Estrogen Dominance During Perimenopause: Top Causes and Fixes

Estrogen dominance is a common issue that many women experience during perimenopause. It is caused by an imbalance between estrogen and progesterone hormones in the body.

Estrogen dominance can lead to a variety of symptoms such as weight gain, headaches, acne, insomnia, and more. This article will explain the top causes of estrogen dominance and how to address them.

What is Estrogen Dominance?

Estrogen dominance is a condition of hormonal imbalance in which the body has too much estrogen relative to progesterone. It affects an estimated 75-95% of all women to some degree, but can usually be managed through lifestyle changes, dietary improvements, and supplements.

Estrogen dominance occurs when significant amounts of stored or “residual” estrogens are not balanced out by sufficient amounts of progesterone. This can lead to common symptoms such as irregular menstrual cycles, heavy menstrual bleeding, fatigue, and irritability.

Estrogen dominance can be caused by a variety of conditions, from environmental toxins to stress and inadequate nutrition. Although there is no single test for estrogen dominance, saliva testing for hormones can help identify imbalances in the ratio of estrogens to progesterone in the body.

Treatment typically includes natural therapies that use food-based health supplements and herbs intended to replace any level below normal with healthy levels that support reproductive wellness.

Symptoms of Estrogen Dominance

During perimenopause, most women will experience symptoms that are related to the natural decline in estrogen levels. Estrogen dominance is a condition that arises when there is an imbalance between estrogen and progesterone. When estrogen levels remain too high compared to progesterone, it can trigger certain health issues and disruptive symptoms, such as:

-Weight gain or difficulty losing weight
-Heavy or irregular periods
-Mood swings and irritability
-Brain fog
-Low libido
-Fibrocystic breasts
-Water retention
-Dry skin and hair loss

Causes of Estrogen Dominance

Estrogen dominance is one of the most common conditions that women face during perimenopause. It occurs when the levels of estrogen hormones are too high relative to the levels of progesterone hormones.

This hormonal imbalance can cause a variety of symptoms ranging from irregular periods to weight gain. Let’s take a look at the causes of estrogen dominance.

Hormonal Imbalances

When talking about the causes of estrogen dominance during perimenopause, it’s important to understand the concept of hormonal imbalance. Hormonal imbalance occurs when there is an increase in one type of hormone, relative to others in the body.

During perimenopause, an imbalance could mean that estrogen levels are high for a woman’s age level, but she may still have too little progesterone relative to her estrogen levels. This can cause a number of issues.

Hormonal imbalance can be caused by various factors, from lifestyle choices and environmental factors to aging and DNA changes. Here are some common causes:

Low progesterone: Women producing lower levels of progesterone can experience high levels of estrogen due to the lack of progesterone’s inhibitory effect on estrogen release.

Poor diet: Diets that are too high in fat and certain processed foods can lead to impaired digestion, which can result in too much estrone (E1) being released into the body.

Exposure to toxins: Exposure to environmental pollutants and chemicals during everyday life may disrupt normal hormonal balance and provoke increased estrogen activity in some people.

Oral contraceptives: Oral contraception is known for affecting hormones due to synthetic hormones being introduced into the system which can be pro-estrogenic, leading to an increase in overall circulating levels in the body.

Stress: Stressful living and working conditions increase cortisol production which impacts women’s hormones directly by blocking its proper effects on our systems. It also impedes the Proper functioning of other hormone systems such as thyroid hormones production by limiting their synthesis of cholesterol as well as their secretion from glandular tissue into circulation for bodily use


Stress is one of the most common causes of estrogen dominance during perimenopause, and managing it can be one of the biggest challenges. Prolonged and intense levels of stress can cause your body to produce hormones such as cortisol that disrupt your hormonal balance. This can lead to a disruption in your estrogen production, leading to a lack of normal functioning.

In order to help reduce stress, there are several lifestyle changes that you can make. These will not only help reduce excess levels of estrogen but also help normalize hormone production overall — which is beneficial for both mental and physical health.

Some steps that can be taken include getting more sleep and exercising regularly, eating nutritious foods and avoiding sugary snacks or processed carbs, taking regular timeouts from work or busy schedules for rest and relaxation, avoiding multitasking when possible to reduce cognitive stressors, increasing social connection by reaching out for support from family or friends when needed, and practicing yoga or meditation for mental clarity.

All these measures may help keep our body in balance during this important transitional phase in life.

Poor Diet

A poor diet can be one of the primary drivers of estrogen dominance during perimenopause and beyond. Poor dietary choices can lead to an imbalance between estrogen, progesterone, and testosterone levels in your body which can then lead to the onset of classic menopausal symptoms.

Consuming high amounts of animal products, processed or sugary foods, or consuming unhealthy oils all contribute to an increase in overall estrogen levels, which then further disrupts the hormonal balance. Furthermore, refined carbohydrates such as white rice and white bread force your liver to work harder to help process all hormones properly.

Not only are their particular things you should avoid eating, but changing what you do eat is equally as important. Eating a balanced diet full of nutrient-rich fruits and vegetables provides your body with the necessary tools it needs the order to help restore hormonal balance, including higher amounts of dietary fiber which aid in digestion and promotes healthy stool production.

Adding cruciferous vegetables such as broccoli or cauliflower into your weekly meal plan provides valuable phytonutrients that help your liver metabolize and excrete additional estrogens produced by the body by helping it conjugate them into safer substances prior to release.

Environmental Toxins

Environmental toxins are a major contributor to estrogen dominance, especially in women approaching menopause. Endocrine-disrupting chemicals (EDCs) like bisphenol A (BPA) and phthalates are found in many of the everyday products we use, such as plastic containers, food can liners and synthetic fragrances.

These toxins mimic the effects of estrogen in the body, disrupting our endocrine system and leading to hormonal imbalances. They can also weaken your liver’s ability to metabolize hormones, further contributing to an estrogen-dominant state.

To reduce your exposure to EDCs:

-Avoid plastics whenever possible
-Opt for stainless steel or glass water bottles/food containers instead of plastic
-Choose natural products without artificial fragrances or dyes
-Store food in non-plastic containers
-Clean your indoor air with an air purifier
-Minimize your consumption of processed foods

By reducing exposure to these potentially harmful chemicals, you can help balance your hormones naturally.

Diagnosis of Estrogen Dominance

Estrogen dominance can be a serious problem for women during perimenopause, but luckily it can be identified and managed. To diagnose estrogen dominance, your doctor will typically look at your symptoms and take a blood test to measure your estrogen and progesterone levels.

If your estrogen level is high and your progesterone level is low, then you likely have estrogen dominance. Knowing this information can help you and your doctor determine the best course of treatment.

Blood Tests

Diagnosis of estrogen dominance requires tests to measure the levels of hormones circulating in your body. The most common test is a blood test, as it can measure estrogen, progesterone, and testosterone levels.

This type of test is done on either a day 3 or day 21 menstrual cycle level, so make sure you understand which one your doctor will use. Blood tests can be more accurate than saliva tests and they’re also more reliable in diagnosing the condition when taken over the course of multiple cycles.

Your doctor may also want to order an ultrasound to check for fibroids or polyps on your uterus, as well as a Pap smear or pelvic exam if you have not had one recently. These tests can help rule out other conditions that could be causing your symptoms.

Additionally, if you are experiencing any abnormal bleeding or discharge, your doctor may want to recommend additional testing such as a biopsy or genetic testing for certain cancers including uterine and ovarian cancer.

Saliva Tests

Saliva testing is a reliable method to assess hormone levels in the body. The test measures levels of estradiol, progesterone, and testosterone in the saliva, which are individual indicators of estrogen dominance during perimenopause.

Adding a saliva test to your regular visits with a healthcare practitioner can be helpful in determining how hormones are affecting your health, Both saliva and blood serum tests detect both the amount and ratio of these hormones, giving a clearer picture of your overall hormone balance.

The testing procedure itself is quite simple and generally requires you to collect saliva samples at specific points during your cycle. These samples are mailed to laboratories for analysis, allowing clinicians to determine if estrogen dominance is present as well as other hormone imbalances.

Most labs will provide complete results that include hormone levels for estradiol and progesterone at different days of the menstrual cycle as well as total testosterone levels. Ratio information (such as estradiol: progesterone) can also be determined from this testing method.

With this information on hand, it is possible to plan a course designed specifically for perimenopausal hormonal balance, such as herbal formulation therapy or lifestyle modifications — both equally important dimensions in treating estrogen dominance during perimenopause effectively.

Urine Tests

Urine hormone tests are the most accurate way to measure estrogen dominance. A 24-hour urine collection is typically used when testing for estrogen dominance. This involves collecting all of your urine over a 24-hour period, or on several consecutive days. Your doctor or healthcare provider will give you instructions and a special collection container.

Your urine will then be sent to a laboratory to be analyzed for estrone sulfate, the principal form of estrogen after menopause, and other hormones that can indicate an imbalance in your estrogenic pathways.

Urine testing can also indicate levels of liver detoxification; this helps doctors rule out potential causes of estrogen dominance such as liver issues and metabolic disorders.

It is important for patients to take an additional saliva test along with their urine test to further evaluate their levels of hormones during different times of day and at different points in their cycle for maximum accuracy in diagnosis and treatment planning by their healthcare provider.

Treatments for Estrogen Dominance

Estrogen dominance during perimenopause can cause a myriad of uncomfortable symptoms and can be tricky to manage. Fortunately, there are treatments available to help balance hormones and alleviate symptoms.

In this section, we will look at various treatments for estrogen dominance including diet and lifestyle changes, natural supplements, and hormone replacement therapy.

Hormonal Balance

Estrogen dominance is a hormone imbalance, commonly linked to an excessive amount of estrogen in the body and an insufficient amount of progesterone. It can lead to a myriad of symptoms, including water retention and bloating, breast tenderness, mood swings, poor sleep quality, heavy periods, irregular cycles, and fertility issues.

Treatments can range from lifestyle and dietary changes to natural therapies such as herbal supplements and flower essences.

When it comes to hormonal balance, the primary aim should be to reduce the amount of estrogen in the body or increase the level of progesterone.

This can be done through dietary interventions such as consuming foods rich in fiber which helps bind with excess estrogen and flush it out via digestion; reducing sugar intake which is known to mimic estrogen in effect; managing the stress response by cultivating relaxation techniques such as mindfulness or yoga; optimizing gut health by including probiotics into your diet; and making sure you get sufficient restorative sleep each night.

If lifestyle modifications alone are not enough to rebalance hormone levels then natural therapies may be helpful. Herbal remedies such as chaste berry (Vitex agnus-castus), red clover (Trifolium pratense), and maca (Lepidium meyenii) have been traditionally used for menstrual and reproductive irregularities due to their ability to promote healthy hormonal balance.

Flower essences can also be beneficial: Rock Rose (Helianthemum numeraum) brings courage during times of anxiety while Mimulus (Mimulus guttatus) is particularly grounding when feeling overwhelmed by emotions. Finally, nutritional supplements such as vitamin B6 or Vitamin C may reduce bloating while aiding cell-level detoxification pathways within our bodies

Stress Management

Managing stress is one of the most important treatments for estrogen dominance. The goal is to reduce the production of stress hormones—especially cortisol—which signals your body to make more testosterone, which in turn gets converted into estradiol.

Long-term, chronic stress can increase the number of hormone receptors on cells, which can further block progesterone from binding and staying active inside the cells.

When it comes to reducing estrogen dominance through stress management, it can help to practice daily relaxation techniques. These might include deep breathing exercises and mindfulness meditation. Exercise also helps balance hormones, although far too many women overdo aerobic activity and don’t respect downtime when needed.

Try limiting cardio to two days a week, with low-to-moderate intensity workouts that last 30 minutes or less on other days of the week if desired.

Furthermore, engaging in restorative activities like gentle yoga, qigong, and tai chi can all help reduce symptoms related to estrogen dominance during perimenopause as well as during menopause itself.

Finally, look at what environmental toxins you are exposed to daily and make modest changes such as switching cleaning products or soaps; buying organic whenever possible; going scent-free; avoiding hazardous chemicals found in personal care products or even furniture; limiting EMFs (electromagnetic frequencies) produced by cell phone towers and electronic devices; and filter your home’s water supply if appropriate.

Dietary Changes

With estrogen dominance, it is important to make some dietary changes. Your goal should be to reduce your overall estrogen levels and increase your progesterone levels. Estrogen dominance can be managed through lifestyle modifications like diet and exercise, as well as natural supplements.

To reduce your overall estrogen levels, you should focus on eating a nutrient-dense diet that includes plenty of fruits, vegetables, whole grains, plant proteins, and healthy fats. Additionally, try to limit your alcohol intake and the number of processed foods you consume. Refined sugar in particular can raise your estrogen levels.

Certain foods may also help decrease the chances of developing certain types of cancer such as breast cancer. Increasing your intake of cruciferous vegetables like broccoli, kale, and cabbage may help inhibit the growth of cancer cells in the body.

If you are consuming soy products like tempeh or edamame, it is best to buy organic varieties due to the presence of pesticides that contain additional hormones which further elevate estrogen levels in the body.

It is also best to avoid foods with high amounts of artificial additives like preservatives or flavorings since these may also impact hormonal health negatively.

By making smart food choices and eating a balanced diet full of fresh produce that is pesticide-free whenever possible, you can reduce your chances of developing estrogen dominance considerably over time.


Detoxification is one of the best treatments for estrogen dominance. This means avoiding or limiting exposure to known environmental estrogens or xenoestrogens such as certain plastics and detergents.

It is recommended that products containing phthalates and parabens be avoided as much as possible and that food be purchased as organic when available. Additionally, it has been suggested to limit the amount of alcohol consumed to help detoxification.

To additionally reduce levels of environmental estrogens, a healthy diet high in fiber can help move them out of the body by binding with them in the small intestine before they are able to enter circulation.

A diet high in anti-inflammatory foods, such as fresh fruits and vegetables, should also be considered since inflammation can increase estrogen levels in perimenopausal women.

Additionally consuming cruciferous vegetables such as broccoli, cauliflower, and Brussels sprouts daily may help improve levels of estrogens in two ways: firstly by aiding detoxification and secondly by helping reduce its production by the liver itself.

Lastly adding fermented foods into one’s diet can aid gut health which may in turn improve an individual’s ability to process both beneficial and toxic forms of estrogen through their digestive tract better before it circulates back into our bodies again.


In conclusion, treating estrogen dominance during perimenopause can be achieved best through making lifestyle changes and taking supplements that are specifically tailored to your body’s needs.

Natural remedies and lifestyle adjustments include cutting out sugar, limiting stress, getting enough rest and exercise, eating a balanced diet that includes healthy fat, and decreasing alcohol consumption.

If hormonal imbalance is the cause of your symptoms then natural treatments such as herbal supplements, homeopathy, and bioidentical hormone replacement therapy can beneficial to your health. Remember to speak to your doctor before starting any new supplement regimen or altering dosage amounts.

Additionally, keep track of any changes in symptoms and discuss them with your doctor if necessary in order for effective treatment and management of estrogen dominance during perimenopause.

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