"Have you ever experienced tender breasts and irritability before your period? What about heavy bleeding and pain with menstruation? Chances are, that at one time or another, you’ve experiences these – and other – uncomfortable symptoms associated with your cycle. We often think of these symptoms as “normal” and just par for the course when it comes to being a woman. Although common in our society, I’m here to tell you that these symptoms are not normal and a sign that hormones are out of balance."

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“When we talk about estrogen dominance, we are really talking about an imbalance between estrogen and progesterone.”

“I’m such an advocate for testing – instead of guessing - when it comes to hormones. We want to understand what case your estrogen dominance falls under along with what is the root cause.”

What Is Estrogen Dominance And How Does It Impacts Body Fat

Have you ever experienced tender breasts and irritability before your period? What about heavy bleeding and pain with menstruation? Chances are, that at one time or another, you’ve experienced these – and other uncomfortable symptoms associated with your cycle. We often think of these symptoms as “normal” and just par for the course when it comes to being a woman. Although common in our society, I’m here to tell you that these symptoms are not normal and a sign that hormones are out of balance. 

In my hormone series, I’ve already covered the stress hormone cortisol and the relationship between cortisol and progesterone. Today, in Part 3 of this series, I will cover estrogen and specifically an imbalance between estrogen and progesterone known as estrogen dominance. This is one of the most common hormonal imbalances among women in my practice. 

Many women desire to lose weight and estrogen levels, among other hormones, may play a role. Keep reading to learn more about the estrogen and fat connection. 

In this article, you will learn more about: 

• What estrogen dominance is and what causes it
• Signs and symptoms of estrogen dominance
• The relationship between estrogen and body fat
• Simple lifestyle changes to support estrogen balance

So pull up a chair; let’s dive in!

What Is Estrogen Dominance?

Before we cover estrogen dominance, let’s back up and talk about what estrogen is first. Estrogen is the sex hormone in women that is responsible for the first half of your menstrual cycle. It builds up the uterine lining and prepares the uterus for a baby. 

Estrogen includes three steroid hormones: estrone (E1), estradiol (E2) and estriol (E3). These estrogens, in normal amounts, gives you curves, supports a balanced mood, helps you to have strong bones, improves your memory, strengthens immunity and keeps your skin plump and moisturized.  So we don’t want to assume that estrogen is all bad – it’s just like most things in life: we want the right amount.

When we talk about estrogen dominance, we are really talking about an imbalance between estrogen and progesterone. Remember that progesterone is the star of the second half of the cycle. It maintains the uterine lining and supports a pregnancy. You must ovulate to produce progesterone and one of the chief reasons for progesterone is its starring role in balancing out estrogen. Not only does it protect you from estrogen related cancers but it promotes deep sleep (when you have enough of it) and gives you that calm, cool, and collected vibe that makes you feel grounded. 

There are two cases where estrogen dominance shows up:

1. Estrogen levels are normal, but progesterone is low. So in effect, estrogen is dominant in relationship to progesterone. This might be related to anovulatory cycles, peri-menopause, PCOS, stress or inflammation. Since hormonal birth control prevents ovulation, that is often another contributor.

2. Estrogen levels are high, but progesterone levels are normal. This might be because of excess body fat, microbiome imbalances, poor digestion, impaired liver detoxification or xenoestrogens acquired from the environment. 

I’m such an advocate for testing – instead of guessing - when it comes to hormones. We want to understand what case your estrogen dominance falls under along with what is the root cause. 

Signs Of Estrogen Dominance

Now that we’ve covered what estrogen dominance is from the biochemical perspective, what are the signs of estrogen dominance that you might experience physically? 

Estrogen dominance symptoms include:

• Heavy periods
• Irregular periods
• Water retention and swelling
• Breast tenderness and breast changes
• Headaches or migraines
• Weight gain
• Mood swings  
• Painful periods
• PMS symptoms
• Fertility challenges
• Hypothyroidism
• Sugar cravings
• Fibroids
• Fertility challenges
• Changes in memory and brain function

Chances are you’ve experienced some of these at one time or another. The symptoms women experience around weight gain and stubborn weight loss are often at the forefront of health goals. 

Does Estrogen Cause Weight Gain? Estrogen Dominance and Belly Fat

What’s the deal with estrogen dominance weight gain? Are these really estrogen fat deposits? Does estrogen cause weight gain?

These are just a sprinkling of real questions I’ve been asked on this topic. Let me break it down for you. 

Estrogen, in normal amounts, does not cause weight gain. In fact, it helps with weight maintenance throughout the years that a woman has a cycle. Estrogen actually benefits muscle mass, bone health and insulin sensitivity. When we lose estrogen production, through menopause, that may contribute to weight or fat gain. So remember that estrogen is good when it’s in balance. 

When estrogen is out of balance and estrogen is clinically high, or high relative to progesterone, the relationship between estrogen and fat takes on a new challenge. 

Estrogen is produced in the adrenal glands, brain, ovaries (or testes) and also by fat tissue. Yes, you heard that right: fat increases estrogen. Estrogen also signals for fat storage, which makes sense because a woman needs a certain amount of fat on her body to be fertile. But, in certain cases, this cycle between fat producing estrogen and estrogen signaling for fat storage can become a cycle, and an unwanted situation if you are trying to lose weight. 

Now let’s add to this picture a little. “Estrogen belly fat” as one patient so bluntly referred to it, may contribute to insulin resistance, making blood sugar higher and it harder to effectively use blood sugar to make energy for the body. Fat cells are also a main site where the body stores toxins and many toxins, known as obesogens, make it hard for the body to lose weight. If you’re under stress and have high cortisol or HPA-axis dysfunction, that contributes as well. 

I want to take an aside to mention that this is one of the reasons that exercising more and eating less doesn’t work for weight loss, especially sustained long-term weight loss. Hormones play a huge role. 

Let’s take a look at some of the research and get a little more precise about too much estrogen and weight gain. 

When looking at the biochemistry, research has uncovered that estrogen decreases lipolysis in adipose tissue (fat tissue) through the estrogen receptor called ER-alpha. This is just a fancy way of saying that estrogen prevents the breakdown of fat. 

Another study states that: “estrogen’s effect on fat may depend where it’s located,” going on to say that estrogen blunts fat breakdown in the abdomen, but not in the butt. This might explain why estrogen dominance is more associated with weight in the midsection and that apple shape, instead of pear. 

Overall, estrogen balance is incredibly important for weight maintenance and weight loss. Addressing estrogen dominance, holistically, is one of the root cause approaches for weight loss. Let’s talk about some ways to do that. 

Estrogen Dominance Treatment

Treatment approaches for estrogen dominance will vary from woman to woman depending on her personal imbalance between estrogen and progesterone and the underlying contributors. Hormones work in concert so it’s also important to consider how other hormones contribute to the whole picture. 

Here are some important steps to consider for estrogen dominance: 

1. Improve nutrition. Nutrition is clearly foundational when it comes to hormone balance and plant foods play a large role by providing nutrients needed for estrogen metabolism, liver detoxification and removing excess estrogen from the body via the colon. A colorful, fiber-rich diet is a good place to start and specific foods including cruciferous veggies (kale, broccoli, cauliflower, etc.), flax seeds, onions, garlic, raw carrots, beets, dandelion and others are superstars when it comes to lowering estrogen levels. I’m going to dive into this topic in greater detail in Post 4 of my hormone series. Stay tuned! 

2. Improve digestion. Since estrogen metabolites leave the body via the digestive tract, it’s so important to have regular bowel movements. If you are constipated, estrogens that are flagged to leave will recirculate in the body contributing to high levels. In addition, there is a portion of the gut microbiome, called the estrobolome, which involves a collection of enzymes that interact with estrogen. We are still learning about all of the intricacies here, but it is clear that a healthy microbiome – and estrobolome – are key for hormone balance. 

3. Support liver detoxification. Before estrogen gets to the colon and interacts with the estrobolome, it must pass through two phases of liver detoxification. In the first phase it can turn into metabolites that are either more or less associated with cancer. And in the second phase, methylation through COMT is needed to fully convert the metabolites so they can leave the body. This is where personal genetics and personal nutrition status plays a great role. I talk all about liver detoxification in this article. 

4. Clean up xenoestrogens. This is a big one in today’s world. The average woman is exposed to hundreds of chemicals and pollutants every day. They easily absorb into your body from personal care products and makeup, from your food and even the air you breathe and water you drink. Xenoestrogens are man-made chemicals that act like estrogen in the body. They bind to estrogen receptors, contribute to estrogen dominance and place additional stress on the body. The best strategy here is to limit exposure by controlling what you can. Here are some more specific tips:

1. Reduce plastic use, especially plastics with BPA. Use glass, stainless steel and ceramic containers for eating, drinking and storing food. And, never heat food in plastic or pour hot food into plastic containers. BPA is also found in receipts so be sure to wash your hands after handling any. (Note that hand sanitizer actually increases absorption of BPA.)
2. Choose clean cosmetics that don’t contain phthalates or synthetic fragrance.  The Environmental Working Group’s Skin Deep Database is a great place to learn more, look up the products that you use and search for cleaner alternatives. 
3. Take off your shoes when you enter your home so you don’t track pesticides and other chemicals inside. 
4. Choose organic as much as possible.  Organic food and organic cotton clothing helps limit the pesticides (and other chemicals) that enter your body.

Although each woman is different, these four areas are foundational when it comes to estrogen balance. They aren’t medication or quick fixes, but real lifestyle change that support hormone balance over the long-term. For more specific guidance, especially for women experiencing estrogen dominance symptoms, please don’t hesitate to reach out for proper testing and personalized support. Remember that even though painful periods, belly fat and mood swings are common, they are not normal. Let’s make your cycle comfortable and easy!

References

1. Schechter D. (1999). Estrogen, progesterone, and mood. The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia, 2(1), 29–36. Abstract: https://pubmed.ncbi.nlm.nih.gov/11252868/ 
2. Toffoletto, S., Lanzenberger, R., Gingnell, M., Sundström-Poromaa, I., & Comasco, E. (2014). Emotional and cognitive functional imaging of estrogen and progesterone effects in the female human brain: a systematic review. Psychoneuroendocrinology, 50, 28–52. Abstract: https://pubmed.ncbi.nlm.nih.gov/25222701/ 
3. Holtcamp W. (2012). Obesogens: an environmental link to obesity. Environmental health perspectives, 120(2), a62–a68. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279464/ 
4. Luglio H. F. (2014). Estrogen and body weight regulation in women: the role of estrogen receptor alpha (ER-α) on adipocyte lipolysis. Acta medica Indonesiana, 46(4), 333–338. Abstract: https://pubmed.ncbi.nlm.nih.gov/25633552/ 
5. Gavin, K. M., Cooper, E. E., Raymer, D. K., & Hickner, R. C. (2013). Estradiol effects on subcutaneous adipose tissue lipolysis in premenopausal women are adipose tissue depot specific and treatment dependent. American journal of physiology. Endocrinology and metabolism, 304(11), E1167–E1174. Full text: https://journals.physiology.org/doi/full/10.1152/ajpendo.00023.2013?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org 
6. Ervin, S. M., Li, H., Lim, L., Roberts, L. R., Liang, X., Mani, S., & Redinbo, M. R. (2019). Gut microbial β-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens. The Journal of biological chemistry, 294(49), 18586–18599. Abstract: https://pubmed.ncbi.nlm.nih.gov/31636122/ 

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