One of the most common (yet severely underdiagnosed) types of hormone imbalance is "estrogen dominance." Dr. Randolph and our clinical team firmly believe that estrogen dominance is an unrecognized epidemic in modern life!

In women, estrogen and progesterone operate like sides of a seesaw, shifting up and down during a woman's monthly cycle. When progesterone gets low, that "side" of the seesaw hits the ground, and negative symptoms arise: weight gain, poor sleep, fatigue, anxiety, heavy periods, uterine fibroids, PMS, irritability, and even rage. When the progesterone side of the seesaw gets "stuck" on the ground, the estrogen side is "elevated," relatively speaking. It's not (necessarily) that your estrogen is high - it's that your progesterone level drops so low that estrogen effectively "dominates."

Estrog en also plays a role for men, by supporting healthy cholesterol, brain function, and bone health. In women, estrogen is produced in the ovaries, adrenal glands, and fat tissues, while men produce estrogen in the testes, through an enzymatic process (aromatase) that transforms testosterone into Estradiol (E2). As men get older, falling progesterone levels lead to a drop in testosterone levels. As both progesterone and testosterone decline, these levels are not enough to balance out the circulating estrogen, and men can also become "estrogen dominant." Symptoms for men include the classic "spare tire" mid-section weight gain, prostate problems, decrease mental acuity, low sex drive and decreased strength.

Are you estrogen dominant? Here's a quick self-assessment that will help you determine whether your suffering from this all-too-common condition.

Self-Assessment for Estrogen Dominance

(1) How old are you? If you are a woman older than thirty or a man older than forty, you are most likely estrogen dominant. A woman's progesterone levels begin to decline in her thirties, even while the ovaries are still producing enough estrogen to stimulate a monthly menstrual cycle. When a woman's periods become irregular (usually in her late 40s), she is said to be perimenopausal: the ovaries' production of estrogen is declining, but progesterone continues to decline even more significantly. Even during and after menopause, estrogen dominance is still a concern: although menopause is a drastic shift in hormonal equilibrium, it does not mean that hormones have suddenly disappeared. Sometimes the ovaries are still producing 40% of the original levels; however, progesterone drops to almost none. The result is continued estrogen dominance. For a man over forty, your progesterone and testosterone levels have already begun to decline. Other lifestlye factors, such as stress and lack of sleep can push a man's system into andropause ("male menopause").

(2) How long have you been overweight? If you have been ten pounds overweight for a year or more, you are most likely caught in a cycle of increasing estrogen dominance. Too much estrogen circulating in the body increases body fat, and fatty tissue within the body produces more estrogen. (Body fat contains an enzyme that converys adrenal steroids to estrogen.) Your body becomes unable to effectively use fat stores for energy, which means that your body's ability to burn body fat is compromised.

(3) Do you have multiple symptoms of estrogen dominance? Weight gain is only one symptom. Because hormone receptors are located throughout the body and in the brain, estrogen dominance can manifest in a host of physical, emotional, and mental ailments, including anxiety, depression, fatigue, headaches (including migraines), digestive problems, fuzzy thinking and/or memory loss, and low libido. Some women may also experience problems with vaginal dryness, and some men have decreased stamina or erectile dysfunction.

(4) Does your environment put you at risk? Estrogen dominance is the inevitable result of your aging body's inability to produce hormones efficiently. However, daily exposure to "environmental estrogens," also called "xenoestrogens," can accelerate the aging process, and/or create a condition of estrogen dominance at an earlier age. There are many surprising sources of endocrine disrupting chemicals in products we use every day, from cosmetics and deodorants; synthetic perfumes (in dryer sheets, scented candles, etc); canned foods; conventionally produced meat and dairy; pesticides in vegetables and fruit; high-mercury fish; cleaning products, and more. You can limit your exposure as much as possible by choosing natural products and eating un- (or low) processed foods.