Estrogen Dominance – What it is, how to recognize it, and what you can do about it

Estrogen dominance, although not an official diagnosis, is an all too common health concern for many women and men. Although hormone levels might be within the normal range, estrogen dominance occurs when the level of estrogen is relatively high compared to the level of progesterone and/or testosterone. Also described as an estrogen-to-progesterone ratio that is shifted too far to the estrogen side of the ratio, it has historically described hormone imbalances in women. More recently, however, hormone imbalances in men are being better understood. 

To better understand estrogen dominance, you should first know how estrogen and progesterone function in the body. Estrogen is a collective term for various types of this hormone: estrone (a weaker form that is higher in postmenopausal women), estradiol (the most common form present in women and men), and estriol (helps prepare the body for childbirth during pregnancy). Primarily made in the ovaries, these estrogens are also produced in the adrenal glands and in fatty tissues.

What does estrogen do?

Estrogens play many roles in the body, and while many of these roles relate to reproduction (modulating libido, preparing the female body for pregnancy, development of sperm), there are other important functions. Estrogens contribute to cognitive, bone, and cardiovascular health, as well as bodily processes like immune function and the aging process.

For menstruating women, estrogen levels change from the lowest levels during menses to a peak just before ovulation, followed by a sharp drop in the days after ovulation, rising to a second, smaller peak about a week after ovulation, then a gradual decline through menses. For menopausal women, estrogen is generally still present, although at much lower levels than during menstruating years. In men, estrogens remain relatively low throughout life, gradually increasing in adulthood as testosterone levels gradually decrease. 

What does progesterone do?

Progesterone is a precursor to other hormones in both men and women, playing a role in bone development, cognitive function, sleep quality, blood sugar balance, and energy production. Progesterone also helps maintain hormonal balance.

Although progesterone is often thought of as a female hormone because of its major role in pregnancy, men also require progesterone, mainly to produce testosterone. Progesterone is made in the adrenal glands and ovaries in women and in the adrenal glands and testes in men.

Like estrogen, progesterone levels change throughout the cycle in menstruating women. It is low in the early part of the cycle, increasing slowly around ovulation, then rising sharply following ovulation. Progesterone then declines just before menstruation, returning to the low level of the early menstrual cycle. As men and women age, overall progesterone production gradually decreases, contributing to symptoms associated with menopause in women and “low-T” in men.

Although estrogen dominance can occur at any time, because of the declining levels of progesterone with aging, symptoms of estrogen dominance become noticeable during middle adulthood. Conditions associated with estrogen dominance in women include PMS, fibrocystic breast, uterine fibroids, and ovarian cysts. Symptoms in females can include decreased libido, irregular menses, mood swings, sluggish energy, weight gain, trouble sleeping, and hair loss. The symptoms men can experience are quite similar to women – abdominal weight gain, low libido, brain fog, fatigue, depression, anxiety, and insomnia.

Many individuals choose hormone replacement therapy (HRT) to mitigate hormone imbalance. And although hormone tests can identify imbalances, only your physician can help you consider the pros and cons to determine if HRT is right for you. However, whether or not you choose HRT, there are lifestyle changes that can ease estrogen dominance-related concerns.

Move Your Body

Exercise promotes hormone balance in several ways. First, exercise supports your body’s natural metabolic processes, helping to shift the breakdown of estrogens toward the 2-hydroxy or “good” estrogens. These estrogens are easier for your body to break down and are less likely to cause negative symptoms. In addition, maintaining a healthy weight with adequate muscle mass promotes healthy hormone production.

Fatty tissues contain active aromatase enzyme – the enzyme that converts androgens to estrogens. So, while some amount of body fat is necessary for balanced hormone production, too much body fat can lead to increased estrogen production in both men and women. Including moderate physical activity in your daily routine promotes a healthy body weight, as well as balanced hormone metabolism.

Manage Stress

Chronic stress, whether from internal or external sources, leads to an increased production of cortisol by the adrenal glands. Cortisol is thought of as the “fight or flight” hormone because it helps our bodies respond to stress. Much like estrogen, progesterone, and testosterone, cortisol is a steroid hormone produced in the adrenals via the same pathway as sex hormones.

In fact, cortisol requires progesterone as a building block, and as the demand for cortisol increases due to chronic stress, progesterone levels can begin to decrease – potentially leading to estrogen dominance. There are many ways to manage stress: exercising, meditating, journaling, crafting, music, hobbies, counseling, and social activities; find one strategy that works for you. 

Detox Your Environment

Endocrine disrupters are chemicals that mimic or interfere with hormones. One category, xenoestrogens, have estrogen-like effects in the body. Xenoestrogens are often found in skin care products (parabens and benzophenone), processed foods (preservatives like BHA and food colorings like  FD&C Red No. 3), plastics (BPA and phthalates), chlorine-containing products (household cleaners and bleached paper products), and many insecticides. Simple ways to decrease xenoestrogen exposure include following the Dirty Dozen/Clean Fifteen guide for purchasing produce, reading labels of beauty and cleaning products, using glass containers to store food, and eating fewer processed foods. 

Eat More Plants

The foods we eat provide nutrients that help our bodies break down and excrete hormones, which supports balanced hormone levels. Plant-based foods – vegetables, fruits, whole grains – are good sources of these nutrients. Fiber, B vitamins, and indoles (found in cruciferous veggies) support healthy hormone metabolism.

Fiber promotes the breakdown and elimination of estrogens in several ways.

Certain types of bacteria can become overgrown in the gut, leading to an increase in an enzyme called beta-glucuronidase. One way our body eliminates estrogens is to bind them to glucuronic acid for removal in the stool.

But when beta-glucuronidase levels increase, this enzyme breaks the bonds between estrogen and glucuronic acid, leading to reabsorption of the estrogens rather than elimination. Fiber, acting as a binder, decreases the absorption of estrogens and improves excretion with regular bowel movements.‡ In addition, calcium d-glucarate down-regulates beta-glucuronidase, thus helping to prevent recycling of hormones back into the bloodstream.

Soluble fibers act as prebiotics to support a healthy microbiome. Beans, berries, avocado, apples, and whole grains are high fiber foods that are beneficial in your diet. You can also take a fiber supplement like Thorne’s FiberMend, which contains a soluble fiber blend that’s easy on the digestive tract.

B vitamins, particularly B6, folate, and B12, play an important role in hormonal balance. Metabolism of estrogens in the liver is a multi-step process, and one important pathway, methylation, relies on these vitamins. Vitamin B6 supports progesterone production, further aiding estrogen-progesterone balance.‡ Although certain B vitamins are sourced from animal products, many are plant-sourced.

Chickpeas, bananas, avocado, and nuts are good sources of vitamin B6. Folate is in leafy greens, peas, asparagus, and many whole grains. For vitamin B12, animal sources are often preferred, but many plant-based products, such as nutritional yeast, plant milks, and cereals, are fortified with B12, since it doesn’t occur naturally in plants. Thorne’s B-Complex #6 is a good source of B vitamins with additional vitamin B6 for added support of estrogen metabolism.

Cruciferous vegetables – broccoli, Brussels sprouts, and cabbage – contain compounds known as indoles, which support the liver’s metabolism of estrogen. When cruciferous veggies are chewed, they release indole-3-carbinol molecules that combine in the stomach to form DIM, a well-studied nutrient that supports estrogen metabolism in the liver.

Sulforaphane, another nutrient in cruciferous veggies, with a particularly high level found in broccoli sprouts, supports liver detoxification and provides indirect antioxidant support in hormone-sensitive tissues. Including a variety of cruciferous vegetables not only provides DIM and sulforaphane, it also provides a good source of fiber. Thorne’s DIM Advantage provides both DIM and sulforaphane, along with pomegranate extract for additional antioxidant support. You can also find sulforaphane in Thorne’s Crucera-SGS and MediClear-SGS.

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