What is estrogen dominance?
Doctors speak of estrogen dominance when the blood level of estrogen is too high in relation to the progesterone level – for example, because the body produces too much estrogen or too little progesterone.
Estrogen and progesterone are two vital sex hormones that perform important tasks, especially in the female body: They are involved in the regulation of various bodily functions such as the menstrual cycle and reproduction.
In estrogen dominance, this balanced interplay of hormones is significantly disturbed.
Estrogen dominance: symptoms
Estrogen dominance can be associated with a wide range of symptoms that affect the general well-being of those affected. The most common symptoms of estrogen dominance are explained in more detail below:
Disturbed menstrual cycle
Spotting between menstrual periods is also possible as a result of estrogen dominance.
An existing desire to have children may remain unfulfilled due to cycle disorders. However, if the cause can be successfully treated, many women do become pregnant.
Increased premenstrual syndrome (PMS)
Estrogen dominance can aggravate the symptoms of premenstrual syndrome (PMS).
Weight gain
Many women with estrogen dominance report weight gain. In particular, fat deposits often accumulate on the hips, thighs and abdomen.
This is due to the hormone’s effect on fat storage and metabolism.
Fatigue
People with estrogen dominance often report chronic fatigue or a general lack of energy.
Mood swings and depression
Some women with estrogen dominance develop mood swings, irritability and even depression.
This is because estrogen affects nerve messengers (neurotransmitters) in the brain that regulate mood (such as serotonin).
Insomnia
Insomnia is another common symptom of estrogen dominance. The hormonal imbalance disrupts the body’s natural sleep cycle.
Decreased sexual desire
Benign breast changes
Estrogen dominance increases the risk of fibrocystic changes in the breasts. That is:
The connective tissue in the breasts increases, and small cysts (fluid-filled cavities) form in the tissue. The breasts then feel nodular, are swollen and tender.
Hair loss
In rare cases of estrogen dominance, affected individuals lose hair. More often, thinner hair is observed.
“Brain fog” and memory problems
Estrogen dominance can trigger cognitive problems such as “brain fog”, i.e. impaired cognitive performance – for example in the sense of word-finding problems and concentration difficulties. Memory lapses are also possible.
This is explained by the fact that estrogen affects brain function, the production of nerve messengers (neurotransmitters) and the networking of nerve cells.
Water retention and bloating
This is because estrogen affects the body’s fluid balance.
Estrogen dominance: treatment
How doctors treat estrogen dominance depends on various factors. Most relevant is the cause of the hormonal imbalance, what symptoms occur, and how severe they are.
General approaches to treating estrogen dominance include:
Lifestyle changes
- Regular physical activity
- Stress reduction
- Change of diet (e.g. less processed foods, more whole foods)
- Avoidance of environmental toxins and hormonally active substances (see: Causes of estrogen dominance)
Hormone therapy
Plants, minerals, probiotics
There are several herbal substances and supplements that may be suitable to treat estrogen dominance.
One of the most commonly discussed substances is DIM (diindolylmethane). DIM is formed in the stomach from an ingredient in cruciferous vegetables such as broccoli, cauliflower, kale, Brussels sprouts and cabbage.
In addition, cruciferous vegetables contain many fibers and other nutrients that support overall hormonal balance and inhibit inflammation.
Medicinal plants such as monk’s pepper, Chinese angelica (Dong Quai) and black cohosh (Cimicifuga) are also often cited as effective remedies for estrogen dominance symptoms. Studies on the safety of their use, for example, are inadequate.
The mineral magnesium is thought to help reduce stress – a possible cause of estrogen dominance. In addition, healthy magnesium levels help with menstruation-related headaches and improve sleep quality.
Probiotics are thought to improve gut health and support healthy estrogen metabolism. These are preparations containing “healthy” microorganisms such as those found in the natural intestinal flora.
Estrogen dominance: causes and risk factors
In estrogen dominance, there is an imbalance between estrogen and progesterone levels in the body: there is too much estrogen in relation to progesterone.
One possible reason for this is that the body produces an excessive amount of estrogen (e.g. if there is a lot of body fat). This then results in an absolute estrogen surplus.
In summary, the main causes of estrogen dominance are:
Hormonal change during menopause
When women reach menopause, the ovaries gradually stop producing sex hormones.
However, in the process, progesterone levels often drop faster than estrogen levels during premenopause and perimenopause. This results in a relative estrogen surplus (relative estrogen dominance).
Excess body fat
This happens especially when someone has a lot of fat stored in the abdominal region (belly fat).
Poor liver function
The liver plays a crucial role in metabolizing and excreting excess hormones, including estrogen. Therefore, when their function is impaired, a lot of estrogen, among other hormones, can accumulate in the body.
Possible causes of impaired liver function include excessive alcohol consumption, environmental toxins and certain medications.
Stress
Decreasing progesterone levels result in a relative excess of estrogen.
Insulin resistance
Insulin resistance occurs when the body’s cells do not respond effectively to the hormone insulin – that is, to its signal to absorb sugar from the blood. Thus, an elevated blood glucose level develops.
This condition contributes to estrogen dominance through two mechanisms:
- Estrogen production in the ovaries and adipose tissue increases.
Other diseases
Some other diseases can also be responsible for estrogen dominance, for example polycystic ovary syndrome (PCOS). This is a common hormonal disorder associated with a large number of ovarian cysts and various symptoms. It may also be associated with excessive estrogen production.
Conversely, malignant tumors of the thyroid gland appear to be more common with high estrogen levels.
Xenoestrogens
Exposure to xenoestrogens may contribute to estrogen dominance by the hormonally active chemicals increasing total estrogenic activity in the body.
Mismatched hormone replacement therapy (HRT).
In some cases, hormone replacement therapy (HRT) can cause estrogen dominance, especially if the hormone supplements administered do not provide an appropriate balance of estrogen and progesterone.
Estrogen dominance: examinations and diagnosis
To diagnose estrogen dominance, medical professionals take the affected person’s medical history, perform physical examinations and laboratory tests.
Taking the medical history
The physician asks the affected person about his or her symptoms, menstrual cycle, possible pregnancy, previous and current illnesses, medications used, and family history.
Physical examination
The next step is a physical examination. This allows the doctor to assess the general health of affected individuals and detect possible signs of estrogen dominance such as weight gain, fibrocystic breasts or hair loss.
He or she also looks for signs of conditions that may be associated with estrogen dominance, such as thyroid problems or polycystic ovary syndrome (PCOS).
Laboratory tests
Estrogen levels: Both estradiol (the most potent form of estrogen) and estrone (a weaker form of estrogen) are usually measured. The measurement results can be used to estimate the total estrogen level in the body.
Progesterone level: Since estrogen dominance is characterized by an imbalance between estrogen and progesterone, the measured value of the progesterone level compared to that of the estrogen level is decisive.
Blood levels of other hormones: When clarifying a hormonal imbalance, physicians also determine the blood levels of other hormones. These include follicle-stimulating hormone (FSH), luteinizing hormone (LH), cortisol and thyroid hormones. These hormones are closely related to estrogen.
Hormone determination by saliva test
However, saliva tests are generally considered less reliable than blood tests, and not all healthcare providers use this method for diagnosis. Rather, they use it particularly to monitor the effectiveness of treatment.
