Estrogen dominance is a state when the female hormones, estrogen and progesterone, are out of balance. There are a number of reasons why this hormone imbalance may occur, and there are also quite a few estrogen dominance symptoms you should be aware of if you suspect you might be experiencing this imbalance.
Premenopausal, perimenopausal, and postmenopausal women and post-pubescent girls can all experience this imbalance of hormone levels. Men can experience it as well.
In addition to understanding the symptoms of estrogen dominance, it’s important to know the potential risk factors and the best way to address the issue at its root cause.
Importantly, women who have high levels of estrogen may be at higher risk of certain reproductive cancers (1). But there are ways you can combat estrogen dominance through diet, lifestyle, and potential medical intervention with a trained health care professional.
What Is Estrogen Dominance?
Estrogen dominance occurs when the balance of sex hormones gets disrupted. Whether due to low progesterone or high estrogen (or a combination of these), when estrogen is dominant, it can create health problems and affect your sense of wellbeing and quality of life. This is true for women and men.
Progesterone and estrogen (the two primary sex hormones for biological women) are necessary for a woman to maintain healthy fertility and a regular menstrual cycle. Both men and women produce these hormones, along with testosterone. But in men, testosterone is the primary sex hormone. That said, it is possible for men to have estrogen dominance symptoms, just less common.
Estrogen is one of the few hormones that can increase the production of its own receptors in human tissue (2). The increase in estrogen receptors can cause the growth of additional human tissue.
When progesterone and estrogen are in balance, progesterone stops excessive tissue growth, which could eventually lead to cancer. But when estrogen is unopposed, due to inadequate progesterone, excessive tissue growth can result.
Excessive tissue growth in women could be as serious as breast or uterine cancer. It could also mean uterine fibroids, polycystic ovaries, or fibrous cysts in the breast tissue (3).
Men who experience this excessive tissue growth due to unopposed estrogen may grow excessive breast tissue. They may also experience erectile dysfunction or infertility due to estrogen dominance (4).
Estrogen Dominance Symptoms in Women
There are quite a few estrogen dominance symptoms in women. The wide array of these symptoms is due mostly to the fact that estrogen plays such an important role in women’s fertility and sense of wellbeing.
An imbalance of estrogen levels and progesterone levels can have a huge impact in a number of areas, and unless you know the symptoms, you might not realize that a hormonal imbalance is at the root of the problem.
Here’s a list of potential estrogen dominance symptoms, according to Dr. Christianne Northrup, a leading naturopathic doctor (ND) in the study and treatment of women's health issues (5):
- Low libido or sex drive
- Irregular or abnormally heavy periods
- Bloating (water retention)
- Breast tenderness or swelling
- Fibrocystic breasts (PCOS)
- Headaches (especially during PMS)
- Mood swings (like irritability, anxiety, and depression)
- Weight gain or fat gain (mostly around abdomen and hips)
- Cold hands and feet (could be a symptom of thyroid dysfunction)
- Hair loss or thinning
- Thyroid hormone dysfunction
- Slow or sluggish metabolism
- Foggy-headedness and trouble with memory
- Exhaustion and fatigue
- Trouble sleeping or insomnia
- PMS symptoms
This long list of potential signs isn’t always due only to estrogen dominance. But if you find that you have quite a few of these symptoms, you should consider getting blood work done with a medical professional. That could be an OBGYN, an ND, a fertility doctor, or an endocrinologist.
What Causes Estrogen Dominance?
Estrogen dominance can occur either due to the excessive production of estrogen or the inadequate production of progesterone. The root causes of these imbalances can be different even if the end result is the same. It’s possible you could be experiencing both as well.
Too Much Estrogen
If you have very high estrogen levels, it could stem from a number of either internal or external factors.
Internal factors include obesity and poor detoxification. In the case of obesity, excess body fat actually carries additional estrogen in its cells. Moreover, through an enzyme called aromatase, fat cells can actually transform testosterone into estrogen.
For this reason, keeping your weight in check and maintaining an active lifestyle is incredibly important. This is the case for both men and women at all ages. However, women who are reaching the age of menopause should be particularly vigilant about excess body fat because of its ability to produce excessive estrogen and eventually lead to breast cancer (6).
If your body is not properly detoxifying, it could also lead to excessive estrogen floating around in your bloodstream. Compromised detoxification is usually due to an overtaxed liver.
Excessive weight could tax the liver, in addition to excessive alcohol consumption or exposure to toxins in the environment. According to preliminary research, women are more susceptible than men to liver damage brought on by alcohol, so this is an important consideration to take into account (7).
Furthermore, constipation could lead to estrogen dominance because your body gets rid of excess estrogen through stool. If your stool is sitting in your intestines for too long, your body could reabsorb the estrogen into your bloodstream (8). Interestingly, excessive estrogen can also cause constipation, according to one study, which could further complicate the problem (9).
External factors that may cause estrogen dominance include hormonal birth control, hormone replacement therapy (HRT), phytoestrogens, and exposure to excessive xenoestrogens.
Hormonal birth control pills can actually create an imbalance of hormones in both directions — too much estrogen and inadequate progesterone. That's because they flood your system with synthetic hormones that cause you to have a menstrual cycle without actually ovulating, or dropping an egg. When this happens, it sends progesterone plummeting and affects your body's natural hormonal production. This imbalance creates estrogen dominance (10).
Hormone replacement therapy (HRT) affects your system similarly to hormonal birth control by adding synthetic hormones to your system as you enter perimenopause. Often doctors will prescribe a hormone therapy that includes a combination of estrogen and progestin to attempt to avoid estrogen dominance symptoms.
But in some cases, women will receive estrogen-only HRT treatment. This is more likely to lead to estrogen dominance side effects and even greater risk of breast cancer and possibly ovarian cancer, although more work needs to be done on ovarian cancer to fully understand the risks (1).
Phytoestrogens are plant-based, estrogen-like compounds found in foods like soy and other legumes, oil seeds (like flaxseed), berries, wine, grains, and nuts (11). The active compound in these foods is called isoflavones.
There are pros and cons to consuming isoflavones, but overconsumption is a major concern, especially for newborns and infants consuming soy-based formula. Eating too many foods rich in isoflavones (soy has the highest concentration and is very high in the American food supply) can add an undue burden of estrogen-like compounds into your system (12).
Xenoestrogens are estrogen-like chemical compounds found in chemical fertilizers and other conventional agricultural products, conventional beauty products and cleaning products, BPA-containing plastics, and even chemicals in the water supply.
It's near impossible to completely avoid exposure, but limiting your exposure by using natural cleaning products and BPA-free plastics, eating organic, and installing a good water filter are all great places to start.
Low Progesterone Levels
Low progesterone levels can also result in estrogen dominance symptoms. We already mentioned that hormonal birth control pills can create low progesterone, but it's also possible that excessive or chronic stress can cause this same problem. Results in this area of research report mixed reviews, but the most compelling evidence is a consistent finding about cortisol, the stress hormone.
During periods of both acute and chronic stress, the hormone cortisol is elevated. The hypothalamus, pituitary gland, and adrenal glands all come together to form the HPA axis.
The HPA axis is responsible for dealing with both physical and psychological stress in humans and animals, and the adrenal glands (the "A" in HPA) produce both cortisol and progesterone. (The ovaries also produce progesterone.) Chronically elevated cortisol negatively affects the production of progesterone and can ultimately suppress it in the face of constant stress.
It can also eventually lead to adrenal fatigue, which negatively affects your reproductive system (15). Some studies do show the opposite or mixed results so more work in this area needs to be done to fully understand the relationship. It is, however, an accepted truth that chronic stress negatively impacts fertility and hormone balance (16)(17).
How to Address and Reduce Estrogen Dominance Symptoms
If you think you might be experiencing this issue, there are quite a few things you can change in your diet and lifestyle to help combat estrogen dominance. This includes making changes to your diet, adding in exercise, reducing your exposure to xenoestrogens, and finding a different form of birth control.
Hormone Balancing Diet
Being more mindful about your diet is one way to help reduce your exposure to phytoestrogens. Reduce your soy consumption and talk to your doctor about other foods you might need to limit to reduce the amount of estrogen you're exposed to.
It's also important to eat high-quality foods, organic whenever possible. This is especially important for meat and dairy, as conventional livestock can be dosed with hormones that you're eating when you eat the animals and drink their milk. Understanding how the food supply affects your hormones is a huge step toward balancing them.
Further on the food front, eating a hormone balancing diet rich in micronutrients is another way to help ensure that all of the critical systems of your body are functioning at the top of their game.
This means going heavy on vegetables, especially crucifers like broccoli, cauliflower, kale, and collards, plus consuming moderate protein, and focusing on healthy fats like omega-3s, olive oil, avocados, and coconut oil. It also means reducing or eliminating alcohol and caffeine.
Reduce Your Exposure
We mentioned changing your personal care products to reduce your exposure to xenoestrogens in an above section. That's a big one.
Using high-quality personal care products that don't contain xenoestrogens is especially important because these products sit directly on your skin where they can be absorbed into your bloodstream very easily. Choosing BPA-free containers, getting a good water filter, and choosing organic, natural cleaning products will also go a long way toward reducing your exposure.
Reconsider Your Hormonal Birth Control
This advice is controversial since birth control is so important to so many women. There are other forms of contraception like IUDs, condoms, and vasectomies for men that can protect against pregnancy. That being said, if getting off hormonal birth control isn't an option for you, talk to your doctor about the lowest hormone options so you can minimize your risk.
If you plan to stay on birth control pills, it's even more important that you make the lifestyle and dietary changes outlined here. This way, you can avoid overtaxing your liver and detoxification pathways, even if you remain on birth control.
Reduce Your Stress
Sure, this one is easier said than done. But knowing your stressors and finding specific ways to cope can help you achieve hormonal balance. Do yourself a favor and do a little bit of research on potential stress relievers like meditation, yoga, or even talk therapy.
Set aside time for yourself during the workweek to allow yourself to decompress every day. Talk about your challenges and welcome help to avoid feeling overwhelmed.
And don't be afraid to say no. Women, in particular, fall into the trap of saying yes to everything and putting others before themselves. Practice keeping your needs front and center to avoid taking on too much or agreeing to do things that you really don't want to do.
You might also consider getting out of the big city to breathe fresh air and reconnect with nature. Exposure to negative ions in the natural environment (found most abundantly near large bodies of water and in the wilderness) may be linked to an improved sense of wellbeing, better sleep, and stress reduction (18)(19).
Take Care of Yourself
The bottom line in understanding and combating estrogen dominance is to take care of yourself. This is especially true with regards to the dietary and lifestyle recommendations outlined above.
These recommendations are standard for nearly every chronic health issue in modern society. Eat well, go outside, and reduce your toxic exposure. The nuance is in the knowledge of what toxic exposure really is and how you can best avoid it. Certain health conditions might require hormonal birth control or HRT, so it's important that you take these lifestyle recommendations seriously if you can't reduce your exposure medically.
Estrogen dominance symptoms can not only be uncomfortable and inconvenient, they can also be a health risk. So take them seriously, get blood work to confirm, and work with your doctor to take steps to prevent further risk.