Root Causes of Estrogen Dominance

Let’s first start with the fact that estrogen (a sex hormone) is not a bad thing despite what you may read on tik-tok. The issue is when estrogen goes too high relative to progesterone (another sex hormone).

What is estrogen dominance?

In non pregnant cycling females, I will often check luteal phase (after ovulation til period starts) estrogen and progesterone to see the ratio of the two. Many advise to specifically check between day 19 to 21 of menstrual cycle and when the ratio starts to become more than 10:1 (estrogen: progesterone), this is problem territory often labeled as estrogen dominance. It is not a medical diagnosis and best to address this estrogen dominance because it is not good for your body. You can affordably self order an estrogen dominance panel here and have it drawn at any Quest labs.

Potential symptoms of estrogen dominance: 

• Fatigue
• Mood swings and irritability
• Breast tenderness and fibrocystic changes
• Irregular menstrual cycles
• Weight gain, especially around the abdomen
• Headaches
• Bloating
• Difficulty sleeping

Conditions associated with estrogen dominance: 

• Endometriosis
• Polycystic Ovary Syndrome (PCOS)
• Uterine fibroids
• Increased risk of breast and uterine cancers

There are many nutrition, lifestyle and environmental related stones to overturn when estrogen dominance is present and I explore this often with patients with the end goal to optimize hormone levels by supporting normal bodily function. As I say on my podcast: “Give the body what it needs and take out what it doesn’t.”

What can lead to estrogen dominance?

• Certain foods: Fruits and vegetables with insecticide or pesticide on them or meat injected with growth hormones. While not perfect, it is best to buy organic as it is much safer
• Gut dysbiosis: When the gut microbiome goes out of balance, a specific enzyme (beta glucuronidase) can increase. The enzyme increasing can facilitate estrogen to reabsorb into the bloodstream thus increasing its measurable level
• Mold: Moisture and humidity indoors can lead to indoor mold growth which is a top biotoxin in Americans homes that can make us sick when its present in clinically significant amounts. Mold spores make mycotoxins which are toxic to the human body. Mycotoxins can bioaccumulate in the body and have strong estrogenic activity.
  • Check your home for mold by ordering an ERMI kit #1 on this website; it is an easy at home dust kit. If elevated with a score above a 5, call a mold inspector to find source, why it grew and pursue remediation.
• Certain Medications: Oral birth control is one very common example as many contain synthetic forms of estrogen.
• Tap water: The water supply in the USA consists of harmful and unwanted chemicals like endocrine disrupting compounds and heavy metals.
  • Visit the Environmental Working Group to see the tapwater database and check out your zip code’s status.
  • Drinking aggressively filtered water is so important – Reverse osmosis (my fav system here) or distilled only for safety, and get your minerals elsewhere. It is more important to not drink arsenic, and consume minerals from other places or get a remineralizer if using RO.
• Excess body fat:  As fat mass increases, so does aromatase expression and consequently estrogen levels also increase. Losing excess weight can be helpful
• Perfume and other personal care products: Most of the human-made personal care products in the USA given the weak standards have obesogens that mimic estrogen and create an imbalance in the body. Important to avoid parabens, phthalates, and benzophenones, and perfumes or fragrances (which many harmful substances can legally “hide” behind the word fragrance). I use 100% organic personal care products from here the meet the EU standards. It even went viral on tik tok for their performance and affectionally became called organic “botox in a bottle.”
• Stress: Stress downregulates progesterone so the ratio of progesterone to estrogen becomes skewed
• Heavy metal bioaccumulation: Many heavy metal have estrogen like activity. Also when heavy metals accumulate, the methylation pathway (in liver detoxification) become impaired and your body is unable to metabolize estrogen as well. Heavy metals are commonly found in tap water, fish, air.
• Plastics: Modern day society use plastics everywhere. Plastics contain xenoestrogen that absorb into the food (think microwaving food in plastic containers) and water (think water bottles).
• Excess Histamine: Mast cells, which store and release histamine, have estrogen receptors. When estrogen levels rise, it can trigger these cells to release histamine. Histamine, in turn, can stimulate the ovaries to produce more estrogen, creating a vicious cycle. Ultimately have to figure out what is triggering the mast cells.

There are many functional tests available to help gather more information, and below is a non-exhaustive list. Depending upon the situation, I will often order:

• Bloodwork or DUTCH test to see current hormone levels for a baseline and this functional test is in the scope of practice for a RD when used in monitoring of nutrition and lifestyle related interventions
• GIMAP test to assess gut microbiome
• Toxin testing – many labs can be self ordered here
• Urine mycotoxin testing and/or CIRS panels
• ERMI Kit 1 to check the dust of the home to see if the home levels of mold are too high (5 or higher is considered health deterring levels and mold is estrogenic)
• Screen for nutrient deficiencies (to see levels as these should be optimized to help with phase 1 and phase 2 liver detoxification)
• Ask your doctor to check labs: whole histamine, serum tryptase

Testing and not guessing is so important so you can know what you are dealing with, and this prompts action and tailored interventions when working with your healthcare team. This blog is the tip of the iceberg on the topic of estrogen dominance and reasons it can happen.

Hormones like estrogen, when abnormal, are typically messengers of something deeper that is off. It is wise to find the dysfunction and then correct it. I can help with this whole process when there is bodily dysfunction, but this is not a replacement for medical management and evaluation which I also encourage.

Schedule a consult package if you would like one on one assistance.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414873

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070283

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237358

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511997

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871760

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459580

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996329

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5316405

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230625

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331505

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731392

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3807508

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