Estrogen Dominance

picture of 3 types of estrogen that may contribute to estrogen dominance

What is Estrogen Dominance?

You may read elsewhere that estrogen dominance is having too much estrogen. That’s only partially true.  Sometimes it is actually having high estrogen.  But, more often it is having relatively more estrogen than one or more of the other hormones that should be available to balance it. These include progesterone, DHEAs and testosterone.  Also, there are environmental pollutants that can act like estrogen. These are called xenoestrogens.  They bind to estrogen receptors and cause excess estrogen activity.

What are the symptoms of Estrogen Dominance?

While you need a certain level of estrogen, too much of a good thing can cause symptoms like:

  1. PMS – sad, emotional, weepy crying type PMS
  2. Breast tenderness
  3. Headaches or Migraines
  4. Uterine fibroids
  5. Uterine polyps
  6. Acne
  7. Heavy periods
  8. Painful periods
  9. Hormone-related cancers such as ovarian, uterine or breast cancer
  10. Endometriosis
  11. Anxiety or depression
  12. Weight gain

Is there an Estrogen Dominance test?

Well, now that depends.  There is a blood test for one form of estrogen (estradiol).  But, did you know that estradiol is only one of 3 main forms of estrogen in your body? The other two are estrone and estriol.  These are not usually measured on blood tests. So your estradiol blood test may come back perfectly normal, but there may still be estrogen dominance.

Even should your estradiol blood test be normal, it depends on how the other reproductive hormones are faring.  It also depends on how active your estrogen is.  This is something that is regulated by a protein called sex hormone binding globulin (SHBG).

Which Hormones Should I Test?

If you want to have your hormone levels tested, a full hormone blood test panel would include:

  • total testosterone
  • DHEAs
  • androstenedione
  • progesterone level (best measured on day 21 of a 28-day cycle)
  • SHBG
  • estradiol (on day 3 and 14 of a cycle)
  • LH and FSH (day 3).

Note that certain hormones need to be tested at certain points in your menstrual cycle to interpret them accurately.  There may only be subtle shifts in these hormones that your doctor considers normal.  But, those subtle shifts are sometimes enough to cause the above symptoms. Even if all the blood tests are normal, we still have the unknowns of estrone and estriol and several other forms of estrogen.

With the above symptoms, I would often help the liver with estrogen metabolism, regardless of blood test results.  Although, I always like to see what the exact numbers are as well.

What About a Saliva Test for Estrogen?

You can do a 30 day series of saliva samples to track estrogen throughout your cycle.  This helps to determine whether estrogen is rising and falling as it should throughout the cycle.  It is an expensive test, however, and is not covered by OHIP.  I find serum tests for estrogen are sufficient and are covered by OHIP.

What about a DUTCH test or urine test for hormones?

DUTCH tests provide extensive information about all of your hormones.  It also tells you about how well you are breaking these hormones down.  This is also an expensive test and is not covered by OHIP.  It may be covered by your employee health benefits, though.

How do you treat Estrogen Dominance?

In order to efficiently process extra estrogen for disposal, your liver requires specific nutrients in specific forms.  It does not require dandelion or milk thistle, which are the constituents of many liver detox kits.  It does require 5-methyltetrahydrofolate, pyridoxal-5-phosphate, indole-3-carbinol, methylcobalamin, n-acetylcysteine, glutathione, and calcium-d-glucarate. These are all natural substances, but almost none of them are found in health food store liver detox kits.  These are the types of treatments that I would use to enhance liver detoxification generally.  But they also ensure complete, and efficient estrogen metabolism.

I have seen dramatic improvements in the above-mentioned symptoms by helping the liver.  This improves the metabolism of excess estrogen and xenoestrogens (chemical pollutants like BPA, that can act like and be even more powerful than estrogen).

For help with this or any other health problem, book an appointment here or call the office for more information at 416-481-0222.

Authored by Dr. Pamela Frank, BSc(Hons), ND