Quick answer: Estrogen dominance means estrogen is high relative to progesterone, or the body isn’t clearing estrogen well. Diet, stress, excess body fat and environmental chemicals that mimic estrogen (xenoestrogens) such as BPA, phthalates and some parabens can all contribute. Reducing exposures, eating fiber and cruciferous vegetables, and supporting liver and gut health help your body process estrogen.
Key takeaways
Estrogen dominance means estrogen’s effects outweigh progesterone’s, or estrogen is cleared slowly.
The liver processes estrogen and the gut helps remove it, so low fiber, gut imbalance and hormone-disrupting chemicals can all play a part.
Glass containers, fragrance-free products, filtered water, cruciferous vegetables and fiber are practical ways to lower exposure and support estrogen metabolism.
What is estrogen dominance?
An imbalance where estrogen effects outweigh progesterone, or estrogen is cleared slowly. For the full clinical picture, see estrogen dominance and estrogen metabolism.
Possible symptoms
Possible symptoms include irregular, heavy or painful periods, PMS, mood swings and bloating, and breast tenderness. Weight gain around the hips and thighs, fatigue and brain fog, and fibroids or endometriosis (with medical evaluation) can also be part of the picture.
Understanding estrogen
The three main estrogens are estradiol, estrone and estriol. Levels are regulated by FSH, LH and progesterone. See .
Causes and risk factors
Diet and gut health
The liver processes estrogen and the gut helps eliminate it. Low fiber can allow more estrogen to be reabsorbed, and an imbalanced gut microbiome can change how much estrogen is reactivated and recirculated.
Lifestyle
Chronic stress affects progesterone, and body fat produces estrogen.
Environmental exposures
Exposures include bisphenol A (BPA) in some plastics and can linings, phthalates in fragrances and soft plastics, and some parabens in personal care products. PCBs, PFAS and some pesticides, along with heavy metals such as cadmium, also play a role.
Testing
Testing can include blood estradiol, progesterone and related hormones, and urine estrogen metabolite tests (functional, optional). Functional labs are optional. They can be helpful in more complex cases.
Supportive steps
Reduce exposure with glass containers, fragrance-free products and filtered water. Eat cruciferous vegetables, flax and chia seeds, berries and fiber, and support the liver and gut while limiting alcohol.
Supplements such as DIM or calcium D-glucarate and herbs such as chasteberry or black cohosh are sometimes used; discuss them with your provider, since they can affect hormones and interact with medications.
Healthy aging lens
Hormone-disrupting chemicals interfere with how cells communicate. Lowering exposure and supporting estrogen metabolism may help protect long-term health.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have ongoing fatigue, headaches, skin or digestive symptoms, or known exposure to lead, mercury, mold or workplace chemicals. The same is true if you take medications or have liver, kidney or heart conditions and want to try an elimination-support plan, or if you are pregnant or breastfeeding (intensive cleansing protocols are not recommended).
See a medical provider promptly for signs of poisoning such as severe abdominal pain, vomiting, confusion, seizures or trouble breathing, or call Poison Control at 1-800-222-1222.
If you’d like to learn about everyday exposures from plastics and personal care products, the free Clean Home Swap sends you five short emails with simple swaps for each room.
What the research shows
Diet and gut health influence how much estrogen the body clears. In a 1982 study by Goldin and colleagues, 10 vegetarian and 10 non-vegetarian premenopausal women were studied four times over about a year. The vegetarians ate more fiber (28 vs 12 g a day), passed more estrogen in their stool, had lower activity of a gut bacterial enzyme (beta-glucuronidase) that can recycle estrogen, and their blood estrogen levels fell as stool estrogen rose. This was a very small observational study.
Cruciferous vegetables may shift estrogen breakdown. In a study by Fowke and colleagues published in 2000, 34 postmenopausal women added broccoli, cabbage and similar vegetables to their diet. After adjusting for other foods, each extra 10 grams a day was linked with a small rise in the urine ratio of 2-hydroxyestrone to 16-alpha-hydroxyestrone. Without that adjustment the change was not significant, and the ratio’s link to health outcomes is not proven.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Would testing my estrogen and progesterone, or estrogen metabolites, help explain my symptoms?
Which everyday exposures might matter most for my estrogen balance?
Which product swaps would be easiest for my household?
Would hormone testing help us understand how exposures might be affecting me?
Frequently asked questions
What causes estrogen dominance?
Slow estrogen clearance, low progesterone, excess body fat, stress and environmental exposures.
What are xenoestrogens?
Chemicals that mimic estrogen, such as BPA and some phthalates.
Does DIM help estrogen dominance?
It may support estrogen metabolism; ask your provider before using it.
Can diet help estrogen balance?
Fiber and cruciferous vegetables may support estrogen clearance.
Sources
- Goldin BR, Adlercreutz H, Gorbach SL, et al. Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 1982. PMID: 7144835. https://pubmed.ncbi.nlm.nih.gov/7144835/
- Fowke JH, Longcope C, Hebert JR. Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev 2000. PMID: 10952093. https://pubmed.ncbi.nlm.nih.gov/10952093/
- Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas 2017. PMID: 28778332. https://pubmed.ncbi.nlm.nih.gov/28778332/
- Zahid H, Simpson ER, Brown KA. Inflammation, dysregulated metabolism and aromatase in obesity and breast cancer. Curr Opin Pharmacol 2016. PMID: 27875786. https://pubmed.ncbi.nlm.nih.gov/27875786/
- Harley KG, et al. Reducing Phthalate, Paraben, and Phenol Exposure from Personal Care Products in Adolescent Girls: Findings from the HERMOSA Intervention Study. Environ Health Perspect 2016. PMID: 26947464. https://pmc.ncbi.nlm.nih.gov/articles/PMC5047791/
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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