High Estrogen

Overview

What does it mean to have high estrogen?

Estrogen is an important hormone that regulates your reproductive system. It plays an essential role in other body systems, too. Estrogen levels rise and fall throughout your life, often in sync with other hormones that control important body processes. Increases in estrogen spur your sexual development during puberty. Along with the hormone progesterone, estrogen prepares your body for pregnancy.

Estrogen levels that are too high or cause a hormone imbalance can cause problems. High estrogen can disrupt reproductive processes, cause unpleasant symptoms and increase your risk of certain conditions.

What is estrogen dominance?

Estrogen and progesterone work well together to prevent the lining of your uterus from getting too thick. Some people’s bodies don’t make enough progesterone, leading to what’s called unopposed estrogen. Unopposed estrogen is called estrogen dominance in some medical literature. Without progesterone’s balancing influence, estrogen can work overtime in your body and cause cell overgrowths, like tumors in your uterine lining.

How does high estrogen affect the body of a woman or AFAB person?

It’s rare for your levels to be high because of the estrogen you’re producing. It’s more likely that your estrogen levels are high because of medications you’re taking. For instance, you may have a low sex drive because of high estrogen levels, but this is most likely caused by your birth control pills — not your body’s natural estrogen.

Elevated estrogen unrelated to medication is most likely caused by PCOS prior to menopause. After menopause, high levels are more common if you are overweight or obese.

If you’re a trans man or nonbinary person with a vagina, high estrogen levels may prevent your body from having the physical appearance you’d like. If this is the case, masculinizing hormone therapy may be an option for you. This treatment involves taking testosterone to develop secondary sex characteristics like more muscle mass and facial and body hair.

How does high estrogen affect the body of a man or AMAB person?

People assigned male at birth (AMAB) need some estrogen for their sexual and reproductive health. But high levels of estrogen can cause:

If you’re assigned male at birth and concerned about your estrogen levels, speak with an endocrinologist or a functional medicine specialist for help.

Symptoms and Causes

What are the symptoms of high estrogen?

Symptoms include:

  • Irregular periods (unpredictable timing, light or heavy bleeding).
  • Dense breast tissue.

What causes high estrogen levels?

Your estrogen levels may be high because:

  • Your body is making too much estrogen.
  • You’re getting too much estrogen in the medicine you’re taking.
  • Your body’s not breaking down estrogen and removing it from your body as it should.

A variety of factors can contribute to high estrogen, including:

  • Medications: Hormone therapy to boost low estrogen levels may cause your levels to become too high at first. It may take some time to get the dosage right. (high-dose oral contraceptives/birth control pills)
  • Body fat: Fat tissue (adipose tissue) secretes estrogen. Having a high percentage of body fat can lead to high estrogen levels.
  • Stress: Your body produces the hormone cortisol in response to stress. Producing high amounts of cortisol in response to stress can deplete your body’s ability to produce progesterone. The estrogen in your body is left unchecked by progesterone.
  • Alcohol: Drinking too much alcohol can increase your estrogen levels and reduce your body’s ability to break down (metabolize) estrogen.
  • Liver problems: Your liver breaks down estrogen and eliminates it from your body. If your liver’s not functioning correctly, too much estrogen can accumulate. Too few digestive enzymes, too much bad gut bacteria (dysbiosis), low magnesium levels and too little fiber in your diet can prevent your liver from removing excess estrogen.
  • Synthetic xenoestrogens: Synthetic xenoestrogens are chemicals found in the environment that act like estrogen once they’re inside your body. They can increase your estrogen levels. Xenoestrogens include bisphenol A (BPA) and phthalates. Both of these chemicals are used in various plastics. Xenoestrogens can also be found in pesticides, household cleaning products and some soaps and shampoos.

What conditions are associated with high estrogen?

High estrogen levels are associated with a variety of conditions. Estrogen doesn’t necessarily cause these conditions. Instead, estrogen may worsen a condition or symptom you already have, including:

Diagnosis and Tests

How do I know my estrogen level?

There are three types of estrogen that your body makes. An estrogen test can measure all three: estrone (E1), estradiol (E2) and estriol (E3). Your provider will do a simple blood draw and send it to a lab for analysis.

  • Estrone (E1) is the primary hormone your body produces during menopause and postmenopause. It’s a weaker form of estrogen than estradiol (E2).
  • Estradiol (E2) is the primary hormone your body produces in your reproductive years.
  • Estriol (E3) is the primary hormone your body makes during pregnancy.

Management and Treatment

What are the treatments for high estrogen?

The treatments your provider recommends will depend on what’s causing your high estrogen levels. In some cases, lifestyle changes may help. If high estrogen levels increase your cancer risk or worsen cancer you already have, your provider may recommend more aggressive treatments.

There are few medications that directly decrease estrogen. Usually, what’s needed is to identify the underlying cause and treating this first.

Lifestyle

Making some lifestyle changes may help lower your estrogen levels. Your provider may recommend that you:

  • Decrease your percentage of body fat. Decreasing your body fat can reduce the amount of estrogen that your fat cells secrete. Talk to your provider or a nutrition specialist about how to safely reduce your percentage of body fat so that you’re getting the nutrients you need.
  • Relieve stress. Decreasing the amount of stress hormones your body produces can help keep your estrogen and progesterone levels balanced.
  • Eat a healthy diet: Eating a low-fat, high-fiber diet with very little processed sugar can make it easier for your liver to process estrogen.
  • Limit your alcohol intake: Eliminating alcohol or drinking in moderation can help your liver break down estrogen.
  • Reduce your exposure to synthetic xenoestrogens. It’s impossible to avoid synthetic xenoestrogens completely, but you can limit your exposure. Avoid pesticides that contain xenoestrogens by choosing all-natural organic foods and consuming hormone-free meat products. Purchase items in steel and glass containers instead of plastic ones when you can.

Medications

Your provider can adjust your prescription if the hormones you’re taking are causing high estrogen. You may need medicine if you have cancer spreading in response to estrogen exposure.

Medications include:

  • Aromatase inhibitors: Aromatase inhibitors are used to treat breast cancer. They prevent your fat cells from making estrogen. Aromatase inhibitors include Anastrozole (Arimidex), Exemestane (Aromasin) and Letrozole (Femara).
  • Gonadotropin-releasing hormone (GnRH) agonists: GnRH agonists stop your ovaries from releasing estrogen.

Living With

How do I get rid of excess estrogen?

Your provider can help you address a hormone imbalance based on what’s causing it. In some instances, your provider may need to adjust your medications. If high estrogen is related to your lifestyle then diet, exercise, alcohol consumption, and sleep changes may help. Discuss your medical history with your provider to identify opportunities to balance your hormones.

Frequently Asked Questions

Does high estrogen mean pregnancy?

Not necessarily. The only way to know for sure if you’re pregnant is to take a pregnancy test.

A note from Cleveland Clinic

Estrogen plays an important role in maintaining your cardiovascular, reproductive and bone health. High levels of estrogen, however, can cause unpleasant symptoms that warrant a visit to your provider. Once your provider identifies what’s causing your estrogen to be high, they can recommend treatments that make your symptoms more manageable.

Last reviewed by a Cleveland Clinic medical professional on 02/09/2022.

References

  • Marquardt RM, Kim TH, Shin JH, Jeong JW. Progesterone and estrogen signaling in the endometrium: what goes wrong in endometriosis?. (https://pubmed.ncbi.nlm.nih.gov/31387263/) Int J Mol Sci. 2019;20(15):3822. Published 2019 Aug 5. Accessed 1/28/2022.
  • Neuhouser ML, Aragaki AK, Prentice RL, et al. Overweight, obesity, and postmenopausal invasive breast cancer risk: a secondary analysis of the women's health initiative randomized clinical trials. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070941/) JAMA Oncol. 2015;1(5):611-621. Accessed 1/28/2022.
  • Patel S, Homaei A, Raju AB, Meher BR. Estrogen: The necessary evil for human health, and ways to tame it. (https://pubmed.ncbi.nlm.nih.gov/29573619/) Biomed Pharmacother. 2018;102:403-411. Accessed 1/28/2022.
  • Smy L, Straseski JA. Measuring estrogens in women, men, and children: recent advances 2012-2017. (https://pubmed.ncbi.nlm.nih.gov/29800559/) Clin Biochem. 2018;62:11-23. Accessed 1/28/2022.

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