Estrogen dominance

The term "estrogen dominance" was coined to describe the 'adverse' symptoms often encountered by men and women if they have a naturally high level of estrogen or, in the case of women, have been on HRT (hormone replacement therapy) or the contraceptive Pill for any length of time and therefore have low progesterone levels.

Initially progesterone has a stimulatory effect. This is because progesterone activates the oestrogen receptors so making oestrogen the dominant hormone which makes many men and women feel worse.

With progesterone therapy, progesterone gradually becomes the dominant hormone and symptoms begin to ease. Some women never experience estrogen dominance, in others it can take several days, whilst in others it can last longer. Much depends on the amount of excess oestrogen that is present.

Men can also experience oestrogen dominance when first using progesterone.

It is essential to use enough progesterone, about 100-200mg/day, to overcome the excess oestrogen. Many women use too little, 20-40mg/day, so progesterone is always in the stimulation mode. This leaves them in a permanent state of oestrogen dominance.

If symptoms are severe, for instance heavy continual bleeding or debilitating hot flushes, up to 400mg/day will be needed.

Normally men will benefit from 10-20mg/day progesterone, but if a higher than normal amount of oestrogen is present, it's advisable to use up to 100mg/day.

It is easy enough to reduce the amount of progesterone to the optimum level, once symptoms have resolved. The reduction should always be done slowly over several weeks.

Please bear in mind that stress drops progesterone levels sharply, so symptoms can come back which puzzles many. Increase the amount used over any stressful time. Large meals also drop progesterone levels, due to an increased clearance rate of the hormone.

Dark, gloomy days and winter reduce progesterone levels, because of a reduction in vitamin D. Please have a vitamin D test done as low levels reduce the benefits of progesterone. See here for home tests.

Conversely supplemental estrogen can initially make us feel better. The reason for this is oestrogen activates the progesterone receptors so making progesterone the dominant hormone, but it wears off as estrogen becomes the dominant hormone.

This is one of the reasons so many women keep changing their HRT script. There are some women who do not suffer any adverse affects, but the risks of using HRT or the contraceptive pill for any length of time are not worth it. Please see the links below.

Estrogen dominance is characterized by any of the following symptoms. These symptoms can also occur in women when first using progesterone. In men too, aside from the obvious women's problems...

aches and pains
anger
bleeding which comes either earlier or later than usual
bloating/weight gain due to water retention
breast tenderness
bruising
constipation
dizziness
headaches
hot flushes
hypoglycaemia
increased appetite/cravings
irritation
migraines
mild depression
mood swings
muscle weakness
nausea
skin problems/acne/melasma
spotting
tiredness/chronic fatigue

If you experience any of these symptoms then your choice is to either...

increase the dose and persevere with the symptoms, or
reduce the dose considerably to begin with and then gradually increase it over a month or two. This will understandably take longer to resolve symptoms

The Pill and HRT contain estrogen and synthetic progesterone (which is commonly called 'progestin'). Progestins cause natural progesterone levels to drop, leading to many of the above symptoms.

If you are on either HRT or a contraceptive pill and you wish to come off it, it's far gentler on the body to do this gradually in conjunction with progesterone, please see here.

Avoid...

large meals (due to the increased metabolic clearance rate of progesterone)
all forms of oestrogen
oxidised fats, (ie margarine, refined oils, and fried foods, in particular fried animal protein)
pasteurised, homogenised milk
all non-organic dairy products and animal protein. Factory farms use growth hormones and especially estrogen as it causes a rapid increase in fat deposits
tap water, which is now contaminated with prescription drugs, including oestrogen from the Pill and HRT, plus the oestrogen mimics generated by industry. Drink only filtered water

Read all labels on containers, especially those for food and cosmetics. Look for natural alternatives to body care products, many contain high levels of endocrine disruptors and carcinogens, particularly the sunscreens.

For more information on natural sunscreens please see here.

More information

Peri-menopause

Menopause

Contraceptives Research Papers

HRT Research Papers

HRT

For a comprehensive list of symptoms please click here.

Learning more about how to use progesterone cream can help lessen the effects of estrogen dominance.

References

Nature 423, 545-550 (29 May 2003) Modulation of oestrogen receptor signalling by association with the activated dioxin recep

Molecular Cell, Volume 8, Issue 2, 269-280, 1 August 2001 Progesterone Receptor Contains a Proline-Rich Motif that Directly Interacts with SH3 Domains and Activates c-Src Family Tyrosine Kinases

Molecular Endocrinology, 2000, 14 (7):972 Sp1 Binding Sites and An Estrogen Response Element Half-Site Are Involved in Regulation of the Human Progesterone Receptor A Promoter

Journal of the Society for Gynecologic Investigation, Vol. 7, No. 1 suppl, S33-S37 (2000) Mechanisms of Action and Cross-Talk Between Estrogen Receptor and Progesterone Receptor Pathways

Human Reproduction, Vol. 15, (Suppl. 3), pp. 48-56, 2000 Heterogeneity of progesterone receptors A and B expression in human endometrial glands and stroma

Molecular and Cellular Biology, March 1999, p. 2251-2264, Vol. 19, No. 3 Progesterone Inhibits Estrogen-Induced Cyclin D1 and cdk4 Nuclear Translocation, Cyclin E- and Cyclin A- cdk2 Kinase Activation, and Cell Proliferation in Uterine Epithelial Cells in Mice

Molecular Human Reproduction, Vol. 5, No. 6, 559-564, June 1999 Oestrogen receptor and RNAtor A expression in human endometrium throughout the menstrual cyclean>

Molecular Endocrinology, 1999, 13 (6): 829-836 Hypothesis: Progesterone Primes Breast Cancer Cells for Cross-Talk with Proliferative or Antiproliferative Signals

Steroids Volume 64, Issues 1-2, 2 January 1999, Pages 168-175 Identification of functional binding sites for progesterone in rat Leydig cell plasma membrane

Gynecol Endocrinol. 1998 Feb;12(1):29-34 Effects of estradiol and an aromatase inhibitor on progesterone production in human cultured luteal cells

NATURE |VOL 395 | 10 SEPTEMBER 1998 Ligand binding and co-activator assembly of the peroxisome proliferator-activated receptor-g

Endocrinology 1997, Vol. 138, No. 7 2900-2908 Transcriptional Activities of Estrogen and Glucocorticoid Receptors Are Functionally Integrated at the AP-1 Response Element

Journal of Cancer Research and Clinical Oncology Issue Volume 122, Number 12 / December, 1996 Effect of oestradiol and insulin on the proliferative pattern and on oestrogen and progesterone receptor contents in MCF-7 cells

Molecular Endocrinology, 1993 Vol 7, 1541-1550 Mutant androgen receptor detected in an advanced-stage prostatic carcinoma is activated by adrenal androgens and progesterone

Cell, Volume 69, Issue 4, 703-713, 15 May 1992 The mechanism of RU486 antagonism is dependent on the conformation of the carboxy-terminal tail of the human progesterone receptor

EMBO J. 1988 November; 7(11): 3385, 3388 Genomic organization of the human oestrogen receptor gene

Biology of Reproduction February 1, 1988 vol. 38 no. 1 63-69 Progesterone abbreviates the nuclear retention of estrogen receptor in the rat oviduct and counteracts estrogen action on egg transport

Am J Physiol Endocrinol Metab 240: E43-E46, 1981 In vivo cell nuclear binding of 17 beta- [3H]estradiol in rat adipose tissues

Journal of Steroid Biochemistry Volume 6, Issues 3-4, March-April 1975, Pages 501-509 Oestrogen-induced progesterone receptor in human uterus