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Understanding Estrogen Dominance (Is Estrogen Really To Blame?)

As a woman, it is extremely important to be in tune with your hormones and really understand the female menstrual cycle. Hormones play a big role in our everyday lives, for both males and females. Only difference is as a woman, our hormones are changing on a day to day basis. These hormone fluctuations and potential imbalances (either having too much or too little) are often blamed for mood swings, libido changes, anxiety, irritability and odd food cravings. 
 
In today’s post we will delve into the main sex hormone for females - estrogen. Estrogen in balanced amounts has positive effects on the body. It is important for primary and secondary sex characteristics and plays a big role in puberty onset, fertility and the menstural cycle. Estrogen also has many positive effects on the body including, regulating menstruation, insulin sensitivity, reducing hunger, helps to maintain optimal bone density and protects against cardiovascular disease. Estrogen requires a very delicate balance with other hormones and when this balance is lost, the symptoms mentioned above can arise. 
 
As I said earlier, it is first very important to understand what is happening in our bodies as women, every day of the cycle before learning what could go wrong. Being in tune with your body is a fundamental pillar in both mental and physical wellness. 
 
So let’s start off by learning the hormones that are involved in the female cycle. 
 

Understanding The Female Cycle

Women have 4 reproductive hormones that are in constant motion - estrogen, progesterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Throughout a woman’s lifetime, these hormones may be affected to varying degrees. Estrogen is the primary hormone that dominates in the first 2 weeks of the female menstrual cycle and progesterone is the primary hormone that dominates in the last 2 weeks of the cycle. These hormones are opposing by nature - estrogen is the energetic hormone while progesterone is the calming hormone. 
 

There Are 4 Stages In The Menstrual Cycle:

  • Proliferative - Day 1 is the first day of menstrual bleeding. This will usually last about 5 days. Around Day 5, estrogen levels are low, which stimulates FSH to be released in high amounts. In response to high amounts of FSH, follicles in the ovaries begin to develop and mature. Growing follicles predominantly produce estradiol which thickens the endometrium. 
  • Ovulation - By around Day 13 estrogen levels have maintained at peak for 48 hours. This promotes the production of the hormone LH and a decline in estrogen thereafter. LH surge causes the egg to be released about 18-36 hours later. The LH surge causes the follicle to be released from the ovary and thus ovulation occurs. 
  • Luteal - This is the second half of a woman's menstrual cycle, where progesterone starts to dominate. Assuming no fertilization has occurred, increasing amounts of progesterone are now released. Then, both estrogen and progesterone steadily decrease in the week prior to menses.
  • Menstrual - The endometrium will respond to decreased progesterone levels which result in uterine contractions and the start of menstruation. And now the cycle resets! 
 
Now that we understand what is happening throughout the full female cycle, let's discuss what happens when hormones, mainly estrogen start to lose their balance. 
 

What Is Estrogen Dominance?

Estrogen dominance is one of the more common conditions among women. Many women will experience these symptoms monthly, some more severely than others. It is defined as, a relative excess of estrogen to a relative deficiency of progesterone. Estrogen dominance isn’t necessarily a surge in estrogen, but in imbalance between both of these hormones. So estrogen dominance happens when there is too much estrogen and not enough progesterone to balance out the estrogen.
 
Estrogen is produced in different areas of the body: adrenal glands, the brain, ovaries, fat cells and testes. Too little estrogen can result in painful intercourse, brain fog and irregular periods. However, too much estrogen has its own slew of problems. 
 
Did you know that excess estrogen over time places women at risk for hormonal issues such as early menopause and breast cancer?
 
Now, how does one develop estrogen dominance...
 

What Are The Causes Of Estrogen Dominance?

Physiology, environmental factors and lifestyle choices can all lead to estrogen dominance. Let’s delve into each of these a bit more to see how this can happen. 
 
  • Diet - Food has the ability to affect estrogen levels in the body. 

  • Pesticides act as endocrine disruptors which just means that it can interfere with the hormones in your body leading to imbalances
  • Soy contains phytoestrogens which can mimic estrogen in the body
  • Processed foods and refined sugars make it harder on the liver to do its job detoxifying, including removing excess estrogen, once again leading to a relative estrogen excess.
  • Excessive Alcohol intake - Ethanol can cause estrogen levels to rise to an unhealthy amount in the body.

  • Alcohol increases an enzyme in the liver which promotes conversion to estrogen. Wine drinking especially has become a big problem is today’s society and is really not good for that delicate balance between estrogen and progesterone in women. 
  • Digestive Imbalances and Liver detoxification - Estrogen is eliminated through the digestive tract in the body.

  • If the digestive system is clogged up, and constipation is predominant, along with changes in the gut microbiome it allows for reabsorption and recycling of estrogen from the intestines back into the body’s circulation, which again leads to a relative estrogen excess. As well, if the liver is not working optimally it may not be able to metabolize estrogen normally and favour the production of estrogen metabolites that are known to be more carcinogenic. 
  • Excess Body Fat - Estrogen is also formed in adipose tissue. 

  • Thus, if you are overweight, you will have an increased amount of adipose tissue that can produce estrogen, which in turn means that you will store more adipose tissue → vicious cycle. 
  • Oral Contraceptive Pill (OCP) - The pill is made with synthetic estrogen and progesterone. 

  • These  have been found to lower natural progesterone production and thus, contribute to estrogen dominance.  Many women go on the OCP as a means to “balance hormones” but in reality it can make the situation a whole lot worse. Read the previous post on how to get your hormones back on track after getting off of OCP’s!
  • Chronic Stress - Pregnenolone is a master hormone that is the prescuror to the sex hormones (estrogen, testosterone and progesterone) and stress hromone (cortisol), depending on what the body needs.

  • When the body is not stressed, it produces a balance between the sex hormone, progesterone and the stress hormone cortisol. However, when the body is under higher amounts of stress, it produces more cortisol and not enough progesterone. Low progesterone levels, means estrogen levels will be higher and promote estrogen dominance. 
 
  • Xenoestrogens are synthetic chemicals that mimic estrogen in the body that can lead to potentially dangerous outcomes.

  • Xenoestrogens can evoke estrogen responses in the body and interfere with endogenous estrogen actions. This can increase the risk of disease in the ovaries and breast.  They are found in a variety of every products like plastics, pesticides, cleaning and beauty products. An example includes Parabens which are one of the dirty dozen of cosmetics and found in moisturizers, shaving creams and hair products.  
 
 

What Are Symptoms Of Estrogen Dominance For A Woman?

  • Depression and anxiety
  • Bloating
  • Mood swings
  • Insomnia
  • PMS
  • Endometriosis
  • Uterine Fibroids
  • Ovarian cysts
  • Painful or heavy periods
  • Weight gain
  • Headaches
  • Water retention
 
 

How Can You Test For Estrogen Dominance?

You would think that on blood work estrogen levels would be seen as extremely high. However, this is most often not the case and estrogen comes back ‘within normal limits’. This is because estrogen dominance is relative to other hormones, not technically an excess condition. Therefore, it is important to test for BOTH estrogena and progesterone on bloodwork to assess for estrogen dominance. 
 
Many women will experience symptoms of estrogen dominance and are told they are “normal”. But this is based on what society tells us. So just because many women experience it, it doesn’t make it normal. And from a physiologic perspective these symptoms are not normal. If these symptoms are severe and they affect your day to day life, it needs to be addressed from a multifaceted approach. Mainstream approach for these symptoms involve birth control or antidepressants. None of these solutions really target the root cause of the problem. 
 
As we talked about in this post, there are many possible reasons for a woman to be estrogen dominant and multiple things can worsen this. Thus, it takes a multifaceted approach in treatment. Stay tuned for next week’s post on how to treat estrogen dominance from a 360 approach! 
 
 
 
 
 
 
 
** Disclaimer: The advice is in this article is for informational purposes only. It does not replace the care of a Naturopathic physician.