Why the Rise in Estrogen Dominance?

The sex hormone estrogen is in a delicate balance with progesterone. Even when estrogen levels are low (as in menopause, or in the second half of the menstrual cycle), if the progesterone levels are even lower, patients can still suffer estrogen dominance.

In women, estrogen dominance can cause:

• PMS: irritability, weepiness, anxiety, depression, mood swings
• Breast tenderness
• Severe menstrual cramping
• Heavy, prolonged bleeding (menorrhagia)
• Spotting between cycles
• Thick clotting in blood
• Acne
• Hot flashes and night sweats
• Water retention
• Fibrocystic breasts
• Fibroids
• Migraines
• Endometriosis

In men, low testosterone may also present with estrogen dominance, or estrogen dominance can present without low testosterone symptoms, looking something like this. 

Causes of Estrogen Dominance

Natural estrogen can be produced by:

• The ovaries
• The adrenals, from the parent hormone DHEA (in both men and women). DHEA is also a parent hormone for testosterone.
• Conversion from testosterone, via an enzyme called aromitase found in adipose tissue (fat cells)
• Even if you are not overproducing estrogen from any of these sources, you may have trouble eliminating it. This may occur at the level of your liver, or your intestines.

Unnatural estrogens, also called xenoestrogens, can be found in great abundance in our modern world. These hide in:

• soft plastics (phthalates)
• canned food (bisphenol A)
• pesticides (dioxins, atrazine, organophosphates)
• agriculture industry dairy and meat (dioxins, growth hormones)
• foam furniture (polybrominated biphenyl ethers)
• carpeting (polybrominated biphenyl ethers)
• metal amalgams (mercury)
• non-stick cookware (perfluorinated chemicals)
• water-resistant coatings (perfluorinated chemicals)
• cleaning products (glycol ethers)

…just to name a few.

For women, the cause of estrogen dominance may be any of the above. For men, the most common causes are xenoestrogen exposure, and conversion of testosterone to estrogen via aromitase. 

Treatments for Estrogen Dominance

The good news is, a lot of the treatments are basic healthy steps that you should take anyway. 

1. Cut out the white carbs and the sugar. There are three reasons for this. First, sugar turns into fat, and fat stores aromitase. Less aromitase = less estrogen. The second is because most of the xenoestrogens listed above are fat-soluble; the less fat you have, the less you can store. The third is because white carbs have been stripped of their nutrients, and therefore not only are they empty calories, they actually cost your body nutrients to metabolize them; this can set you up for malnutrition at the micronutrient level, which can worsen estrogen dominance.
2. Lose fat. Same two reasons as above: this will lower both your aromitase and your xenoestrogens. You can do this effectively by cutting out white carbs and sugar, and by increasing your cardio exercise.
3. Gain muscle. This is especially true for men, for two reasons: weight-bearing exercise stimulates testosterone release (as this is necessary to help build the muscle in the first place), and the more muscle you have, the faster your metabolism becomes, which in turn burns fat (see #2).
4. Inhibit aromitase. You can also do this directly, via certain micronutrients, botanicals, and supplements. For instance, a great choice is zinc.
5. Avoid xenoestrogens. Your liver is remarkably efficient at clearing out toxins. Choose your dirty dozen fruits and veggies organic and uncanned; choose free range and organic dairy and meat, rather than agriculture-industry animal products; leave your windows open when you can, and get a good air filter for your home; swap out your plastic storage containers for glass or pyrex; swap out your cookware for stainless steel; and choose truly clean cleaning products and skin products.
6. Detox your liver. What you cannot avoid and your liver cannot effectively eliminate will have to be flushed out. Skim to the bottom of this article for more on manual approaches to detoxification. This tends to be necessary for more obviously toxic patients.
7. Support the adrenals. The more you support your body’s production of adequate cortisol, the more emotionally and hormonally balanced you will be.
8. Balance production from the ovaries. In my experience, this is best done with appropriate botanical supplementation.
9. Balance the ratio of hormones directly. In patients who are very symptomatic, often the best approach is to augment the progesterone with bioidentical hormones to balance out the estrogen.