Are Your Estrogen Levels Off? Here's How To Tell + Exactly What To Do About It
My 34-year-old patient Jenni’s former doctor diagnosed her with polycystic ovary syndrome (PCOS), a metabolic disorder that left her with sugar cravings, near-constant fatigue, weight-loss resistance, and depression. A dietitian had put Jenni on a low-carbohydrate diet combined with some high-intensity interval training (HIIT) and a few supplements like a blood sugar-supporting multi. Insulin plays a big role in PCOS, and managing this master hormone makes an excellent first step to reverse PCOS.
But for Jenni, diet, nutrients, and exercise weren’t enough. Even though she professed she'd done everything correctly, she still suffered from headaches (especially in the beginning of her cycle), thyroid imbalance, terrible sleep, and an inability to maintain her happy weight. As a doctor who helps women balance their hormones without the need for birth control pills, I started putting the pieces together to treat Jenni’s condition.
Getting to know estrogen—and why we might have too much or too little.
She worked at a high-end cosmetics store and was using at least a dozen of their skin care products. As we talked during our initial consultation, Jenni chugged from a plastic water bottle. Her low-carbohydrate diet included lots of conventionally raised beef, eggs, and poultry. I immediately uncovered a condition I often see with women around her age (though it can affect nearly everyone): estrogen dominance, which for Jenni became a driving factor behind her hormonal symptoms and PCOS.
My patients have a love-hate relationship with estrogen. Some vilify it, and some (normally post-menopausal women) revere it. Yet like any hormone, estrogen isn’t good or bad; it all comes down to balance. Among its duties, estrogen gives your body fabulous hips, breasts, and thighs. It builds up endometrial tissue in your uterus to have a baby (important even if you don’t want to get pregnant). Adequate estrogen levels also protect your mood, brain, heart, and bones. You want estrogen sticking around, but you also want it to stay in check. When it starts running the show and knocks other hormones like progesterone out of whack, estrogen imbalance occurs.
Common factors that create estrogen imbalance in the body.
Dr. John R. Lee coined this term to describe what occurs when a woman has deficient, normal, or excessive estrogen but little or no progesterone to balance estrogen’s effects. Even low estrogen levels can create estrogen dominance symptoms if you’re also low in progesterone. In my practice, I’ve found that these factors create estrogen imbalance:
- Being overweight or obese (fat cells produce excess estrogen)
- Being overly stressed (adrenal hormones are overly stimulated)
- Poor diet choices
- Autoimmune conditions
- Gut conditions like constipation
- Environmental toxins
That last one was a biggie for Jenni. Like most people, her body was inundated with estrogen-mimicking chemicals from personal care products, water, food, and even the air she breathed.
Chemicals are everywhere, but they're only one piece of the estrogen dominance puzzle.
Those excess chemicals—called xenoestrogens—were constantly bombarding her and set the stage for estrogen dominance. One study found that mineral water with xenoestrogens leached from plastic packaging material could create estrogenic activity, and sadly, these chemicals are all over the place in our modern world. That being said, estrogen dominance doesn’t occur in a vacuum. In Jenni’s case, when estrogen gets out of balance, other hormones like insulin and cortisol quickly follow. Even though she followed a low-carbohydrate diet, her insulin levels were still high, and chronic stress working long hours revved up her cortisol levels. Female hormones are intricately connected and complicated. I strongly recommend working with a functional practitioner to overcome estrogen dominance and other imbalances.
10 ways to take charge of your hormones and live your best life:
In the meantime, I've found that these 10 strategies have helped Jenni and other clients create and maintain hormonal balance:
1. Get tested.
Lab testing can reveal whether and why you have estrogen dominance. In my clinic, we use advanced hormone lab testing to develop an individualized protocol based on your body’s needs.
2. Pay attention to what you put on your skin.
Your skin is a sieve, and estrogen-mimicking chemicals linger in many cosmetics. I asked Jenni to toss her cosmetics (she initially balked but eventually consented) and use the Environmental Working Guide’s (EWG’s) Skin Deep® Cosmetics Database.
3. Eat the highest-quality food you can afford.
Factory-farmed animals get estrogen-containing growth hormones to fatten them up, and guess where those hormones end up? Look instead for grass-fed meats, pasture-raised eggs, and organic produce.
4. Give your liver some love.
Studies show environmental estrogens can mimic, block, or cancel estrogen levels. Your liver helps eliminate excess estrogen, but an overburdened liver means you’re not efficiently moving that excess estrogen out. Liver-healing strategies include eating quality protein, garlic and onions, taking a B vitamin, and really filling up on those cruciferous vegetables.
5. Heal your gut.
Once the liver processes estrogen for elimination, your gut moves it out. Gut issues mean estrogen probably isn’t making its way out efficiently and instead could be recirculating in your body. As you can see, identifying and treating underlying causes of your digestive issues becomes crucial to balancing hormones.
6. Eat more fiber.
Sufficient dietary fiber helps eliminate waste, including binding and releasing excess estrogen. Fabulous fiber-rich foods include avocado, leafy and cruciferous veggies, berries, and freshly ground flaxseeds. I had Jenni gradually increase her intake until she got 35 grams of fiber daily.
7. Eat a ton of vegetables.
Or at least about a pound daily. Among its copious nutrients, studies show indole-3-carbinol (I3C)—prevalent in broccoli and other cruciferous vegetables—prevents the development of estrogen-enhanced breast, endometrial, cervical, and other cancers. Numerous types of studies support I3C’s efficacy. Green is great, but go for a variety of leafy and cruciferous vegetables.
8. Supplement smartly.
A functional practitioner or nutritionist can help you design an estrogen-balancing supplement protocol. Studies show two antioxidants—N-acetylcysteine (NAC) and resveratrol—can help reduce formation of estrogen-DNA adducts and prevent several cancers. Optimal vitamin D is also crucial, as studies show sufficient vitamin D levels can inhibit breast cancer cell growth. Ask your doctor for a 25(OH)D test, NOT the 1,25(OH)₂D test.
9. Dial down stress.
Chronic stress can lower progesterone, ramp up your stress hormone cortisol, and—you guessed it—create estrogen dominance. Lowering stress can help rebalance estrogen and other hormones. If yoga or meditation aren’t your thing, even five minutes of deep breathing or laughing with your best friend can help lower cortisol and reset estrogen levels.
10. Get better sleep.
Sleep becomes mandatory to balance estrogen and so many other hormones. If you have trouble drifting into eight hours of solid sleep nightly, try a relaxing tea, a warm bath, or maybe a melatonin supplement. Studies show melatonin possesses anti-estrogenic effects on estrogen receptor-expressing breast cancer cells.
While it took several months to reverse Jenni’s estrogen dominance—we focused on things like detoxification and thyroid support during our follow-up consultations—eventually she felt better and hit her weight loss goals. During her last visit, she told me she felt like a new woman.
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Jolene Brighten, N.D., is a women’s health expert currently working as the President and Chief Medical Officer at Rubus Health in Portland, Oregon. She received her Doctorate of Naturopathic Medicine at the National University of Natural Medicine and a bachelor’s in Nutrition Science from Cal Poly, San Luis Obispo. She is the best-selling author of Beyond the Pill, in which she shares her clinical protocols aimed at supporting women struggling with symptoms of hormone imbalance, including Post-Birth Control Pill Syndrome and birth control related side effects. Dr. Brighten has been featured in the New York Post, Cosmopolitan, Forbes, ABC News, and The Guardian.