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Hormones

What Is Estrogen Dominance (And How Does It Affect My Fertility)?

Zoe Kaplan
Zoe Kaplan

Estrogen dominance is when your estrogen levels are disproportionately higher than other sex hormones. Learn about signs, how it affects your fertility, and treatment.

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Published:
Sep 11, 2023
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Jun 17, 2024
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Estrogen dominance is when your estrogen levels are disproportionately higher than other sex hormones. Learn about signs, how it affects your fertility, and treatment.

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Estrogen dominance is when your estrogen levels are disproportionately higher than other sex hormones. Learn about signs, how it affects your fertility, and treatment.

The hormones in your body have a lot of responsibility. Estrogen, the primary female sex hormone, plays a role in regulating your reproductive health, menstrual cycle, bone density, mood, cognitive function, and even cardiovascular health. If this hormone is so important, isn’t having a lot of estrogen—like in estrogen dominance—a good thing?

Good things come in moderation, and estrogen dominance—when you have high levels of estrogen compared to other hormones—isn’t always the best for your overall health and well-being. In this guide, we’ll uncover signs, causes, and symptoms of estrogen dominance, and what you can do to get your levels back in balance.

  • What is estrogen dominance?
  • What causes estrogen dominance in females?
  • How can you tell if you have estrogen dominance?
  • How to test for estrogen dominance
  • Estrogen dominance and fertility
  • How to fix estrogen dominance

What is estrogen dominance?

Estrogen dominance is a condition where you have unbalanced levels of estrogen relative to other sex hormones.

Estrogen, the primary female sex hormone, is not a single entity, but rather a family of hormones that includes estradiol, estrone, and estriol. These hormones play pivotal roles in the female reproductive system and contribute to secondary sexual characteristics, bone health, and overall well-being.

Estrogen is typically counterbalanced by progesterone, another important sex hormone. Together, these hormones work in harmony to regulate the menstrual cycle and maintain reproductive health. Progesterone helps prepare the uterus for pregnancy, while estrogen prepares the body for ovulation.

In a healthy hormonal environment, estrogen and progesterone are present in a delicate equilibrium. However, estrogen dominance occurs when the balance tips in favor of estrogen, leading to elevated levels of estrogen relative to progesterone.

What causes estrogen dominance in females?

How do estrogen levels get to be much higher than other hormones? Lifestyle habits, environmental factors, and medications can all cause estrogen dominance in females.

Hormonal imbalances

Estrogen dominance can occur because of a hormonal imbalance of other hormones; a common cause of estrogen dominance is a relative deficiency in progesterone levels. When progesterone is low, even a normal estrogen levels can lead to estrogen dominance.

Progesterone deficiency can occur during the latter stages of the menstrual cycle, especially in women experiencing anovulation (lack of ovulation), or as a result of medical conditions like polycystic ovary syndrome (PCOS).

>>MORE: 8 Signs Your Hormones May Be Out of Balance – And What to Do Next.

Environmental factors

Xenoestrogens, synthetic compounds found in various environmental sources, including plastics, pesticides, and some personal care products, can mimic the effects of natural estrogen in the body and contribute to estrogen dominance.

Certain plant-based foods, like soy products, contain compounds called phytoestrogens that can act as weak estrogens when consumed in excess—and therefore lead to estrogen dominance.

Diet

Consuming a diet high in processed foods, sugar, and unhealthy fats can disrupt hormonal balance. Particularly, a diet low in fiber and rich in refined carbohydrates can hinder the body's ability to eliminate excess estrogen. Drinking excessive alcohol can also affect the body’s ability to metabolize and eliminate estrogen by impairing liver function.

Medications and hormone therapy

Certain medications, such as birth control pills, hormone replacement therapy (HRT), or fertility treatments, can introduce synthetic hormones into the body, potentially disrupting the natural hormonal balance.

Remember, estrogen dominance is a multifaceted condition and can be a result of a variety of factors—and sometimes, even multiple factors at once.

How can you tell if you have estrogen dominance?

When estrogen dominance takes hold, it can trigger a range of health issues.

Estrogen dominance symptoms include:

>>MORE: What Are Estrogen Dominance Symptoms?

Recognizing these symptoms is often the first step to knowing whether you might have estrogen dominance; however, it's important to note that these symptoms can vary in intensity and may not be exclusive to estrogen dominance. If you suspect you have estrogen dominance based on these signs and symptoms, it’s essential to get tested to assess your hormone levels.

Estrogen dominance and fertility

Estrogen plays a vital role in regulating the menstrual cycle and supporting fertility. When you have estrogen dominance, it can affect your ability to conceive.

Disrupted menstrual cycles

Estrogen dominance often leads to irregular menstrual cycles. This can manifest as shorter or longer cycles, missed periods, or unpredictable ovulation. Irregular cycles can make it challenging to find your fertile window, reducing the chances of successful conception.

Anovulation

Anovulation, or the lack of ovulation, can occur in cases of estrogen dominance. When estrogen levels are consistently high relative to progesterone, the normal process of releasing an egg from the ovaries may be disrupted. Without ovulation, there is no egg available for fertilization, making conception impossible.

Implantation issues

Even if fertilization occurs, estrogen dominance can affect the ability of a fertilized egg to implant in the uterine lining. Adequate progesterone is required for a healthy uterine lining, and when estrogen dominance is present, progesterone levels may be insufficient for proper implantation.

Increased risk of miscarriage

Estrogen dominance may also increase the risk of miscarriage during early pregnancy. Hormonal imbalances can interfere with the stability of the uterine environment, making it difficult for a pregnancy to progress successfully.

Polycystic ovary syndrome (PCOS)

In some cases, estrogen dominance can contribute to the development or exacerbation of conditions like polycystic ovary syndrome (PCOS). PCOS is associated with irregular periods, anovulation, and cysts on the ovaries, all of which can adversely impact fertility.

>>MORE: PCOS and Pregnancy: What to Know If You're TTC with PCOS

Reduced cervical mucus

Cervical mucus, which changes in consistency during the menstrual cycle, is crucial for sperm transport and survival. Elevated estrogen levels can alter cervical mucus production and quality, hindering the sperm's journey to meet the egg—and making it harder for fertilization to occur.

How to fix estrogen dominance

Estrogen dominance can lead to a variety of health issues and can even affect your fertility. However, there are both natural strategies and medical interventions you can try to combat estrogen dominance—to both alleviate symptoms and improve your chances of a healthy pregnancy.

Lifestyle adjustments

Lifestyle changes to combat estrogen dominance include:

  • Diet adjustments: eating more fiber to help eliminate excess estrogen through the digestive system; eating more cruciferous vegetables, which contain compounds that support estrogen metabolism; eating more healthy fats, to aid in hormone regulation; eating less processed foods, which contain additives and chemicals that can disrupt hormonal imbalance
  • Stress management: Trying relaxation techniques like meditation, yoga, and deep breathing, to reverse the effects chronic stress can have on hormonal balance
  • Regular exercise: Moving regularly to help regulate hormones and promote overall health
  • Avoiding hormone-disrupting chemicals: Reducing exposure to xenoestrogens, which are synthetic chemicals that mimic estrogen in the body; this includes avoiding plastic containers, opting for organic products, and using natural cleaning and personal care products

Medical interventions

If lifestyle adjustments don’t help combat estrogen dominance, or in severe cases, medical interventions might be necessary. A healthcare provider may prescribe medications like:

  • Hormone replacement therapy (HRT): Can help balance estrogen in menopausal women especially
  • Selective estrogen receptor modulators (SERMs): Medications that can block the effects of estrogen in certain tissues and are used to treat conditions like breast cancer
  • Aromatase inhibitors: Drugs that can reduce estrogen production and are often used in the treatment of breast cancer

If you’ve determined you have estrogen dominance, it’s crucial to work closely with a healthcare provider or reproductive endocrinologist to determine the most appropriate treatment plan for your specific situation. Addressing estrogen dominance often involves a holistic approach that combines dietary changes, lifestyle modifications, and, in some cases, medication interventions.

By taking proactive steps to restore hormonal balance, you can alleviate symptoms, reduce the risk of associated health complications, and increase your chances of conception.

About the author

perimenopause-periods
Should I still see my gynecologist if my periods are just "weird" but not painful?
Yes. Annual visits remain important during perimenopause. Your provider can help determine if your "weird" periods are typical perimenopause changes or something requiring attention. They can also discuss management options to improve your quality of life.
perimenopause-periods
How long do irregular periods last before menopause?
Irregular perimenopause periods typically last 4 to 8 years before your final period, though this varies greatly. Some women experience irregularity for just a few months, while others have irregular periods for over a decade before reaching menopause.
perimenopause-periods
Is it normal to have two periods in one month during perimenopause?
Yes, this can happen, especially in early perimenopause when cycles shorten. You might have a 21 day cycle, meaning you could have a period at the beginning and end of the same calendar month. Track these patterns to distinguish between short cycles and abnormal bleeding.
perimenopause-periods
Why are my periods suddenly so heavy in my 40s?
Heavy perimenopause periods often result from estrogen dominance. When progesterone drops but estrogen remains high, your uterine lining builds up more than usual, causing heavier bleeding when it sheds. This is common in perimenopause but should be evaluated if it affects your daily life.
perimenopause-periods
Can I still get pregnant if my periods are irregular during perimenopause?
Yes. As long as you're having periods, even irregular ones, you may still be ovulating. Pregnancy is possible until you've gone 12 full months without any period. If you don't want to become pregnant, continue using contraception throughout perimenopause.
perimenopause-and-weight-gain
Can you prevent perimenopause weight gain completely?
While you may not prevent all weight changes during perimenopause, you can minimize gain through proactive strategies. Starting strength training before perimenopause, maintaining consistent sleep habits, and managing stress can help your body adapt to hormonal changes more smoothly. Remember, some body changes during this transition are normal and healthy.
perimenopause-and-weight-gain
At what age does perimenopause weight gain typically start?
Perimenopause weight gain can begin in your late 30s or early 40s, often coinciding with the first hormonal changes. Many women notice gradual changes starting 5 to 10 years before their final period. The timing varies greatly based on genetics, lifestyle, and overall health.
perimenopause-and-weight-gain
Does everyone gain the same amount during perimenopause?
No. Perimenopause weight gain varies significantly. Some women gain 5 pounds, others 20 or more, and some maintain their weight. Factors include genetics, starting weight, activity level, stress, sleep quality, and how dramatically hormones fluctuate. Your experience is unique to your body.
Is perimenopause weight gain different from regular aging weight gain?
Yes. While metabolism naturally slows with age, perimenopause weight gain has distinct characteristics. The hormonal shifts cause fat redistribution to the midsection, even if overall weight doesn't change dramatically. This abdominal weight gain pattern is specifically linked to declining estrogen and progesterone, not just aging.
perimenopause-and-weight-gain
Will the weight come off after menopause?
Perimenopause weight gain often stabilizes after menopause when hormones level out, but the weight doesn't automatically disappear. The metabolic and body composition changes that occur during perimenopause tend to persist. However, with consistent healthy habits, weight management becomes more predictable post menopause than during the fluctuating perimenopause years.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.