Estrogen dominance — the condition of having higher estrogen relative to progesterone levels — is one that plagues millions of women at all ages. It can occur during reproductive years, perimenopause, and menopause. It can also be coming from a wide variety of sources within a woman’s diet and lifestyle. This makes estrogen dominance a bit of a complex nut to crack. But a holistic approach to health should at least get everyone on the right track, and provide a proper learning environment in which you can figure out precisely where your dysregulation is coming from.
Estrogen dominance occurs when estrogen levels run too high, or on the flip side when progesterone levels run too low. There are some natural swings throughout a woman’s life that can make estrogen dominance more or less of a problem. Progesterone tends to fall during perimenopause, for example, so this can be the primary source of hormonal discomfort for women cresting age 35 or so. Progesterone levels also fall during menopause, though estrogen levels should be low at that time, too. The reasons estrogen may remain relatively high in a woman’s later years are largely to do with the same mechanisms that occur in the reproductive years. In each the reproductive years, perimenopause, and menopause, a woman is subject to be influenced by her dietary and lifestyle choices.
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Estrogen dominance is a big deal. It can cause a wide variety of symptoms, as well as put us at greater risk for a wide variety of diseases and conditions. Symtpoms associated with estrogen dominance include:
Weight gain
PMS
Mood swings
High emotional sensitivity
Heavy Periods
Breast Tenderness
Headaches
Decreased libido
Sluggish Metabolism
Insomnia
Conditions we find more often in women with estrogen dominance and that may in fact explicitly develop as a result of estrogen dominance include:
Cystic Fibroids
Endometriosis
Adenomyosis
Hypothyroidism (estrogen is antagonistic to thyroid hormone)
Breast Cancer
Ovarian Cancer
Cervival Cancer
These aren’t problems we can just shrug off of our shoulders. In many ways, we can reasonably view estrogen dominance as contributing to the deaths of thousands of women every year.
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The causes of estrogen dominance
The causes of estrogen dominance are wide and varied, but largely have to do with metabolic dysregulation and organ malfunction. Some dietary factors may also offset the balance.
1) Being overweight:
Fat cells perform a function called “aromatization” which converts testosterone to estrogen. The more body fat we have on us, then, the more and more our bodies tip their balances towards estrogen and away from testosterone.
Now, this doesn’t mean testosterone levels will be necessarily low in overweight women. To the contrary: testosterone levels also happen to climb the higher and higher insulin levels are. For this reason, a woman predisposed to insulin insensitivity will likely experience increases in both testosterone and estrogen levels. Progesterone receives no bump from weight gain, however: progesterone thus remains incapable of offsetting the estrogen increases associated with higher body fat percentages in overweight women.
2) Overburdening the liver:
The liver is responsible for clearing the body of “old” hormones, especially estrogen. If the liver is overburdened with a hyper-caloric diet, with high volumes of sugar, with high volumes of alcohol, or with high volumes of processing chemicals, then, it becomes sluggish in it’s ability to process everything. When the liver slows down, estrogen ends up becoming back-logged in a way, and wreaks havoc on the reproductive system as it waits for the liver to heal and to catch up in it’s bloodstream clearing capacity.
This effect is interestingly even more pronounced in men than it is in women, and it accounts largely for the development of breast-like fat deposits in heavy drinkers. Being overweight and being stressed may also contribute to this process in men.
3) Stress:
Stress wreaks havoc on all of our bodily systems. Perhaps most pressingly for women, however, it decreases the production of progesterone in the body. When a woman is stressed, her adrenal glands “steal” the precursor to progesterone and instead use it to produce cortisol, the stress hormone. For this reason, high volumes of stress can yank the rug out from under progesterone, which can precipitously tip hormonal balance in favor of estrogen.
4) Consumptions of phyto and xenoestrogens:
Much as I have difficulty with soy in my own life, I typically preach caution when talking about soy. I honestly belieeve that it is a good therapeutic tool for some women, and each of us needs to use it appropriately.
In every single case, however, soy, flax, legumes, and other sources of estrogen outside of the body interfere with our bodies own production of estrogen. In the case of estrogen dominant women, it may be causing too much estrogen to be produced. Phytoestrogens can increase the aromatization process in fat cells that I described above. They can also simply just dump an increased estrogen load into the body, which automatically tips the balance. In a properly functioning metabolism, the liver should probably be able to clear out this increased estrogen load. But sometimes the load is too heavy or the liver not quite strong enough, and that becomes an impossibility.
5) A low fiber diet:
Estrogen is processed in the liver, but it is also processed partly by gut flora, and also excreted through the digestive track.
It has been shown time and time again that low fiber diets are associated with estrogen dominance. There are many cofounding variables that may play a role here, but the general idea is that estrogen can be reaborsed through the intestinal walls. With poor gut flora and with slow intestinal motility, estrogen sits too long in the gut and gets reabsorbed back into the bloodstream.
Fiber is generally correlated with improved digestive pace and motion, though not exclusively. A proper amount of fiber helps push things along in the digestive track. Too much fiber can obviously be damaging. It causes something health advocates like to call “roughage.” It is abrasive, and it can lead to gut deteriorating conditions such as diverticulitis. In any case, however, meeting a minimum requirement for estrogen processing such as regularly consuming fruits and vegetables can be quite helpful for gut motility and health.
Increasing fruit and vegetable intake can also, of course, increase nutrient status, which can boost liver function, hormone function, and the processing of all of these chemicals.
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Moving beyond estrogen dominance
How do we mitigate estrogen dominance, then? We eat diets designed to cool inflammation, to support organ- and particularly liver- function, to minimize phytoestrogen intake, and to maximize nutrient status.
This means that we want to eat a paleo-template type diet, which includes animal products, both the protein and the fat, seafood, fruits, vegetables, olive oil, coconut, starchy vegetables, and to some extent seeds and nuts. However, in an estrogen dominant system, seeds and nuts can act as phytoestrogens and tip the hormonal balance in favor of estrogen, so they should be carefully stepped around. Foods that support thyroid health such as seafood and seaweed should also be quite helpful for boosting metabolic health and hormone clearance. Foods to be avoided are of course all processed sugars, grains, omega 6 seed oils, phytoestrogens which include soy, flax, legumes, seeds, and some herbs, which I list in great detail here, and alcohol.
Foods to emphasize for estrogen clearing are the ones that are the most nutrient dense, particularly those that boost B vitamin levels, omega 3 levels (fermented cod liver oil!), choline (for the liver!), zinc, magnesium, calcium, and vitamin D. For that reason, eggs (choline), fish (omega 3 fats, iodine, selenium, and vitamin D), liver (vitamin A, B vitamins, and iron, zinc, manganese, etc), other organ meats, and high quality animal protein may be your best companions in this journey.
Some supplements have also been rumored to be helpful, and I thought Dr Hoffman (one of the estrogen dominance heroes) summarizes them well:
Lecithin (a phospholipid) and the sulfur-containing L-taurine and L-methionine amino acids are compounds that will promote bile circulation, which enhances estrogen’s excretion out of the body. These lipotropic formulas support the liver metabolism of estrogen. A typical formula might provide the following, sometimes in a base of liver-stimulating herbs like milk thistle, black radish, beet, or dandelion, for twice-daily consumption: choline (a concentrated form of lecithin), 500 milligrams; inositol, 250 milligrams; taurine, 250 milligrams; methionine, 250 milligrams.
Exercise should also be high on your list, since exercise can sharpen insulin sensitivity, boost weight loss, help mitigate mood swing problems associated with estrogen dominance, and reduce levels of stress hormones in the body.
Stress reduction is huge. I cannot emphasize enough how important this is. Without progseterone in our bodies, it is nearly impossible to rectify estrogen dominance. Every other aspect of estrogen mitigation can be in place. But without sufficient progesterone, symptoms of estrogen dominance may persist.
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Estrogen dominance plagues a wide variety of women, and at all stages throughout the reproductive lifestyle. Supporting organ health, reducing stress, and generally focusing on healthful foods should get us most of the way there towards greater hormone balance. There are, of course, many other things you can to do help mitigate problems associated with estrogen dominance– for example, experimenting with neurotransmitter supplementation or boosting neurotransmitter health with diet and supplements in order to mitigate mood swing problems– but those are wide and varied and left for their own places in this blog at an upcoming time.
In the meantime: what is your experience? Does paleo help with these symptoms? What parts of your diet and lifestyle are best for keeping you hormonally balanced and healthy? What’s worked, and what hasn’t?
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I just did a salivary hormone panel with my ND because of my irregular cycles. To my surprise, that particular cycle looked like one of the most “normal” that I’ve had (31 days long, ovulation on day 16), but the panel still showed high estrogen in relation to progesterone (high androgens too). She prescribed lots of fiber, lots of brassicas, DIM and calcium-d glucarate. I guess we’ll see how things go. I have only a few symptoms of estrogen dominance and none of PCOS (besides a history of somewhat irregular cycles, but I don’t go months without a period or anything).
Fascinating post, thank you.
I have always assumed that I had low estrogen levels – I had a 31-32 day cycle and did not have periods for two years after giving birth twice and during breastfeeding. I had no difficulty conceiving. I am significantly overweight, but the only other symptom I had from the list was sluggish metabolism.
For the past few years I have been eating mostly paleo. I am 48 and perimenopausal, but interestingly the only two periods I have had in the last year have come about a week into a Whole-30 style period of eating. I don’t know what that says about my hormones. My mother died of ovarian cancer 20 years ago at age 47, so I would like to know if I am at increased risk for that disease.
I have not lost much weight in the past two years, but am beginning to see the scales move as I have become much fitter and can do more exercise, including free weights.
I think these are great starting points in addressing estrogen dominance. But, I have to say, when I ate a strict paleo diet, my symptoms of estrogen dominance were at their worst (debilitating cramps that no OTC pain-killers could touch; I would often vomit and feel like passing out/fainting). As I added more carbohydrates back into my diet (including gluten-free grains) and sugar(!), my menstrual cramps have been pretty non-existent, but I still suffer from a little bloating around that time of the month. I attribute this to fueling my cells (including my liver) with glucose/fructose so that they could process things better and eliminate excess estrogen from my body. Just thought I’d chime in, in case those who follow a low-carbohydrate/low-sugar diet are wondering why it isn’t working for them. I do very much agree about stress though. De-stressing your life and incorporating exercise are essential for better cycles/reproductive health!
Oh, absolutely. I don’t consider a paleo diet a low carbohydrate diet at all, which I guess I should have been more explicit about in the post. I forget, often, that others consider paleo a low carbohydrate diet more often than not. I’m so glad you have found some relief!
hi, thanks for this. i’ve done a fair amount of research for myself on this over the years and i’m a little confused about lecithin… soy and sunflower seem to be the main sources but i thought that they were also estrogenic… so what to do? what’s your take on this?
They are estrogenic! For that reason I think it best in the majority of cases to steer clear of them.
any suggestions for a soy & sunflower free source of lecithin then?
I had that entire first list of symptoms before starting the Gaps Diet, which is similar to Paleo. I had been managing the hormone imbalance for the prior 3 years through supplements (chasteberry). When I started Gaps, my hormones balanced within the first couple of months, and I no longer need the supplements.
Would you suggest a progesterone cream to help with progesterone issues? Such as this one: http://www.beeyoutiful.com/beeyoutiful-balance.html
Or femmenessence a form of maca. Or vitex to lower estrogen and help with progesterone production. This is one of my biggest issues. Trying to correct it with Paleo diet… Three months in and still working on regulating my periods. Any suggestions on giving my progesterone a jump start?
Thank you so much – this is a great refreshed on estrogen. Having PCOS, I knew I was high in testosterone, but my lab results also showed high estrogen, and I couldn’t remember how they both could be high.
Anyway I am still struggling to balance hormones, but a paleo diet has definitely helped. I stay away from all forms of sugar besides some occasional fruit, otherwise cravings & hormones & skin just go all wonky on me.
I am having right now an “induced” estrogen dominance.
Not having my period for almost two years now, one of my Endocrinologists prescribed me Estrogen as gel, combined with 15 days high dosis Progesterone… Still no results.
My Estrogen was 1008 ng/L and my pretty low.
Total Testo: 0,22 (ref 0,20 – 0,7)
Free Testo: 0,05 (ref 0,02 – 0,27)
FT3: 2,3 pg/ml (ref 2,4 – 5,1)
FT4: 1,1 ng/dl and TSH 0,75 I/Ul seem to be OK thou.
What kinda pisses me off is to hear like “your Tyroid and your Testosterone are OK”…
But it seems the problem lies on my LH (less than 0,1 IU/l), which is just not enough for menstruating.
The thing is, I dont wanna get medicated to just menstruate, I wanna solve the “root” of the problem, whatever it is hypodiroidism or whatever else…
Perhaps I will have to look for a 3rd Opinion on that… Geez…
What do you think?
BTW, I am 32 years old, 171cm, 56 kg, 3x/week weights, 1x HIIT and not on a carb restricted diet. ~120g/day with some “high” carb days with ca. 300g.
Thanks for the great articles and cheers!
Do you have any links/more info about estrogen and thyroid hormone being antagonistic? I am beginning to unravel my hormonal puzzle after a decade of veganism, then being diagnosed with both celiac and hashimoto’s, switching my diet to paleo and then the autoimmune protocol and then getting on medication. I am a normal weight/on the thin side and have always had a regular cycle but horribly painful cramps. When I started eating meat again and tried the autoimmune protocol, my cramps have lessened drastically, but I saw an increase in cystic acne. I got on thyroid hormone and every time I increase my dose my cycle is off by about a week, then in a month it is normal again. I increased about a month ago, and I am 10 days overdue for my period. I have always assumed that I have lower estrogen as opposed to high (I never have symptoms of PMS and instead feel horrible while menstruating, and get cystic acne only right before ovulation). I also started menstruating late, at 16. Anyways, if you have any nuggets for me or anywhere I could go to research, I would gladly appreciate it!
Also – I have been loving your podcasts to death lately! They are just what I need in my life right now.
Mickey
Hi Stephini, Long time follower and absolutely think your’re spot on everything! I have some very dry, flaky skin and poor digestion. I was a raw vegan for a couple of years and boy did that screw me up-leading ultimately to an eating disorder of epic proportions. I have regained the weight/grew a couple inches taller even. And have been paleo for almost 2 years. However do you think resulting seb derm or roasea could be a result of a hormonal imbalance/hypothyroidism or nutritional imbalance? Any feedback would be greatly appreciated because its pretty embarrassing and socially isolating. Being paleo has pretty much cured by acne though.
I’d look first to nutritional deficiencies, gut health, and hypothyroidism to hack the rosacea. Perhaps the use of different cleansers and lotions, too. I highly recommend Liz Wolfe’s Skinterventions in that regard — http://purelyprimalskincare.com.
And congratulations on your journey!! Really, Chelsea, that’s so inspiring to me.
My skin (Rosacea, cystic acne) gets better the week or few days before my period. Is this estrogen dominance related?
What do you think about the Autoimmune Protocol for Paleo diets for hormone imbalance?
Or do you think the Gaps diet would be better, as someone mentioned above? Thanks!
I may have missed the details– a lot of information to sort through. Estrogen seems to both promote and inhibit health…and affect many systems in the body.
So, I was pregnant about a year ago and my thyroid was great, my skin was great, I felt physically and mentally amazing.
I attribute this to the rise in hormones.
Just came across info that estrogen increases thyroid activity. http://link.springer.com/article/10.1007/s13105-010-0056-0
I am currently taking glandular thyroid and it has stopped hair loss and warmed me up a bit.
I think it’s possible that if I get my reproductive hormones happy again, (almost) everything else would snap into place. While estrogen dominance can clearly be an issue, it seems it down-regulates our own production of estrogen. I eat raw liver regularly (it contains nutrients that help my liver clear estrogen, right?)
I really just want my pregnancy hormones back, without getting pregnant.
Any insight appreciated!