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Estrogen Dominance: Losing the Healthy Hormonal Balance

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Insomnia, mood swings, irregular bleeding, irritability, anxiety, water retention, low thyroid symptoms, depression, fat gain (especially around hips, thighs, and abdomen), fibrocystic breasts, uterine fibroids, and low sex drive.

If you’re a woman approaching middle age, there’s a good chance that you are experiencing one or more of these symptoms. Often my patients ask me, “Am I going crazy? Why does it seem like my body is rebelling against me?” The answer may be as simple as having too much estrogen in your system—a condition known as estrogen dominance.

Most women are aware that as they enter perimenopause their bodies begin to produce less estrogen. So how is it possible that along with that decrease the body may actually have too much estrogen?

The answer to that question is that estrogen dominance is relative to a progesterone deficiency. A decade or so before actual menopause the woman may stop ovulating, which causes a lack of production of progesterone from the ovaries. Menstrual cycles will continue even without the progesterone so there is no awareness that the lack of progesterone is causing symptoms of hormonal imbalance. In perimenopause and the menopausal and post-menopausal years estrogen levels drop 40-60%, but without ovulation, progesterone output drops to nearly zero.

In Dr. John Lee’s book What Your Doctor May Not Tell You About Menopause, he writes: “Estrogen dominance is a condition in which a woman can have deficient, normal, or excess estrogen, but in the absence of ovulation, little or no progesterone to balance its effects upon the body. When estrogen is dominant and progesterone deficient, estrogen becomes toxic to the body.” * It’s this hormonal imbalance that can result in many of the frustrating symptoms that women associate with menopause.

However, it’s not just middle-aged women who can suffer from estrogen dominance. Younger women can experience it, too, in the form of premenstrual syndrome (PMS). The hormonal imbalance in this case may be linked to toxins, contraceptive use, stress, extremes in diet and exercise, or xenoestrogens found in foods.

Saliva hormone testing combined with a thorough history of symptoms can accurately determine an imbalance of hormones. The results of specific hormone testing coupled with a patient’s symptoms history will provide a basis for an individualized treatment program for the patient. (I’m a real patient advocate when it comes to choosing a testing laboratory—the prices and quality of tests can vary greatly and I spend a good deal of time “comparison shopping” before ordering labs for my patients.)

Once a patient’s individual needs have been assessed and a treatment protocol has been started, I’ll closely monitor a patient’s hormone levels with follow-up testing. The goal then is to achieve the proper balance of estrogen and progesterone by supplementing with bioidentical hormone replacement therapy (if needed) and other treatments. The success of the treatment, or course, is measured not only by the hormone levels in the body but also by a reduction of the symptoms that caused the patient to seek help in the first place!

* Lee, John R., MD, and Hopkins, Virginia. What Your Doctor May Not Tell You About Menopause: The breakthrough book on natural progesterone. New York: Warner Books; 1996.

Dr. Tina Marcantel is a naturopathic doctor practicing in Gilbert, Arizona. For more information about her practice and to read many more articles by Dr. Marcantel, please visit her website at http://www.drmarcantel.com.

Add a Comment7 Comments

EmpowHER Guest

Great post about estrogen dominance. Thanks for sharing this to us.

September 24, 2012 - 7:41pm
EmpowHER Guest

I live in South Australia & found it hard to convince my Doctor to prescribe Natural bio identical progesterone for me - in Australia a prescription is needed ,as far as I know there is only one Chemist in Adelaide who makes up the cream - my Chemist had to get them to send some to them. I have started using 1303 BHRT COMPOUND Natural Progesterone 2% in Macadamia cream - 1 ml daily, it cost $ 57 for 100g. I feel that the container will go too fast, so I was rubbing in only 2 units daily, now I am trying 2 units twice daily. I have not had a blood or saliva test. I read the book 'Unlock your hormones ' by Dr Graeme Williams. My body is my teacher - dosing by my instints ! I don't like chemicals, artifical,synthetic additives, etc, I believe Holistic Health is best where possible. I am feeling a lot better and it's only been a couple weeks of use. I had a hysterectomy ( I still have my ovaries )a couple of years ago, I am 55 years old & have suffered bad menapause symptoms for about 5/6 years.

April 24, 2009 - 2:36pm
EmpowHER Guest

Great Article. I'm glad to have articles to refer friends to when they are facing these issues.

Thank you for writing and I'm looking forward to seeing more.~Charlotte Salafia

April 19, 2009 - 12:55pm


There are other naturopathic doctors that share similar views.

You can find an ND by looking for AANP (American Association of Naturopathic Physicians) online.
They have graduated from a four year graduate level medical program and have passed medical boards exam for naturopathic doctors.

Thanks for your inquiry.

Dr Marcantel

April 16, 2009 - 7:41pm

Dr. Marcantel,

I agree, this is fascinating information and would actually explain a lot of things that I've been experiencing the last few years.

Would other naturopathic doctors share similar views, for the most part? And how would someone outside of Arizona (I live in Dallas, for instance) go about finding someone they trust to do this testing?

April 15, 2009 - 8:19am
EmpowHER Guest

This is great info. What hormone levels are checked with the saliva test?

April 12, 2009 - 3:12pm
(reply to Anonymous)

Progesterone, estrogen, testosterone, DHEA and cortisol levels are the main ones. There are others that can be added as needed.

April 13, 2009 - 7:19am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.



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