Estrogen Dominance in Menopause

Estrogen dominance in menopause is when the body has too much estrogen compared to progesterone. Ideally, estrogen and progesterone should exist in perfect ratio to one another. 

Estrogen dominance can happen during reproductive years but worsens during perimenopause and menopause when the ovaries stop making estrogen and progesterone. As a result, both estrogen and progesterone fall to low levels. While it is true that estrogen levels are low during menopause, if progesterone levels can decrease at a faster rate than estrogen, you can still become estrogen dominant.

The issue with this imbalance is that it can worsen hot flushes, night sweats, weight gain, bloating, irritability, mood swings, and others symptoms of menopause (2, 3).

It is also important to note that hormones fluctuate, which is not a steady decline.

Symptoms of Estrogen Dominance in Menopause

Women may experience the following signs of estrogen dominance:

  • Bloating
  • Weight gain
  • Breast tenderness
  • Decreased sex drive
  • Vaginal discomfort 
  • Irregular periods
  • Heavy periods
  • Fertility problems
  • Mood swings
  • Irritability 
  • Headaches
  • Anxiety
  • Memory problems
  • Brain fog
  • Hair loss
  • Cold feet or hands
  • Poor Sleep
  • Fatigue
  • Hot flashes
  • Night sweats

Causes of Estrogen Dominance in Menopause

Estrogen dominance during menopause can happen for multiple reasons, but three common reasons are the transition to menopause, chronic stress, and poor digestion.

Transition to Menopause 

Estrogen hormone and supplements

During perimenopause, estrogen and progesterone begin to fluctuate. As a result, levels of estrogen and progesterone may be higher or lower than usual for lengths of time during perimenopause.

Because of these fluctuations in hormones, it is common for women to find themselves in states of estrogen dominance.

Once a woman reaches menopause, both estrogen and progesterone levels drop notably. However, while estrogen levels are low during menopause, you can still become estrogen dominant if progesterone levels decrease faster than estrogen.

Many unpleasant symptoms occur when women are estrogen dominant. As a result, quality of life and health are impacted (1, 2).

Chronic Stress

Chronic stress can be a reason for estrogen dominance in menopause. During periods of chronic stress, the body produces a lot of cortisol from the adrenal glands. Indeed, cortisol is often thought of as the “fight or flight” hormone, as it helps our body manage stress. Like estrogen, progesterone, and testosterone, cortisol is a steroid hormone produced in the adrenals.

Cortisol requires progesterone as a building block, and as the demand for cortisol increases due to chronic stress, progesterone levels can begin to decrease – potentially leading to estrogen dominance (3).

Constipation

When the digestive system is healthy, the body eliminates estrogen through a bowel movement. However, If you experience frequent constipation, your estrogen levels can rise. Therefore, treating constipation through food and lifestyle is vital for proper estrogen elimination and balance. 

Unfortunately, during perimenopause and menopause, constipation is common.

Diagnosis of Estrogen Dominance in Menopause

Your doctor can diagnose estrogen dominance by performing a blood test to collect estrogen and progesterone levels. Using these results, your doctor can provide a diagnosis of estrogen dominance (2, 4, 5).

Symptoms of estrogen dominance look similar in perimenopause, menopause, or premenstrual syndrome (PMS).

Complications of Estrogen Dominance in Menopause

Estrogen dominance can put you at risk for other conditions. For example, excess estrogen levels are a risk factor for endometrial, breast, and ovarian cancer.

Additionally, high estrogen levels may put you at risk of blood clots and stroke. Estrogen dominance is also related to thyroid dysfunction (6, 7).

Lifestyle Treatment for Estrogen Dominance in Menopause

Various food, lifestyle, and medical treatments are available to treat estrogen dominance in menopause.

Decrease Stress

Chronic stress can lead to surges in cortisol, causing estrogen dominance. Here are a few things that can help distress:

What are you doing for yourself today?
  • Deep-breathing
  • Self-nurturing activities that make you feel relaxed
  • Exercise
  • Yoga, pilates, and other mind-body exercises
  • Relaxation and stress-reduction activities 
  • Meditating
  • Journaling
  • Music
  • Hobbies
  • Social activities 
  • Massage therapy
  • Therapy
  • Sleep

Nutrition for Estrogen Dominance

Good eating habits can help balance your hormones and feel great overall. Here are what you want to do to decrease the symptoms related to estrogen dominance in menopause:

Increase Ease Your Fiber Intake

Fiber promotes the breakdown and excretion of estrogen (8). You can find fiber in vegetables, fruits, whole grains, legumes, nuts, and seeds.

Drink Enough Water

Proper hydration can decrease constipation, a common cause of estrogen dominance.

Eat Foods High in B Vitamins

B6, folate (B9), and B12 can help with hormone balance. Foods that contain these B vitamins include chickpeas, bananas, avocado, nuts, leafy greens, peas, asparagus, meat, nutritional yeast, plant milk, and cereals (9).

Eat More Cruciferous Vegetables

Cruciferous veggies like broccoli, brussels sprouts, and cabbage help break down estrogen. In addition, sulforaphane, a nutrient found in veggies like broccoli sprouts, supports hormones. Last, cruciferous veggies are a great source of fiber (10).

Mediterranean Diet

The Mediterranean can help you balance hormones because it is naturally anti-inflammatory, rich in fiber, and contains a variety of vitamins and minerals. In addition, the Mediterranean diet has a low intake of meat and dairy products. Instead, the diet is high in vegetables, fruits, legumes, grains, nuts, beans, fish, and unsaturated fats like olive oil (11).

Limit Alcohol

Alcohol increases estrogen levels. Furthermore, alcohol is guilty of poor sleep leading to other causes of high estrogen levels.

Promote a Healthy Gut by Eating Prebiotic and Probiotic Foods

An unhealthy gut can create estrogen dominance by preventing the excretion of estrogen from the body. Therefore taking care of your gut health can balance your estrogen levels.

Making the changes mentioned above can help you with the healing process but consuming prebiotics and probiotics can speed the process.

Maintain a Healthy Weight

A healthy weight helps decrease the risk of insulin resistance, which can increase estrogen levels (12).

Fiber is a great source of prebiotics

A Good Night’s Sleep

Sleeping well can help you improve most menopause symptoms. While this is easier said than done, there are many things that you can do to help you sleep better. For example, the following lifestyle changes can help:

  • Go to bed and wake up at consistent times on weekdays and weekends
  • Avoid long naps (over 20 minutes)
  • Relax and wind down before sleep with a book or bath
  • Avoid using the television, computer, or phone 2 hours before going to bed 
  • Keep your bedroom at a comfortable temperature 
  • Exercise in the morning or afternoon
  • Avoid large meals before bed
  • Avoid caffeine in the afternoon or evening
  • Limit or avoid alcohol

Other Lifestyle Changes

Similar to diet, lifestyle changes can help with hormone balance.

  1. Remove endocrine disruptors: these are chemicals that are similar to or interfere with hormones. Xenoestrogens have estrogen-like effects on the body. Xenoestrogens are found in skincare products like parabens. Additionally, they are found in processed foods, BPA plastics, chlorine-containing household products, and insecticides. Purchase glass cookware and replace any household products (8).
  2. Exercise in moderation: moderate exercise helps you maintain a healthy weight and manage your mood. 

Hormone Replacement Therapy

In some cases, lifestyle changes will not effectively relieve symptoms of estrogen dominance. However, hormone replacement therapy can be a good option. In particular, here are some benefits and risks of hormone replacement therapy:

Benefits

Hormone replacement therapy can help conditions such as hot flashes, vaginal dryness, night sweats, and bone loss. In addition, benefits can lead to improved sleep, sexual relations, and quality of life. 

Risks

Hormone replacement therapy does carry risk factors. In high doses over long periods, hormone replacement therapy increases the risk of breast cancer, stroke, and blood clots. These risks are primarily in women over age 60. 

The best dose for hormone replacement therapy is the lowest effective dose for the shortest amount of time to minimize health risks.

Women with a uterus can take progesterone with estrogen to help protect against uterine cancer (13).

What’s next?

You take action and start making the changes. Lifestyle changes to treat estrogen dominance include reducing stress, and improving sleep, nutrition, and exercise. They are effective!

It is also a good idea to make an appointment with your doctor so that they can provide a diagnosis based on blood work.

You got this! Start making changes today.

“Estrogen Dominance in Menopause” was written by soon-to-be registered dietitian Rebecca Davis Rashidifard and edited by Dr. Su-Nui Escobar.

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