Estrogen dominance is an imbalance between the hormones estradiol and progesterone that correlate with a number of health challenges in both men and women. Because these hormones play such a pivotal role in women’s health, estrogen dominance is closely associated with symptoms of premenstrual syndrome and menopause.
Estimates vary, though a healthy cycling woman should have a ratio of progesterone to estradiol of about 20:1 or 30:1 in favor of progesterone, with many women feeling best anywhere in between. This balance can be thrown off in one of three ways – estradiol being too high, progesterone being too low, or both.
Some of the conditions associated with estrogen dominance include irregular menstrual cycles, fibrocystic breasts, migraines, ovarian cysts, hypothyroid symptoms, and foggy thinking. Menopausal symptoms such as hot flashes and night sweats are caused by the fluctuating levels of estrogen. Because progesterone stabilizes estradiol, a healthy ratio of progesterone to estradiol around peri-menopause makes for an easier transition.
Medical practitioners will often suspect estrogen dominance based upon case history and symptoms, but an imbalance can be clearly identified through lab testing. The preferred method of lab testing is through saliva which gives an accurate picture of your body’s exposure to free hormones. Blood serum tests report hormones bound to proteins which may not necessarily reflect what is happening on a cellular level.
One of the more common experiences woman have that is indicative of estrogen dominance is the admission that they feel/felt great while pregnant. Progesterone, being the main hormone sustaining pregnancy, rapidly increases after the egg has implanted. Morning sickness and swollen feet aside, if a woman feels wonderful while pregnant, it usually points to the increased progesterone turning the estrogen dominance on its head.
Causes of estrogen dominance vary. In the case of elevated estradiol, exogenous exposure to pseudo-estrogens (from body care products), xenoestrogens (from consumer products), and hormone disruptors, like the infamous BPA, all create a state of excess estrogen. Sluggish liver function can create a backup of estrogen as well. This is especially true when a woman drinks alcohol around her cycle to ease PMS. The liver’s priority is to detoxify the alcohol which can leave estrogen levels elevated for an extended period of time. That glass of wine might make you feel better temporarily but it will only prolong the symptoms of PMS.
Progesterone, on the other hand, can become deficient through chronic stress. The adrenal hormone cortisol, used to mitigate stress and balance blood sugar, is synthesized directly from progesterone. If the body’s demand for cortisol goes up, resources will be shunted away from a mode conducive to reproduction (progesterone) to one needed to help you cope with stress (high cortisol). If stress or blood sugar ups and downs persist, the body can run a deficit of progesterone.
Treatment includes the removal of exogenous estrogens, which can be difficult as many products either don’t list trace amounts of estrogens, such as anti-wrinkle creams, or are hidden, such as hormones used in the meat industry. Start by checking consumer products on a database such as Skin Deep or call the company and persistently ask if the product in question contains any hormones. Buying organic meat is the only way to sidestep the estrogens used in the livestock industry.
Once the toxic exposure has ceased, elevated estrogens can be safely eliminated by increasing dietary fiber and taking herbs or supplements that help your liver to cleanse. In some cases, a longer purification protocol is indicated. There are also specific compounds available as dietary supplements that are helpful to relieve an excess estrogen burden; those compounds include calcium d-glucarate (CDG), indole-3-carbinol (I3C) and diindolylmethane (DIM). Whole-food sources of these compounds include potatoes, cruciferous vegetables, and sauerkraut respectively.
For the progesterone deficiency side of the equation, one must first plug up the leaks in terms of eliminating, mitigating, or coping better with stress while avoiding processed foods, vegetable oils, and refined carbohydrates to prevent blood sugar from spiking. Once this has been addressed, there are many herbal remedies that can balance cortisol and progesterone naturally, although in some cases bioidentical progesterone can be used. One example of this is a woman who has had a hysterectomy where her ovaries were also removed. These cases may not respond to herbal therapy now that the ovaries, which would have produced progesterone after menopause, are no longer lending support to the adrenal glands, which are the primary site of progesterone production.
Properly diagnosed and holistically addressed, the alleviation of estrogen dominance can be a life-changing healing for cycling and menopausal women, as well as men with a history of prostate problems.
For more information on toxins that disrupt this endocrine system, consult this document from the Environmental Working Group and Keep a Breast.