What are the symptoms of high estrogen?
Iakovos Soussis MD. MSc. FRCOG
Consultant Obstetrician-Gynaecologist, Fertility and IVF Specialist at IASO Maternity Hospital, Founder IVF&Genetics
Summary
Estrogen is a type of sex hormone that plays an essential role in the body. Abnormal levels can affect many aspects of health. For instance, high estrogen levels may cause weight gain, low mood, and severe premenstrual syndrome (PMS) in females.
Estrogen is also present in males but in much smaller amounts. Estrogen levels that exceed a healthy range can make it difficult to get an erection.
It is normal for estrogen levels to rise and fall to a certain extent, but more serious problems can occur if the levels stay consistently elevated. When estrogen is high relative to progesterone in females, this is known as estrogen dominance.
High estrogen levels affect males and females differently.
?Females
?In females, having too much estrogen may cause:
?·?????weight gain, especially around the hips and waist
·?????heavy or light periods
·?????worse PMS than usual
·?????fatigue
·?????fibroids in the uterus
·?????fibrocystic lumps in the breasts
·?????low sex drive
·?????low mood or anxiety
Additional possible symptoms include:
·?????bloating
·?????headaches
·?????disrupted sleep
·?????hair loss
Males
In males, having too much estrogen may cause:
·?????enlarged breasts, known as gynecomastia
·?????difficulty getting or maintaining an erection
·?????infertility
According to a 2018 study, high estrogen levels are also associated with increased rates of depression in males.
Estrogen and its effects on the body
Estrogen is an important hormone for male and female health and sexual development.
Estrogen regulates cholesterol levels, maintains bone health, and affects mood. In females, this hormone also influences puberty, the menstrual cycle, pregnancy, and menopause.
There are three main types of estrogen:
Estradiol: This is the most potent form of estrogen, and its concentration is highest in females of childbearing age. Doctors use this form of estrogen as a marker for ovary health.
Estrone: This is the primary type of estrogen in males. It is also the primary form of estrogen in females after menopause. The ovaries, placenta, testicles, and fat tissue produce estrone from androstenedione or androgens.
Estriol: The placenta produces this type of estrogen, which reaches peak levels during pregnancy. The amount of estriol increases as the fetus grows.
When estrogen levels rise or fall, this can affect many areas of the body, including the reproductive system, skin, hair, bones, muscles, brain, and breast tissue. Fluctuations can also have these effects in males, as everyone has some breast tissue.
What causes an increase in estrogen?
There are several reasons why estrogen levels can become high. They may rise as a result of:
·?????an overproduction of estrogen
·?????changes in how the body breaks estrogen down
·?????changes in how the body excretes estrogen
Any of the above might lead to a hormonal imbalance. In females, estrogen dominance happens when estrogen levels are high compared with the amount of progesterone in the body, which is one of the other main female sex hormones.
Many factors may contribute to estrogen dominance, including:
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Obesity: Having excess body weight can result in higher amounts of estrogen due to the fact that fat tissue produces estrone.
Stress: Stress increases cortisol levels. When cortisol levels remain consistently high, this hormone can deplete the levels of progesterone, which can have a knock-on effect on estrogen.
Alcohol consumption: Drinking alcohol excessively raises estradiol levels and makes it harder for the body to metabolize estrogen, too.
Dysbiosis: Intestinal dysbiosis occurs when someone has too many harmful species of bacteria, or not enough beneficial species, in their large intestine. Some types of gut bacteria can reduce how well the body gets rid of excess estrogen, leading to higher levels in the body.
Xenoestrogen exposure: These chemicals mimic estrogen if they get inside the body. Examples include bisphenol A (BPA) and phthalates, which are present in some plastics. Phthalates are also present in some personal care products, such as soaps and shampoos.
Medications: Some medications may elevate estrogen or suppress progesterone.
Health conditions: Some health conditions have an association with or lead to estrogen dominance. These include polycystic ovary syndrome (PCOS), uterine fibroids, endometriosis, and certain cancers. Insulin resistance also increases estrogen levels.
In males, estrogen can also become high relative to the amount of testosterone in the body if testosterone levels become low.
Complications of high estrogen levels
If a person has consistently high estrogen for an extended period, this increases their risk of:
·?????high blood pressure
·?????blood clots
·?????hypocalcemia, which is low calcium
·?????breast cancer
·?????cervical cancer
High estrogen may also worsen preexisting conditions, such as asthma or epilepsy.
A 2017 study in South Korea found an association between high levels of free estriol and an increased risk of gestational diabetes in pregnancy.
Diagnosing and testing estrogen levels
In females showing signs of estrogen dominance, diagnostic tests may not be necessary to prove that the estrogen ratio is out of balance. The reason for this is that many of the recommendations that doctors might make to reduce estrogen levels are generally beneficial to overall health and unlikely to cause harm.
However, if an underlying medical condition may be causing high estrogen levels, a doctor might run tests to determine whether there is an imbalance and confirm the root cause. Doctors also monitor estriol levels in high risk pregnancies.
In females, doctors can measure all three types of estrogen via blood testing. In males, they only measure estradiol and estrone.
Treatment for high estrogen
The treatment for high estrogen depends on the underlying cause. For estrogen dominance that is not due to a specific medical condition, doctors may recommend lifestyle changes to reduce the levels. People can try:
·?????eating an anti-inflammatory or vegetarian diet
·?????eating more soy, flaxseed, and cruciferous vegetables, such as broccoli and kale
·?????getting more omega-3 fatty acids in the diet or taking a supplement
·?????maintaining a moderate weight
·?????reducing stress
·?????limiting or stopping alcohol consumption
·?????avoiding xenoestrogens, such as BPA in plastics
·?????avoiding any natural or herbal remedies that may increase estrogen
If high estrogen may result from a medication or supplement, a person can speak with their doctor about alternatives. It is important never to change the dosage of a medication or stop taking it without consulting a doctor first.
If a person has high estrogen and a doctor believes that it is important to lower the levels — potentially to avoid damage to the body in the long term — they may prescribe aromatase inhibitors. Aromatase is an enzyme that the body uses to help convert androgens into estrogen.
Doctors may also prescribe a synthetic form of luteinizing hormone-releasing hormone (LHRH) to stop the signal that initiates estrogen production in the ovaries. They may recommend LHRH if estrogen is exacerbating a potentially life threatening condition, such as metastatic breast cancer.
Summary
High estrogen levels can cause symptoms such as irregular or heavy periods, weight gain, fatigue, and fibroids in females. In males, they can cause breast tissue growth, difficulty getting or maintaining an erection, and infertility.
A doctor can diagnose high estrogen levels by taking a medical history and, in some cases, performing blood tests. Once they know the cause, the doctor can recommend the best treatment options. The cause of the high estrogen levels will determine the treatment options.
Lifestyle and dietary adjustments may reduce the amount of estrogen that the body produces or increase the amount that it breaks down and excretes. However, anyone with persistent or concerning symptoms should speak with a medical professional.
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