle can occur in which high estrogen can increase fatty tissue in the hips, thighs, and breasts, which then causes the fatty tissue to generate even more estrogen. This is one way hormones can affect a person's ability to lose weight!
5. Birth control pills and other contraceptives
Synthetic estrogen in birth control pills and other forms of contraception can increase estrogen. Furthermore, the progesterone in these contraceptives can suppress the body's own progesterone production, which might otherwise help balance out high estrogen.
6. Poor gut health
Poor gut health aka "dysbiosis" (bacterial imbalance) can lead to estrogen dominance in a few ways:
1 - Bacterial imbalance in the gut causes an increase in the enzyme beta-glucuronidase, which blocks the normal breakdown and elimination of estrogen.
2 - Constipation can worsen a high-estrogen state. When your body isn't easily and regularly eliminating toxins and excess hormones through stool, not only are you not getting rid of extra estrogen efficiently, but this back-up can also strain the liver and gallbladder, which can make estrogen dominance even worse.
3 - Poor gut health can also lead to chronic inflammation, which can disrupt hormone-producing glands and organs. This can lead to hormone imbalances including estrogen dominance.
7. Low progesterone
In some cases, estrogen levels are relatively normal, but low levels of progesterone create a a relative estrogen dominance. In these cases, correcting the low progesterone can correct the balance.
Low progesterone can be caused by many things, including lack of ovulation (called anovulation), PCOS, chronic stress, hypothyroidism, high prolactin, low cholesterol, perimenopause, medications, and other medical conditions.
1. Chronic stress can lead to high estrogen
Chronic stress causes your adrenal glands to produce high amounts of the hormone cortisol (referred to as the "stress hormone"). High levels of cortisol cause a drop in production of progesterone. Since progesterone helps balance out high estrogen, this reduction in progesterone can result in symptoms of estrogen dominance.
2. Poor liver function can cause high estrogen
Your liver plays a crucial role in hormone balance, actively filtering out excess hormones your body doesn’t need. If your liver is overwhelmed by toxins, a poor diet, medications, or other factors, it may struggle to break down and eliminate excess estrogen efficiently, leading to elevated estrogen levels.
3. Xenoestrogens may be to blame
Xenoestrogens are synthetic or naturally occurring estrogen-like substances present in plastics, personal care products, and pesticides (to name a few sources). Xenoestrogens can mimic or block estrogen by binding to estrogen receptors in the body. Exposure to xenoestrogens can lead to reproductive issues and certain types of cancer.
4. Obesity
Estrogen can be produced by fatty tissue. An enzyme called aromatase in fat cells converts androgens (testosterone-like hormones) into estrogen. A vicious cycle can occur in which high estrogen can increase fatty tissue in the hips, thighs, and breasts, which then causes the fatty tissue to generate even more estrogen. This is one way hormones can affect a person's ability to lose weight!
5. Birth control pills and other contraceptives
Synthetic estrogen in birth control pills and other forms of contraception can increase estrogen. Furthermore, the progesterone in these contraceptives can suppress the body's own progesterone production, which might otherwise help balance out high estrogen.
6. Poor gut health
Poor gut health aka "dysbiosis" (bacterial imbalance) can lead to estrogen dominance in a few ways:
1 - Bacterial imbalance in the gut causes an increase in the enzyme beta-glucuronidase, which blocks the normal breakdown and elimination of estrogen.
2 - Constipation can worsen a high-estrogen state. When your body isn't easily and regularly eliminating toxins and excess hormones through stool, not only are you not getting rid of extra estrogen efficiently, but this back-up can also strain the liver and gallbladder, which can make estrogen dominance even worse.
3 - Poor gut health can also lead to chronic inflammation, which can disrupt hormone-producing glands and organs. This can lead to hormone imbalances including estrogen dominance.
7. Low progesterone
In some cases, estrogen levels are relatively normal, but low levels of progesterone create a a relative estrogen dominance. In these cases, correcting the low progesterone can correct the balance.
Low progesterone can be caused by many things, including lack of ovulation (called anovulation), PCOS, chronic stress, hypothyroidism, high prolactin, low cholesterol, perimenopause, medications, and other medical conditions.
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Lab tests for estrogen dominance
In some cases, lab tests help clarify the cause(s) of your hormone imbalance if the causes are not obvious. Some of the lab tests I might consider in someone experiencing symptoms of estrogen dominance are:
1. Liver function testing
I like to order liver function tests (blood tests) to get a general sense of how liver is doing. It is rare to see overt liver disease but I pay attention when lab results come back as "high-normal" levels or out of the normal range. This usually tells me liver is playing a key role and should be addressed.
2. Digestive health tests
If someone has digestive symptoms like gas, bloating, constipation, diarrhea, or abdominal pain, I may recommend digestive health tests such as SIBO testing, stool testing for parasites and other infections, or tests for yeast overgrowth. Addressing problems with gut heath is important for hormone balance.
3. Hormone tests
Testing estrogen and progesterone through blood testing at different points in the menstrual cycle can help. Comprehensive hormone panels such as the DUTCH Complete or the Hu-Map can be used when a lot more information would be helpful for guiding treatment.
4. Toxin panels
Tests that evaluate toxin burden can be helpful. These might include tests that measure certain chemicals, heavy metals, or mycotoxins (molds) in the body, among other toxins.
Together, we'll come up with an assessment plan that is based on your unique presentation, symptoms, and history.
1. Liver function testing
I like to order liver function tests (blood tests) to get a general sense of how liver is doing. It is rare to see overt liver disease but I pay attention when lab results come back as "high-normal" levels or out of the normal range. This usually tells me liver is playing a key role and should be addressed.
2. Digestive health tests
If someone has digestive symptoms like gas, bloating, constipation, diarrhea, or abdominal pain, I may recommend digestive health tests such as SIBO testing, stool testing for parasites and other infections, or tests for yeast overgrowth. Addressing problems with gut heath is important for hormone balance.
3. Hormone tests
Testing estrogen and progesterone through blood testing at different points in the menstrual cycle can help. Comprehensive hormone panels such as the DUTCH Complete or the Hu-Map can be used when a lot more information would be helpful for guiding treatment.
4. Toxin panels
Tests that evaluate toxin burden can be helpful. These might include tests that measure certain chemicals, heavy metals, or mycotoxins (molds) in the body, among other toxins.
Together, we'll come up with an assessment plan that is based on your unique presentation, symptoms, and history.
How is estrogen dominance treated?
It depends on the cause!
With so many potential factors that could lead to estrogen dominance, the treatment will depend on what's causing the issue
First, we take a full symptom & lifestyle inventory
Some of the considerations are:
Addressing these questions will allow us to develop a personalized plan for testing and treatment designed to address the root of your estrogen dominance.
- Are you overweight or obese?
- Do you have digestive issues like IBS, SIBO, IMO, or chronic constipation?
- Do you cook with plastics or use plastic containers?
- Do you clean with chemicals?
- Do you use artificially-scented candles and plug-ins?
- Are you burdened with toxins from things like smoke and mold?
- Do you experience high stress or struggle to manage stress?
- Do you drink alcohol or take medications that could affect your liver?
- Do you use contraceptives or other hormone replacement therapy?
- Is your progesterone too low?
Addressing these questions will allow us to develop a personalized plan for testing and treatment designed to address the root of your estrogen dominance.
How is estrogen dominance treated?
Treatment depends 100% on the cause of the problem. That said, here are some of the tools and treatments I might use when addressing estrogen dominance:
1. Fibre
Fibre is one of the most effective ways to eliminate excess hormones out through the bowels. This is especially true in people who struggle with irregular stools, sluggish bowel, or chronic constipation. In cases where fibre makes symptoms worse, I would definitely consider intestinal dysbiosis on my mind as a potential underlying problem.
2. Liver detox support
Supplements and strategies that help support liver function and improve bile flow and detox are often a mainstay in treatment for any hormone imbalance.
3. Progesterone
In some cases, progesterone cream or pills can help balance out estrogen dominance. Certain nutrients and herbs like vitamin B6, magnesium, and chaste tree (vitex) can also be used to help promote progesterone naturally.
4. Home detox
Eliminating use of chemicals, plastics, and artificial fragrances can sometimes be just what you need to help your hormones balance themselves out. I recommend using natural cleaning agents like vinegar and baking soda and using only pure essential oils for scents in the home. Chemicals and artificial scents are not good for your health.
5. Mold detox
In some cases, chronic mold in the body can greatly disrupt hormones. This issue can be quite complex and treatment is not a quick fix for most people. That said, treating mold is entirely possible and it can have a significantly positive impact on your health when any chronic mold (both outside of you and inside of you) is addressed.
6. Estrogen detox
There are a few supplements that help your body eliminate excess estrogen. These include things like DIM, I3C, and calcium-D-glutarate. There are many "estrogen quench" type of supplements on the market. These are sometimes used to help reduce high levels of estrogen.
7. Sauna
I'm a huge fan of the power of sweat when detoxing excess estrogen. Increasing the temperature in the body can help mobilize lots of toxins out of fatty tissue to help get them out of the body. This type of detox support is often very helpful for people who are overweight or obese and who struggle to lose weight due to the toxins-estrogen cycle.
8. Stress management
If stress is a number one issue, addressing this needs to be a number one treatment. Stress management might include counselling, practical skills like CBT and reframing, mindfulness and meditation techniques, breath work, establishing healthier boundaries, ending toxic jobs or relationships, and more. Stress can be complex! Managing stress often requires an honest look at what's causing the stress and getting real with yourself about what needs to change in order to end the stress cycle.
9. Exercise
Exercise is the number one determinant of health for virtually all ailments. If physical activity is lacking, getting moving will help. Exercise helps with detox, supports healthy organ function, helps support mental health and more.
10. Other lifestyle changes
Smoking, alcohol, caffeine, sugar, processed food, junk food, artificial dyes and preservatives, and other diet & lifestyle factors can all contribute to estrogen dominance. Treatment may involve adjustments in lifestyle. In general, it is recommended to avoid alcohol, caffeine, and tobacco and to eat a whole-foods plant-based diet - preferably organic.
11. Correct digestive dysfunction
If digestive symptoms are present, gut heath must be addressed. Diagnosing and treating the issue will be necessary to support hormone balance in the long term. This might include lab testing and gut health treatment protocol specific to your unique situation.
1. Fibre
Fibre is one of the most effective ways to eliminate excess hormones out through the bowels. This is especially true in people who struggle with irregular stools, sluggish bowel, or chronic constipation. In cases where fibre makes symptoms worse, I would definitely consider intestinal dysbiosis on my mind as a potential underlying problem.
2. Liver detox support
Supplements and strategies that help support liver function and improve bile flow and detox are often a mainstay in treatment for any hormone imbalance.
3. Progesterone
In some cases, progesterone cream or pills can help balance out estrogen dominance. Certain nutrients and herbs like vitamin B6, magnesium, and chaste tree (vitex) can also be used to help promote progesterone naturally.
4. Home detox
Eliminating use of chemicals, plastics, and artificial fragrances can sometimes be just what you need to help your hormones balance themselves out. I recommend using natural cleaning agents like vinegar and baking soda and using only pure essential oils for scents in the home. Chemicals and artificial scents are not good for your health.
5. Mold detox
In some cases, chronic mold in the body can greatly disrupt hormones. This issue can be quite complex and treatment is not a quick fix for most people. That said, treating mold is entirely possible and it can have a significantly positive impact on your health when any chronic mold (both outside of you and inside of you) is addressed.
6. Estrogen detox
There are a few supplements that help your body eliminate excess estrogen. These include things like DIM, I3C, and calcium-D-glutarate. There are many "estrogen quench" type of supplements on the market. These are sometimes used to help reduce high levels of estrogen.
7. Sauna
I'm a huge fan of the power of sweat when detoxing excess estrogen. Increasing the temperature in the body can help mobilize lots of toxins out of fatty tissue to help get them out of the body. This type of detox support is often very helpful for people who are overweight or obese and who struggle to lose weight due to the toxins-estrogen cycle.
8. Stress management
If stress is a number one issue, addressing this needs to be a number one treatment. Stress management might include counselling, practical skills like CBT and reframing, mindfulness and meditation techniques, breath work, establishing healthier boundaries, ending toxic jobs or relationships, and more. Stress can be complex! Managing stress often requires an honest look at what's causing the stress and getting real with yourself about what needs to change in order to end the stress cycle.
9. Exercise
Exercise is the number one determinant of health for virtually all ailments. If physical activity is lacking, getting moving will help. Exercise helps with detox, supports healthy organ function, helps support mental health and more.
10. Other lifestyle changes
Smoking, alcohol, caffeine, sugar, processed food, junk food, artificial dyes and preservatives, and other diet & lifestyle factors can all contribute to estrogen dominance. Treatment may involve adjustments in lifestyle. In general, it is recommended to avoid alcohol, caffeine, and tobacco and to eat a whole-foods plant-based diet - preferably organic.
11. Correct digestive dysfunction
If digestive symptoms are present, gut heath must be addressed. Diagnosing and treating the issue will be necessary to support hormone balance in the long term. This might include lab testing and gut health treatment protocol specific to your unique situation.
Next steps in treatment of estrogen dominance
If you experience symptoms of estrogen dominance, working with a professional can help quickly identify the issue and get you (and your hormones) back on track. In some cases, a few simple tweaks will make a big difference. In more complex situations, you might have to address some bigger obstacles. Having support to guide this process can help save time and money spent on unnecessary and unhelpful treatments.
If you are in BC and need help navigating the complexity of your hormones, please book an appointment below and we'll get started right away!
You deserve hormonal harmony. I can't wait to help you!
If you are in BC and need help navigating the complexity of your hormones, please book an appointment below and we'll get started right away!
You deserve hormonal harmony. I can't wait to help you!
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address1025 Tamarack Drive
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