Related Topics: Hormones, Menopause

What Signs of Oestrogen Dominance Do You Have?

Are you putting on weight, or getting tender breasts? There are many signs of oestrogen dominance and hormone imbalance so check the list to see what may be affecting you.

AnnA Rushton

Women need hormone balance from puberty to post menopause and ideally their oestrogen and progesterone levels should work together. Unfortunately today many women suffer from excess oestrogen that is not balance by the progesterone they need throughout their lives.

The late John Lee, MD first coined the term ‘oestrogen dominance’ to describe this condition in the 1990’s and since then it has been widely accepted as being a major part of hormone imbalance.

What hormones do you need?

I hear from many women who have had a hysterectomy and been told that the only hormone they need replacing is oestrogen, but bioidentical doctors know that – aside from the health risks of unopposed oestrogen – if there is very low or insufficient progesterone then there is no protection from oestrogen dominance – the results of which are linked to heart disease, cancer and osteoporosis.

That is why women find themselves now being taken off their HRT after the maximum recommended time of 5-6 years, but unfortunately this is often done suddenly so they have severe withdrawal symptoms and may also be offered antidepressants as an unsatisfactory alternative.

While oestrogen and progesterone decline with age gradually, there is a drastic change in the rate of decline during the perimenopausal and menopausal years and for women who have had a hysterectomy, even if the ovaries have been left.

Between 35 to 50 years of age there is a 75% reduction in production of progesterone but our levels of oestrogen during the same period only declines about 35%. By menopause, the total amount of progesterone made in the body is extremely low, but oestrogen is still present at about half its pre-menopausal level.

If you add in external forms of oestrogen such as HRT, then there is insufficient progesterone to counteract the effects of this amount of oestrogen in the body. This results in oestrogen dominance.

Many women tell me they have HRT/Pill/Coil which contains progesterone, but this is not the case. These are being balanced with synthetic progestins which try to mimic the action of the natural hormone but the body simply does not recognise them as such.

That is why they can be associated with side effects of their own.

What are the signs of oestrogen dominance?

It is helpful to read the following list which was originally compiled by the late Dr John Lee of the USA, the pioneer in bioidentical hormone cream usage, and check against your own symptoms:

*  allergies

*  autoimmune disorders such as lupus

*  bloating

*  breast tenderness

*  decreased sex drive

*  depression

*  fatique

*  fibrocystic breasts

*  foggy thinking

*  headaches

*  hypoglycaemia

*  increased blood clotting

*  infertility

*  irritability

*  memory loss

*  miscarriage

*  osteoporosis

*  PMS

*  thyroid problems

*  uterine cancer

*  uterine fibroids

*  water retention/weight gain

What can you do?

You may have some, or all of those symptoms as hormones respond to many factors and influence your health in ways you may not have anticipated.

Symptoms of peri/menopause such as hot flushes and night sweats for instance can affect your sleep and lack of sleep is a know risk factor for weight gain and a number of illnesses. Also, don’t underestimate the effects of stress, anxiety and tiredness on your hormones as they can make menopause symptoms worse.

Nor are such symptoms confined to the menopause itself as I am hearing about an increasing number of women who are experiencing menopause symptoms well post menopause.

A recent study has shown that a much higher proportion of ‘older’ women (average age 59 in this study) than was expected still suffer from hot flashes and night sweats, well after menopause is assumed to be over.

Helpful information:

Oestrogen dominance is simply helped by ensuring you have sufficient progesterone levels to balance out the excess oestrogen.

It is commonly thought that if you have low oestrogen you cannot be oestrogen dominant but this is simply not the case if your progesterone levels are even lower.

You can establish your levels of the two  hormones by saliva testing – more accurate than blood tests – or simply by noting the symptoms that you have. The more symptoms then the more likely you are to be oestrogen dominant.

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Please feel free to discuss this article in the comments section below, but note that the author cannot respond to queries made there.
Comments 42
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AnnA Rushton | 11:01 am, June 14th, 2018

Claudia Please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

Claudia Aaron | 2:27 pm, June 13th, 2018

Hello, I will take anticoagulants for the rest of my life (rivaroxabin) due to blood clots occurring in my lungs (APLS) if I come off them.
I suffer from vaginal dryness/very very painful intercourse, eczema, fatigue, waking in the night/poor sleep, mood swings and zero libido. My periods have practically stopped, they were never heavy and I’m aged 50.
What is the best bio-identical hormone cream for me, do you think? Can I even use it due to my propensity for blood clots?? I’d be so grateful if you could point e in the right direction, many thanks!

AnnA Rushton | 7:18 pm, August 8th, 2017

A number of companies offer this Jo, do a web search, but you are unlikely to be offered it on the NHS. This article may be helpful:

Jo Robson | 10:57 am, August 8th, 2017

How does one go about saliva testing please?

AnnA Rushton | 4:18 pm, November 24th, 2016

Jacqui women use hormone creams from puberty to post menopause so there is no age barrier, it just depends on whether you still have symptoms that need help. Progesterone is beneficial in helping heart health and strokes and there is no contraindication with any medication, other than those containing synthetic hormone such as the Pill/Coil/HRT. This article may be helpful:

AnnA Rushton | 4:16 pm, November 24th, 2016

Cathy we are not able to help with analysis of blood tests, but suggest you go on your symptoms and your certainly indicate oestrogen dominance. This article on adrenal fatigue may be helpful:

Jacqui | 1:50 pm, November 24th, 2016

Hello Anna,
I’m 52 and have been on serenity only and now 20-1 for approx. 3 years cant live without. I know that the cream has other benefits and wondered if you can continue to stay on the cream well after menopause? I also have a mother age 78 who is passed menopause but also wondered if introducing her to serenity it could have benefits to her health? she has had a stroke in the passed but has made a full recovering however, she does take Warfrin as a prevention. Can you give me your expertise on this query, Many thank Jacqui

Cathy | 12:45 pm, November 23rd, 2016

I was put on bio-identical estrogel (gel) and progesterone (pills) five years ago. I’m to apply the gel from day 5-25 of cycle, and take progesterone pills from day 15-25 of cycle.
I am now 47 and my periods have changed in recent months; they have always been like clockwork, every 28 days, but now my cycles are sporter (23-24 days).
I have ordered Wellsprings 20-to-1 as it has been getting great reviews and I find it practical to get the two hormones in one cream. However, lately, I have been wondering if I was estrogen dominant to begin with, and only required progesterone? If I go back and look at my lab results from five years ago, is there any way of telling? I have only measured hormone levels in blood and 24 h urine, not saliva.
It’s interesting what you say about it being possible to have low estrogen levels, yet be estrogen dominant if progesterone levels are even lower…I have had classical symptoms of estrogen dominance for years, such as bloating and weight gain, but also typical symptoms of estrogen deficiency. I have been diagnosed with underactive thyroid (Hashimoto’s disease) and adrenal fatigue; I don’t know if adrenal fatigue can increase the need for both estrogen and progesterone?

AnnA Rushton | 6:22 pm, November 13th, 2016

Jacqui dry vaginal is low oestrogen, not oestrogen dominance Julie, and the progesterone content in 20-1 will also help you with lack of sex drive. Certainly internal vaginal application would help once daily with the dryness or you can combine that with once daily skin application as many women tell us they do.

Jacqui | 1:02 pm, November 10th, 2016

Hello Anna, just wanted to ask you if my choice of 20-1 cream is the correct choice? I only have 1 symptom of oestrogen dominace which is vaginal dryness (painful sex) lack of sex drive? and if so is it best to apply internally rather than skin?

AnnA Rushton | 3:46 pm, July 7th, 2016

Molly many women use progesterone to help with fertility and this article will help:

grumps | 7:52 am, July 6th, 2016

Hi .. im 28 and have been on femoston and dostinex.. the endocronology specialist cant see me because the wait list os going to take a bit less then a year..
I want to have a baby and dont have the money to see a private specialist.. what can i do? Is there a over the counter fertility treatmwnt? Or can normal gps give me perscriptions??

AnnA Rushton | 1:35 pm, May 10th, 2016

Vaginal atrophy always requires additional oestrogen from your GP Shirly and you would balance that with Serenity which is progesterone only.

Shirley | 4:36 pm, May 9th, 2016

But what if my oestrogen levels are low and the result is Vaginal Atrophy or Interstitial Cystitis?

AnnA Rushton | 6:19 pm, April 30th, 2016

Yes Janet that is recommended by Dr Mercola of the USA, you can use either of our creams in this way, but there is no problem in applying to the skin if you follow there recommended application routine. It is overuse of any specific receptor sites that can stop hormone being absorbed, but this is not the case if applied properly and certainly no associated health issues through such application – see this article:

Janet | 2:07 pm, April 27th, 2016

I read a Dr’s article that hormone creams should be used internally so that the hormone naturally goes to the pelvic arteries,as this is how we would receive the hormones progesterone/oestrogen naturally in our younger producing days. Putting the cream onto the skin allows the hormone to be stored within our fat cells and can cause health problems. Please can someone advise me if serenity cream would be safe to use internally rather than topically.

Sharon | 10:41 pm, April 25th, 2016

I have been using serenity cream since the 9th of April, and my regime is 24 days being 1/4 tsp morning and night reducing to 1/8 in the 2nd month. My cream has nearly gone and I have actually only used a proper 1/4 tsp for measuring but am short by a week, has anyone else found this.

AnnA Rushton | 9:26 am, April 13th, 2016

Sally you can get direct help by emailing with any usage queries.

Sally | 1:39 pm, April 11th, 2016

Thank you, Ann…I’ve been doing as you advise (above) since 5th April and have noticed a very slight improvement during the day. The nights are still bad but I’ll continue to complete the fortnight you recommended and then re-evaluate the situation. Is there a way I can email directly rather than having to trawl through this site to find my post & your replies, please? Thank you.

AnnA Rushton | 9:19 am, April 11th, 2016

This is something that must first be investigated by your doctor Julie, certainly 20-1 which is a combination cream with the majority ingredient of progesterone, plus two natural oestrogens can be effective for your symptoms but constant urination needs to be checked.

julie menzies | 10:56 pm, April 10th, 2016

I am having bad urges all the time to urinat it it so bad the presure down below is terrible. It is worse when i have flushes. I got hrt patches but was having side effects. Need help with this .i am not feeling well can i take those tablets or cream. It is due to the menopause i think

AnnA Rushton | 11:18 am, April 7th, 2016

That is as sign of oestrogen dominance, excess oestrogen, so rebalancing with progesterone in Serenity can help.

S Robertson | 7:51 pm, April 6th, 2016

I am 55 and since menopause my breasts have grown from a 34B -DD cup in the last year and seem to be still growing. Is there anything I can do to counteract this?

AnnA Rushton | 11:48 am, April 5th, 2016

Sally yes you can increase the amount of Serenity – go back to the initial quarter teaspoon twice daily for two weeks. If this is not sufficient then it can help to switch to 20-1 which is a combination cream with the majority ingredient of progesterone, plus two natural oestrogens, as that can be effective for more severe symptoms.

Sally | 11:51 am, April 3rd, 2016

I am 3 weeks post-op after having giant ovarian cyst and both ovaries/tubes removed. I’ve been using Serenity for a couple of years for menopause symptoms with great success. However, I am one experiencing severe hot flushes again! Would you please advise me on what I can do? Do I use more Serenity or is there another cream to use in addition to or instead of the Serenity? Thanks a lot.

AnnA Rushton | 6:29 pm, March 24th, 2016

Dr Lee died of a heart attack in 2003.

Dr Michael Burt ND | 5:52 pm, March 22nd, 2016

Does anybody know why dr John Lee died ?

AnnA Rushton | 5:28 pm, March 22nd, 2016

After a hysterectomy you normally do need both hormones replacing, so 20-1 would be the right cream. If weight is a major concern though then yes you would be better to have more progesterone so you could use Serenity as well.

tracy Craven | 2:16 pm, March 21st, 2016

i have had a full hysterectomy i have weight gain problems i have the 20-1 cream its working fine but iam wondering if i should buy the serenity cream as well what do you think

AnnA Rushton | 3:36 pm, February 18th, 2016

You can have oestrogen dominance at any point Sandy, you will still be producing oestrogen in the fat cells of the stomach, abdomen and thighs instead of theories. You simply judge on symptoms.

Sandy Epley | 1:19 pm, February 17th, 2016

Had uterine cancer 8 years ago, total hysterectomy. Hypothyroid (Hasimitos) and have started having allergic type reactions but don’t know to what. It comes and goes. Since total hysterectomy how does one tell oestrogen dominace?

AnnA Rushton | 5:06 pm, February 11th, 2016

Bloating can be related to oestrogen dominance Linda then progesterone may help. However if symptoms are after eating that is something your GP or a nutritionist may be able to help with.

Linda Craig | 4:46 pm, February 11th, 2016

Interested in some advise been having anxiety attacks at times nausea after eating, bloating been to GP who states bloods are fine also suffer from Lichen Sclerios Im 49

AnnA Rushton | 3:12 pm, January 26th, 2016

The majority of women do not test their levels but go on symptoms alone Cecili, but Dr Tony Coope offers testing and you will find information on him here:

Cecili DeMonte-Bahr | 3:27 am, January 26th, 2016

How do I find a Doctor who is suitable for finding hormone levels and treating with bio identical hormones.

AnnA Rushton | 1:55 pm, January 6th, 2016

No in fact the reverse Jane as progesterone helps with weight loss. See this article:

Jane mackinnon | 8:15 am, January 6th, 2016

Will using serenity cause weight gain?

AnnA Rushton | 9:55 am, September 17th, 2015

Progesterone is used by women with a history of breast cancer and/or treatment Annette but generally with any history of this we recommend you avoid all phytoestrogens. This article may be helpful:

Annette | 11:26 am, September 16th, 2015

Do I have to avoid phytoestrogens as had previous Breast cancer oestrogen pos

AnnA Rushton | 7:44 am, June 14th, 2015

This can often be related to polycystic ovary syndrome and in menopausal women to the change in hormone balance Fiona. There is also a genetic component if there is a previous history of this in the women in your family.

Supplementing with Serenity bioidentical natural progesterone cream can help as this condition often occurs when progesterone levels are low and oestrogen levels high and this article will be helpful:

Fiona rigby | 10:20 am, June 11th, 2015

Hi I have some of above but also extra facial hair since hysterectomy
Ovaries still intact. What eo you advise?

Julie | 4:43 pm, May 26th, 2015

Thank you very much for you’re help with this priblem

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