What is Estrogen Dominance?

by | Aug 1, 2020

Image of Endocrinology text book and estrogen diagrams

When searching for information about hormone imbalances, it is likely you’ll come across the term “Estrogen Dominance”.

Estrogen dominance has emerged as a buzzword over the past ten years, and is used to describe a hormonal imbalance commonly observed in women. It should be noted that estrogen dominance is not a medical diagnosis, but rather an umbrella term that encompasses the symptoms that occur when estrogen is elevated relative to progesterone – it’s balancing counterpart.

While estrogen dominance is not a standalone condition, it is a pattern that many functional medicine practitioners observe in practice.

This video provides a summary of “estrogen dominance”:




Understanding Estrogen and its Metabolites

Estrogen is a group of hormones that are important for our menstrual health and fertility, protects our bones and supports cognitive health. It is the hormone that keeps us feeling youthful and sexy. While having adequate estrogen levels are important, too much estrogen can cause issues.

The symptoms of estrogen dominance in women and people who menstruate include:

  • Short or irregular menstrual cycles
  • Painful periods
  • Mood swings and irritability
  • Cyclic breast tenderness
  • Heavy periods
  • Breast cysts
  • Anxiety
  • Weight gain


For men:

  • Enlarged breasts
  • Sexual dysfunction
  • Infertility

Why Does This Happen?

The truth is: there is not one single cause of “estrogen dominance”, there are multiple. Elevated estrogen activity can happen secondary to certain conditions (i.e. PCOS), or may be a result of normal fluctuations in hormones with age (i.e. perimenopause).

Estrogen dominance does not refer to medical conditions that cause gross elevations in estrogen, such as aromatase excess syndrome or adrenal cancer, but rather encompasses the hormonal imbalance that is influenced by diet, lifestyle, and natural hormonal fluctuations.

Some of the proposed or observed causes of estrogen dominance include

In general:

  • Sub-optimal hormone metabolism
  • Gut dysbiosis and low fibre diet
  • Elevated estrogen exposure
  • Alcohol consumption



  • Failure of ovulation (i.e. due to PCOS)
  • Perimenopause



  • Weight
  • Inflammation

How To Determine If You Have Estrogen Dominance.

If you suspect that you may be experiencing symptoms of estrogen dominance, it is important to investigate with a health-care provider. The multiple causes of estrogen dominance further underline the need for individualized care.

This starts with identifying WHY you’re experiencing these symptoms. Is it poor estrogen metabolism? Is it PCOS? Are you in perimenopause? Certain conditions should be ruled out, or diagnosed and treated.

The functional medicine approach to addressing estrogen dominance starts with identifying the root cause, using comprehensive testing, and building a plan to balance hormones and restore function within the body.

The beauty of addressing estrogen dominance from a functional medicine approach is that we have a lot of tools to use, which can be gentle and effective.

If you’re interested in further investigating your hormones, you can book a complimentary 15-minute meeting, to ask questions about my approach in balancing hormones.

Further reading:

    1. Miao, S., Yang, F., Wang, Y., Shao, C., Zava, D. T., Ding, Q., & Shi, Y. E. (2019). 4-Hydroxy estrogen metabolite, causing genomic instability by attenuating the function of spindle-assembly checkpoint, can serve as a biomarker for breast cancer. American journal of translational research, 11(8), 4992.1.

    2. Samavat, H., & Kurzer, M. S. (2015). Estrogen metabolism and breast cancer. Cancer letters, 356(2), 231-243.

    3. Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: physiological and clinical implications. Maturitas, 103, 45-53.

    4. Aubertin-Leheudre M, Gorbach S, Woods M, Dwyer JT, Goldin B, Adlercreutz H. Fat/fiber intakes and sex hormones in healthy premenopausal women in the USA. J Steroid Biochem Mol Biol 2008;112: 32–9.

    5. Recommended Daily Fibre Intake. (2019, April 08). Retrieved June 30, 2020, from https://cdhf.ca/health-lifestyle/recommended-daily-fibre-intake/

    6. Quagliani, D., & Felt-Gunderson, P. (2017). Closing America’s fiber intake gap: communication strategies from a food and fiber summit. American journal of lifestyle medicine, 11(1), 80-85.

    7. Muti P, Trevisan M, Micheli A, et al. Alcohol consumption and total estradiol in premenopausal women. Cancer Epidemiol.Biomarkers Prev. 1998; 7:189–193. [PubMed: 9521430]

    8. Noth, R. H., & WaIter Jr, R. M. (1984). The effects of alcohol on the endocrine system. Medical Clinics of North America, 68(1), 133-146.

    9. Yilmaz, B., Terekeci, H., Sandal, S., & Kelestimur, F. (2019). Endocrine disrupting chemicals: Exposure, effects on human health, mechanism of action, models for testing and strategies for prevention. Reviews in Endocrine and Metabolic Disorders, 1-21.

    10. Crinnion, W. J., & Pizzorno, J. E. (2018). Clinical Environmental Medicine-E-BOOK: Identification and Natural Treatment of Diseases Caused by Common Pollutants. Elsevier Health Sciences.

    11. Siiteri, P. K. (1987). Adipose tissue as a source of hormones. The American journal of clinical nutrition, 45(1), 277-282.

    12. Berga, S. L. (2019). Stress-induced anovulation. In Stress: Physiology, Biochemistry, and Pathology (pp. 213-226). Academic Press.