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Hormones

What Are Estrogen Dominance Symptoms?

Clara Siegmund
Clara Siegmund

Hormones fluctuate, but when they remain elevated it can lead to health problems. Estrogen dominance is one of those problems, but it isn’t permanent. Here’s how to recognize estrogen dominance symptoms and what to do next.

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Aug 3, 2023
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Hormones fluctuate, but when they remain elevated it can lead to health problems. Estrogen dominance is one of those problems, but it isn’t permanent. Here’s how to recognize estrogen dominance symptoms and what to do next.

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Hormones fluctuate, but when they remain elevated it can lead to health problems. Estrogen dominance is one of those problems, but it isn’t permanent. Here’s how to recognize estrogen dominance symptoms and what to do next.

Hormones control a lot of what happens in your body. Your hormone balance is crucial to your overall health and wellbeing. That balance is often in flux as your hormones naturally rise and fall month-to-month and throughout your life.

However, when a hormone stays high (or low), it can throw your hormone balance off, and that can create problems.

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

Estrogen dominance is one example of what can happen when your hormones are thrown out of sync with each other.

What is estrogen?

The hormone estrogen is often referred to as the “female hormone,” presumably because it’s typically present in higher levels in people assigned female at birth (AFAB). However, this is a bit of a misnomer: everybody has estrogen, and everybody needs it.

There are three main types of estrogen:

  • Estrone (E1)
  • Estradiol (E2)
  • Estriol (E3)

The three types of estrogen play different roles and are produced differently. Estradiol is the strongest of the three.

Estrogen helps regulate functions in your body like:

  • The reproductive system
  • The immune system
  • The menstrual cycle
  • Fertility
  • Bone health
  • Heart health
  • Secondary sex characteristics

If the estrogen levels in your body are high, you may have what’s known as estrogen dominance. Here’s what that means and some estrogen dominance symptoms.

What is estrogen dominance?

If you’re experiencing estrogen dominance, it means that the levels of estrogen in your body are consistently higher than usual. But higher compared to what? Well, other hormones.

In AFAB people, estrogen dominance generally occurs when estrogen levels are elevated relative to progesterone levels. In people assigned male at birth (AMAB), estrogen dominance is usually characterized by higher estrogen levels in relation to testosterone levels.

>>MORE: What Are Low Progesterone Symptoms?

What causes estrogen dominance?

It’s rare that estrogen levels rise naturally, on their own, without descending again. Typically, estrogen becomes elevated due to other health conditions. Estrogen dominance can also be caused by certain medications.

Some of the factors that could contribute to estrogen dominance include:

Conditions such as these may cause the body to overproduce estrogen, impact the way the body breaks down and removes estrogen, or lead to an imbalance in the ratio of estrogen to progesterone or testosterone.

What are the symptoms of estrogen dominance?

Symptoms of estrogen dominance can be different depending on your sex assigned at birth. Estrogen plays different roles in AFAB and AMAB people, which means that estrogen dominance manifests differently.

Like with any condition, estrogen dominance symptoms can also vary from person to person. Maybe you don’t experience many symptoms, or maybe you tick off everything on the list.

Estrogen dominance symptoms in AFAB people

Common symptoms of estrogen dominance in AFAB people include:

  • Irregular cycles
  • Infertility
  • Breast swelling or tenderness
  • Fibrocystic breasts
  • Uterine fibroids and uterine polyps
  • Worsening PMS or PMDD symptoms
  • Weight gain
  • Constipation
  • Acne
  • Low sex drive
  • Depression or anxiety
  • Fatigue
  • Mood swings

Irregular cycles

Estrogen helps regulate your reproductive system, including your menstrual cycle. Along with progesterone and other fertility hormones, estrogen plays a role in triggering ovulation and helps thicken the uterine lining.

Estrogen dominance can lead to irregular periods, including excessively heavy or light flows, very short or very long cycles, and unpredictable period timing.

Infertility

Estrogen dominance can affect reproductive health in other ways, as well. High estrogen levels can cause irregular menstrual cycles and disrupt ovulation, which can lead to issues with infertility.

Fibrocystic breasts

High levels of estrogen can cause the development of noncancerous lumps in the breasts, also called fibrocystic breasts. Fibrocystic breasts often feel lumpy or ropelike. The lumps are benign, but it’s still a good idea to have them evaluated by your doctor.

You may not have any symptoms related to fibrocystic breasts, or your breasts may feel tender or painful. These symptoms tend to be the most noticeable around your period.

Fibrocystic breasts don’t increase your risk of breast cancer, but they can make it more difficult to detect cancerous tumors. Talk to your doctor if:

  • You find a new or persistent lump
  • A lump that your doctor already evaluated changes
  • You have specific areas of pain
  • Breast changes continues after your period

Aside from fibrocystic breasts, estrogen dominance may also lead to breast tenderness, breast pain, and breast hypertrophy (the overgrowth of dense, heavy breast tissue).

Uterine fibroids and uterine polyps

Uterine fibroids are noncancerous growths in the uterus. However, they should still be monitored by a doctor.

Research suggests that estrogen, which promotes the thickening of the uterine lining during each menstrual cycle, appears to also trigger fibroid growth in the uterus. This means that estrogen dominance can lead to an increase in uterine fibroids, in both number or size of existing fibroids.

Uterine polyps are another type of growth that can occur in the uterus. They are usually non-cancerous, but some can be or could become precancerous. Uterine polyps should also be monitored by a doctor.

Uterine polyps grow in response to estrogen, meaning consistently high estrogen levels like those of estrogen dominance can trigger uterine polyp growth.

Worsening PMS or PMDD symptoms

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) refer to symptoms that can occur before your period. While the two are similar, PMDD is a more severe form of PMS. Possible symptoms include headaches, menstrual cramps, nausea, constipation, mood swings, and irritability.

Estrogen dominance is associated with more severe PMS or PMDD symptoms. If your symptoms are suddenly worse, it may be an indication that the balance of estrogen in your body has been thrown off.

Estrogen dominance symptoms in AMAB people

Common symptoms of estrogen dominance in AMAB people include:

  • Infertility
  • Erectile dysfunction (ED)
  • Gynecomastia
  • Low sex drive
  • Dry skin

Infertility

Estrogen, and in particular estradiol, plays a role in reproductive function in AMAB people, too. This hormone contributes to sperm production, sperm movement (motility), sperm shape (morphology), and erectile function, among other aspects of fertility.

Estrogen dominance can impede the production of healthy sperm (spermatogenesis), which can lead to issues with infertility.

>>MORE: What You Need To Know About Male Factor Infertility

Erectile dysfunction (ED)

Estrogen, and in particular estradiol, also impacts erectile function. Too much estrogen can lead to impaired erectile function, or even erectile dysfunction (ED). This means that estrogen dominance can make it harder to get and/or maintain an erection.

Gynecomastia

Gynecomastia is an increase in breast gland tissue, leading to enlarged breasts. Many people don’t experience symptoms aside from tissue growth. In those who do, symptoms can include breast tenderness, breast pain, or nipple sensitivity. Most cases of gynecomastia go away without treatment, but in some instances medication or surgery may be used.

Estrogen dominance, with high levels of estrogen and low levels of testosterone, can trigger the development of gynecomastia.

What medical conditions are associated with estrogen dominance?

High levels of estrogen have been linked to multiple health conditions. While estrogen dominance may not necessarily cause these conditions, it can exacerbate existing conditions or put you in a higher risk category.

Medical conditions associated with estrogen dominance in AFAB and AMAB people include:

  • Breast cancer
  • Prostate cancer
  • Ovarian cancer
  • Endometriosis
  • Uterine cancer
  • PCOS
  • Autoimmune diseases like multiple sclerosis (MS)
  • Stroke

How do you treat estrogen dominance?

If you’re experiencing symptoms that you believe may be signs of estrogen dominance, consider talking to your doctor to undergo hormone tests.

>>MORE: 3 Things You Need to Know About Hormonal Imbalance Tests

Your healthcare provider will aim to help you treat the underlying condition (or conditions) causing high levels of estrogen. Treating the cause can then help lower your estrogen levels and relieve your estrogen dominance symptoms. This, in turn, may help lower your risk of developing related medical conditions.

Treatment options available to people dealing with estrogen dominance include:

  • Regular exercise: exercise helps your body metabolize and remove estrogen, which can lower estrogen levels
  • Balanced diet: a balanced diet helps promote hormone balance
  • Medication: depending on the underlying condition(s) causing elevated estrogen levels, medications such as hormonal birth control may be an option
  • Surgery: in rare cases, the ovaries may be removed (oophorectomy) to help lower the risk of ovarian or breast cancer

If estrogen dominance is causing your body to look differently than you want or need it to, pharmaceutical options available to you include:

  • Estrogen blockers
  • Testosterone replacement therapy (TRT)
  • Masculinizing hormone therapy

As with any medication, these options can come with side effects and risks. Your healthcare provider can help you figure out which option is right for you.

The takeaway

Estrogen levels can become elevated due to factors like underlying health conditions, certain medications you may be taking, or lifestyle habits.

When estrogen levels go up and don’t come back down, you may be experiencing estrogen dominance. Everyone has estrogen, so anyone can experience this condition. Some estrogen dominance symptoms can manifest differently depending on sex assigned at birth.

Estrogen dominance isn’t permanent. With the help of your doctor, you can figure out the best path to treat the factors contributing to your high estrogen, and bring those levels back down—so you can get some relief from the estrogen dominance symptoms you’re facing.

About the author

Clara Siegmund
Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

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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.

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