Estrogen Dominance: What you need to know
Ever been told your symptoms are “just part of being a woman?” Or “just the joys of getting older?”
Acne, fatigue, anxiety, weight changes, constipation, hair loss — you name it.
For many women, these get brushed under the rug or managed with a quick birth control or HRT prescription.
But in functional and integrative health, we often see a common thread behind these symptoms: estrogen dominance. And we believe that there’s underlying reasons the body is holding on to too much estrogen that can be managed vs. immediately reaching for a prescription.
Estrogen dominance sounds pretty straight forward, but it doesn’t always mean your estrogen levels are too high. More often, it’s about the relationship between estrogen and progesterone. And what happens when that balance is off.
Tracking my basal body temperature daily to stay in tune with my hormones and support balanced estrogen levels.
What the research says about estrogen dominance and its symptoms
As mentioned, estrogen dominance doesn’t always mean there’s an absolute excess of estrogen. Sometimes the problem is that estrogen is too high relative to progesterone - or that your body isn’t metabolizing or clearing estrogen properly. In either case, symptoms arise because tissues are exposed to more estrogenic influence than they should be.
Here are common symptoms women experience:
Acne, Oily Skin & More Breakouts
You thought you left acne behind in college. But estrogen affects androgen activity and can influence oil production in your skin. When estrogen is unopposed (not balanced by progesterone) for too long, this may lead to increased oilness and breakouts in women who have more sensitive or reactive skin.
Weight Gain, Especially Around the Belly & Hips
High estrogen is often associated with weight gain or difficulty losing weight. Some evidence suggests that estrogen encourages fat storage, particularly in the hips and lower abdomen, and may slow metabolic rate when out of balance. Which makes sense considering progesterone is responsible for increasing our metabolism and metabolic rate in the later half of our cycles. High estrogen levels are also known to contribute to fluid retention and blating.
Hair Loss / Thinning
Hormonal imbalances, like estrogen dominance, can influence the hair growth cycle. While estrogen generally supports hair, when it’s unbalance, or when it shifts toward androgen activity (or when progesterone is insufficient), hair follicles may prematurely shift into a resting phase, leading to more shedding or slower growth.
Anxiety, Mood Swings & Brain Fog
Estrogen is closely connected to neurotransmitter pathways, including serotonin and GABA, and can influence mood, cognition, and emotional regulation. Too much unopposed estrogen may exacerbate PMS, irritability, anxiety or brain fog.
Constipation & Bloating
Estrogen has a slowing effect on gut motility and can reduce bile flow, which can cause food to move more slowly through the digestive tract. High estrogen also impacts the gut microbiome, potentially leading to dysbiosis, which further aggravates digestive issues leading to bloating, IBS and more. These symptoms can also worsen estrogen dominance by slowing the body’s natural detoxification process, allowing excess estrogen to be reabsorbed instead of being excreted. A key reason why digestive health is crucial to hormone balance.
Fatigue & Low Energy
When your hormones are imbalanced, thyroid function often suffers and energy production becomes inefficient. Too much estrogen (relative to progesterone) can contribute to fatigue, especially when combined with poor detoxification, insulin resistance or nutrient deficiencies.
So, What Causes Estrogen Dominance in the First Place?
Estrogen dominance can happen in two ways:
Too much estrogen overall —> levels are above the normal range for your age/cycle phase. Likely an issue clearing estrogen from the body due to detoxification process or gut health.
Too much estrogen relative to progesterone —> your estrogen may be in range, but if progesterone is low due to stress, nutrient deficiencies, etc. estrogen dominates by default even within “normal” ranges.
Common contributors to estrogen dominance include:
Anovulatory cycles - no ovualtion = no progesterone production
Chronic stress - cortisol steals resources from progesterone production
Impaired detox pathways - liver or gut sluggishness leads to estrogen recirculating
Xenoestrogen exposure - plastics, conventional cleaning or personal care products and fragrances all are known endocrine disruptors
Blood sugar and insulin imbalances - can cause stress on the body and disrupt ovarian hormone production
Two Ways to Rebalance Estrogen
Estrogen isn’t “bad” — in fact, it is essential for bone health, brain function, heart protection and reproduction. But when it builds up unchecked or isn’t balanced by progesterone, symptoms can creep in. Left unaddressed, estrogen dominance has been associated with increased risks for conditions like endometriosis, fibroids, and even hormone-sensitive cancers.
The best approach to rebalance your estrogen depends on why estrogen dominance is happening in your body in the first place. Here are tow main paths I often take with clients who exhibit symptoms or show an imbalance on a Thyroid Adrenal Hormone Panel.
Option 1: Support Progesterone (if it’s low)
Track your cycles to confirm ovulation and understand when ovulation is occurring in your body (spoiler alert, most women do NOT ovulate on day 14…)
Prioritize protein, healthy fats, and minerals that support the luteal phase hormone production. Most women are under fueling especially during this back half of the cycle.
Manage stress — because cortisol is the biggest thief of progesterone
Support thyroid function, since sluggish thyroid can reduce progesterone output
Ensure you’re sleeping. If you’re not giving your body the time to rest and repair each night, all functioning is going to be subpar.
Option 2: Improve Estrogen Metabolism & Support Detoxification & Elimination
Support your liver with cruciferrous veggies, B Vitamins, and sulforaphane to help the liver break down estrogen
Eat plenty of fiber to support overall gut health. Fiber helps bind estrogen for elimination. A sluggish gut means estrogen gets reabsorbed.
Sweat and hydrate to help excrete excess estrogen. Regular movement, sauna, adequate water and lymph system support all help.
Reduce your xenoestrogen exposure by swapping plastic in the kitchen, conventional personal care and fragranced products for safer alternatives.
Figure out what your body actually needs
Estrogen dominance isn’t just about “too much estrogen.” It’s about balance. And balance comes from understanding your unique hormone picture, supporting progesterone where needed and/or giving your body the tools to metabolize estrogen effectively.
Supplementation or hormone replacement therapies can be supportive, but they don’t get to the root of why this is happening in the first place.
If you’ve been told your labs are “normal” but you’re struggling with any of the symptoms listed above — it’s time for a deeper look.
Download our free guide, What to Ask for in Your Hormone Panel, or schedule a consult today to learn how we can get clarity on your hormones and create a plan that works with your body, not against it. All services are FSA/HSA eligible and come with functional lab panels so we have real data to create a strategy around.