Estrogen Dominance: When Hormones Are Out of Balance

Estrogen dominance doesn't mean your estrogen is too high - it means estrogen is high relative to progesterone. This imbalance is incredibly common and often overlooked.

What Is Estrogen Dominance?

Estrogen dominance occurs when:

• Estrogen is elevated
• Progesterone is too low
• Or both

The ratio between these hormones matters as much as the absolute levels.

Symptoms of Estrogen Dominance

• Heavy or painful periods
• PMS and mood swings
• Breast tenderness
• Weight gain (especially hips/thighs)
• Bloating and water retention
• Headaches, especially premenstrual
• Fibrocystic breasts
• Fibroids
• Endometriosis
• Anxiety and irritability

What Causes It?

• Anovulatory cycles (no ovulation = no progesterone)
• Perimenopause
• Chronic stress (cortisol "steals" progesterone)
• Environmental estrogens (xenoestrogens)
• Poor estrogen metabolism
• Excess body fat (produces estrogen)

Testing for Estrogen Dominance

Key Hormones

• Estradiol
• Progesterone
• Estrogen/Progesterone ratio

When to Test

• Days 19-21 of your cycle (luteal phase)
• When progesterone should be at its peak

Supporting Tests

• Cortisol (stress affects progesterone)
• Thyroid panel (thyroid affects hormone balance)
• Liver function (liver metabolizes estrogen)

References

• Prior, J. C. (1998). Perimenopause: the complex endocrinology of the menopausal transition. Endocrine Reviews, 19(4), 397-428.
• Santoro, N., et al. (2011). Body size and ethnicity are associated with menstrual cycle alterations in women in the early menopausal transition. Journal of Clinical Endocrinology & Metabolism, 89(6), 2622-2631.
• Patisaul, H. B., & Jefferson, W. (2010). The pros and cons of phytoestrogens. Frontiers in Neuroendocrinology, 31(4), 400-419.