Susan Merenstein, Pharmacist/Owner

(412) 586-4678

Estrogen Dominance

Estrogen Dominance is like the elephant in the room that most modern medicine is not addressing.

Testing your hormones is a great start, in addition to being aware of your symptoms and becoming a pro-active participant in your health.

By balancing all of your hormones, you can choose health and longevity versus disease and a shortened life.

Please read the following information to help you balance your estrogen and lead a healthier life.

Here is a blog from our favorite testing lab, ZRT Laboratory:

What is Estrogen Dominance?

Estrogen dominance refers to an excess of estrogen when progesterone levels are inadequate. This condition can occur in women during the reproductive years, but tends to be particularly symptomatic for women during perimenopause and in menopause. Estrogen dominance is worsened by women not ovulating, women being exposed to synthetic estrogens and/or women not metabolizing estrogens correctly. Estrogen dominance is a term coined by John Lee, M.D. in the book What Your Doctor May Not Tell You About Menopause.

The Problem

Scientific studies link high estrogen or estrogen imbalance with a wide range of symptoms and conditions, from hot flashes, night sweats, low libido, and foggy thinking to more serious conditions related to reproductive health (endometriosis and PCOS) as well as breast disease including cancer. Hormone imbalances triggered by medications like synthetic hormone combinations have also been found to contribute to estrogen dominance problems.

Symptoms of Estrogen Dominance Include:


  • Weight gain, mainly in hips, waist, and thighs
  • Menstrual problems such as light or heavy bleeding
  • Irregular menstrual cycles
  • PMS
  • Mood Swings
  • Fibrocystic and tender breasts
  • Uterine fibroids
  • Fatigue
  • Loss of sex drive
  • Depression or anxiety
  • Hot flashes
  • Night Sweats


  • Enlarged breasts
  • Sexual dysfunction
  • Infertility


Premenopause: Lack of ovulation and/or reduction of ovarian production of progesterone.

Perimenopause (40s-mid-50s): Lack of ovulation or erratic cycles, when estrogen levels fluctuate rapidly from high to low in the absence of adequate progesterone.

Postmenopausal: An imbalance of estrogen to progesterone ratio in waning reproductive years when ovarian production of estrogen can decline by as much as 60% and levels of progesterone can drop to nearly zero with the cessation of ovulation.

Balancing Estrogen

Women of all ages benefit from balanced hormones. With menstrual irregularities, PMS, endometriosis and infertility, testing can be helpful in understanding the underlying condition. Healthcare providers working with perimenopausal and menopausal women find hormone testing to be a key step in detecting and correcting imbalances. Testing hormone levels is also invaluable for monitoring women using hormone replacement therapy.

Why Test Hormones

Because hormones work together to create a balanced internal milieu, it makes sense to test all of the following to help determine estrogen dominance:

  • Estradiol (E2) the most potent of the estrogens
  • Progesterone (Pg)
  • Testosterone
  • Cortisol (stress hormones, for adrenal function)
  • Thyroid Profile (TSH, T3, T4, TPO Antibodies for Hashimoto’s Thyroiditis)


From fatigue and irritability to autoimmune conditions, thyroid dysfunction, and cancer, estrogen can wreak havoc on your body if it’s not in proper balance with your other reproductive hormones, such as progesterone.

Help for Estrogen Dominance

Good Nutrition is Vital! The right diet can help to bring estrogen back into balance by reducing estrogen production by the ovaries and adrenal glands, and by interfering with estrogen’s ability to bind to tissue receptors. Also affected by diet are the breakdown and detoxification of estrogen by the liver, and its elimination from the body.

  • Avoid caffeinated drinks and foods (including chocolate), sugar, fried and fatty food, refined starches, and salt—a diet with a low glycemic index keeps insulin and estrogen down. The above foods decrease the metabolism/elimination of estrogen from the body. Several studies have found that caffeinated beverages actually increase breast lumpiness and tenderness. Caffeine creates a cortisol dominant, stressful environment. Salt increases bloating and fluid retention. Sugar depletes your body of B vitamins and minerals that are necessary for stress reduction, healing and normal hormone metabolism.
  • Avoid Insulin resistance by eating low glycemic foods and avoiding all sugar (which can be caused in turn by high cortisol). LH/FSH are unbalanced and signals are sent to the ovaries as if to develop a dominant follicle. This leads to cyst formation. Also causes increase in estrogen and testosterone levels.
  • Limit alcohol consumption-Alcohol is extremely stressful to your liver. It hinders the liver’s ability to break down estrogen effectively, thereby leading to excess estrogen levels in the body.
  • Avoid ALL NON-ORGANIC, NON-GRASS FED AND FINISHED saturated fats, red meats, dairy products, and wheat products-All of these foods elevate estrogen levels and contain fats like aracadonic acid which stimulates production of the bad, inflammatorytype of prostaglandins that can worsen inflammation of the endometrium.
  • Organic when Possible—Pesticides mimic estrogen and hormones are given animals. Organic fruits and vegetables contain a wide range of nutrients and enzymes that strengthen blood vessels, balance hormones, dramatically reduce fibroid-induced bleeding, pain and cramps.
  • High Fiber and whole grains –Both soluble insoluble-Helps remove excess estrogen through the gastrointestinal tract by binding to estrogen. Whole grains are an important source of B vitamins and essential minerals. (Organic when possible) Increases SHBG, which reduces levels of unbound, active estrogens. Fiber eliminates conjugated steroid hormones, increases SHBG, absorbs and eliminates bile toxins
  • Ground Flaxseeds or Ground Chia—Lots of lignans, vitamins, protein and fiber. Helps your body achieve hormonal balance. Maintain healthy cholesterol and blood sugar levels, supports healthy breast tissue, and even provide moisture to skin and joints.
  • Eat Non-GMO soy foods, whole grains (such as buckwheat, rice, millet, and oats), and fresh fruits and vegetables —Soy is a phytoestrogen, which can prevent the more aggressive estradiol from binding to receptors in the body. All of these foods are high fiber, which help to eliminate estrogen from your body. They also help reduce estrogen production.
  • Cruciferous Vegetables—Broccoli, cauliflower, Brussels sprouts, cabbage; or DIM® —the active ingredient in the vegetables helps with excess estrogen.
  • Increase consumption of cold-water fish (salmon, mackerel, herring, and sardines) and omega-3-rich seeds and nuts, especially ground flaxseed (2-4 tablespoons ground, every other day)-Also effective are sesame, sunflower, almonds, pecans, and pumpkinseeds. According to a 2002 study from Cancer Epidemiology Biomarkers, women who ate at least 2 servings of fatty fish such as salmon and herring a week had lower risk for endometrial cancer than women who consumed less than one serving a week, due to the omega-3 fatty acids found in the fish. Essential fatty acids help you produce the anti-inflammatory prostaglandins.
  • Get off trans-fats. They can lead to the formation of bad estrogen metabolites as well as slow the metabolism down.
  • Eliminate external sources of estrogen and Xenoestrogens and limit Phytoestrogens-Many OTC products including women's vitamins, energy pills for women, facial creams, etc have been found to have hormones in them, unlabeled. They interfere with estrogen activity, and in some cases the body compensates by making more endogenous estrogen. We love our Non-toxic skin care called LabNaturals ( preservative, dye and TOXIN FREE!!
  • Conjugating as much estrogen as possible: liver detox (pooping regularly first) and probiotic (Probiotic 30BU) to help ensure normal population of the lower intestine to keep beta-glucuronidase level under control. Increases amount of inactivated estrogen metabolites that leave the body via the large intestine.
  • Speed up safe estrogen metabolism: make sure Progesterone is at physiologic level--The natural blocker of excess estrogen effects in the body. Progesterone makes sure that any buildup of the endometrial lining is shed each month during menstruation. Postmenopausally, Progesterone should be used daily with a 2-3 day break each month-Monday through Saturday, Sundays off.

Supplements to help balance Estrogen Dominance

Healthy Estrogen Metabolism Capsules-This multi-ingredient product contains Calcium D Glucarate, DIM, Indole 3 Carbinol, Resveratrol, Turmeric, Green Tea, Black Pepper Fruit Extract. Helps to remove excess estrogens and xenoestrogens. May inhibit tumor formation caused by chemical cancer-causing agents and helps liver detox.

Green Duo Detox (Sulforaphane 120mg)-inhibits the development of Cancer by enhancing the function of endogenous enzymes to block carcinogens. Increase Quinone Reductase activity: Sulforaphane (found in broccoli sprouts or as supplement) - R Lipoic Acid, Trans Resveratrol, Green Tea Extract EGCG

Magnesium Elemental Chelate/Glycinate-5mg per pound of body weight – 500-1000mg/day Too much Mg will give you diarrhea so decrease dose if this happens. Mg helps with the breakdown of estrogen. by promoting the methylation of catechol estrogens. Helps with breast tenderness, weight gain, extremity swelling, and bloating abdominally.

Vitamin C 1,000 - 5,000mg daily-Found in soy, buckwheat, alfalfa sprouts, the inner peel of citrus fruits, and many berries-helps to lower the body’s estrogen production by binding to an enzyme required for estrogen synthesis, strengthen blood vessels, build collagen and reduce inflammation. They also bind to and block estrogen receptor sites on uterine tissue and block fibroid stimulating effects.
Adrenal C with bioflavonoid, Ascorbyl Palmitate, Sodium Ascorbate, Ascorbic Acid, Vitamin C Packets

Vitamin A Palmitate - 10,000 IU daily-This nutrient appears to play a role in correcting a number of estrogen-dominant conditions in humans, such as female reproductive cancers. A study of 71 women found that those with excessive bleeding had significantly lower blood levels of Vitamin A than the normal population.

Vitamin D - (45 iu/pound of body weight) Make sure your level of 25 (OH) D is between 50-80ng/ml -
Vitamin D drops-2000iu/drop- 3-5 drops/day. Or you can take Vitamin D plus K capsules.

Zinc- Essential part of structure of estradiol receptor (zinc fingers); inhibits aromatase; low zinc may lead to low testosterone and high estradiol levels; essential part of structure of SHBG. Also reduces Prolactin and helps with premenstrual acne.

Support methylation and breakdown of estrogen: B1, B6, B12 and folate with a methyl donor and enzyme cofactors and support the COMT enzyme to detoxify estrogens. Reduce menstrual pain and cramps. In clinical studies, Vitamin B6 (50-100mg) has led to a reduction in PMS-related cramping, fluid retention, weight gain, and fatigue. Vitamin B6 is involved in clearance of estradiol from nuclear receptors. A B6 deficiency can lead to estrogen dominance. Estrogen supplementation, including birth control pills increased need for B6. Vitamin B Trio Activated or B Supreme or Active B12/Folic Acid sublingual.

Alpha Lipoic Acid (Racemic) – 300-600 mg / day—an Antioxidant that helps to prevent insulin resistance and helps enhance our natural detoxifier, immune booster and antioxidant called Acetyl Glutathione

Acetyl Glutathione is the body’s Master Antioxidant, Immune Booster, and Detoxifier. It strengthens the immune system, detoxifies liver and cells, reduces the effects of stress, increases energy, and improves the quality of sleep. The body makes about 100mg per day but 300mg per day is needed to restore levels. It neutralizes free radicals, increases Natural Killer Cells, enhances the body’s ability to fight off toxins, infectious disease, pre-cancerous cells and the aging process itself. Lower quinone formation: avoid pesticides and trans hydrogenated fats- They can lead to the formation of bad estrogen metabolites as well as slow the metabolism down, and take an antioxidant to lower lipid peroxidase activity. Typical dose is 2mg/pound of body weight, 4mg/pound in cancer disease. It can be used topically to the breast tissue and combined with iodine. Support Glutathione activity: avoid toxins that stress the liver (including excess hormones and alcohol), garlic, MSM, Acetylated Glutathione 300mg, Selenium. Other good antioxidants are Astaxanthin and Trans Resveratrol

Phytoestrogens such as Black Cohosh, Dong Quai, and Vitex (chaste tree berry)—Vitex is an herb from the chaste plant that increases the ratio of progesterone to estrogen. Helps the body produce progesterone. Has a beneficial effect on breast pain (mastitis) and can suppress Prolactin. Can improve irritability, mood alteration, anger, headache, breast fullness, bloating, and other menstrual symptoms. Black Cohosh Plus with Dong Quai-1-4 per day.

Iodine (inorganic) Nascent Iodine 3 drops 3 times a day in water - Iodine may also be incorporated into a breast cream using Palmitated Glutathione as a base

Iodine’s main function is in the production of thyroid hormone by the thyroid gland. Can decrease fibrocystic breasts and weaken the estradiol molecule. Works well for sore and fibrous breasts. “Iodine has been shown to induce apoptosis (death) in breast and thyroid cancer cells”

“It is known that ovaries concentrate a large amount of iodine. After the thyroid, the ovaries have the second largest concentration of iodine in the body. Iodine deficiency produces changes in the ovarian production of estrogens as well as changes in the estrogen receptors of the breasts. In an iodine deficient state, research has shown that ovarian estrogen production increases, while estrogen receptors in the breast increase their sensitivity to estrogens. Both of these conditions will increase the risk of developing pathology of the breasts, including breast cancer.”