If you’ve heard me talk about perimenopause at all, you have likely heard me talk about estrogen dominance. Having suffered from this myself and having worked with many women who have experienced this condition,
This condition could be the cause of many of the symptoms women experience in the years before menopause. It can leave you feeling confused, alone and powerless to break free.
I thought it was time I wrote an article about this and shared it with my readers. I hope it will help you to understand that your hands aren’t tied in this stage of life. There are steps you can take to support hormone health at this, and any age.
What is estrogen dominance?
Estrogen dominance can be experienced when a woman has deficient, normal or excessive estrogen, but has little or no progesterone to balance its effects in the body. The amount of estrogen relative to progesterone is relevant in this condition. The ratio of estrogen to progesterone is out of balance in estrogen dominance in a way that estrogen is disproportionately higher and unopposed in its activity in the body.
How do these hormone levels appear with estrogen dominance?
Below are 3 ways that estrogen dominance can present itself with these two hormone levels.
- Estrogen dominance can be experienced by a woman who has high levels of estrogen and normal levels of progesterone.
- Estrogen dominance can be experienced by a woman who has normal estrogen levels but low levels of progesterone.
- Estrogen dominance can also take place when a woman has normal estrogen and normal progesterone but a high exposure to hormone disrupting chemicals like xenoestrogens or where a woman is progesterone resistant, as can occur with PCOS and endometriosis.
What are some common symptoms of estrogen dominance?
These are some common symptoms of endometriosis. (in alphabetical order)
Bloating (water retention)
Bowel irregularity (especially with PMS)
Breast tenderness and swelling
Mood swings (anxiety and depression)
Thyroid dysfunction (slowed metabolism, cold hands and feet)
Weight gain (especially around the abdomen, hips, thighs, and butt)
What are some of the causes of estrogen dominance?
Adrenal Fatigue (often due to chronic stress)
Anovulatory cycles (in perimenopause)
Diet high in soy foods
Genetic variations and dysfunction in the detoxification pathways
High Cortisol levels
Hormone disrupting chemicals
Insulin resistance and high blood sugar
Low Fiber Intake
High Body Fat Levels (greater than 28%)
Low Thyroid Function
What can you do about it?
High Vegetable Diet with lots of cruciferous vegetables (cauliflower, cabbage, garden cress, bok choy, broccoli, Brussels sprouts and similar green leafy vegetables). Vegetables are high in fiber which helps with the elimination of estrogens once they have been metabolized and excreted into the gut, but cruciferous vegetables also contain an added bonus substance called indole 3 carbinol that helps your body break down estrogen to be eliminated.
This does not mean that you should eat a vegetarian or vegan diet. This simply implies an emphasis on consuming a large quantity of vegetables and avoiding or limiting processed foods high in sugar, refined and simple carbohydrates. A whole food diet including organic vegetables and fruits, fresh meats, fish, poultry, and healthy fats with a limited amount of dairy, and grain can go a long way to helping reduce the estrogen burden in the body.
Stress Reduction: Addressing stress is important to balancing estrogen and progesterone levels. Acute and chronic stress can cause elevated cortisol production, with sustained levels leading to inflammation, muscle loss, increased gut permeability and other digestive health issues.
Mindfulness, mind-body exercises, meditation, prayer, enjoying healthy relationships and leisure activities can all be supportive means of reducing stress. In addition, cultivating awareness and habits that serve you in this area can go a long way to mitigating the effects of everyday stress.
In my work with clients, we discuss this in detail but ultimately, this is a very personal area and each of us must take stock of our circumstances and what changes or interventions might work best for us. Emphasis on the word “must”. I am known to frequently tell my clients, and friends…Stress will kill you faster than a bad diet. Trust me on this.
For example, dancing anytime, anywhere, makes me happy, releases tension and helps me let go of my burdens. I love dancing for stress relief. But my husband wouldn’t dream of adding dancing into his daily routine for stress relief, it would only stress him out more. He isn’t comfortable dancing for any old reason. On the other hand, if he is dancing with me, he is happy as a clam…and this relieves stress for both of us.
Know yourself, know the circumstances you are comfortable in, know what relaxes and calms you and experiment with new methods to relieve stress. You will be glad you did.
Support Detoxification: Supporting liver function is critical to ensuring detoxification of estrogen, as these the metabolic pathways for detoxification are located in the liver. The liver has many jobs and can often be overwhelmed by food chemicals and environmental toxins, alcohol, endotoxins and more.
While the liver was designed to be the place for detoxification in the body, the biochemical pathways must be supported nutritionally by a healthy, balanced diet, and supplementation when necessary. Including foods like avocado, almonds, berries, garlic, leafy greens, omega -3 fats, green tea, liver and other foods high in vitamins A, B, C, and E are all important to support liver health. Ensuring daily dietary intake of these foods can help optimize your detoxification and elimination of estrogens from the body.
Movement/Exercise: Movement throughout the day is important for hormone health. If you have a desk job or a job that offers few opportunities to move around, taking frequent movement breaks throughout the day can help with focus, energy and it can cut the cycle of insulin resistance that sitting for long periods creates. Getting up from your desk and moving around for a few minutes at 30-minute intervals is a great way to help your mental focus and your hormones. So, take go for a walk, do some jumping jacks or burpees, or just crank up your favorite feel good song like I do and just dance!
Exercise, particularly strength training has a positive impact on hormone balance in the body, especially for weight management. Strength training, HIIT training can help you to maintain and even build muscle mass, while Pilates and other lower intensity workouts, with focused breathing, can help manage stress while improving core strength, conditioning and flexibility.
What if progesterone levels are low? Or progesterone resistance is present?
If you are a perimenopausal woman, increasing progesterone levels naturally can be tricky. As you move closer to menopause, cycles become more irregular due to ovarian failure leaving progesterone levels fluctuating but consistently lower. For many women in the early stages of perimenopause, simply optimizing nutrition, exercise and managing stress can bring estrogen and progesterone into balance to eliminate symptoms of estrogen dominance.
As women progress through perimeopause, progesterone will continue to drop off. When this happens, I still recommend doing everything possible to bring estrogen to normal levels. If symptoms of estrogen dominance are still unmanageable, then some women may choose to supplement with bio-identical progesterone.
While I believe that bio-identical progesterone can be useful and effective, it is not within the scope of my practice, it is not my first recommendation for women in perimenopause who have not made nutrition and lifestyle changes to manage stress, optimize detoxification and support hormone production and metabolism.
With progesterone resistance, there are usually more complicated factors at play and I recommend an in depth analysis of hormone levels and addressing inflammation and it may warrant bio-identical progesterone supplementation with a qualified practitioner.
Conclusions: If you are a perimenopausal woman, the likelihood that you are or will suffer from estrogen dominance is high. Knowing what it is and what can be done about it can empower you to take the necessary steps that can influence your hormone system toward balance.
As you get closer to menopause, you will have natural fluctuations in your hormones but with the right support, the ebbs and flows don’t have to take you on a trip to “crazy town”.
If you are struggling with any the symptoms of estrogen dominance and haven’t tried, dietary changes, exercise, stress management or detoxification, yet. Read through the “What can you do about it?” section again. Choose an area to begin working on and make that your goal for the next month. Start small and record your progress. You will most certainly have setbacks but you can make progress. And if you don’t know where to start get help from a professional who can show you the way.
I’d love to help you take your first steps toward hormone harmony or just hear your feedback and find out more about your story in the comments section below.
This time in a woman’s life doesn’t have to be a struggle, it can be a great opportunity to care deeply for the amazing body you have been given so that you can continue to be the amazing woman that you are!