Oestrogen Dominance

Oestrogen dominance is one of the most widely experienced yet least understood hormonal conditions affecting women during menopause and perimenopause. It occurs when progesterone levels fall out of balance with oestrogen, allowing the effects of unopposed oestrogen to take hold.

Despite its name, oestrogen dominance does not necessarily mean that oestrogen levels are high. Rather, it describes a state where the ratio between oestrogen and progesterone has shifted — and this can happen even when both hormones are declining, as they do during the menopausal transition.

Understanding oestrogen dominance is key to understanding many of the symptoms women experience during menopause, and to finding effective, natural ways to address them.

What is oestrogen dominance?

In a healthy woman, two vital hormones — progesterone and oestrogen — are maintained in a delicate equilibrium. They work together to regulate the menstrual cycle, support bone health, influence mood, and govern dozens of other bodily processes.

When progesterone levels drop in proportion to oestrogen, this equilibrium is disrupted. The effects of oestrogen, no longer kept in check by adequate progesterone, begin to dominate. This is oestrogen dominance.

In menopausal women, the most common effects include:

Why does oestrogen dominance happen?

In most women, hormone levels start to decline around their mid thirties, gradually at first, then accelerating through their forties, before levelling out between 50 and 55.

However, when this decline commences, progesterone production falls considerably faster than oestrogen. The result is a widened gap in the levels of these two hormones which does not right itself until hormone levels finally stabilise in the years following the menopause.

This natural change in hormone levels is aggravated by modern environmental and lifestyle factors, which are believed to be responsible for the increasing incidence of oestrogen dominance.

The role of diet

In cultures where diets still largely comprise a variety of fresh vegetables, progesterone deficiency remains rare. Plants produce substances that behave much like progesterone, and as such, when the body's progesterone production winds down, these substances are able to counteract the effects of oestrogen.

In Western cultures, where processed foods form the bulk of diets, these nutrients are largely absent. A diet high in refined carbohydrates, sugar, and processed foods can also contribute to higher circulating oestrogen levels, further widening the gap.

Xenoestrogens and environmental factors

For women in modern societies the problem is accentuated through increased exposure to oestrogenic substances known as xenoestrogens. These are synthetic chemicals found in plastics, pesticides, household cleaning products, and personal care items that mimic the behaviour of oestrogen in the body.

Common sources include BPA in plastic containers, parabens in cosmetics, and pesticide residues on non-organic produce. While each individual exposure may be small, the cumulative effect over years can be significant.

Birth control and medical history

Extended use of hormonal birth control treatments can also contribute. These products typically contain synthetic progestins and oestrogens which, while preventing pregnancy, can disrupt the body's natural hormone production patterns. When women discontinue hormonal contraception, particularly in their late thirties or forties, the transition can coincide with the natural decline in progesterone, intensifying the imbalance.

This combination of increased oestrogenic exposure and reduced natural, progestogenic nutrients accentuates normal changes in hormone levels, creating a ‘perfect storm’ for oestrogen dominance.

How to recognise oestrogen dominance

Many women attribute their symptoms to ‘just menopause’ without realising that oestrogen dominance may be the specific mechanism behind what they are experiencing. The symptoms can be wide-ranging because oestrogen receptors exist throughout the body — in the brain, bones, heart, skin, and digestive system.

Physical symptoms:


Emotional and cognitive symptoms:


Long-term health concerns:


If you recognise several of these symptoms, it is worth speaking to your healthcare professional about hormone testing. A simple saliva or blood test can help confirm whether oestrogen dominance is a factor.

The connection between oestrogen dominance and weight gain

One of the most frustrating aspects of oestrogen dominance for many women is the weight gain that accompanies it — and the difficulty of losing that weight through diet and exercise alone.

When oestrogen is not adequately balanced by progesterone, it can interfere with thyroid function, reducing the thyroid's effectiveness. This can lead to increased conversion of carbohydrate into fat, as well as sugar cravings, making the weight pile on more easily while making slimming down much harder.

An overabundance of oestrogen can also decrease natural lipolysis in adipose tissue (fat tissue) through the oestrogen receptor ER-alpha. In other words, oestrogen dominance may prevent the natural breakdown of fat in the body. This effect is especially pronounced for abdominal fat.

The cruel irony is that fat tissue itself produces oestrogen — particularly in the belly, abdomen, and thighs. So the weight gained as a result of oestrogen dominance can make the whole situation worse, creating a self-reinforcing cycle.

As Dr John Lee wrote: “There are no doubt good evolutionary reasons for some of oestrogen's seemingly negative actions on the body such as water retention and weight gain. If we think of oestrogen in terms of procreation and survival of the fetus, it would seem advantageous to the baby for the expectant mother, in times of famine, to store body fat.”

For more on this topic, see our article on menopause and weight gain.

Natural progesterone and oestrogen dominance

Since the 1930s, doctors have prescribed progesterone supplements to combat the effects of hormone imbalance. While at that time our understanding of hormones was limited, the benefits of progesterone supplementation for numerous conditions were apparent.

Supplementing progesterone levels is a proven method of counterbalancing the effects of oestrogen dominance and its symptoms. Natural progesterone is bioidentical to progesterone produced in the body and has been prescribed since the 1930s as a safe, effective treatment.

It is important to differentiate between natural progesterone and the artificial forms used in conventional hormone replacement therapy (HRT). Commonly prescribed HRT treatments employ artificial variants of progesterone, known as progestins. While in some ways these perform the role of natural progesterone, they are in fact alien to the body and believed to be responsible for many of the reported side effects of HRT.

Natural progesterone, being bioidentical — meaning it has the same molecular structure as the hormone your body produces — is treated within the body exactly as native hormones are. During decades of use, women have reported symptoms relieved and quality of life restored without the side effects associated with artificial hormone treatments.

When applied as a transdermal cream, natural progesterone is readily absorbed into the fat cells that sit below the skin, where the body naturally stores its progesterone reserves. This method is more effective than oral supplementation, which is largely metabolised and removed by the liver before it can take effect.

Which cream is right for oestrogen dominance?

The right approach depends on your individual situation and symptoms:


For guidance on how to use these creams, see our detailed usage guide.

Lifestyle changes that can help

While natural progesterone supplementation addresses the hormonal root cause, there are several lifestyle changes that can support your body in managing oestrogen levels:

Eat more cruciferous vegetables — Broccoli, cauliflower, Brussels sprouts, and kale contain compounds called indoles that support the liver in metabolising and clearing excess oestrogen from the body.

Increase dietary fibre — Fibre binds to oestrogen in the digestive tract and helps remove it from the body. Whole grains, legumes, fruits, and vegetables all contribute. A high-fibre diet has been associated with lower circulating oestrogen levels.

Reduce exposure to xenoestrogens — Switch to glass or stainless steel food containers, choose natural personal care products where possible, and opt for organic produce when practical. Small changes add up over time.

Maintain a healthy weight — Since fat tissue produces oestrogen, maintaining a healthy weight can help prevent the self-reinforcing cycle of oestrogen dominance and weight gain. Even modest weight loss can make a meaningful difference.

Exercise regularly — Physical activity helps regulate hormone levels, supports metabolism, improves mood, and aids sleep. Weight-bearing exercise is particularly beneficial during menopause as it also supports bone health.

Manage stress — Chronic stress raises cortisol levels, which can further disrupt the balance between progesterone and oestrogen. Techniques such as meditation, yoga, deep breathing, and regular gentle exercise can all help.

Limit alcohol — Alcohol increases oestrogen levels and impairs the liver's ability to metabolise and clear oestrogen from the body. Reducing intake can help support better hormonal balance.

Getting help

If you suspect you may be experiencing oestrogen dominance, the first step is to speak to your healthcare professional. A hormone test can help confirm the diagnosis and guide the right approach for your situation.

Wellsprings Serenity is a premium natural progesterone cream that has been helping women overcome menopause symptoms and conditions associated with hormone imbalance since 1997. On this site you can find out more about natural progesterone and read the stories of just some of the women who have found relief.

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