Written by Lauren Lund, APRN-CNP
Hormones are the body’s chemical messengers, impacting everything from mood and energy levels to metabolism and reproductive health. One common — but often misunderstood — hormone imbalance is estrogen dominance. This condition can cause a wide range of symptoms and affect overall well-being.
Let's dive into what estrogen dominance is, how to recognize it, how to test for it, and what treatment options — including lifestyle changes and supplements — can help restore balance.
What Is Estrogen Dominance?
Estrogen dominance occurs when estrogen levels are too high relative to other hormones, particularly progesterone. This doesn't always mean you have "too much" estrogen overall — you might actually have normal estrogen but low progesterone, creating an unhealthy ratio between the two.
Examples of estrogen dominance:
- High Estrogen + Normal Progesterone
- High Estrogen + Low Progesterone
- Normal Estrogen + Low Progesterone
- Low Estrogen + Even Lower Progesterone (Menopause)
Estrogen dominance can occur naturally during perimenopause as progesterone decreases as ovulation becomes less consistent, but it’s also influenced by factors like stress, diet, environmental toxins, and certain medications.
Symptoms of Estrogen Dominance
Estrogen dominance can show up in a variety of ways, and symptoms often mimic other conditions, making it tricky to diagnose without proper testing. Common signs include:
- Irregular periods (heavy bleeding, spotting between periods)
- Severe PMS symptoms (mood swings, irritability, breast tenderness)
- Weight gain, especially around the hips and abdomen
- Fatigue
- Anxiety or depression
- Low libido
- Bloating
- Hair loss
- Memory issues or brain fog
- Sleep disturbances
- Increased risk of fibroids, endometriosis, or ovarian cysts
Men can experience estrogen dominance too, often presenting with fatigue, low libido, weight gain, and enlarged breast tissue (gynecomastia).
Causes of Estrogen Dominance
Several factors can contribute to estrogen dominance:
- Chronic stress (high cortisol suppresses progesterone production)
- Obesity (fat tissue can produce and store estrogen)
- Please note if you are struggling with weight loss despite diet and exercise, please contact your MOBO provider to see if weight loss medicine is right for you.
- Poor liver function (the liver helps detoxify excess estrogen)
- Exposure to xenoestrogens (environmental chemicals that mimic estrogen, found in plastics, pesticides, personal care products)
- Hormonal birth control use
- Diet high in processed foods and sugars
- Lack of exercise
- Lack of Sleep: During sleep, the endocrine system, including the brain's pituitary gland, regulates hormone levels, including those of estrogen and progesterone. Sleep deprivation can disrupt this delicate balance, leading to various health issues.
How to Test for Estrogen Dominance
Testing is crucial to accurately diagnose estrogen dominance and personalize treatment. At MOBO Med Spa, we often start with blood tests of your hormones (LH, FSH, Free Testosterone, Total Testosterone, Estrogen, Estradiol, Progesterone, etc.).
On a cycling female, testing should be completed on Day 18-20 of your cycle. Remember, Day 1 is considered the first day of your period / when you bleed.
Image credits to Dutch
How to Treat Estrogen Dominance
The goal of treatment is to rebalance hormone levels, support detoxification, and address underlying causes.
1. Lifestyle Changes
- Reduce stress: Incorporate daily mindfulness, yoga, deep breathing, or meditation.
- Exercise regularly: Both strength training and cardio help balance hormones and support fat loss. Excessive estrogen is stored in fall cells so fat loss is key to addressing estrogen dominance.
- Improve sleep: Aim for 7–9 hours of quality sleep per night to regulate hormone production.
- Detox your environment: Switch to natural beauty and cleaning products, avoid plastics (especially with food), and choose organic produce when possible.
2. Dietary Adjustments
- Mediterranean Diet: Consider a Mediterranean Diet which is known to have increased fiber, increased healthy fats, and decreased processed inflammatory foods.
- Eat fiber-rich foods: Helps the body eliminate excess estrogen through the digestive system. (Think flaxseeds, leafy greens, and berries.)
- Increase Cruciferous vegetables (broccoli, cauliflower, cabbage, kale, and Brussels sprouts) as these vegetables naturally contain DIM (Diindolylmethane) which can help aide in estrogen metabolism and balance and decrease inflammation.
- Support liver health: Include foods like cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), garlic, onions, and beets.
- Choose healthy fats: Avocados, olive oil, and nuts that have omega 3s to support hormone production.
- Cut down on sugar and alcohol, which strain the liver and promote fat storage.
3. Supplements
These should always be recommended based on personal testing and health history, but commonly used supplements for estrogen dominance include:
- DIM (Diindolylmethane): A compound found in cruciferous vegetables (such as broccoli, cauliflower, cabbage, kale, and Brussels sprouts) that supports healthy estrogen metabolism.
- Calcium D-Glucarate: Helps the body eliminate excess estrogen via the liver.
- Black Cohosh: Supports hormonal balance, especially during menopause, and supporting the normal production of neurotransmitters, including serotonin and dopamine, which also support healthy mood.*
- Probiotics: Healthy gut bacteria help in metabolizing and eliminating estrogen.
- Magnesium: Supports hormone balance and reduces PMS symptoms.
- B Vitamins: Play a vital role in methylation, a key part of phase 2 liver detoxification. Methylation helps the body process and eliminate excessive estrogen, preventing imbalances that can impact reproductive health, mood, and overall well-being. Specifically, B6, B12, and folate are essential for this process.
- Omega 3: Anti-inflammatory properties. Inflammation can lead to increased levels of aromatase, an enzyme that converts androgens into estrogens, potentially contributing to estrogen dominance.
Our favorite Estrogen Metabolism Supplement is FemGuard + Balance which includes (but is not limited to) the following ingredients:
- 100 mg of DIM to support healthy estrogen ratios*
- 100 mg of black cohosh extract standardized to contain 2.5% triterpene glycosides
- 50 mg of broccoli seed extract standardized to contain 13% sulforaphane glucosinolate
- 100 mg of green tea extract standardized to contain 95% polyphenols and 45% EGCg
- 200 mg of chaste tree extract standardized to contain 0.5% agnusides
- Methylated vitamin B12 and folate for enhanced bioavailability
- 400 mg of calcium D-glucarate to support estrogen clearance*
4. Hormone Therapy
For some patients, bioidentical hormone therapy can be used to optimize progesterone levels and rebalance the estrogen-to-progesterone ratio. This is individualized based on testing results and health goals. This may include the use of pellets, creams, and/or pills.
Book a Consultation with Us
Estrogen dominance is a real and treatable condition — but because its symptoms overlap with many other health issues, proper testing and a personalized treatment plan are essential.
If you suspect you may be experiencing estrogen dominance, schedule a consultation with us. We can guide you through testing, lifestyle adjustments, and treatment options.
Remember: hormone balance is about the whole body — not just the hormones themselves! Nutrition, stress management, gut health, and detoxification all play critical roles.
This article is for educational purposes only. This article is not a substitute for a substitute for medical or health advice from a certified professional who is aware of the facts and circumstances of your individual and personalized situation. Information provided by this article DOES NOT create a practitioner/patient relationship between you and any persons affiliated with this article or website. Always speak with your physician or healthcare professional before taking any medication or nutritional, herbal, or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website.
