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1670 ROUTE 34 N. 3R FLOOR SUITE 3C WALL • NJ 07727

Estrogen Dominance

Estrogen Dominance

  • Estrogen is an important hormone in the health and development of women
  • However, excess estrogen, especially combined with inadequate levels of progesterone can lead to a multitude of medical problems • Estrogen also is found in men and if elevated also contributes to many problems

Estrogen Dominance

  • Excess estrogen, especially other estrogen balancing hormones (progesterone and testosterone) are low can cause many physical and emotional problems
  • Very common and commonly unrecognized problem

Estrogen Dominance

  • A common problem in menstruating and post menopausal women
  • Increases risk for uterine, cervical, ovarian, breast and other non-gynecological cancers 
  • Can contribute to menstrual problems including irregular, heavy and painful cycles
  • Can contribute to endometriosis, ovarian cysts and polycystic ovarian syndrome

Estrogen Dominance in Women

  • Can contribute to weight gain 
  • Can contribute to thryoid dysfunction
  • Can contribute to mood disorders
  • Can contribute to pre-menstrual syndrome
  • Can contribute to pre-menstrual dysphoric disorder
  • Can contribute to gynecologic and non-gynecologic cancers
  • Can contribute to autoimmune diseases
  • Can contribute to sexual dysfunction

Estrogen Dominance in Women

Diagnosing Estrogen Dominance

  • In menstruating women, measure levels of multiple forms of estrogens, preferably during the mid – luteal phase of her cycle.
  • Simultaneously measuring progesterone levels
  • Elevated estrogens with low progesterone indicates estrogen dominance
  • High levels of total estrogen in men in diagnostic of estrogen dominance
  • Often times these patients also have elevated levels

Conventional Treatment of Estrogen Dominance Symptoms

  • Birth control pills – to treat symptoms of painful cycles, and heavy bleeding
  • Medications to treat various symptoms – anti-depressants to treat depression, SSRI to treat premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)
  • Other medications to alleviate other symptoms – nausea, headaches, cramping….

Metabolically Directed Approach to Treating Estrogen Dominance

  • Measure sex hormones during appropriate time of cycle
  • Take measures to decrease excess estrogens (if elevated)
  • Take measures to increase low progesterone (if insufficient)

What Causes High Estrogen?

  • Genetic predisposition
  • Poor dietary habits 
  • Low iodine levels
  • Exposure to estrogenic toxins in the environment and food chain – pesticides, insecticides, pharmaceutical drugs, plastic bottles, extensive use of soy in foods, chronic inflammation

Aromatase Transforms Androgens into Estrogens and Visa Versa

  • Aromatase activity is increased by excess insulin levels
  • Aromatase activity is increased by chronic inflammation
  • Therefore, a metabolically directed approach to treatment of estrogen dominance includes a relatively low carbohydrate diet and treatment for chronic inflammation

Aromatase Transforms Androgens into Estrogens and Visa Versa

There are Several Forms of Estrogen

  • The most potent Estradiol (2 alcohols)
  • The least potent Estriol (3 alcohols)
  • Intermediate potency Estrone (1 alcohol and 1 ketone) 
  • These estrogens are then metabolized by various enzymes to produce estrogenic intermediates 
  • The 4 hydroxy and the 16 hydroxy estrogens cause proliferation of estrogen sensitive tissues and are causative in PCOS

Some forms of Estrogen are more Potent than Others Diindolylmethane (DIM) can lower the Potency of Estrogen

Diindolylmethane (DIM)

  • Diindolylmethane (DIM) is a natural compound that is found in cruciferous vegetables like broccoli, cabbage, cauliflower, and brussel sprouts. DIM has been found to have a wide range of potential health benefits.

Catechol O Methyl Transferase

  • COMT
  • An important enzyme that transfers methyl groups from one substance to another 
  • Important for the metabolizing of hormones and neurotransmittors 
  • Needed for the proper detoxification of estrogens
  • Adequate methyl groups need to be available for this transfer
  • Therefore, inadequate availability of methyl groups can increase estrogen and contribute to estrogen dominance

Specific Estrogens (Catechols) can be Metabolized by Catechol O Methyl Transferase (COMT) to Safer Metabolites


  • An important process in your liver
  • Processes carbohydrates, therefore a high carbohydrate, high sugar diet can raise your estrogen
  • Helps detoxify both estrogen and testosterone
  • Dysbiosis (imbalanced bowel flora) increases glucuronidase levels which impede glucuronidationleadingtoelevatedestrogen

Estrogens can be Detoxifed by your Liver Through a Process Known as Glucuronidation


  • What is the function of glucuronidation?
  • The human body uses glucuronidation to make a large variety of substances more water-soluble, and, in this way, allow for their subsequent elimination from the body through urine or feces (via bile from the liver). Hormones are glucuronidated to allow for easier transport around the body.
  • Glucuronidation-Wikipedia

Metabolic Imbalances Contributing to Estrogen Dominance

  • Excess Alkalinity – contributes to insulin resistance 
  • Parasympathetic imbalance contributes to excess insulin secretion 
  • Ketogenic imbalance contributes to excess alkalinity and insulin resistance
  • Glucogenic imbalance depletes glucuronidation leading to increased estrogen

Thyroid Involvement in Estrogen Dominance

  • Elevated Insulin and elevated estrogen, commonly seen in estrogen Dominance will contribute to Reverse T3 Syndrome
  • Reverse T3 syndrome leads to a functional hypothyroidism consequently exacerbating the weight gain, insulin resistance and fatigue seen in estrogen dominance

Diet Myths

  • Myth -“Eating multiple small meals will boost your metabolism”
  • Fact – every time you eat, your pancreas secretes insulin
  • Myth – Saturated fat causes heart disease and obesity
  • Fact – Consuming saturated fats increases your metabolism and reduces inflammation 

Effects of Chronic Stress on Estrogen Dominance

  • Chronic stress increases the production of cortisol at the expense of other sex and adrenal cortex hormones, therefore, tending to lower progesterone levels 
  • Estrogen is also a stress hormone and tends to increase with chronic stress.
  • Therefore, chronic stress contributes to estrogendominance

What Causes Low Progesterone?

  • Genetic predisposition
  • High carbohydrate, Low cholesterol, low saturated fat diet.
  • Chronic stress, chronic inflammation

All of your Sex and Adrenal Cortex Hormones are Made from Cholesterol

All of your Sex and Adrenal Cortex Hormones are Made from Cholesterol

Chronic Stress Can Initially Increase ACTH and Cortisol Levels

Numerous Studies “Proving” That Cholesterol is the Root Cause of Heart Disease were done on Rabbits

Saturated Fats Have no Double Bonds, They are very Stable and Tend to Stimulate Your Metabolism and Reduce Chronic Stress and consequently Reduce Estrogen Dominance

Unsaturated Fats Have Double Bonds – They are unstable and tend to increase cortisol levels at the expense of progesterone contributing to estrogen dominance

Testosterone Balances Estrogen

  • Many men have simultaneously high estrogen and low testosterone
  • This is another form of Estrogen Dominance

Soy is not a Health Food, It is a Hormonal (Estrogenic) Poison

Men Also Suffer From Estrogen Dominance

Estrogen Dominance in Men

  • Can contribute to weight gain
  • Can contribute to thryoid dysfunction
  • Can contribute to mood disorders
  • Can contribute to growth of breast tissue (man boobs)
  • Can contribute to prostate hypertrpophy and cancer
  • Can contribute to autoimmune disease
  • Cancontributetosexualdysfunction

Estrogen Dominance Treatment Summary

To learn more about Michael Rothman MD contact us today by giving us a call at (732) 268-7663, emailing us at [email protected] or by requesting an appointment online.
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