Estrogen Dominance: What Is It and How It Affects Your Health

by Jan 21, 2021

If you have ever experienced heavy periods, breast tenderness, or water retention during your premenstrual phase, you are already familiar with the effects that estrogen can have on your body. But when estrogen is chronically high, some of these symptoms can become more than just an occasional annoyance. You could experience problems ranging from constant breast tenderness to anxiety or depression, to significant weight gain. 

A female doctor

Chronically high estrogen levels can lead to a condition called estrogen dominance. Here’s everything you need to know about the condition, including how to tell if it might be affecting you — and what you can do about it.

What is estrogen dominance?

As women, our bodies depend on a delicate balance of sex hormones to regulate our menstrual cycle, maintain our weight, balance our mood, and generally keep us happy and healthy. When our hormone levels are higher or lower than what is normally expected, a hormonal imbalance can occur.

Estrogen dominance is a type of hormone imbalance resulting from high estrogen, low progesterone, or both. When progesterone is too low, estrogen becomes comparatively high, allowing it to have a dominant effect on the body. The same effects can occur if your estrogen levels are too high.

Some women are genetically prone to estrogen dominance, while others may experience estrogen dominance due to a clear secondary cause. Read on to learn more about the causes of estrogen dominance and what they mean for your overall health.

What Causes Estrogen Dominance?

As we mentioned previously, estrogen dominance does not always have a clear secondary cause. Some women are simply genetically prone to producing more estrogen than others. However, many times, estrogen dominance is caused by an external factor, such as weight gain, medications, or environmental toxins. 

Here are some of the reasons why a person without a genetic predisposition for high estrogen might suddenly develop estrogen dominance:


Chronic psychological stress commonly results in hormone imbalance — like estrogen dominance — due to the effects of the stress hormone cortisol on the body. When your body produces too much cortisol, it must also produce progesterone to compensate. Ultimately, this depletes your progesterone stores, resulting in a comparatively high level of estrogen. As a result, women can experience symptoms of estrogen dominance when they are stressed. Thankfully, this also goes the opposite way: managing your stress levels can help relieve the symptoms of estrogen dominance.

Excess Body Fat

Obesity is linked to estrogen dominance due to the role of fat, or adipose tissue, in producing estrogen. Adipose tissue produces estrogen, meaning that if you store too much fat in your body, you may become estrogen dominant. One of the most harmful potential complications of estrogen dominance in obese women is the elevated risk of endometrial cancer, a hormone-driven disease.

Birth Control and Hormone Therapy

Some types of hormonal birth control, including the combined oral contraceptive pill, contain a synthetic form of estrogen. The estrogen found in oral contraceptives works to prevent ovulation, thereby preventing pregnancy. However, it can also result in unpleasant symptoms of estrogen dominance, such as depression or low libido. Hormone therapy used to treat symptoms of menopause, like hot flashes and night sweats, also contains estrogen and may have the same effects.

Heavy Metal Pollution

Heavy metals like cadmium, lead, and mercury are considered endocrine disruptors, meaning they can throw off the delicate balance of hormones in your body. One way they do this is by mimicking the role of estrogen in the body. The increased presence of heavy metals in our environment may be responsible for the prevalence of estrogen dominance, and even for the earlier onset of menstruation found in many modern societies. 


Bisphenol A, or BPA, is a harmful form of plastic you have probably heard much about. One of the reasons why you should avoid BPA is that it contains xenoestrogens, which mimic the role of natural estrogen in the body. When found in food containers or water bottles, BPA-containing plastic may leach into food or water, finding its way into the body. This can lead to estrogen dominance, as we are unwittingly consuming these excess estrogenic chemicals. Studies show that similar chemicals may even leech from BPA-free plastics. As a result, glass containers and water bottles may be a safer alternative to plastic when it comes to preventing estrogen dominance.

How to Identify Signs of Estrogen Dominance

The symptoms of estrogen dominance can be difficult to identify because they tend to be similar to those caused by other conditions. Below, we list some of the key symptoms seen in women with the condition. 

The more of these symptoms you have, the more likely it is that they are caused by estrogen dominance, rather than another medical condition. However, if you suspect you may have estrogen dominance or are bothered by any of these symptoms, it is always a good idea to consult your doctor to rule out serious illness.


Premenstrual syndrome, or PMS, can make you dread the arrival of your monthly period. PMS is responsible for symptoms like mood swings, breast tenderness, and menstrual cramps that occur in the week leading up to your period. When PMS causes severely low mood and other symptoms of depression, its more serious counterpart, premenstrual dysphoric disorder (PMDD), may be diagnosed.

Mood Swings

Estrogen plays an important role in regulating our mood, meaning that estrogen dominance may cause mood instability at any time of the month. Fluctuating estrogen levels, either throughout your cycle or due to estrogen dominance, may cause you to have more mood swings, making you more emotional or irritable than usual.

Reduced Sex Drive

One in three women in the United States suffers from low libido. Many times, low sex drive can be attributed to estrogen dominance. Our sex drives are regulated by the delicate balance of sex hormones like estrogen, progesterone, and testosterone found in the female body. When these hormones fall out of balance, low libido may be one of the results.


Women are twice as likely to get depression as men, leading many experts to speculate that estrogen may be to blame. Estrogen plays an important role in regulating the production of serotonin, the “happy hormone” that helps us maintain a normal mood. Its relationship to serotonin may have something to do with its role in depression. 

Regardless, depression is known to be a serious side effect of estrogen-containing medications like hormone therapy and oral contraceptive pills, suggesting that estrogen dominance may increase the likelihood of experiencing this disorder.


Excess estrogen may lead to symptoms of anxiety in some women. Research shows that estrogen and its receptors play a key role in the expression of anxiety in both humans and animals. It’s possible that high estrogen may increase the stimulation of certain estrogen receptors responsible for symptoms of anxiety.


If you experience bloating during PMS, you are not alone. Estrogen is a fluid-retaining hormone, so high levels may lead to water retention and bloating. When estrogen is chronically high, as in estrogen dominance, this bloating may become much more frequent. 

Breast Tenderness

Another well-known symptom of estrogen dominance is breast tenderness. High levels of estrogen hyperstimulate the cells in the breast tissue, causing pain, swelling, and discomfort. In the long-term, this can cause the cells of the breast tissue to proliferate, making you possibly more likely to develop breast cancer.


Excess estrogen interferes with the production of melatonin, an important hormone in regulating your sleep and wake cycles. As a result, you may be more likely to experience insomnia and other sleep disorders with estrogen dominance.

What Are the Risks of Estrogen Dominance?

Estrogen does much more than simply regulate your menstrual cycle and prepare the body for pregnancy. As you can tell from the myriad of symptoms associated with estrogen dominance, this hormone plays an important role in the body and your overall health. 

In the long-term, untreated estrogen dominance may be associated with certain risks. Here are just a few of the reasons why you should consult your doctor for treatment and advice if you suspect you may have high estrogen:


High estrogen does not directly cause endometriosis, but endometriosis is a hormone-modulated condition. Just as estrogen promotes the proliferation of endometrial tissue prior to menstruation, it also promotes the growth of the endometrial-like tissue that grows outside the uterus in endometriosis. As a result, excess estrogen can worsen the symptoms of endometriosis if you are one of the 1 in 10 women who have the disease.

Breast and Ovarian Cancer

Certain types of breast and ovarian cancer — such as estrogen-receptor-positive breast cancer — are strongly linked to estrogen. In these types of cancer, high levels of estrogen can promote the proliferation of malignant cells in the breasts or ovaries. Because estrogen plays an important role in its growth, these types of cancers are often treated with anti-estrogenic therapy.

Autoimmune Disease

Women are more prone to developing autoimmune diseases than men, leading many scientists to suspect that estrogen may play an important role in autoimmunity. Research shows that estrogen receptors activate a type of T-cell implicated in many autoimmune diseases, promoting autoimmune inflammation. As a result, high estrogen may make you more prone to developing autoimmunity or worsen autoimmune symptoms in people who already have an autoimmune condition (read our guide on what to expect with autoimmune diseases and pregnancies).

Blood Clots and Stroke

Blood clots are well-known side effects of taking oral contraceptive pills, especially if you have a history of smoking. In fact, estrogen-containing birth control pills make you three to four times more likely to develop a blood clot. Thus, high estrogen may increase your risk of having a dangerous blood clot. When blood clots go to the brain, they can cause a stroke, which may lead to permanent damage or even death. 

How to Track Your Estrogen Levels

If you are concerned about the potential of estrogen dominance, you may want to consider tracking your estrogen levels with a digital hormone tracker like Mira. Tracking your estrogen levels can give you peace of mind and help you make important decisions about your health (or check out our guide to reversing estrogen dominance naturally). 

Similar to a home pregnancy test, Mira measures your estrogen levels through your urine (more on estrogen home testing here). Once you submerge the test strip in urine, you can insert it into the Mira digital fertility analyzer to receive results about your estrogen levels straight to your phone. Bring these results to your doctor’s office to discuss them and help make important decisions about your medical care — especially if you have estrogen dominance.

✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG

Banafsheh Kashani, MD, FACOGBanafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treatingcouples and individuals with infertility since 2014.

Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation.

Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.

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