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What Are Estrogen Dominance Symptoms?

08.09.2023 / Clara Siegmund
A close-up image of a woman's neck and upper chest. The article focuses on the symptoms of estrogen dominance.

Hormones fluctuate, but when they remain elevated it can lead to health problems. Estrogen dominance is one of those problems, but it isn’t permanent. Here’s how to recognize estrogen dominance symptoms and what to do next.

Hormones control a lot of what happens in your body. Your hormone balance is crucial to your overall health and wellbeing. That balance is often in flux as your hormones naturally rise and fall month-to-month and throughout your life.

However, when a hormone stays high (or low), it can throw your hormone balance off, and that can create problems. 

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

Estrogen dominance is one example of what can happen when your hormones are thrown out of sync with each other. 

What is estrogen?

The hormone estrogen is often referred to as the “female hormone,” presumably because it’s typically present in higher levels in people assigned female at birth (AFAB). However, this is a bit of a misnomer: everybody has estrogen, and everybody needs it.

There are three main types of estrogen:

  • Estrone (E1)
  • Estradiol (E2)
  • Estriol (E3)

The three types of estrogen play different roles and are produced differently. Estradiol is the strongest of the three.

Estrogen helps regulate functions in your body like:

  • The reproductive system
  • The immune system
  • The menstrual cycle
  • Fertility
  • Bone health
  • Heart health
  • Secondary sex characteristics

If the estrogen levels in your body are high, you may have what’s known as estrogen dominance. Here’s what that means and some estrogen dominance symptoms.

What is estrogen dominance?

If you’re experiencing estrogen dominance, it means that the levels of estrogen in your body are consistently higher than usual. But higher compared to what? Well, other hormones. 



In AFAB people, estrogen dominance generally occurs when estrogen levels are elevated relative to progesterone levels. In people assigned male at birth (AMAB), estrogen dominance is usually characterized by higher estrogen levels in relation to testosterone levels.

>>MORE: What Are Low Progesterone Symptoms?

What causes estrogen dominance?

It’s rare that estrogen levels rise naturally, on their own, without descending again. Typically, estrogen becomes elevated due to other health conditions. Estrogen dominance can also be caused by certain medications.

Some of the factors that could contribute to estrogen dominance include:

Conditions such as these may cause the body to overproduce estrogen, impact the way the body breaks down and removes estrogen, or lead to an imbalance in the ratio of estrogen to progesterone or testosterone.

What are the symptoms of estrogen dominance?

Symptoms of estrogen dominance can be different depending on your sex assigned at birth. Estrogen plays different roles in AFAB and AMAB people, which means that estrogen dominance manifests differently.

Like with any condition, estrogen dominance symptoms can also vary from person to person. Maybe you don’t experience many symptoms, or maybe you tick off everything on the list. 

Estrogen dominance symptoms in AFAB people

Common symptoms of estrogen dominance in AFAB people include:

  • Irregular cycles
  • Infertility
  • Breast swelling or tenderness
  • Fibrocystic breasts
  • Uterine fibroids and uterine polyps
  • Worsening PMS or PMDD symptoms
  • Weight gain
  • Constipation
  • Acne
  • Low sex drive
  • Depression or anxiety
  • Fatigue
  • Mood swings

Irregular cycles

Estrogen helps regulate your reproductive system, including your menstrual cycle. Along with progesterone and other fertility hormones, estrogen plays a role in triggering ovulation and helps thicken the uterine lining.

Estrogen dominance can lead to irregular periods, including excessively heavy or light flows, very short or very long cycles, and unpredictable period timing.


Estrogen dominance can affect reproductive health in other ways, as well. High estrogen levels can cause irregular menstrual cycles and disrupt ovulation, which can lead to issues with infertility. 

Fibrocystic breasts

High levels of estrogen can cause the development of noncancerous lumps in the breasts, also called fibrocystic breasts. Fibrocystic breasts often feel lumpy or ropelike. The lumps are benign, but it’s still a good idea to have them evaluated by your doctor.

You may not have any symptoms related to fibrocystic breasts, or your breasts may feel tender or painful. These symptoms tend to be the most noticeable around your period. 

Fibrocystic breasts don’t increase your risk of breast cancer, but they can make it more difficult to detect cancerous tumors. Talk to your doctor if:

  • You find a new or persistent lump
  • A lump that your doctor already evaluated changes
  • You have specific areas of pain
  • Breast changes continues after your period

Aside from fibrocystic breasts, estrogen dominance may also lead to breast tenderness, breast pain, and breast hypertrophy (the overgrowth of dense, heavy breast tissue).

Uterine fibroids and uterine polyps

Uterine fibroids are noncancerous growths in the uterus. However, they should still be monitored by a doctor.

Research suggests that estrogen, which promotes the thickening of the uterine lining during each menstrual cycle, appears to also trigger fibroid growth in the uterus. This means that estrogen dominance can lead to an increase in uterine fibroids, in both number or size of existing fibroids.

Uterine polyps are another type of growth that can occur in the uterus. They are usually non-cancerous, but some can be or could become precancerous. Uterine polyps should also be monitored by a doctor.

Uterine polyps grow in response to estrogen, meaning consistently high estrogen levels like those of estrogen dominance can trigger uterine polyp growth.

Worsening PMS or PMDD symptoms

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) refer to symptoms that can occur before your period. While the two are similar, PMDD is a more severe form of PMS. Possible symptoms include headaches, menstrual cramps, nausea, constipation, mood swings, and irritability.

Estrogen dominance is associated with more severe PMS or PMDD symptoms. If your symptoms are suddenly worse, it may be an indication that the balance of estrogen in your body has been thrown off.

Estrogen dominance symptoms in AMAB people

Common symptoms of estrogen dominance in AMAB people include:

  • Infertility
  • Erectile dysfunction (ED)
  • Gynecomastia
  • Low sex drive
  • Dry skin


Estrogen, and in particular estradiol, plays a role in reproductive function in AMAB people, too. This hormone contributes to sperm production, sperm movement (motility), sperm shape (morphology), and erectile function, among other aspects of fertility.

Estrogen dominance can impede the production of healthy sperm (spermatogenesis), which can lead to issues with infertility.

>>MORE: What You Need To Know About Male Factor Infertility

Erectile dysfunction (ED)

Estrogen, and in particular estradiol, also impacts erectile function. Too much estrogen can lead to impaired erectile function, or even erectile dysfunction (ED). This means that estrogen dominance can make it harder to get and/or maintain an erection.


Gynecomastia is an increase in breast gland tissue, leading to enlarged breasts. Many people don’t experience symptoms aside from tissue growth. In those who do, symptoms can include breast tenderness, breast pain, or nipple sensitivity. Most cases of gynecomastia go away without treatment, but in some instances medication or surgery may be used.

Estrogen dominance, with high levels of estrogen and low levels of testosterone, can trigger the development of gynecomastia.

What medical conditions are associated with estrogen dominance?

High levels of estrogen have been linked to multiple health conditions. While estrogen dominance may not necessarily cause these conditions, it can exacerbate existing conditions or put you in a higher risk category.

Medical conditions associated with estrogen dominance in AFAB and AMAB people include:

  • Breast cancer
  • Prostate cancer
  • Ovarian cancer
  • Endometriosis
  • Uterine cancer
  • PCOS
  • Autoimmune diseases like multiple sclerosis (MS)
  • Stroke

How do you treat estrogen dominance?

If you’re experiencing symptoms that you believe may be signs of estrogen dominance, consider talking to your doctor to undergo hormone tests. 

>>MORE: 3 Things You Need to Know About Hormonal Imbalance Tests

Your healthcare provider will aim to help you treat the underlying condition (or conditions) causing high levels of estrogen. Treating the cause can then help lower your estrogen levels and relieve your estrogen dominance symptoms. This, in turn, may help lower your risk of developing related medical conditions.

Treatment options available to people dealing with estrogen dominance include:

  • Regular exercise: exercise helps your body metabolize and remove estrogen, which can lower estrogen levels
  • Balanced diet: a balanced diet helps promote hormone balance
  • Medication: depending on the underlying condition(s) causing elevated estrogen levels, medications such as hormonal birth control may be an option 
  • Surgery: in rare cases, the ovaries may be removed (oophorectomy) to help lower the risk of ovarian or breast cancer

If estrogen dominance is causing your body to look differently than you want or need it to, pharmaceutical options available to you include:

  • Estrogen blockers
  • Testosterone replacement therapy (TRT)
  • Masculinizing hormone therapy

As with any medication, these options can come with side effects and risks. Your healthcare provider can help you figure out which option is right for you.

The takeaway

Estrogen levels can become elevated due to factors like underlying health conditions, certain medications you may be taking, or lifestyle habits. 

When estrogen levels go up and don’t come back down, you may be experiencing estrogen dominance. Everyone has estrogen, so anyone can experience this condition. Some estrogen dominance symptoms can manifest differently depending on sex assigned at birth. 

Estrogen dominance isn’t permanent. With the help of your doctor, you can figure out the best path to treat the factors contributing to your high estrogen, and bring those levels back down—so you can get some relief from the estrogen dominance symptoms you’re facing.


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