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Dr. Jacquelyn Paykel
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Home >> Gynecology >>
Estrogen Dominance
Gynecology & General Health
WHAT YOU NEED TO KNOW ABOUT ESTROGEN DOMINANCE
While estrogen levels will decrease during menopause, the truth is, estrogen levels do not fall
appreciably until after a woman’s last period. In fact, far more women suffer from the effects of
"estrogen dominance" during the transition—that is, they have too much estrogen relative to
progesterone. Some women even experience a
significant excess in estrogen production to
compensate for the impaired ovulation that occurs in later peri-menopause.  And some women can
suffer from the symptoms of estrogen dominance for 10 to 15 years, beginning as early as age 35.

LISTEN TO YOUR BODY
The symptoms listed below, as well as many others, often arise when estrogen over-stimulates
both the brain and body. All of these symptoms are exacerbated by stress of all kinds. Many women
in their thirties and early forties find that they experience moderate to severe symptoms of estrogen
dominance as they approach peri-menopause.
Decreased sex drive
Irregular or otherwise abnormal menstrual periods
Bloating (water retention)
Breast swelling and tenderness
Fibrocystic breasts
Headaches (especially pre-menstrually)
Mood swings (most often irritability and depression)
Weight and/or fat gain (particularly around the abdomen and hips)
Cold hands and feet (a symptom of thyroid dysfunction)
Hair loss
Thyroid dysfunction
Sluggish metabolism
Foggy thinking, memory loss
Fatigue
Trouble sleeping/insomnia
PMS symptoms
Food cravings

Estrogen dominance has also been linked to allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, and increased blood clotting, and is also associated with
acceleration of the aging process.

WHAT CAUSES THIS
When a woman’s menstrual cycle is normal, estrogen is the dominant hormone for the first two
weeks leading up to ovulation. Estrogen is balanced by progesterone during the last two weeks. As
a woman enters perimenopause and begins to experience anovulatory cycles (that is, cycles where
no ovulation occurs), estrogen can often go unopposed, causing symptoms. Skipping ovulation is,
however, only one potential factor in estrogen dominance. In industrialized countries such as the
United States, there can be many other causes, including:
Excess body fat (greater than 28%)
Too much stress, resulting in excess amounts of cortisol, insulin, and norepinephrine,
which can lead to adrenal exhaustion and can also adversely affect overall hormonal
balance
A low-fiber diet with excess refined carbohydrates and deficient in nutrients and high quality
fats
Impaired immune function
Environmental agents


WHAT YOU CAN DO ABOUT ESTROGEN DOMINANCE:
1.  Take a high potency multivitamin/mineral combination.

2.  Follow a hormone-balancing diet: Eat lots of fresh fruits and vegetables, adequate protein, and
moderate amounts of healthy fat. Remember to get enough fiber. Estrogen is
excreted by the bowel; if stool remains in the bowel, estrogen is reabsorbed.  
Cruciferous vegetables are particularly important, including: cabbage, brussels
sprouts, kale, collard greens, broccoli, cauliflower, bok choy, arugula, canola, radish,
wasabi.

3. Use transdermal 2% bioidentical progesterone cream (one brand name to consider
is Progest): Many of the symptoms of estrogen dominance can be relieved with
natural, bioidentical progesterone, available over the counter in a 2% cream (one-
quarter teaspoon contains ~20 mg progesterone). Use one-quarter to one-half
teaspoon 2% progesterone cream on skin (e.g., face, breasts, abdomen, hands) daily
for two to three weeks prior to onset of period. If periods are irregular, use 2%
progesterone daily, or from the full moon to the dark of the moon. (That way you’ll be
teaming up with the cycle of the Earth itself — the same cycle that governs the tides
and the flow of fluids on the planet.) If progesterone cream is inadequate, prescription
strength bioidentical pill is also available.  I recommend starting with 100 mg tablet
nightly.

4.  Lose excess body fat and get regular exercise—especially strength training.

5.  Block excess estrogen with phyto-hormones from flax, soy, and other sources: Soy
helps regulate estrogen, so if you have too much estrogen relative to progesterone,
soy will act as an estrogen blocker at the tissue level.

6.  Increase estrogen metabolism by taking a natural supplement: Di-indol-methane
(DIM).  This supplement is an extract from cruciferous vegetables.  DIM increases the
breakdown of estrogen in the liver, increasing the elimination of the excess estrogen
from the system.  

7.  Detoxify your liver: Traditional Chinese Medicine explains that menopausal
symptoms are caused by blocked liver and kidney chi. This makes sense. The liver
acts as a filter, helping us screen out the harmful effects of toxins from our
environment and the products we put in our bodies. When the liver has to work hard
to eliminate toxins such as alcohol, drugs, caffeine, or environmental agents, the liver’
s capacity to cleanse the blood of estrogen is compromised.

8.  Decrease stress: Learn how to say no to excessive demands on your time.
Remember, peri-menopause is a time to reinvent yourself. This means investing time
and energy in yourself, not everyone else.

LEARN MORE | RECOMMENDED READING OR RESOURCES
•        The Wisdom of Menopause, by Christiane Northrup, M.D., Chapter 4, "This Can’t Be
Menopause, Can It? The Physical Foundation of the Change"
•        The Wisdom of Menopause, by Christiane Northrup, M.D., Chapter 7, "The Menopausal Food
Plan: A Program to Balance Your Hormones and Prevent Middle-Age Spread"
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