What Is “Estrogen Dominance?”
The phrase, ‘estrogen dominance’ gets used a lot in functional, integrative, holistic, and naturopathic medicine. However, it is not well recognized in more conventional medicine despite the symptoms women are having. I’m here to help clear this up and provide more understanding about what it means!
Estrogen dominance is actually a short 2-word phrase for a longer definition. My colleagues and I tend to use it when we mean: higher estradiol relative to another hormone called progesterone in the luteal phase of a woman’s cycle resulting in symptoms such as PMS, bloating, tender full breasts, water retention, cramps, and even cycles that are heavy or clotty.
You can see why that paragraph got shortened down!
The second half of your cycle is known as the luteal phase. After ovulation (egg release), you create cells known as lutein cells - they form a corpus luteum. This structure pumps out the hormone progesterone.
Progesterone is your ‘pro-gestation’ hormone whether you’re looking to become pregnant or not. It helps get the uterus ready (with estradiol) for potential implantation. It also helps reduce PMS as it has a calming effect. It also helps reduce breast tenderness or fullness and water retention as it can help with salt-water balance in the body.
If you do not ovulate (release the egg), or if you do ovulate but you do not make large, healthy levels of progesterone and/or if you have a lot of estrogens floating around…everything is imbalanced and you sure feel it!
The interesting thing is, you don’t have to have HIGH levels of estrogens to feel those symptoms. You might only have LOW levels of progesterone. Again, it’s an imbalance.
Or you might have normal levels of progesterone but HIGH levels of estrogens. Still an imbalance.
This imbalance can occur at any age where you are having menstrual cycles. Even if you’re in your 40’s or early 50’s!
What can you do?
First, it really is helpful to work with someone who understands hormones and can help you figure out WHY there is this imbalance. There are a number of WHY reasons that are quite varied. Common reasons include age (being perimenopausal), sluggish detoxification, excessive endocrine disrupting chemicals in the body, medications that interrupt hormone pulses, high stress, over-training, under-eating, thyroid dysfunction, PCOS, head trauma or traumatic brain injury, poor blood flow up into the brain and down around the pelvic area, and more!
Sometimes, my patients would realize their stress had been really high, they hadn’t been taking great care of themselves, they weren’t sleeping well, they were off their routine and consuming more alcohol. As a result, their cycle hormones were not happy!
Other times, they were going through perimenopause and didn’t realize it. One of the first hormones to decline in perimenopause is progesterone. This is due to the changes in ovulation as the reproductive years are coming to a close.
However, as you can see from the list, sometimes it’s more complicated.
This means you might need some laboratory testing to see what’s going on in your body and with your hormones!
There are hormone replacement options (such as progesterone if you’re low and need it) and supplement options to support many of these reasons. This isn’t a “one supplement to rule them all” type of situation. While you’ve probably read about products such as chaste tree berry (vitex), Vitamin B6 (P5P = active form) evening primrose oil, broccoli sprouts, resveratrol, DIM, and others, be aware they act to support different things.
Chaste tree berry (Vitex), active B6, and evening primrose oil seem to support progesterone production through a few mechanisms of action.
Broccoli sprouts (or the active sulforaphane) resveratrol, and DIM seem to support estrogen detoxification if that is the concern. Working on the gut microbiome is also beneficial here.
Of course, your primary care might suggest the birth control pill. If you’re not looking to prevent pregnancy, consider trying to find the actual cause of your symptoms! The pill might help in the short term, but what happens when you eventually stop the pill in the future?
In the end, remember to get back to your basics of health first and build from there!