Estrogen Dominance – Is It Real?
What’s critical here is the role of progesterone, which “opposes” the estrogen by helping the body break it down into metabolites that are absorbed and removed in the process. Estrogen stimulates tissue growth, and progesterone signals the body to slough it off.
The original concept of estrogen dominance was very simple. Dr. Lee argued that the first sign of menopause is a drop in progesterone production (not estrogen deficiency!). Without enough “opposing” progesterone, estrogen levels stay unnaturally high in the second half of the menstrual cycle. This causes discomfort in a great many women and can lead over time to some severe health consequences.
The history of HRT contains a tragic example of the effects of unopposed estrogen. For many years after its creation, the synthetic estrogen drug Premarin was prescribed to women without any accompanying progesterone. The result was an epidemic of uterine cancer. This eventually led to Premarin being prescribed in tandem with a synthetic progesterone called Provera to protect the uterine lining. Much more recently these two were bundled together and marketed as a new combination drug called Prempro. For decades now the combination of Premarin with Provera has been the most widely prescribed synthetic HRT in the world.
Over time, Dr. Lee’s concept of estrogen dominance evolved to promote another compelling argument: that our overall estrogen levels (in women and men) are too high because of xenoestrogens — manmade chemicals in the environment that mimic estrogen in our bodies and act as endocrine disruptors even at minute concentrations.
Scientific study of wildlife — specifically, frogs and fish — is proving this unfortunate reality to be without doubt. In an interesting twist, researchers worldwide have observed that fish in our lakes and rivers are actually switching gender due to the high levels of effluent estrogens. Even though mainstream media has only begun to recognize this as “news,” experts have been discussing the problem of pharmaceutical pollution for over 25 years, and have known about “gender-bent” fish for more than ten years!
Some surmise these changes to be caused in part by excessive levels of steroids — largely excreted by humans using birth control pills and Hormone Replacement therapy (HRT). Our water treatment facilities are not designed to remove hormonal pollutants. Myriad studies indict environmental estrogens as the cause of reproductive abnormalities in small life forms. So it should come as no surprise that these and other widespread contaminants are now suspected of negatively impacting humans as well, contributing to the problems of estrogen dominance and infertility.
As evidence, it’s often noted that women in Western Europe and the US have estrogen levels that are much higher than women in underdeveloped countries. Many experts link these high levels of estrogen with the rise in breast cancer, autoimmune diseases, infertility and other health issues. They question whether or not xenoestrogens are the cause.
The truth about estrogen dominance as related to premenopause and menopause
While we all owe a huge debt of gratitude to Dr. Lee for his groundbreaking work on the importance of progesterone in relation to estrogen, to my mind the concept of estrogen dominance is too simplistic, as is the concept of progesterone supplementation.
Since Dr. Lee’s death in October 2003, we have witnessed huge leaps in our biochemical understanding. If he were still with us, I’m sure he would feel vindicated to learn that the latest research indicates many women actually do have normal levels of circulating progesterone. Just as Dr. Lee himself noted, what often throws the balance off is an excess of estrogen, caused by environmental, dietary, and lifestyle factors.
What this all means is that the theory of estrogen dominance is very real, but its significance lies in the overall ratio of estrogen to progesterone — and this ratio is an individualized and dynamic one. Of all women experiencing symptoms of estrogen dominance, some with low levels of progesterone may do very well with progesterone supplementation, whereas others with normal progesterone levels may be better off focusing on changes that can normalize their estrogen or testosterone levels. How do you know where you fit in? The only way to really tell is to have your hormone levels checked and take action from there.
It is true that estrogen is often too high relative to progesterone. Most of us who have had PMS are familiar with this temporary form of excess estrogen. You can see by the chart above how progesterone levels gradually fall during the course of a regular menstrual cycle. In some women this drop may be more precipitous and cause symptoms of PMS.
During premenopause it’s common for estrogen levels to decrease slowly while progesterone levels plummet — a natural result of fewer ovulations, fewer burst follicles and less progesterone. This can cause many of our worst symptoms. See our article on irregular periods and menstrual cycles to learn more.
Calling this state “estrogen dominance” is catchy but misleading. It implies there is one problem, which isn’t true; and not all women experience the condition anyway. And it implies there is one solution, which also isn’t true. Most of the tens of thousands of women we have treated for premenopausal symptoms have suffered not from simple estrogen dominance but from a more fundamental disruption of the body’s ability to maintain hormonal balance. There are usually multiple causes, including stress, emotional factors, and the estrogen-like chemicals in our environment called xenoestrogens.
The truth is, healthy hormonal balance is complicated. It isn’t just a matter of not enough progesterone. That’s a little like arguing that menopause is caused by not enough estrogen. As you can see from the chart below showing how hormones are made in your body, there are lots of players out on the dance floor at any given time.
There’s no simple test for estrogen dominance. But if you have severe symptoms of PMS, premenopause or menopause that don’t respond to a program of increased support for your body within a month or two, you may have persistently higher than normal levels of estrogen (click here to take our Hormonal Health Assessment). Let’s talk about why it’s important to pay attention to these symptoms.
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What are the health consequences of estrogen dominance?
Another of Dr. Lee’s contributions was to raise women’s awareness of the profound connections between hormonal imbalance and health.
When estrogen levels are high in relation to our progesterone we experience many severe symptoms, among them anxiety, breast tenderness, cyclical headaches or migraines, depression, digestive issues, fuzzy thinking, palpitations, food cravings, irregular bleeding, water retention, weight gain and more.