Estrogen dominance (ED) is a theory about a metabolic state where the level of estrogen outweighs the level of progesterone in the body. This is said to be caused by a decrease in progesterone without a subsequent decrease in estrogen.

The theory was proposed by John R. Lee and Virginia Hopkins in their 1996 book, What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone.[1] In their book Lee and Hopkins assert that ED causes fatigue, depression, anxiety, low libido, weight gain specifically in the midsection, water retention, headaches, mood swings and white spots on fingernails fibrocystic breasts.[1] The book criticizes estrogen replacement therapy and proposes the use of "natural progesterone" for menopausal women in order to alleviate a variety of complaints. Lee's theories have been criticized for being inadequately supported through science, being primarily based on anecdotal evidence with no rigorous research to support them.[2] Estrogen dominance can affect both men and women.


Estrogen dominance is widely discussed by many proponents and on many alternative medicine websites, including:

Christiane Northrup, former obstetrics and gynaecology physician, believes that estrogen dominance is linked to "allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, and increased blood clotting, and is also associated with acceleration of the aging process." She believes that ED can be reduced by several methods including taking multi-vitamins, using progesterone cream, decreasing stress and detoxifying the liver.[3]

Nisha Chellam, an internal medicine and holistic and integrative health physician, admits that "estrogen dominance isn't an official medical diagnosis" but believes that it is "an under-diagnosed condition." The list of symptoms Chellam attributes to ED include "unexplained weight gain, difficulty losing weight, breast tenderness, subcutaneous fat, heavy periods, missing periods, prolonged cycles, painful periods, premenstrual dysmorphic disorder [sic?], infertility, mood swings, insomnia, headaches and migraines."[4]

Bob Wood, R.Ph., lists the symptoms of estrogen dominance as "fibrocystic and tender breasts, heavy menstrual bleeding, irregular menstrual cycles, mood swings, vasomotor symptoms, weight gain and uterine fibroids" and believes that testing and "balancing hormones is of benefit to women of all ages".[5]


Extensive research has been conducted on all aspects of estrogen including its mechanism of action, contraindications to estrogen supplementation and estrogen toxicity.[6] Research on hormone replacement therapies have indicated that hormone replacement did not help prevent heart disease and it increased risk for some medical conditions.[7][8] Research conducted by Alfred Plechner points to cortisol as a possible cause of naturally elevated estrogen. "The cortisol abnormality creates a domino effect on feedback loops involving the hypothalamus–pituitary–adrenal axis. In this scenario, estrogen becomes elevated..."[9]


  1. ^ a b Lee, J.R.; Hopkins, V. (2004). What Your Doctor May Not Tell You About(TM): Menopause: The Breakthrough Book on Natural Progesterone. Grand Central Publishing. ISBN 978-0-7595-1004-3. Stated differently, it is clear that many of estrogen's undesirable side effects are effectively prevented by the presence of progesterone. I would propose that a new syndrome be recognized: estrogen dominance.
  2. ^ Watt PJ, Hughes RB, Rettew LB, Adams R (2003). "A holistic programmatic approach to natural hormone replacement". Fam Community Health. 26 (1): 53–63. doi:10.1097/00003727-200301000-00007. PMID 12802128. S2CID 34859665.
  3. ^ Northrup, Christiane (6 February 2007). "What Are the Symptoms of Estrogen Dominance?". Christiane Northrup, M.D. Archived from the original on 19 October 2021. Retrieved 10 March 2022.
  4. ^ "Estrogen Dominance: What It Is and Why You Can and Should Treat It". Nutritious Life. 13 December 2021. Retrieved 10 March 2022.
  5. ^ "Estrogen Dominance – Integrative Hormone Consulting". Integrative Hormone Consulting. 30 October 2017. Retrieved 10 March 2022.
  6. ^ Delgado, Benjamin J.; Lopez-Ojeda, Wilfredo (20 December 2021). "Estrogen". NCBI Bookshelf. PMID 30855848. Retrieved 10 March 2022.
  7. ^ "Estrogen's Effects on the Female Body". Johns Hopkins Medicine. 19 November 2019. Retrieved 10 March 2022.
  8. ^ "Estrogen & The Heart: Risks, Benefits & Side Effects". Cleveland Clinic. Retrieved 10 March 2022.
  9. ^ Plechner, Alfred J (2004). "Cortisol abnormality as a cause of elevated estrogen and immune destabilization: insights for human medicine from a veterinary perspective". Medical Hypotheses. Elsevier BV. 62 (4): 575–581. doi:10.1016/j.mehy.2003.12.005. ISSN 0306-9877. PMID 15050110.