The modern day trend of estrogen dominance in women is alarming.

Some of what you’re about to read in this blog post may seem contrary to what you’ve heard elsewhere.

Yes, “estrogen dominance” can be the root cause of hormone imbalance symptoms irrelevant of whether as a woman you are menstruating or not.

Interesting!

Of course, there are certain stages during a woman’s life when she is more likely to struggle with hormone imbalance symptoms as a result of high estrogen in comparison to progesterone.

However, chronic lifestyle stress, ongoing environmental toxin exposure and how good an individual’s diet and general state of health is, means estrogen dominance is becoming less determined by hormonal life stage alone.

Types of Estrogen

Let’s break down the generic word estrogen or oestrogen as this will make understanding estrogen dominance easier.

Estrogen includes the following, with the first 3 being naturally produced by the body:

Estrone (E1) - produced mainly in the liver and from the body’s fat cells. It’s the only estrogen that is found in the body following menopause.

Estradiol (E2) - is the most common form of estrogen produced by the ovaries, and performs a variety of functions during a woman’s reproductive age.

Estradiol is sometimes referred to as “dirty” estrogen. This is because it’s a very strong growth stimulator and it can contribute to estrogen dominance and the problems associated with it. So we don’t want an excess of estradiol.

Estriol (E3) - made in the liver and breast cells and placenta during pregnancy. It’s a highly protective form of estrogen. This is often why some women feel so well when they are pregnant.

Estrobolome (estrogen metabolites) - Estrobolome are part of the gut microbiome. A healthy estrobolome facilitates the body in eliminating excess estrogen. Unhealthy estrobolome can lead to reabsorption of estrogen and excess estrogen.

Ethinyl estradiol - synthetic estrogen. Present in oral contraceptives and conventional HRT.

Xenoestrogens - from endocrine disrupting chemicals. Xenoestrogens mimic estrogen in the body and can out-compete the estrogen our bodies make, leading to hormonal and endocrine disruption.

What is Estrogen Dominance

Scenario 1

The most common scenario is where estrogen levels are too high. This excess estrogen can be due to a number of factors. To put some context around this I’ve listed a few below:

1. The body is making too much estrogen - hello high histamine levels and gut dysbiosis.

Histamine & Estrogen Are Best Friends

Histamine and estrogen feed off one another. If you’re struggling with high histamine or histamine intolerance, histamine will stimulate the ovaries to make more estrogen.

In turn, high estrogen will be adding fuel to inflammatory histamine, as estrogen stimulates mast cells (which also have receptors for estrogen) to release more histamine, and down-regulates the DAO enzyme that clears histamine from the body.

A menstruating woman experiencing histamine reactions will usually find that their symptoms appear worse at certain times of their menstrual cycle, i.e. mid cycle and just before their period.

It’s during these times that the high estrogen / low progesterone imbalance is typically more pronounced.

Progesterone stabilises mast cells, up-regulates DAO and is therefore helpful in reducing histamine. So if progesterone is low that harmonising histamine activity will drop off too.

Histamine receptors are on the cells of most organs and tissues in the body, so histamine intolerance symptoms can show up in a multitude of ways.

The digestive system, skin, nervous system, urinary tract, vagina and cardiovascular system. Yes, symptoms like a fast heart rate and palpitations can be caused by high histamine.

It is important to also remember it may not be histamine that’s causing your symptoms. But histamine intolerance is problematic for many people today and there’s definitely a strong link between histamine reactions and excess estrogen.

Poor Gut Health

Our microbiome plays a huge role in estrogen regulation. Poor gut health increases the risk of estrogen-related diseases.

Parasites, bacterial infections, candida overgrowth, yeast infections and gut microbiota imbalances can all play a role in estrogen dominance.

I recommend a comprehensive gastrointestinal (GI) test for clients so we can identify and treat the digestive and gut microbiota triggers that could be contributing to any hormone imbalance, gut health issues and auto-immunity.

Estrogen Dominance - Other Causes

2. Estrogen is coming from an unwanted external source like xenestrogens (e.g. plastics, household cleaners, pesticides, tap water…)

3. Estrogen metabolites and molecules from xenoestrogens aren’t being metabolised in the right way, due to compromised detoxification.

4. Physical nerve stress - where there is injury or alterations with nervous system and spine function it will result in high cortisol levels.

Elevated cortisol lowers progesterone. This is why posture and root cause treatments to address physical dysfunction are important.

There can in fact be a number of estrogen dominance causes and symptoms because the body and its organs are so intricately inter-connected and inter-dependent.

Scenario 2

In scenario 2, estrogen levels may be normal or low, but there’s little to no progesterone.

Even a woman with low estrogen levels can be estrogen dominant if she has less progesterone or no progesterone.

In this case the ratio of estrogen to progesterone could be high due to:

• a prolonged stress response and elevated cortisol levels that’s having a negative effect on progesterone production.
• the rapid decrease in progesterone compared to estrogen levels that happens during perimenopause and menopause.

At this time in a woman’s life the conventional approach / mainstream media spotlight is very much on low estrogen and how to increase estrogen levels.

But actually during perimenopause, the first hormone to decrease is usually progesterone.

While it’s true that estrogen levels drop significantly during menopause, if progesterone levels decrease at a faster rate a menopausal woman can still become estrogen dominant, no matter how little estrogen they actually have in their body.

When there is less progesterone than estrogen, a woman is likely to experience many symptoms associated with estrogen dominance.

It’s also important to factor in any potential unhealthy estrogen metabolites recirculating in the body too (aka "dirty" estrogen), adding to this estrogen excess.

Low Thyroid Function

Too much estrogen suppresses thyroid hormone and increases the need for TSH (thyroid stimulating hormone), while progesterone stimulates thyroid hormone.

This is often why many women also start to experience thyroid problems with estrogen dominance.

The Effects of Ageing on Hormones

Regardless of anything else - the ageing process alone leads to a natural decline of both estrogen and progesterone.

From 35 to 50 years of age there is about a 35% drop in estrogen.

This is nothing when you compare it to about a 75% drop in progesterone though.

That’s right - a woman’s levels of natural progesterone drops more than double that of estrogen.

Estrogen - Progesterone Ratio

Dr John Lee, one of the world’s leading hormone experts believes that the right ratio of progesterone to estrogen is 200:1.

That’s a huge proportional difference to what most women probably think should be the case.

Estrogen Dominance Storm

Coupling this ageing hormonal picture with physiological and mental stress that can also negatively impact progesterone levels, as well as those scenario 1 causes I mention above, like histamine and gut dysbiosis, it’s the perfect recipe for an estrogen dominance storm.

The evidence is in the research around the increased risks associated with excess estrogen effect.

Studies show that - nearly 80% of all breast cancers are estrogen receptor positive which is why current and emerging therapy is very much estrogen receptor targeted.

There’s more research on estrogen positive receptor effects on a woman’s health. Autoimmune conditions, candida overgrowth, and Hashimoto’s are other health risks associated with estrogen dominance.

While estrogen dominance is one of the most common hormonal imbalances today, there are solutions.

First, get a handle on the root cause(s), so you know where to start with re-balancing your estrogen levels.

This includes making sure the body is eliminating estrogen metabolites in a healthy way.

Because as you've probably already gathered, estrogen dominance is not just about your total estrogens, it’s also about your total estrogen metabolites.

Post Menopause & Estrogen

Even in post-menopause, estrogen continues to be made in the form of estrone (E1).

Although some progesterone is made by the ovaries, brain and peripheral nerves at this time of life, the levels are extremely low.

Surprisingly, women with a lot of body fat can actually make more estrogen after menopause in the form of estrone (E1) than a thin woman makes before menopause in the form of estradiol (E2).

Even with the ovaries removed, post-menopausal women make estrone (E1).

Symptoms of Estrogen Dominance

The symptoms of estrogen dominance are real and can significantly impact a woman’s quality of life. The table below lists some common symptoms:

Estrogen Receptor Sensitivity

There’s also more to estrogen dominance than the actual amount of estrogen in your body and estrogen metabolism.

Some women are more sensitive to estrogen.

For example if they have mast cell activation syndrome (MCAS), high histamine, chronic inflammation, or are deficient in certain nutrients this can magnify their symptoms compared to a woman who’s not estrogen receptor sensitive.

Hormone Health Testing & Support

Would you love to learn more about your hormone levels and how well your body is metabolising estrogen?

If you've read this far, by now you've probably realised why hormone testing is crucial. It’s not enough to go by symptoms alone when there are so many potential triggers at play.

Symptoms and conditions also aren't always that clear cut in terms of what's causing them.

Get in touch if you’d like to know more about how I can help and support you with improved hormonal balance.

Hormone tests are chosen to suit your specific needs.

One of the best tests I recommend and personally use tracks individual sex and stress hormones.

It includes:

• tracking your stress hormones throughout the day and potentially sleep hormone
• progesterone, DHEA & testosterone levels
• the 3 main types of estrogen (so you can see your estrogen ratios and compare them to the ideal estrogen quotient),
• how well your body is metabolising estrogen, showing the different pathways estrogen is taking when it leaves the body
• and markers of detoxification support functions to give a complete hormonal health picture.

It’s brilliant!

The more we can learn about our body and what’s happening at a physiological and functional level and not just how we operate in our external world, the better equipped we are to bring about positive healthy outcomes.

My blog post on How to Balance Your Estrogen Levels Naturally shares causes and ways in which you can support your own hormonal health.

Do feel free to share below any estrogen dominance symptoms you've experienced.

Nicola x