Estrogen Dominance – Is It Real?

by Marcelle Pick, OB/GYN NP

Topics covered in this article:

  • Dr. John Lee and the original theory of estrogen dominance
  • Why “estrogen dominance” is misleading — and a new understanding
  • Symptoms of estrogen dominance
  • Effects of xenoestrogens
  • Phytotherapy — a gentle approach to a complex issue
  • What you can do

Most conventional doctors still tell women that menopause — and all premenopause, perimenopause and menopause symptoms — result from a drop in estrogen production. In their view the solution is estrogen supplementation, or Hormone Replacement Therapy (HRT), usually with synthetic hormones.

In contrast, many alternative practitioners believe that women have too much estrogen, leading to a condition known as “estrogen dominance.” The late healthcare pioneer Dr. John Lee broke new ground when he claimed that estrogen dominance was the real cause of premenopause and menopause symptoms, especially in younger women. In his view the obvious solution was to rebalance the ratio of estrogen to progesterone through progesterone supplementation.

This idea has led to the marketing of hundreds of brands of progesterone cream and other natural products designed to boost progesterone — all promising a quick fix and miraculous results in curing premenopausal and menopausal symptoms.

Unfortunately, both of these views are simplistic and misleading for women, because they overlook how dynamic all your hormones are — including DHEA, estrogen, progesterone and testosterone.

Let’s focus today on the concept of estrogen dominance, the incredible claims being made for the efficacy of progesterone, and how well your body is equipped to restore the dynamic dance between these hormones when it gets the support it needs.

How do estrogen levels work and what is estrogen dominance?

Estrogen and progesterone are two of the primary female sex hormones. During a normal menstrual cycle, they take turns driving the process of maturing and releasing an egg and preparing the uterus for possible pregnancy: estrogen rises in the first half of the cycle, peaks at ovulation, then falls in the second half as progesterone rises. Progesterone is released by the rupturing of the egg follicle during ovulation. Testosterone too is secreted in “surges” around the time of ovulation, perhaps as Mother Nature’s way to increase our interest in sex, and again before menses. If there is no pregnancy, you have a period and the whole cycle begins again.


* Adapted from information at McGill University and the University of Wisconsin.

When estrogen, progesterone and testosterone are doing their jobs, they work well together. How much or how little of each hormone is made at any one time relies on a complicated feedback system between the brain: specifically the hypothalamus and the pituitary gland, which release LH (luteinizing hormone) and FSH (follicle stimulating hormone), the ovaries, and the adrenal glands. Stress and diet affect that feedback system and so directly impact your hormonal balance.