The Ups and Downs of Estrogen. Part 2: Estrogen Excess

estrogen excessEstrogen is a powerful hormone. We don’t want too little (see Part 1: Estrogen Deficiency), but we definitely don’t want too much.

Estrogen excess causes heavy periods, breast pain, fibroids, and premenstrual irritability. It also suppresses thyroid and increases the risk of breast cancer.

The many types of estrogen

The tricky thing about estrogen is that it’s not one thing—it’s many different things.

  • There is estradiol, the main (and best) estrogen from our ovaries.
  • There’s also estrone from body fat and estrogen metabolites from intestinal bacteria.
  • There are xenoestrogens or endocrine disrupting chemicals (EDCs), which are environmental toxins that act like estrogen.

👉 Tip: The estrogen in birth control (ethinylestradiol) is a xenoestrogen.

  • Finally, there are plant estrogens (phytoestrogens), which generally have an anti-estrogen effect in young women. Read How Soy Affects Hormones.

Causes of estrogen excess

1) Hormonal birth control

The estrogen in hormonal birth control is a xenoestrogen called ethinylestradiol. It’s stronger than the body’s own natural estradiol and damages gut bacteria so it impairs estrogen metabolism or detoxification.

2) Impaired metabolism or detoxification

All estrogens (including xenoestrogens) must be detoxified in a two-step process through the liver and bowel.

Step 1 is liver conjugation which requires B-vitamins, selenium, and the amino acid glycine. Liver conjugation is impaired by xenoestrogens and by alcohol, which is why alcohol causes measurably higher blood levels of estrogen and an increased risk of breast cancer.

Step 2. Conjugated estrogens enter the bowel, where they should then exit the body. When healthy gut bacteria are present, they assist with the safe removal of conjugated estrogens. When unhealthy bacteria are present, they impair estrogen metabolism by making an enzyme called beta-glucuronidase, which deconjugates and reactivates estrogen. The reactivated estrogen is then reabsorbed into your body by a process called enterohepatic recirculation or “gut-liver recirculation.” The result is estrogen excess. That’s why antibiotics can cause or worsen PMS.

3) Perimenopause

Estrogen can triple during the years before menopause. And it’s erratic. It swings from low to high, and back to low again. I call this the perimenopausal estrogen roller coaster. Roller coaster symptoms include the hot flushes and insomnia of estrogen deficiency, plus the breast pain and irritable mood of estrogen excess.

👉 Tip: At its highest point, serum estradiol should not exceed 270 pg/mL (1000 pmol/L).

4) Obesity

Body fat makes an estrogen called estrone which can be a problem with polycystic ovarian syndrome (PCOS). After menopause, too much estrone can increase the risk of uterine cancer.

5)  Histamine and mast cell activation

Estrogen stimulates mast cells to make more histamine and estrogen down-regulates the DAO enzyme that you need to clear histamine. At the same time, histamine stimulates the ovaries to make more estrogen. The net result is a vicious cycle of:

estrogen → histamine → estrogen → histamine.

For many women, symptoms of “estrogen dominance” such as PMS, period pain, and heavy periods improve by avoiding cow’s dairy and other histamine-reducing strategies. Read The Curious Link Between Histamine Intolerance and Estrogen.

6) Receptor hypersensitivity

The actual amount of estrogen is only part of the story. What matters more is your response to estrogen and that happens at the estrogen receptors in the brain, bowel, thyroid, and muscle. They’re stimulated by estradiol. They’re also stimulated by reabsorbed estrogens and xenoestrogens.

Your estrogen receptors become more or less sensitive depending on different factors.

👉 Teenagers
As a teen, your estrogen receptors are naturally more sensitive and that can cause heavy periods. The estrogen excess of the teenage years should settle down after a year or two, and in the meantime, there are simple non-hormonal ways to reduce menstrual flow. See Chapter 9 of my book and also my Heavy Period post.

What is estrogen dominance?

Estrogen dominance usually means too much estrogen, but it can also describe a situation of normal estrogen and too little progesterone.

I don’t like the term “estrogen dominance” because I prefer the more precise terms of estrogen excess and progesterone deficiency. It’s possible to suffer both conditions simultaneously. Read Why I Don’t Use the Term Estrogen Dominance.

👉 Endometriosis
Endometriosis is not a hormonal condition and is not caused by estrogen.  Instead, it’s an inflammatory disease that is affected by hormones. Read Endometriosis: 5 Natural Treatments That Really Work.

How to reduce estrogen

  • Don’t take hormonal birth control.
  • Avoid cow’s dairy and employ other strategies to reduce histamine.
  • Reduce alcohol to promote the healthy metabolism or detoxification of estrogen.
  • Eat vegetables to promote liver conjugation, feed healthy intestinal bacteria, and shelter estrogen receptors (phytoestrogens).
  • Avoid antibiotics to maintain healthy intestinal bacteria.
  • Maintain a healthy body weight to reduce the production of estrone.
  • Avoid inflammatory foods such as dairy to reduce histamine and hypersensitivity of the estrogen receptors.
  • Reduce exposure to xenoestrogens such as plastics and pesticides.

Best supplements to lower estrogen

  • Calcium d-glucarate. Glucarate is a small molecule that’s made by the body and is found in foods such as oranges and broccoli. It assists with estrogen detoxification in two ways. First, it binds to estrogen in the liver and deactivates it. Second, it inhibits beta-glucuronidase, which is the enzyme made by gut bacteria that causes estrogen to be reabsorbed.
  • Iodine down-regulates estrogen receptors, making them less sensitive. It is particularly helpful for breast symptoms such as tenderness or breast cysts. Iodine is safe up to a dose of 500 mcg (0.5 mg), but higher dose iodine can damage the thyroid gland. Read my Iodine post.
  • Natural progesterone. Progesterone counterbalances estrogen. It lightens periods and improves breast tenderness and premenstrual irritability. The progestins of hormonal birth control are not progesterone. Read The Crucial Difference Between Progestins and Progesterone.

112 thoughts on “The Ups and Downs of Estrogen. Part 2: Estrogen Excess”

  1. I wish you could meet my daughter! She is about to see a gynaeocologist for her heavy periods, facial hair and extreme pain and i just know theybare going to put her onto the pill. I wish i had your knowledge to explain how i dont want it. But i am desperate for her to come right as its effecting her day to day to living. Shes 17. But thank you for a wonderful forum/blog and ill definitely be getting your book when i return to the UK. I currently live in Zambia . Many thanks Hope

  2. I’m a bit worried about my most recent hormone blood draw. My pre-ovulation estrogen level was 400 pg/mL and I have not ovulated the last two cycles that we have tested. I also had excision surgery for endometriosis and a hyst sparing ovaries for adenomyosis about a year ago, with a long history of heavy bleeding prior to my hyst. I am in my late 30s, but my mom went through menopause at age 40, so I am assuming the high estrogen and no progesterone due to anovulation is from perimenopause? I am certainly on the rollercoaster, and boy is it unpleasant!

    My GYN has me on 200mg of Prometrium to help with night sweats, anxiety, and insomnia, but I have noticed that breast tenderness has increased for the two cycles since I started taking it.

    Questions:
    1. Can Prometrium stimulate estrogen receptors to increase breast pain? I am concerned about this symptom and wondering if iodine is the best starting point?
    2. As a thin person with a healthy diet, who has a moderate exercise routine, how the heck am I making so much estrogen? Do some people just naturally make more estrogen? With my history of heavy bleeding and endometriosis, this seems to be the case for me.

  3. Anything similar to DIM and calcium d-glucarate?….. I have PCOS due to estrogen dominance. I’ve been taking DIM and Calcium d-glucarate for the past four months and I feel much better, my period is regular, I don’t get PMS and my acne cleared up. The only problem is that I’ve put on 13lbs in three months and I have not changed anything apart from taking DIM and calcium d-glucarate! Is there anything else that I can substitute these two supplements with?

    I must note that my diet is very good, I stop drinking cow’s milk and eating gluten 2 years ago and eat mostly cooked vegetables, fish and rice/root vegetable.

  4. Iodine only 0.5 mg ? mhhh… so all japanese are in trouble because they consume in average 12.5 mg a day…and all that green tea must be dangerous too, right

  5. Hi I just recently tried a dose of DIM at 150mg and it caused major anxiety and migraines. With that one dose only, the dull headaches continued for the subsequent weeks despite not taking any DIM except for that initial dose. Why does it have this effect on me? I thought I’d try a small dose of 100mg calcium d glucarate to help detox the excess estrogen and it also affected me in a way that wasn’t positive. Is my liver too damaged to even consider taking these two supplements? Should I just stick to something like dandelion tea?

    I am trying these because my gyno gave me high dose birth control to stop a massive 3 month bleed and all it did was give me menopausal symptoms without cessation of the bleeding. I stopped bleeding using acupuncture but the menopausal symptoms the pills caused are still with me. It severely imbalanced me. How can I rectify this if I can’t even take DIM or calcium d glucarate? Please help.

  6. Hi Dr Lara!
    Happy holidays!
    My breasts have been very sore for about 3 weeks now. Not positive about length of time. I just finished my period. I’m 49, on a mostly anti inflammatory diet for Hashimoto’s. I do drink coffee and tea. I take Mg every night, and have been using emerita Progesterone cream 2x/day for 2-3 cycles now. I like how it seems to balance my mood and lighten my heavy-ish periods. I take a break from day1 to day 10 of period.
    The only new thing I added was 1 DIM pill/day for the last month and a half. Could this be the culprit?
    Thanks so much!
    Jennifer

  7. Hi
    Some tests I’ve just had done show I have high levels of beta gluconoride. I’m taking calcium d glucurate but I also have low iodine which I’m now supplementing. I have to be careful of cruciferous vegetables so I wondered if the calcium d glucarate would inhibit iodine uptake ??
    Thanks. Katie

  8. I just have to say THANK YOU for this article, for your book, for sharing your knowledge. I have had eczema flare ups for the past 8 months and tried so many different things. It wasn’t until I read your articles here about estrogen and histamine and also the sections in your book that I realized it was a hormonal issue for me. I just started taking Calcium d-glucarate as outlined in your book (1500mg daily) and I have had the best 4 days in a row I’ve had in a while. Minimal itching, my skin redness has gone down and looks like it’s starting to heal, my nose is less stuffy. I am so thankful for some relief! I know I still have a ways to go and I’m curious to see how I fare through the different parts of my cycle, but this gives me hope. Is Calcium d-glucarate something that you can take long term? Or should I lessen the dose as I heal? I have also been avoiding the high histamine foods listed in your book, but just wondering if there is anything else I can do to reduce histamines in my body? I’m assuming that this is a process that takes time for the levels to come down?

  9. Hi Dr Lara,
    thank you so much for an easy explanation on the role of estrogen. And I appreciate your terms for the “other” types of Franken….. Elements which are definitely not health providing. Keep up the good work, you must have a very busy practice and I’ll just bet your patients are quite happy. Good doctoring Dear.
    Aloha
    Teresa Shea

  10. Hi Lara! I am considering buying your book, the information on your site is very helpful! I have a question about something you said: “Progesterone should be used only after ovulation, or it can suppress ovulation and progesterone.” My main symptoms occur during menstruation and especially the week after (weakness, insomnia, anxiety, depression, breast tenderness, blacking out easily, nausea with weepiness, body aches, feeling wired, pelvic pain, constipation and loose stools, and other symptoms). Would taking a bioidentical progesterone troche during the first two weeks of my cycle cause issues with ovulation and progesterone production? I am 31, suffered with adrenal fatigue and hormonal issues for over 3 years now, probably have endometriosis, and have really bad symptoms (feel like passing out, diarrhea, severe anxiety/panic attack) when I go off my progesterone troche for my period-75 mg at that point- for a couple of days as recommended by my naturopath.

  11. Hi, If you are getting symptoms of oestrogen excess in luteal part of cycle (endometriosis and DUTCH test result) and low oestrogen or oestrogen withdrawal (migraines and depression with period and follicular Phase) in other half of cycle is calcium -d glucarate suitable to take who whole cycle to reduce rollacoaster or could it make things worse when oestrogen crashes in follicular phase. Your thoughts??
    Thank you!

  12. Hi Lara,
    First off I want to say I have your book and love it! It has been very helpful as I go through perimenopause! I have recommended it to many friends! However, I have recently started taking iodine for breast pain, and I’m wondering is it safe to take with DIM? DIM along with zinc,Calcium d glucarate, vitamin D, have been helpful for the estrogen dominance that I have been experiencing over the past couple of years, but still experience breast pain and heavy periods. I have read your article regarding iodine, and have recently started with the violet brand. I have only been taking it a month, and already feel a difference with the breast pain, but wasn’t sure if DIM would interfere with the Iodine or are they safe to take together? Curious on your thoughts?

    Thank you!
    Sara R.

    • I have been taking iodine for 8 months and it has significantly helped reduce breast cysts. I was first using drops of iodide really and now use pills by Terry naturally. I forgot to take a few days last week and now have another breast cyst appear that was not there before. As you said the iodine/iodide helps very quickly. My Dr(ob/gyn) knows nothing about using it! It’s some amazing stuff!

  13. Please forgive this long comment. I’m so desperate.

    I am wondering if your book covers menopausal topics. I’m 50 years old, have had some menstrual irregularities in the past year, but since January 2018 I’ve had 3 periods 3 weeks apart and now I seem to be delayed for this next one. While I’ve endured fibromyalgia and chronic fatigue syndrome throughout my life (all worse during hormonal changes), I have managed to muddle through. However, since March 1st 2018 I suddenly am having 10-12 hot flashes a day and every couple of hours at night preventing me from sleeping. (have never had them in daytime before and only occasionally right before period at night)

    I’m exhausted, dry eyes, postural hypotension, fluctuating blood pressure, heart palpitations, anxiety, depression, chronic migraines, memory loss, brain fog, muscle aches, joint aches and even panic attacks. I started using natural progesterone cream a few days ago and it seems to make everything worse when I use it. I tried again last night and again today I have more severe exhaustion, more brain fog, and a migraine.

    Ive lost 30 pounds since November and am now at ideal weight. I lost the weight rapidly due to migraines that were every day. I was eating very little because even eating seemed to make the migraines worse.

    I was diagnosed with Undifferentiated Connective Tissue Disease in 2006. No treatment as diet helped. No severe disease.

    I was diagnosed 6 years ago with Chronic Lymphocytic Leukemia so am seen regularly by my oncologist. My oncologist just says I’m going through the menopause. Since the CLL diagnosis I’ve eaten a whole food diet that is gluten free and for the past 6 months has been grain free.

    I’m so sorry that this is so much information. I found you by researching hormone allergy. I’m at my wits end. I am so miserable and need some quality of life back. Do you think I will be helped by your book?

    Thank you.

    • Darlene, your experience is mine. Cfs and menopause is just too much. Ive been using the gupta program and it is helping my cfs. How are u doing now? I dont know ehatbto so either about HRT. It seems to have made me worse too.

  14. Hi Lara, I was wondering if you have any advice about fibroids. I am 27 and just found out I have a baseball-sized fibroid. I also found out I’m anemic, likely due to the fibroid. My doctor has recommended surgery (laparoscopic myomectomy) as the solution. In researching online I’ve seen several articles suggest making diet changes and taking supplements to shrink fibroids. I mentioned this to the doctor but she said that those things aren’t likely to make any significant difference. I haven’t had kids yet but would like to in a few years.

    After reading about excess estrogen as a contributor to fibroids I asked my doctor about it, but she doesn’t think it’s a factor in my case. What I’m trying to find out is if there is anything I can do to prevent more fibroids in the future. In the past few months my periods have been irregular, every 6 to 8 weeks. They’ve been heavier and I’ve frequently had lots of spotting between them (which is why I went to the doctor in the first place). She has suggested going on the pill (which I don’t want to do) or taking progesterone. Do you have any recommendations? Thank you!

  15. Hi Lara,

    I am 55 and post menopausal, have not bled for 2 1/2 years. I am on bioidenticals and have been for about 5 years. My dr. is not a specialist and does only blood testing to “balance my hormones”, and has been a great MD for our family, but I feel awful, like I did 5 years ago when I came to him first. I was still having periods, but they were definitely changing. I had gone on a anti dep and anti anxiety just to function and seeing several doctors no one mentioned menopause and any natural helps for how crazy I felt. My current labs indicate high estrogen 227 or more and my TSH is high and I have anxiety and now depression like crazy. Just recently went on an anti anxiety med and have some wise friends who think I am estrogen high and that I really need to go on progesterone cream. I was on it for years and felt VERY good and went off it because he put me on bioidentical hormone replacements. I eat very healthy, probiotics, don’t drink or smoke, am active and lately have gotten VERy intolerant to cold, am losing weight and a little hair…just like 5 years ago. Is it possible I have too much estrogen and not enough progesterone. My bioidenticals are BI-3/DH-5/PG-10/P4-50/TE-0.9MG I need to do something else here. A medical friend suggest lowering my EST to 1, increase my progesterone to 100 and decrease testosterone to 0.5 Me, I am clueless and foggy and just want to feel better soon. I have read several posts, can you give me guidance? Is titrating off the bioidenticals and then adding natural progesterone the answer? I have tried so much and feel so very badly.

    • You’re already on natural progesterone. That’s the P4 part of your formula, but 50 mg is a low dose. And 3 mg is a high dose of bi-est (estrogen). I agree with your friend that a strategy might be to lower estrogen and increase progesterone. I would also question whether you need testosterone or not. I have seen it cause anxiety.

      A more modern approach to bioidentical hormones is the approach I discuss in my latest blog post: Rescue Prescription for Menopause. There I suggest starting with a natural progesterone capsule like Prometrium (which you can obtain from any doctor–it doesn’t need to be compounded). And then adding a small dose of natural estradiol like Estraderm. Again, you can obtain from any doctor–it doesn’t need to be compounded.

  16. I’m writing regarding “Progesterone should be used only after ovulation, or it can suppress ovulation and progesterone”

    but in part 1 of the Estrogen series, you add your wisdom to the comments

    “I generally do not recommend progesterone in the follicular phase because it can suppress ovulation. BUT it is sometimes necessary for severe symptoms such as endometriosis and perimenopausal flooding periods”

    If someone has perimenopausal bleeding (Dr & Gyno has ruled out anything else), what day would someone start the bio-identical progesterone in the follicular phase?

    • According to Professor Jerilynn Prior (who helped me with my new book), women with perimenopausal flooding probably need to use micronised progesterone every day. With my own patients, I recommend to stop it for 5 days from about days 4 (after the heavy flow) until day 9, and then start up again. The reason perimenopausal women can take progesterone in the follicular phase is that they’re probably not going to ovulate anyway. And the reason I like stop it for a few days is to prevent the saturation of the progesterone receptors and attenuation of the benefit.

  17. Im 36 years old .im estrogen dominant with saliva test.im on cysteine,arthicoke extract,vitamin b6.but soon after my periods my breast starts getting heavy.and cotinues until i get my period and worsens 1 week prior to period

    I take b vitamins too.if i stop taking the mentioned tablets i end up getting lot of breast tenderness,acne ,hairloss and im going through lot of insomnia

    • I really only prescribe DIM for acne. If acne is an issue, then I might sometimes give immediately after the Pill. But usually, I start with diet and zinc.

  18. Hi there,

    I’ve taken Calcium -d- glucarate before and it seemed to give me terrible migraines.. Would you know a reason for this? I’ve tested it twice and both times, bam! Migraine city. Ive been testing high in estrogen, semi-high testosterone, with very little progesterone for a very long time now. I’ve tried DIM, but I didn’t notice a difference in my heavy periods. My blood calcium levels are always slightly elevated (no parathyroid condition though), so was wondering if this is why Calcium d glucarate is causing issues for me? What do you think?

  19. I have very light periods but very bad PMS. I took some progesterone in luteal phase and when I had saliva test done it showed my progesterone was high. I just dont know what to do or take anymore as my PMS is so bad. Crashing fatigue, and feel so sick before period. I feel like giving up 🙁

  20. Very well written, intellectual, informative and concise! Thank you. This is the first post I’ve seen that lists Bone Broth as High Histamine. I found out through a rash and research, and happily discovered that I was sensitive to high histamine foods, explains the why behind a lot of my food sensitivities that cause menstrual related migraines. Now I’m getting closer to a solution! PTL

  21. Hi Lara, Thank you for writing such wonderful posts! After getting a Paragard IUD in 2012 I suddenly gained 35 lbs in 3 months, and I’m an avid runner and have a strict diet (no dairy for 15 years!) I had the IUD removed two years later, because my body never adjusted to it – just the opposite, I began having Niagara Falls flows with HUGE blood clots, migraines every month, and severe cramps. I had to urinate CONSTANTLY and urgently. I’m 34 years old now and just 3 months ago I read another blog post about estrogen dominance and progesterone cream. I decided to start the cream on my own, and it has cleared up ALL of my symptoms! Even the constant/urgent urination! I’m still exercising regularly and I have a strict diet – but the weight doesn’t seem to come off. I just started taking magnesium, calcium, and DIM and probiotics to get my gut in order.

    I am hoping if I stay on the progesterone cream and continue with the vitamins the weight will start coming off, but it’s insanely frustrating as I’ve been a long distance runner my whole life and 35 extra pounds is impossible to run with easily.

    Thank you for your knowledge and if you have any recommendations for me, please let me know!

    • Thanks so much for sharing your story and I’m glad progesterone cream worked for you.
      Quick question: At the time when you had the Paraguard inserted, had you just stopped hormonal birth control?

  22. Hello Lara, I have a question in regards to estrogen excess. In my late 30’s and 40’s I experienced heavy periods due to fibroids which I learned were because of too much estrogen in my body. So being into natural therapies I changed my diet which shrunk the fibroids and I was able to stabilize the blood loss during my period.
    The issue is when I became peri-menopausal in my late 40’s it stirred up my fibroids causing excessive bleeding and I opted to have iron injections instead of a hysterectomy. Still aware of being on a diet which helped release estrogen from my body.
    The problem today at 55 is,due to not having a bleed (almost 2 years ago) after my last two sets of iron injections (because I had been anaemic with an iron count of 3.4) my ferritin was becoming very high. Now jumping to 218. My iron being 18 which is within normal limits.
    My doctor requested that I reduce my red meat and foods with very high iron intake, as much as possible. Which I did for 6 months but it made no difference.Eating red meat 1-2 times a week and staying away from others sources. I am aware giving blood would help but after having so many injections during peri-menopause I do not wish to have any more injections.
    Is there anything I could take to release this excessive amount of ferritin in my body please. I seem to also be experiencing frequent tiredness and all my blood test came back normal. I did read excessive iron can cause tiredness and am also wondering if this may be causing it.
    Would you have any advice for me please. Thank you.

  23. Hello Lara:) Do you know of any DIM supplement brands without the indole 3 carbinol? I would value your expert opinion:) thanks in advance!

  24. Lara I’m so frustrated. But I think my estrogen is a roler coaster. I’ve had acne for years. But after beginning on magnesium glycerate, zink, dim and berberine, probiotics it has been so much better. But I’m still missing something cause I still break out on my jawline, but not nearly asmuch as before. Still I have breast tenderness (almost every day), fluid retention before my period. Should I cut out some of these supplements? should I add iodine or b6? But i’ve read iodine can worsen acne. Please answear I’m desperate. Have been to so many doctors who only think bcp or accutan is the solution, but I just can’t let them win!

  25. Hi Lara,

    I’m still a bit confused about phytoestrogens– good or bad? What do you think? Seems to be a lot of conflicting views out there.

    Thanks,
    Jade

      • Yes, there is some misinformation out there, but the fact is the phytoestrogens reduce estrogen excess. They block estradiol at the receptor and they also up-regulate estrogen detoxification. So phytoestrogens are anti-estrogen in reproductive women (ie. in the presence of estradiol).
        Phytoestrogens are mildly pro-estrogen in a low-estradiol situation, which is men, children and post-menopausal women.

  26. Hi Lara, I know this is an old post, but I was hoping you could answer my question.

    My background is I am 35, I went off the pill 14 months ago after being on it for 15 years. I got my first period after 6 weeks and have had cycles between 28 and 35 days since then and getting more consistent (28-30 days). I tracked my first few cycles and believe I am ovulating (have obvious fertile mucous). I think I got adrenal fatigue earlier this year, building up over several years due to stress and insomnia (had insomnia on and off during teen and 20s, got it under control in 2014, but relapsed at the end of 2015). A naturopath I was seeing (I can’t afford it anymore) also thought there was an adrenal problem – I was extremely stressed, could not sleep, could not hydrate myself no mater how much water I drank it just went through me, having to urinate a lot, bleeding gums. These symptoms have improved over time, particularly the thirst (I get more salt now, try to stress less), but I found that I was still depressed (crying every day, irritable, worried) due to life circumstances (unfinished PhD hanging over my head mainly) and eventually gave in to taking 10mg of lexapro two 2.5 months ago to get me out of the hole I’ve been. It’s working, I feel much happier, but only want this to be a temporary thing to get me writing again because I prefer a natural approach is possible, plus I would like to have a baby next year.

    I now think that hormones have also been in play over the past year, not just the PhD, given that I only went off the pill 14 months ago and the fact that adrenal problems can throw other hormones out. I’m thinking I may have a build up of estrogens due to use of the pill so I was thinking of taking estroblock in my transition off the SSRI in a couple of months, but would this be bad to do if I don’t have ‘estrogen excess’. I’m not sure if I do because I don’t have breast tenderness, periods can occasionally be heavy, but probably not as heavy as many other women AND one of the biggest problems I have right now is very dry, flakey skin, especially on my forehead, which seems more associated with lower estrogen, right? It takes all day for my skin to feel less dry. I also have blackheads on my chest and back, which I didn’t have before, and tend to get puffy eyes in the morning and blocked nose at night at times.

    I read your book when I was going off the pill, I did a sugar detox before coming off and have remained low sugar. My diet is very good according to your advice. I’m slim, always have been, exercise. My question is: Do you think estroblock (DIM) would help me? Can I take it whilst I’m still on the Lexapro? Does dry facial skin always mean low estrogen? After reading your estrogen and histamine post, I think my dry blocked nose and puffy eyes are more around ovulation. Could DIM help with this? Sorry for such a long question! Your book and blog have been so helpful to me so I would thought I would given this a try.

    Claire

  27. Thank you for all your information! I have struggled with hypoglycemia all my life and PCOS since 13 (although I had already had my period 3 years by then) and wasn’t to be diagnosed until I was almost 40! The feeling of being choked, brain fog, anger, depression, etc. Ugh! It seems to run in my family since my aunts all died of female cancers and had the square-torso physique. I had two pre-cancers in my late 30s and early 40s even though most of my life I was thin (until I had children – no problem getting pregnant), had regular cycles, and was physically fit. Spent 15 years on glucophage which almost killed me (vitamin B12 deficiency) and am now searching for a natural alternative. I’m having some success with NAC and other supplements, but I want to kick this thing in the behind! I still think most of this is because of our food and toxins affecting our adrenals. Is there any information on this?
    Thanks again!

  28. Can not wait to get your book.
    Do you address headaches in your book?
    I have had severe headaches that start right before my period and last 1-2 days into my period. They are so severe that they usually make me bed bound and vomit. I have had these since starting my period. I am now 49 and still have them but am now getting them a second time at ovulation. I am at my wits end any recommendations would be welcomed.

    • Her book and recommendations helped me! I was already taking DIM and evening primrose oil but starting b6 (as p-5-p – and I do take the other b’s) and calcium d-glucarate (which I had never heard of until I got this book) totally took care of my hormonal migraines. I also take b2 and magnesium (threonate) to prevent migraines but those hormonal ones would still show up until I started following the advice in Dr. Briden’s book. I hope you have as much success as I have – good luck.

      • Thanks Sara
        I will try those. I have never heard of DIM or calcium d-glucarate either. I have been taking Vitex and B vitamins(EPO and black cohosh did not help) magnesium and I take Feverfew and butterbur to help prevent the headaches but still have them:( I have just recently started some progesterone cream. I am getting desperate and have started researching bio identical pellet therapy. I stumbled across an Lara’s book while researching Vitex. So hoping she has some answers for me

    • I do discuss premenstrual headaches in my book. In particular, I mention magnesium, natural progesterone, and vitamin B2 (the last one is for migraines)

      • Loved the book:) stayed up for 2 hrs reading it. I read in your bio you are in Christchurch NZ. We have family there? I know It is a big city but do you happen to know Deborah Thomason or Clive Weston? Deborah is my husband’s 1st cousin. We visited them in Jan.2015. Our kids absolutely fell in love with the country. We would love to move to New Zealand.
        Now to my ??
        This is what I have been taking to help with the headaches and fatigue
        Vitex ( I was taking it the entire month)
        CQ10
        Calcium + VitD
        Chelated magnesium 400mg
        Vit B complex sublingual
        Fish oil 300EPA/200 DHA
        Progesterone cream ( metered dose) was taking ovulation to period but have tried it 1 month for everyday.
        Feverfew
        Butterbur
        Additional info
        I also am gluten free for over 1 year and have recently gone dairy free.
        I did take BC from age 18-24 but stopped due to them causing headaches to be more severe. The only time I have been headache free was when I was pregnant.

        From reading the book. I think I should add, change or try
        DIM
        Calcium d glucarate
        Change my B vitamins to individual
        5 MTHF
        B2
        B12
        B6
        Milk Thistle
        Selenium
        Rhodiola or Ashwagandha
        Am I on the right track?
        Thanks so much
        Barbara Ashcroft

        • Hi Barbara, I don’t know Deborah and Clive, but it’s definitely worth asking.
          As for your supplements, I would never recommend that number of things to a patient. I prefer to target with a good quality magnesium, and also to identify — if possible–the underlying cause of the headaches. I did not go into that amount of detail in my book… For example, have you considered histamine intolerance as a cause of your headaches. Please see my post The Curious Link Between Estrogen and Histamine Intolerance. Treatment is a low histamine diet and vitamin B6.

          • Just read the article. It could be my problem. I am basically on that diet now. I do not drink alcohol and I am diary and gluten free. I do love chocolate so I guess that needs to go:(. I know I am very sensitive to histamine and can tell immediately when it is high. It mostly happens if I am extremely anxious, my neck gets really red rash and I itch like crazy. I did have my hormones tested 1 year ago and the only thing that came back abnormal was low testosterone. She treated that with DHEA. I am schedule to see her again in May ( she has a naturopathic dr who works with her) any recommendations of additional tests I should ask her to do? She is very open to suggestions.
            Thanks again for all the advice

  29. Hi there, can you have both high levels and low levels of estrogen? I have symptoms of low estrogen (before menstruation I get severe depression, low libido, insomnia for 2 days before, cold at night, exhausted, increased hair loss) But I also have tender breasts. I then get headaches on about day 3 of menstruation. I’m confused!

    • Hi Eileen, Yes, it’s possible to suffer both low and then high estrogen in the same cycle. I call it the estrogen roller-coaster.
      But if breast tenderness is your only symptom of estrogen excess, then you may just need iodine. Please see my Iodine post.

  30. Hi !! Thank You for really good information !! Need to read it a couple of more times 😀 but to make my history short 4 years ago started to have swellings in face , ears , tongue over my eyes !! Test at the allergy specialist came back negative !! I cleared up candida an no goes every day to the toilet was every five or six day before … But now I see that it starts 10days after menstruation with skin rashes in face… Eyelid swellings and constipation.. After that I get really sore breasts and swelling near the tear ducts !! Have to take prednisolon and it clears !! Then it’s a week before menstruation and the same thing happens but usually more extreme always get a big rash on my belly usually the same spot !!have a big Problem with floating stool !! I’m taking magnesium , sink , selen, was really low on b6 and b12 so I take supplements for this as well .. And of course High D – Vitamins !! Don’t now what to do next? My dockor says my hormones are normal … But I have very high s-Hgb (180 ) Feeling hopless but I would do anything to get my life back !! What to do next ?! Please come with feedback and maybe your book have some chapters that you can refer me to ?! Thank you best regards Louise

  31. Your blog is the best I’ve come across about hormones! Wonderful wonderful source of information. Thank you for aharing this wealth of hard to find and understand with us!

  32. Hi Laura I recently stopped birth control pills almost a year ago. Haven’t had a cycle on my own (2 by using Provera) blood work shows low progesterone, high testerone. Any suggestions?

  33. Dr. Lara,

    I have PMS with acne and irritability and I am not sure what supplement should I take. You say in your book “High-estrogen PMS causes premenstrual irritability” (p. 169) and then you recommend zinc to treat PMS acne because it “promotes the production of estrogen.” (p. 241).

    I was thinking about taking Magnesium, B6 and selenium? What about Zinc??

  34. Hi Dr. Briden,

    I have had a long history of PMS symptoms and endometriosis but even more problematic for me is the time around ovulation when I get severe irritability, headaches and water retention out of the blue. Could this be a sign of estrogen dominance or just sensitivity to estrogen? In addition, since the birth of my third child almost 2 years ago I have had incredibly heavy periods sometimes with palm-sized clots and have also not been able to lose the last 5 pounds of baby weight no matter what I do (mostly in stomach hips and thighs). I eat a very clean diet along with taking magnesium, calcium, iron, zinc. I also just started DIM to see if that helps. All these things seem to suggest something is clearly out of whack but can’t figure out if it’s too much estrogen, not enough, or lack of progesterone. Any thoughts? Been stumped and frustrated for so long. Many thanks in advance.

    Holly

    • Those are all very clear signs of estrogen excess (irritability, headaches, fluid retention, heavy periods). For my patients with those symptoms, I prescribe dairy-free diet, vitamin B6, low dose iodine, DIM, and sometimes turmeric. I didn’t mention it in the post, but turmeric is a natural aromatase inhibitor, so it reduces estrogen. (I mention turmeric in my book as a treatment for heavy periods.) You may also want to think about the health of your intestinal bacteria, and reduce alcohol (if you have much alcohol).

      • This is very helpful, thank you. I forgot to mention that I also take a B-complex as I’ve always heard that you should take the B vitamins together but I notice in your book that you only mention single B vitamins, specifically B6 (P5P). Should I switch? And would adding calcium d glucarate be beneficial or not necessary? Also, I also have hypothyroidism and am on levothyroxine (my TSH levels are fine now-i have a great endo who likes adheres strictly to the new . Should avoid iodine (even low dose) due to these issues? Thanks again for all your help.

        • I often prescribe activated B6 on its own to address estrogen excess, sometimes up to 100 mg (but only short term).

          Doctors avoid iodine supplements with thyroid disease for two reasons: 1) Too much iodine can trigger or worsen thyroid antibodies (thereby worsen autoimmune thyroid disease or Hashimotos, and 2) They think that with thyroid replaced, then there is no need for iodine. In other words, they mistakenly believe that the thyroid is the only gland that needs iodine (not true).

          My response is: 1) high dose iodine is dangerous for thyroid, but low dose iodine (< 500 mcg or 0.5 mg) is safe because it usually does not flare antibodies, and 2) The thyroid is not the only gland that needs iodine. Far from it. All estrogen sensitive tissue (including breasts and uterus and brain) need iodine. Thyroid disease is not a reason to deprive the entire rest of the body of iodine. If it has to, the body will harvest elemental iodine from thyroxine, thereby requiring higher dose hormone replacement. Please see my Iodine-Breast post.

          • Hi Lara,

            Writing again after several months of actively trying to get my estrogen dominance under control. I added the turmeric and iodine and continued my DIM. For a few months things were very slightly better. After test results revealed that my progesterone is, in fact, low (also low cortisol) my doctor put me on compounded bioidentical progesterone cream for the last two weeks of my cycle. This was my second cycle on it and my period this month though always extremely heavy has been heavier than it’s ever been (huge clots, needing to sleep on towels at night, etc). I’m on Day 6 and still bleeding very heavily with terrible cramps. Have you heard of this happening after starting progesterone. My doctor and the compounding pharmacist have been suggesting i may need more progesterone and have suggested starting to use it everyday for a short while (one pump from day 1-14 and two pumps from day 15-28) but i’m worried it could make bleeding worse, increase side effects or could prevent ovulation. Any thoughts on this or where to go from here? Many thanks for any advice.

            Holly

          • Bioidentical progesterone can be very helpful for heavy bleeding. I talk about it in my heavy period post. The fact that it hasn’t worked yet may just mean that you need more time with it. Or Yes, possibly more days on it. As for preventing ovulation, yes, that’s something to consider, but if you’re perimenopausal, you may not be ovulating very often anyway. (That’s why you’re having heavy anovulatory bleeds.) How old are you?

          • Thanks so much for your reply. I’m only 38 and while my periods have always been pretty heavy this extreme heaviness, premenstrual bleeding and other symptoms started after having my last baby (got my period back about a year after he was born while still nursing). He is 2.5 yrs now. I definitely haven’t felt like things ever got back to normal after having him. Could I still be anovulatory if I have monthly bleeds (albeit with midcycle bleeding)?

          • Yes. I am hypothyroid and have been on medication (now Armour) for 6 years. My doctor monitors it closely and I have my levels checked frequently.

          • Hello. I have had Grave’s for 18 years. It’s always been managed by meds and haven’t been on meds in almost 5 years. I have a goiter and nodules. Both have grown but goiter is still tolerable. Nodules tested benign. Thyroid panel came back at normal range. I do have a pretty stressful life, but probably about the same as most. I manage the stress well and don’t dwell on my problems but my hair has been falling out at uncomfortable rate for 8 months. I did break my knee 6 months ago, and delt with some high stress situations all at same time as break without being on any vitamins. Now I’m taking vitamins, trying to not eat much sugar, less coffee, and less junk food. I am almost 40; I have six children, and have had fibrocystic disorder for approximately 20 years. Do you have any suggestions? Thank you.

  35. Hi Dr. Briden,
    I was wondering if you have any recommendations for lowering a woman’s libido. My sex drive is significantly higher than my husband’s, and it is causing problems. Not just in not having enough intercourse, but I am frustrated at feeling aroused all the time. I would like it to calm down.

    • Sorry, I don’t have any specific recommendations for lowering a woman’s libido. Is a side effect of something else you’re taking?

      • Nope, not a side effect. Been this way all my life. Was on birth control for menstrual reasons, and that definitely lowered it!!!! I’ve been off birth control for almost two years now and the libido is just running wild. I also am going 50 days between periods and my emotions are roller coastery, so….I’m sure they’re all related. Yes I am looking into this!

  36. Hi Lara, you mention about detoxification of oestrogen being impaired by intestinal bacteria. What’s your protocol for reducing candida etc? There’s a lot of information out there about eliminating sugar, but what about carbs? You advocate “gentle carbs” for thyroid etc. What’s the best way of creating a good intestinal balance? Do you use any natural anti fungals?

    • I find that many patients required treatment for SIBO (small intestinal bacterial overgrowth). I generally prescribe 8 weeks of a low FODMAP diet combined with herbal antimicrobial formula with berberine and oregano, together with HCl supplement. I follow with a course of probiotics and sometimes glutamine formula. Gentle Carbs rice and potato are permitted on a low FODMAP diet.

      • Hi Lara, that’s very informative about the SIBO. I’m a bit confused though, I bloat up instantly with rice, potatoes etc, but with cauli and broccoli which are fodmaps, I don’t. Currently taking Grapefruit Seed extract, but have seen no improvement yet. Is it maybe something other than SIBO, or should I just do low FODMAP anyway. I do get stomach upset with sorbitol, malitol which are FODMAPs, maybe its certain ones.

        • Have you been following a low carb diet up till now? More than two months on a low starch diet down-regulates starch enzyme production, which can make it difficult to re-introduce healthy starches. You have to go slowly, a tablespoon at a time. And maybe supplement amylase enzyme.

          I never prescribe grapefruit seed extract ever since I found out that some commercial preparations contain the toxic preservative benzalkonium chloride. See research → https://www.ncbi.nlm.nih.gov/pubmed/16159196

    • If it’s truly candida overgrowth, then I temporarily remove sugar and fruit from the diet, and prescribe a course of saccharomyces boulardii (probiotic). But most cases of dysbiosis (wrong intestinal bacteria) are a combination of too many gram negative bacteria and small intestinal bacterial overgrowth (SIBO). In that case, I prescribe an 8 week low FODMAP diet together with a berberine/oregano oil formula. Followed by glutamine and probiotics. Rice and potato are permitted on a low FODMAP diet.

  37. Hi Lara, firstly I want to thank you so much for your fantastic book, the Period Repair Manual. Unfortunately I come from a line of women that suffer from endometriosis and polycystic ovaries. This book has been an absolute blessing to me! I’m trying to get my sister and mother, “natural treatment” sceptics, to get it too. Compliments aside, I would love your professional opinion on supplements. I’m in the process of cutting out sugar, gluten and cow dairy, and am currently taking vitamin d3, magnesium and a vitamin b complex after dinner. I want to take zinc, krill oil, berberine and possibly iodine on top. Is this too much? Should I take some at different times of the day instead of all together? Will taking all of these at around the same time prevent optimal absorption, or cancel each other out?
    Thanks again,
    Sarah.

    • Thanks for your feedback about my book! That is a long list of supplements, and I probably wouldn’t prescribe so many together. For endometriosis, I usually prescribe priority supps of magnesium, zinc, berberine, and sometimes selenium. It’s okay to combine the ones you list, and to take them at the same time.

  38. Hi Lara,

    In your book you prescribed magnesium to one of your patient and saw her progesterone level go up without using the progesterone cream. Would magnesium also help with lowering estrogen if it boosts progesterone? Also in your book you mention two kinds of magnesium, magnesium glycinate and citrate. What are the differences between the two?
    Thanks in advance!

  39. Great article. I have very low progesterone. Went to a pharmacist who did the saliva testing. I am now on a compounded progesterone cream but she said to start day 10 of my cycle. I have never heard of that. Should I see when I ovulate or if I do and use after that? I am having short cycles now. Thank you.

  40. Fantastic article Lara, I love all the resources you have provided on your blog. I practice as a clinical nutritionist and I find your articles so valuable. You have an amazing ability to explain things in a very easy to understand way.

  41. Hi, i’m wondering how to access the natural progesterone that you reference above. Is it something available by prescription only, or through a naturopath? I live in Victoria, B.C. so Canadian/BC laws and regulations would apply.

    • Progesterone is over the counter is the US, but I believe is still prescription-only in Canada. Naturopathic doctors in BC can prescribe, or you can check with your local compounding pharmacist to learn of a local family doctor who will prescribe.

  42. Thanks! Great article but since I went and bought your book, I now conveniently have this info in my home! I was wondering more about calcium d-glucarate. I started it last mid-cycle and had started b6 (p5p) supplementation 2 weeks prior. My period was soooo much lighter (like a normal person’s) as compared to the “I can’t leave the house” type I had been experiencing for the past 3 yrs (but I have always had bad periods). I also did not have a migraine. I have been taking dim for a year- that has helped with hormonal acne and evening primrose oil too. I have read you info on vitex and following that too~ I started that this cycle. My question – is calcium d-glucarate ok for long term use? Is it needed every day? Btw I do have a bunch of genetic variants related to metabolizing estrogen – not that I needed that info to know I had problems! 🙂 love your book! I think every pre – menopausal woman should own it!

    • Hi Sara, thanks for your comment, and feedback about my book. I love hearing from readers. And thanks for bringing up the topic of genetic variants that impair estrogen detoxification. I mention MTHFR briefly in the book, and I hope to write a future post.
      Yes, calcium-d-glucarate is safe for long term use. 🙂

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