Guest post by Melissa Lee
What is estrogen dominance and how can detoxification help relieve your PCOS symptoms?
Our hormones are chemical messengers in our body, and they work together in what can be seen as a hormone soup/dance. Insulin and cortisol are top tier because their levels impact the other sex hormones downstream. Hormones are produced, transported, and attached to receptors on cells to execute their effects, then later broken down via detoxification and excreted through the stool or urine via kidneys.
Polycystic Ovary Syndrome (PCOS) is a different experience for all of us but we want the same outcome – a balance when it comes to hormone health. Many hormone imbalances can occur but the most common one involves an imbalance in the ratio between two main female sex hormones estrogen and progesterone. Specifically, many with PCOS experience estrogen dominance or too much estrogen in relation to progesterone.
Root causes of estrogen dominance
Estrogen dominance occurs when there is too much estrogen as compared to the levels of progesterone. Symptoms might be familiar to you – breast tenderness, mood swings, anxiety, insomnia, the desire to rage, depression, painful and heavy cramps, water retention, headaches, migraines, and more.
The three root causes of estrogen dominance are excess estrogen, the inability to detoxify or excrete excess estrogen, and insufficient progesterone.
1) Excess exposure to estrogens
- Eating too many processed and refined carbohydrates and sugars promotes insulin to store glucose as body fat
- Exposure to xenoestrogens – chemicals in the environment which can compete with biological estrogen for receptors in our cells and disrupt signaling between the ovaries and the brain. This has been linked to development of various cancers. 
- Hormones in conventionally farmed foods including meats and vegetables expose us to unwanted excess estrogens
- Birth control pills promotes exposure to estrogens on an ongoing basis
- Body fat itself is an endocrine tissue which can produce estrogen
- Ovarian cysts
- Pesticides in conventionally grown crops
- Personal care products which contain endocrine disrupting chemicals 
- Unnecessary hormone replacement therapy
*NOTE- For more on endocrine disrupting chemicals, read “Endocrine Disruptors Make Your PCOS Worse- What Can You Do?”
2) Insufficient progesterone
- Birth control pills consisting of synthetic progestin instead of biological progesterone
- Luteal insufficiency or anovulation in PCOS (without ovulating, we are unable to make progesterone)
- Menopause – a life stage where progesterone now produced in the adrenals in a smaller amount instead of ovaries
- Natural reduction of levels during perimenopause
3) Inability to detoxify/excrete estrogen
- Alcohol increases conversion of testosterone to estrogen and impairs liver clearance
- Low levels of B Vitamins & Magnesium – nutrients needed to make a powerful antioxidant glutathione that can help to break down excess estrogen in the liver. Both vitamin B and magnesium are depleted by the birth control pill and metformin.
- Constipation which impairs stool clearance of estrogen
- Genetic variation which can impair detox pathways
- Fatty liver
- High levels of beta-glucuronidase because of gut dysbiosis or small intestine bacterial overgrowth (SIBO). This enzyme enables estrogen to be re-absorbed into circulation.
- Low bile production or a missing gallbladder means there is inadequate bile to move estrogen into the GI tract for excretion.
Detoxification mainly happens in the liver in two phases. Phase I produces hydroxy (-OH) metabolites and Phase II produces methoxy metabolites via the process of methylation. We then have Phase III which is excretion of these metabolites via the stool or urine.
There are many points where the nutrients that come from our diet can help boost Phase I and Phase II accordingly. Examples include the intake of berries, cooked cruciferous vegetables, green tea, vitamin Bs, sea vegetables, eggs, magnesium, garlic, and onion.
On the flip side, if the liver is bombarded by too many endocrine disrupting chemicals, alcohol, caffeine, and becomes fatty from a processed food diet, it will be overwhelmed and unable to set aside energy and nutrients to break down estrogen. Estrogen does not get excreted out and recirculates back into the body which can contribute to estrogen dominance and more PMS symptoms. This can also happen when someone is unable to poop on a regular basis or does not urinate much, excess estrogen being released from body fat loss can build up and re-circulate.
Counter estrogen dominance
The best way to counter estrogen dominance is to boost detoxification! Interventions include:
- Eat organic whole foods
- Lose body fat and build muscle
- Eliminate dairy and conventionally farmed meats
- Clean up personal hygiene products
- Reduce stress
- Eliminate constipation
- Moderate yoga
- Estrogen detox support (DIM)
- Reduce caffeine
- Include phytoestrogens in the diet (ground flaxseed, resveratrol, curcumin, rosemary)
- Reduce conversion of testosterone to estrogen (ground flaxseed, grape seed extract, zinc)
- Increase methylation of estrogens (B-complex supplement might be helpful)
- Incorporation of sea vegetables
- Progesterone cream (for menopausal women)
- Chaste tree berry (women struggling with anovulation/sub optimal ovulation)
- Limit alcohol consumption
- Adaptogenic herbs
- Evening primrose oil
- Vitamin D
Dealing with hormone imbalances like estrogen dominance is similar to dealing with inflammation. We need to focus on changing the components of our foods, ensure we get adequate water and sleep, reduce toxin exposure, and work on managing stress levels. Our lifestyle choices can influence our genes and biochemistry and we can harness that power to get back into balance!
- Naturopathic Doctor News and Review: Estrogen Dominance: When an Unhealthy Gut Estrobolome is to Blame.
- Chris Kresser: The Gut–Hormone Connection: How Gut Microbes Influence Estrogen Levels
- Dr Sara Gottfried: How to Resolve Constipation and Maintain a Healthy Gut
Melissa Lee is a women’s health coach who helps women with PCOS manage their symptoms through natural lifestyle solutions. She also helps women with hormone balancing issues and finding ways to eat for optimal health. Melissa uses functional medicine tools in order to get to the root cause of hormonal issues and she re-empowers her clients to be inspired to take care of their bodies.
You can find more about her work at www.nourishmel.com
She has interviewed Amy Medling on her NourishMel podcast on being a PCOS Diva.
 Fucic, A., Gamulin, M., Ferencic, Z. et al. Environmental exposure to xenoestrogens and oestrogen related cancers: reproductive system, breast, lung, kidney, pancreas, and brain. Environ Health 11, S8 (2012). https://doi.org/10.1186/1476-069X-11-S1-S8
 National Institute of Environmental Health Sciences. Endocrine Disruptors. https://www.niehs.nih.gov/health/topics/agents/endocrine/
 Jan Gill, THE EFFECTS OF MODERATE ALCOHOL CONSUMPTION ON FEMALE HORMONE LEVELS AND REPRODUCTIVE FUNCTION, Alcohol and Alcoholism, Volume 35, Issue 5, September 2000, Pages 417–423, https://doi.org/10.1093/alcalc/35.5.417
 Maruti SS, Lampe JW, Potter JD, Ready A, White E. A prospective study of bowel motility and related factors on breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2008;17(7):1746-1750. doi:10.1158/1055-9965.EPI-07-2850
 Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas. 2017;103:45-53. doi:10.1016/j.maturitas.2017.06.025
 Malekinejad H, Rezabakhsh A. Hormones in Dairy Foods and Their Impact on Public Health – A Narrative Review Article. Iran J Public Health. 2015;44(6):742-758.
 Jennifer D Brooks, Wendy E Ward, Jacqueline E Lewis, John Hilditch, Leslie Nickell, Evelyn Wong, Lilian U Thompson, Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy, The American Journal of Clinical Nutrition, Volume 79, Issue 2, February 2004, Pages 318–325, https://doi.org/10.1093/ajcn/79.2.318