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What Is Estrogen Dominance (And How Does It Affect My Fertility)?

09.13.2023 / The Oova Team
What Is Estrogen Dominance (And How Does It Affect My Fertility)?

The hormones in your body have a lot of responsibility. Estrogen, the primary female sex hormone, plays a role in regulating your reproductive health, menstrual cycle, bone density, mood, cognitive function, and even cardiovascular health. If this hormone is so important, isn’t having a lot of estrogen—like in estrogen dominance—a good thing?

Good things come in moderation, and estrogen dominance—when you have high levels of estrogen compared to other hormones—isn’t always the best for your overall health and well-being. In this guide, we’ll uncover signs, causes, and symptoms of estrogen dominance, and what you can do to get your levels back in balance.

What is estrogen dominance?

Estrogen dominance is a condition where you have unbalanced levels of estrogen relative to other sex hormones.

Estrogen, the primary female sex hormone, is not a single entity, but rather a family of hormones that includes estradiol, estrone, and estriol. These hormones play pivotal roles in the female reproductive system and contribute to secondary sexual characteristics, bone health, and overall well-being.

Estrogen is typically counterbalanced by progesterone, another important sex hormone. Together, these hormones work in harmony to regulate the menstrual cycle and maintain reproductive health. Progesterone helps prepare the uterus for pregnancy, while estrogen prepares the body for ovulation.

In a healthy hormonal environment, estrogen and progesterone are present in a delicate equilibrium. However, estrogen dominance occurs when the balance tips in favor of estrogen, leading to elevated levels of estrogen relative to progesterone.

What causes estrogen dominance in females?

How do estrogen levels get to be much higher than other hormones? Lifestyle habits, environmental factors, and medications can all cause estrogen dominance in females. 

Hormonal imbalances

Estrogen dominance can occur because of a hormonal imbalance of other hormones; a common cause of estrogen dominance is a relative deficiency in progesterone levels. When progesterone is low, even a normal estrogen levels can lead to estrogen dominance.

Progesterone deficiency can occur during the latter stages of the menstrual cycle, especially in women experiencing anovulation (lack of ovulation), or as a result of medical conditions like polycystic ovary syndrome (PCOS).

>>MORE: 8 Signs Your Hormones May Be Out of Balance – And What to Do Next.

Environmental factors

Xenoestrogens, synthetic compounds found in various environmental sources, including plastics, pesticides, and some personal care products, can mimic the effects of natural estrogen in the body and contribute to estrogen dominance.

Certain plant-based foods, like soy products, contain compounds called phytoestrogens that can act as weak estrogens when consumed in excess—and therefore lead to estrogen dominance.


Consuming a diet high in processed foods, sugar, and unhealthy fats can disrupt hormonal balance. Particularly, a diet low in fiber and rich in refined carbohydrates can hinder the body's ability to eliminate excess estrogen. Drinking excessive alcohol can also affect the body’s ability to metabolize and eliminate estrogen by impairing liver function.

Medications and hormone therapy

Certain medications, such as birth control pills, hormone replacement therapy (HRT), or fertility treatments, can introduce synthetic hormones into the body, potentially disrupting the natural hormonal balance.

Remember, estrogen dominance is a multifaceted condition and can be a result of a variety of factors—and sometimes, even multiple factors at once.

How can you tell if you have estrogen dominance?

When estrogen dominance takes hold, it can trigger a range of health issues. 

Estrogen dominance symptoms include:

  • Irregular cycles
  • Breast tenderness
  • Mood changes
  • Fatigue
  • Weight gain
  • Bloating and water retention
  • Headaches
  • Decreased libido
  • Insomnia
  • Brain fog

>>MORE: What Are Estrogen Dominance Symptoms?

Recognizing these symptoms is often the first step to knowing whether you might have estrogen dominance; however, it's important to note that these symptoms can vary in intensity and may not be exclusive to estrogen dominance. If you suspect you have estrogen dominance based on these signs and symptoms, it’s essential to get tested to assess your hormone levels.

How to test for estrogen dominance

If you’re experiencing estrogen dominance symptoms, your next best step is to test for estrogen dominance. A hormonal imbalance test—whether it’s one that analyzes your blood, urine, or saliva—can help you learn about your different hormone levels. 

Oova’s test kit helps you measure your hormone levels with lab-quality accuracy from the comfort of your own home. Unlike traditional one-time testing, Oova provides a comprehensive view of your hormonal fluctuations over time.

You can review your results with Oova experts, or share your Oova results with your provider. Results are easily accessible, so you and healthcare professionals can interpret your Oova results in the context of your overall health—and recommend appropriate interventions if necessary.

Estrogen dominance and fertility

Estrogen plays a vital role in regulating the menstrual cycle and supporting fertility. When you have estrogen dominance, it can affect your ability to conceive.

Disrupted menstrual cycles

Estrogen dominance often leads to irregular menstrual cycles. This can manifest as shorter or longer cycles, missed periods, or unpredictable ovulation. Irregular cycles can make it challenging to find your fertile window, reducing the chances of successful conception.


Anovulation, or the lack of ovulation, can occur in cases of estrogen dominance. When estrogen levels are consistently high relative to progesterone, the normal process of releasing an egg from the ovaries may be disrupted. Without ovulation, there is no egg available for fertilization, making conception impossible.

Implantation issues

Even if fertilization occurs, estrogen dominance can affect the ability of a fertilized egg to implant in the uterine lining. Adequate progesterone is required for a healthy uterine lining, and when estrogen dominance is present, progesterone levels may be insufficient for proper implantation.

Increased risk of miscarriage

Estrogen dominance may also increase the risk of miscarriage during early pregnancy. Hormonal imbalances can interfere with the stability of the uterine environment, making it difficult for a pregnancy to progress successfully.

Polycystic ovary syndrome (PCOS)

In some cases, estrogen dominance can contribute to the development or exacerbation of conditions like polycystic ovary syndrome (PCOS). PCOS is associated with irregular periods, anovulation, and cysts on the ovaries, all of which can adversely impact fertility.

>>MORE: PCOS and Pregnancy: What to Know If You're TTC with PCOS

Reduced cervical mucus

Cervical mucus, which changes in consistency during the menstrual cycle, is crucial for sperm transport and survival. Elevated estrogen levels can alter cervical mucus production and quality, hindering the sperm's journey to meet the egg—and making it harder for fertilization to occur.

How to fix estrogen dominance

Estrogen dominance can lead to a variety of health issues and can even affect your fertility. However, there are both natural strategies and medical interventions you can try to combat estrogen dominance—to both alleviate symptoms and improve your chances of a healthy pregnancy.

Lifestyle adjustments

Lifestyle changes to combat estrogen dominance include:

  • Diet adjustments: eating more fiber to help eliminate excess estrogen through the digestive system; eating more cruciferous vegetables, which contain compounds that support estrogen metabolism; eating more healthy fats, to aid in hormone regulation; eating less processed foods, which contain additives and chemicals that can disrupt hormonal imbalance
  • Stress management: Trying relaxation techniques like meditation, yoga, and deep breathing, to reverse the effects chronic stress can have on hormonal balance
  • Regular exercise: Moving regularly to help regulate hormones and promote overall health
  • Avoiding hormone-disrupting chemicals: Reducing exposure to xenoestrogens, which are synthetic chemicals that mimic estrogen in the body; this includes avoiding plastic containers, opting for organic products, and using natural cleaning and personal care products

Medical interventions

If lifestyle adjustments don’t help combat estrogen dominance, or in severe cases, medical interventions might be necessary. A healthcare provider may prescribe medications like:

  • Hormone replacement therapy (HRT): Can help balance estrogen in menopausal women especially
  • Selective estrogen receptor modulators (SERMs): Medications that can block the effects of estrogen in certain tissues and are used to treat conditions like breast cancer
  • Aromatase inhibitors: Drugs that can reduce estrogen production and are often used in the treatment of breast cancer

If you’ve determined you have estrogen dominance, it’s crucial to work closely with a healthcare provider or reproductive endocrinologist to determine the most appropriate treatment plan for your specific situation. Addressing estrogen dominance often involves a holistic approach that combines dietary changes, lifestyle modifications, and, in some cases, medication interventions. 

By taking proactive steps to restore hormonal balance, you can alleviate symptoms, reduce the risk of associated health complications, and increase your chances of conception.


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