Estrogen Dominance

Estrogen dominance basically presents with two distinct body shapes, heavy and slender. Which are you? We know that the estrogen levels themselves don’t define estrogen dominance, but the relationship of estrogen to progesterone. It’s the ratio of the two hormones that defines the state, not the absolute values.

 

Estrogen Dominance Categories

 

Understand that these are broad categories; in many women, there can be some overlap.

 

Based solely on the frequency of overweight and obese people in the United States, I would guess that the “heavy” phenotype is the most common. This is characterized by increased weight, increased fat cell mass, increased conversion of testosterone to estrogen in these fat cells, and increased inflammation. In these cases, the absolute estrogen levels tend to be higher.

 

For these reasons, the absolute levels of estrogen rise, and with this come the increased risk factors associated with prolonged exposure. Over time this group can be expected to increase their risk of breast and uterine cancers– particularly without augmenting the balancing progesterone.

 

Conversely, another group of women could be seen as the “slender” body type. Typically a stressed-based physiology, found in association with higher cortisol levels, impedes the efficiency of ovulation and creates a state of estrogen dominance through lowered progesterone levels. Reproductive endocrinologists have known for decades that in stressed women, less robust ovulatory cycles are reflected in lower day 20 progesterone levels. The absolute estrogen levels don’t go up as much, but the increased ratio persists.

 

For this reason, it is clear that the most concerning presentation is in a woman who is overweight or obese and also experiencing significant stressors.

 

Which are you? Understanding this simple designation can help to rectify the underlying process. Recall that ED is to some degree a “pathological” state; it’s not normal. Yes, as women age through their reproductive years there is some progressive lowering of the Progesterone. But having worked with thousands of women, I can say that the majority move through the peri-menopausal years with the symptoms of ED. Progesterone is a great, effective, and safe “band-aid”. But it alone doesn’t address the genesis of the problem.