KBW | Estrogen Dominance: What Does It REALLY Mean and What Do You Do About It?

Estrogen dominance means that estrogen is more dominant than it’s “balancing” hormone, progesterone. This can mean that progesterone is normal but estrogen is way too high or it can mean estrogen is normal but progesterone is way too low. As you can imagine, treatment for these two versions of estrogen dominance should look very different, as they are in fact very different reasons for estrogen dominance!

Sadly, this is not often the case, most people do not realize that there are different forms of estrogen dominance and they simply take progesterone to “balance” the estrogen. The issue with this is that it will only mask the problem and help from a symptomatic standpoint, but it doesn’t fix the root cause of the problem, which is too much estrogen, and too much estrogen can actually do very damaging things to the body. Let’s unpack what else you need to know about estrogen and what to do about it. 

Estrogen Dominance Symptoms 

• difficulty sleeping
• irritability 
• mood swings 
• candida 
• achy joints
• weight gain
• hair loss
• spotting between periods
• bloating and water retention
• Infertility
• fibroids
• elevated triglycerides
• craving sweets

As you can see, estrogen dominance symptoms can range from everything from difficulty sleeping to candida overgrowths to fibroids and weight gain and beyond. That’s a LOT. And it's important to note that there are other potential causes for many of these as well. This is just one of the reasons why I prefer to test to see if my clients have estrogen dominance vs. just guessing. 

Another reason I feel it is important to test is because there is so much more to know than just that one marker being too high or too low. There are different types of estrogen (estriol, estrone, estradiol) and different ratios to look for (progesterone vs. estrogen) and different pathways the estrogen can go down (2-OH, 4-OH, 16-OH), and all of this is important data to know!  

This is yet again another area where I highly recommend working with someone that understands these principles if you suspect you have estrogen dominance because the stakes can be high when it comes to estrogen. 

Excess Estrogen Can Cause 

• Cardiovascular issues (estrogen promotes blood clots in the lungs, increases risks of heart attack, contributes to blood high blood pressure and blood vessel spasm) 
• Stimulation of cell growth (which can increase the risk of cancer, endometriosis, and hyperplasia), 
• A decreased ability of the thyroid to absorb iodine
• Increases in gallbladder problems
• It is also implicated in the development of RA (Rheumatoid Arthritis) and SLE (Systemic Lupus Erythematosus) 

But don’t be afraid of estrogen, we WANT estrogen, we just don’t want it in excessive amounts or going down the “wrong” pathway.  

Here are some things we NEED estrogen for: 

• Bone formation
• Blood clotting
• Vaginal thickness and lubrication
• Aids in a healthy libido
• Affects skin, hair, mucous membranes, and pelvic function
• Brain and mood functions 

Sample DUTCH Test

This is a picture taken from a sample DUTCH test. The DUTCH is my preferred method of hormone testing because you get SO MUCH more data than a blood test alone. This additional data helps me to figure out where your hormones are going “wrong” and how we’re going to fix them using ROOT CAUSE SOLUTIONS. 

How do we interpret the DUTCH above? 

Step one: 

First, at the top, you’ll see E1, E2, and E3. 

E1 is Estrone, E2 is Estradiol, and E3 is Estriol. 

You can see she has too much E1 and E2, as indicated by the red arrow on the dial. Each type of estrogen, 1, 2, and 3, has different effects on the body, so it's important to know which ones you have in what amounts.

Step two: 

E1, 2, and 3 then go down different pathways, 2-OH, 4-OH, and 16-OH. 

This sample patient has some issues going on. Not only does she have way too much E1 and E2, but her body is pushing it all down the 4-OH pathway. 

This is the pathway associated with DNA damage and breast cancer. We want estrogen to preferentially go down the 2-OH pathway, which we call the “protective pathway.” 

Now that we know this, we can work on figuring out why she is pushing this pathway and work to remedy it. One example of what can push the 4-OH pathway: too many toxins. I once had a client that had a perfect 2-OH pathway, she used all non-toxic house cleaners, beauty supplies, and more until one Christmas, her husband bought her perfume (perfumes are notoriously full of toxic chemicals!), she loved the smell and used it daily, and when we retested her DUTCH, she had switched over from the “good” pathway to the “bad.” As you can imagine, she immediately stopped using it and went back to non-toxic fragrances instead! 

Step three: 

 Not shown in this part of the sample DUTCH is step three, which is the methylation and, later, removal of estrogen. This can be heavily impacted by a gene called COMT and the cofactors the gene needs to be able to methylate properly (B6 and magnesium are two important ones here!). 

Where It Can Go Wrong

You can probably see that hormones are fairly complicated. This is why I recommend working with someone that understands these principles. You can have problems at different steps in this process, and where the problem is, dictates what the solutions should be. 

For example, I see DIM thrown around a lot for estrogen issues, but If someone isn’t able to get the excess estrogen out of their body because they’re chronically constipated, all the DIM in the world won’t fix that, and in fact, it’ll likely make them feel even worse. 

What I recommend instead is working with someone who can help you figure out exactly where things are going wrong, both using the DUTCH and a detailed health history and symptom survey. You should be able to put this all together to figure out the root cause of some of the issues (going back to that example with the perfume, toxins were an issue there). 

Potential root causes of excess estrogen

Each of these potential root causes has several layers to it but to get started, some causative factors of elevated estrogen can be: 

• Chronic infections
• Heavy metals
• Mold
• Food sensitivities 
• Gut problems
• Delayed phase one or two detox
• Age 
• Insulin resistance 
• Copper IUD increases estrogen (and BCP pills)
• Over aromatization 
• Xeno-estrogens

Where YOUR estrogen goes wrong depends on your root cause and can dictate your best options for solutions to the problem. 

Example 1: That  “cancer” pathway (the 4-OH pathway) is often due to xeno-estrogens (chemicals that look like estrogen) in the body. In this case, you’d work on removing chemicals from their lives. That means cleaning up your beauty supplies (for my full blog on cleaning up beauty supplies click here), cleaning up your house cleaning supplies, ditching plastic Tupperware and water bottles and more. 

Example 2: If your estrogen methylation is impaired, you’d take a closer look at your diet, and possibly your genetics, to see if you have a COMT SNP or lack of magnesium in your diet and work on that. 

Example 3: If your hormonal imbalances look insulin resistance related, you’d work on balancing your blood sugar. 

I could go on and on but hopefully, you see my point...you can’t just throw an “estrogen” supplement at the problem and hope it will go away. It needs targeted and intelligent treatment based on the root cause at hand. 

What To Do About It

THIS IS MY REAL CLIENT, and look at how beautiful her results are! 

She came to me in 2020 with the first DUTCH in hand. She had tried other things with another practitioner but wasn’t getting results. I worked with her on HER root causes, individual to her, which were: 

-blood sugar balance

-nutrient density 

-gut health, including SIBO 

And her results were amazing! She was able to get both estrogen and progesterone, and testosterone not only into a perfect range but all in total balance as well. You can see here how all of her dials are pointing in the exact same direction. 

We did not do much “direct” hormone work either, it was really all about root-cause solutions. We worked on cleaning up her diet and increasing her nutrient density, we worked on balancing her blood sugar, and we spent a LOT of time working on her gut health. 

By doing this, we were able to get any roadblocks to healing out of the way and allow her body to come back into balance naturally. This is why I harp on root cause solutions: if you fix something at its root, everything else falls into place. 

This is what we do inside of KB Wellness, and if you want to learn more about working with me and my team on rebalancing the body using root cause solutions, click the link HERE to apply.