Do You Know What Estrogen Dominance is?

Posted by Ben White on


Estrogen dominance refers to an excess of estrogen when progesterone levels are inadequate. This condition can occur in women during the reproductive years, but tends to be particularly symptomatic for women during perimenopause and in menopause. Estrogen dominance is worsened by women not ovulating, women being exposed to synthetic estrogens and/or women not metabolizing estrogens correctly. Estrogen dominance is a term coined by John Lee, M.D. in the book What Your Doctor May Not Tell You About Menopause.

The Problem

Scientific studies link high estrogen or estrogen imbalance with a wide range of symptoms and conditions, from hot flashes, night sweats, low libido, and foggy thinking to more serious conditions related to reproductive health (endometriosis and PCOS) as well as breast disease including cancer. Hormone imbalances triggered by medications like synthetic hormone combinations have also been found to contribute to estrogen dominance problems.

Symptoms of estrogen dominance include:

  • Fibrocystic and tender breasts
  • Heavy menstrual bleeding
  • Irregular menstrual cycles
  • Mood swings
  • Vasomotor symptoms
  • Weight gain
  • Uterine fibroids


Premenopause: Lack of ovulation and/or reduction of ovarian production of progesterone.

Perimenopause (40s-mid-50s): Lack of ovulation or erratic cycles, when estrogen levels fluctuate rapidly from high to low in the absence of adequate progesterone.

Postmenopause: An imbalance of estrogen to progesterone ratio in waning reproductive years when ovarian production of estrogen can decline by as much as 60% and levels of progesterone can drop to nearly zero with the cessation of ovulation.

Balancing Estrogen

Women of all ages benefit from balanced hormones. With menstrual irregularities, PMS, endometriosis and infertility, testing can be helpful in understanding the underlying condition. Healthcare providers working with perimenopausal and menopausal women find hormone testing to be a key step in detecting and correcting imbalances. Testing hormone levels is also invaluable for monitoring women using hormone replacement therapy.

Why Test Hormones

Because hormones work together to create a balanced internal milieu, it makes sense to test all of the following to help determine estrogen dominance:

  • Estradiol (E2) the most potent of the estrogens
  • Progesterone (Pg)
  • Testosterone
  • Cortisol (stress hormones, for adrenal function)
  • Thyroid Profile (TSH, T3, T4, TPO Antibodies for Hashimoto’s Thyroiditis)


At ZRT Laboratory, we compare symptoms with or without hormone usage and relate these back to tested hormone levels providing more information than is available with standard lab results. In this way, comprehensive hormone testing can assist detection of previously undiagnosed disorders, and serve as a rational basis for physician treatment to relieve symptoms and restore hormone balance.


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Original of this article was published on ZRT Laboratory Blog. 


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