Oestrogen Dominance: Symptoms, Causes and Treatment

Oestrogen dominance is also commonly known as high oestrogen and unopposed oestrogen in some medical literature. But what exactly is oestrogen dominance? What causes it? And most importantly, how do you cope if you have it? In this article we’ll shed some light on this common imbalance, offering insights and guidance to help you restore balance and reclaim your vitality.

What is Oestrogen Dominance?

Imagine your body as a beautifully orchestrated symphony, with all of your hormones playing different instruments to maintain balance and harmony. Oestrogen and progesterone are the two main hormones associated with women and people assigned female at birth, but oestrogen is the main hormone so it's the concertmaster or the star of the show. It guides important aspects of your reproductive health (like puberty, the menstrual cycle, pregnancy) and overall well-being (like bone strength, blood sugar levels, brain function and other bodily functions). But sometimes, things can get a little out of tune. Oestrogen dominance occurs when the delicate hormonal melody becomes unbalanced and oestrogen takes centre stage, overpowering other hormones like progesterone. Think of oestrogen dominance as a hormonal rockstar barging on stage and stealing the spotlight, causing a variety of symptoms and throwing your body's harmony off balance.

Oestrogen dominance occurs when there is an imbalance between the hormones progesterone and oestrogen. These two hormones play an important role in the menstrual cycle, both individually and together. Normally, oestrogen plays a more dominant role in the first half of the menstrual cycle, while progesterone takes the lead in the second half, preparing the lining of your uterus (endometrium) for pregnancy and shedding it if implantation doesn’t happen. When you have oestrogen dominance, the delicate balance between oestrogen and progesterone is disrupted. This can happen for a number of a reasons:

• Oestrogen levels are too high, or
• Progesterone levels are too low
• A combination of high oestrogen levels along with low progesterone levels

Absolute vs. relative oestrogen dominance

What Causes Oestrogen Dominance? 

To understand the causes of oestrogen dominance, we need to understand what raises our oestrogen levels as well as what lowers our progesterone levels. Let's explore the four most common causes of oestrogen dominance.

#1 Oestrogen Dominance during Perimenopause

Hormonal changes don’t begin when we have our last period - they start long before that in the perimenopausal phase. Menopause is often associated with oestrogen deficiency and rightly so, but before this happens, we often have an excess of oestrogen. Studies show that many perimenopausal women have very high oestrogen levels. Sometimes these levels are even higher than the average oestrogen levels in women aged 20 to 35 just before ovulation, when oestrogen levels peak during the monthly cycle.

During perimenopause, the symphony of hormones undergoes significant changes. Follicle-stimulating hormone (FSH), the conductor of the reproductive system, sends out stronger signals to locate and develop the remaining eggs. However, as perimenopause progresses, the supply of eggs declines, making it harder for the ovaries to respond to FSH's cues. This can result in consistently high FSH levels. Inhibin, the hormone that regulates FSH release, may also decrease during this time, further impacting the delicate hormonal balance. As a consequence, progesterone production may be affected, leading to irregular periods and potentially lower progesterone levels in the future. These hormonal fluctuations disrupt the delicate interplay between FSH, progesterone and oestrogen, leading to erratic oestrogen levels and associated symptoms of oestrogen dominance.

#2 Oestrogen Dominance Caused by Xenoestrogens

Xenoestrogens, also known as endocrine disruptors, are synthetic compounds that mimic the effects of natural oestrogen in our bodies. One of the main concerns with xenoestrogens is their ability to bind to oestrogen receptors in our cells. This binding can cause oestrogen dominance. Unfortunately for us, endocrine disruptors are found everywhere in the modern world. They sneak their way into our lives as preservatives in cosmetics, plasticisers in our food containers, plastic bottles, UV filters in sunscreens and even pesticides on our beloved veggies. It’s almost impossible to avoid coming into contact with xenoestrogen on a daily basis. Of course, occasional exposure may not cause significant harm, but in large quantities, these disruptors can promote the development of oestrogen dominance or worsen the condition if you already have it.

#3 Oestrogen Dominance Caused by Excess Weight

Obesity is widely recognised as a significant health concern, carrying risks beyond cardiovascular diseases and diabetes. It also has a notable impact on hormonal balance. There are two main reasons for this. Firstly, fat cells have the ability to produce oestrogen, a hormone closely linked to various bodily processes. Secondly, within adipose tissue, androgens can be converted into oestrogen, further contributing to the hormonal disruption caused by excess weight.

#4 Oestrogen Dominance Caused by Stress

From your body's perspective, stress and reproduction are not compatible. When reproduction is not a priority, progesterone takes a backseat. Simply put, high levels of cortisol, which are typically associated with stress, can contribute to reduced progesterone production and lead to low progesterone levels. This interplay between cortisol and progesterone sheds light on how stress can impact hormonal balance.

This becomes especially crucial during menopause. As mentioned earlier, perimenopause is often characterised by a deficiency in progesterone. When stress enters the picture, the scarcity of this feel-good hormone becomes even more pronounced. And when menstruation ceases altogether, the issue intensifies. At this stage, the adrenal glands take on the sole responsibility of producing progesterone. However, if these glands are preoccupied with generating stress hormones they can’t produce as much progesterone as they did before. So again, we see that our inner hormonal symphony relies on a very delicate balance that can be easily disrupted by the pressures of stress paired with hormonal changes.

What are the Most Common Symptoms of Oestrogen Dominance?

Typical symptoms of oestrogen dominance include:

• Heavy and/or prolonged bleeding
• Irregular periods
• Spotting between periods
• Water retention
• Breast swelling and tenderness
• Exacerbation of premenstrual syndrome (PMS)
• Headaches or migraines (especially premenstrually)
• Mood swings (accompanied by irritability, depression, anxious feelings)
• Weight gain and/or fat accumulation, especially in the abdomen, waist, hips and thighs
• Fatigue, lack of energy and exhaustion
• Sleep disturbances, insomnia, fatigue
• Low libido

A Natural Way to Address Oestrogen Dominance

An effective approach to tackling oestrogen dominance must eliminate excess oestrogen while at the same time promoting progesterone production.

To begin with, we need to focus on supporting our liver and gut. These two internal organs are paramount because the liver plays a key role in breaking down oestrogen, while the gut aids in eliminating any excess. A high-fibre diet and eating foods that contain bitter substances does wonders for both your liver and your gut health.

A hormone-friendly diet can also play a crucial role in treating oestrogen dominance. Firstly, it provides your body with all the nutrients it needs for hormone production and regulation. Secondly, it avoids burdening your body with additional toxins, inflammatory triggers or hormone disruptors.

Perimenopause lost—reframing the end of menstruation	Professor Jerilynn C. Prior, Pages 323-335, Published online: 23 Jan 2007
Perimenopause: The Ovary's Frustrating Grand Finale	BC Endocrine Research Foundation, Volume 3, Number 3: Fall Equinox, 2001
Ovary Cycle	Science Direct