The Estrogen Dominance and Endometriosis Connection (+ Endometriosis Symptoms Checklist)

August 5, 2019

If you have landed on this page, my guess is that you or someone you love has been diagnosed with endometriosis and you’re wondering if there are any alternative or natural ways to get rid of it. However, what you may not have heard about is estrogen dominance and its important connection to endometriosis.

Endometriosis is often a very frustrating and painful condition as there are not many proposed solutions, outside of surgery. There are also varying degrees, or stages, of endometriosis—some causing extreme pain and others being virtually asymptomatic. So, why is there only one common treatment recommendation (surgery)?

My mom ended up going through with a complete hysterectomy at age 50 due to endometriosis. Surgery was her recommended option due to her age. Even though she had other signs of estrogen dominance, the solution was to remove her ovaries, uterus, and cervix.

While complete hysterectomies are often needed, they require a lot of emotional acceptance as well. It is not easy to lose your womb—and psychologically— it can wreak havoc on many women.

Understanding this key relationship between hormonal balance and endometriosis can help you to not only find relief for your symptoms, but also possibly help you resolve your condition altogether if you are in the early stages of endometriosis. Keep reading to learn more about estrogen dominance and how it interacts with endometriosis.



What Is Endometriosis?

Endometriosis is a condition that causes endometrial tissue (the tissue that lines the uterus) to grow in other parts of the body besides the uterus. These growths are known as endometrial adhesions.

Typically, endometriosis occurs in organs and tissues close to the uterus such as the ovaries, fallopian tubes, bladder, and bowel, but it can also occur in other parts of the body.

See the list of endometriosis symptoms and signs below for more details.

Endometriosis Symptoms Checklist [1]

  • Painful periods (painful menstruation is called dysmenorrhea)
  • Painful sex
  • Painful ovulation
  • Heavy bleeding
  • Fatigue
  • Chronic pelvic pain
  • Infertility
  • Intestinal pain
  • Nausea

Endometriosis facts and figures - Dr. Pingel

The physical toll of endometriosis can also cause mental and emotional distress.

Endometrial tissue grows based on stimulation from estrogen. So, if you’re diagnosed with endometriosis, the first step toward treatment is to review your hormone profile. Unfortunately, many patients end up in surgery before anyone has even investigated their hormones.

Sometimes, the extent of the endometriosis is severe enough where surgery is the best option. However, if your hormones are out of balance, you will have more estrogen dominant complications that occur after surgery.

Just removing the results or symptoms will not change the situation. You have to hit it from the root cause.

As with any condition, the first question to ask is “why?” Why did the endometriosis start in the first place? You can’t possibly come up with a solution if you don’t know the details as to what is happening.

In the following sections, I’ll explain in more detail what estrogen dominance is and how it can impact endometriosis. I also offer some recommended natural remedies to help support treatment of estrogen dominance and endometriosis.


What Is Estrogen Dominance?

The most common situation I find in those with endometriosis is estrogen dominance. Estrogen dominance must be corrected, regardless of the proposed treatment of overgrowing tissue, to avoid future problems.

Estrogen dominance occurs when your estrogen levels are out of balance with progesterone, favoring an estrogen dominant state. This can occur from excess estrogen or low levels of progesterone or both.


What are some possible estrogen dominance symptoms in women? 

Many signs, symptoms, and other medical conditions can occur as a result of estrogen dominance. Below is an estrogen dominance symptoms list for your reference.


Estrogen Dominance Symptoms and Conditions in Women

  • Heavy or excessive periods
  • Ovarian cysts
  • Uterine Fibroids
  • Endometriosis
  • Polycystic ovarian syndrome (PCOS)
  • Uterine cramping
  • Abdominal pain
  • Enlarged breasts
  • Fibrocystic Breasts
  • Breast tenderness
  • Abdominal bloating
  • Constipation
  • Decreased sex drive
  • Irregular periods
  • Insomnia
  • Weight gain
  • Anxiety
  • Irritability
  • Hair loss
  • Fatigue
  • Brain fog 
  • Mood swings
  • Hot flashes or temperature sensitivity
  • Subclinical hypothyroidism 
  • Estrogen-based cancers


Understanding Estrogen Dominance 

What can you do to correct estrogen dominance?

The key to creating a treatment plan for estrogen dominance is to “rebalance” estrogen and progesterone. Each woman is completely different, some requiring progesterone supplementation and others simply requiring the reduction of estrogen levels in their body and some requiring both.

Signs of estrogen dominance - Dr. Pingel

What causes estrogen dominance?

The body stores estrogen whenever it is under stress, has poor liver detoxification, or is producing too much estrogen.

Measuring the levels of estradiol and estrone (two forms of estrogen) will provide a good indication if your body is overstoring estrogen as estrone or not. A good rule of thumb is a 2:1 ratio of estradiol to estrone. I also recommend screening these values against progesterone—preferably drawn around one week before your expected menstrual period.

Note that progesterone is only read in the blood correctly during the luteal phase … so seven to 10 days or so before the start of your period. If you run an estrogen dominance test at other times in the cycle, the progesterone will show up as low and give a “false positive” of estrogen dominance.

In fact, many doctors run hormones during the first two weeks of a woman’s menstrual cycle and at that time we should be slightly estrogen dominant—because we are ovulating!

How do I lower estrogen in my body?

Liver support is essential for this purpose. In order to clear excess estrogen, it has to run via the liver. Depending on the severity of the condition, it could be as simple as changing to a more plant-based diet that supports the liver or adding a few liver-supporting herbs, such as milk thistle to your regimen.

In many cases, I use an extract from cruciferous vegetables called 3,3’-diindolylmethane (DIM) to quickly and effectively lower estrogen. If you tend to be overweight, losing weight will also promote the removal of excess estrogen because it stores in the fat cells!


 7 FAQs About Endometriosis and Estrogen Dominance


1. Is endometriosis hereditary?

Research shows that the risk of developing endometriosis does appear to run in families. [2]

2. Is endometriosis an autoimmune disease?

While endometriosis itself is not considered an autoimmune disease, there does appear to be a correlation between the two. Women who suffer from endometriosis are also often diagnosed with autoimmune diseases and other chronic conditions. [3, 4]

3. Can endometriosis cause miscarriage?

Research has shown that endometriosis does appear to be a risk factor for miscarriage, but further research is warranted to confirm the results. [5]

4. Does a hysterectomy cure endometriosis?

Surgical interventions in advanced stages of endometriosis that include the conservation of the ovaries have shown a high recurrence rate of 62 percent. It’s important that all endometrial lesions are carefully removed by the surgeon to avoid the recurrence of endometriosis. [6]

5. Is there a connection between MTHFR mutations and endometriosis?

Yes, research shows that there is an important connection between methylenetetrahydrofolate reductase (MTHFR) mutations and endometriosis. Finding out if you have this mutation may help with your endometriosis treatment. [7] 

6. My endometriosis is really bad, so I am going to have surgery. How can I best prepare to avoid future problems? 

I completely understand how frustrating it is and how painful endometriosis can be. Your life needs to be lived, and often surgery is the best option. My best advice is to make sure you know your hormonal situation prior to surgery—so that you can attempt to regulate it and avoid problems post-surgery. That way, you can live your life without any complications in the future.

7. My doctor has recommended the birth control pill to control my endometriosis. Are there any concerns with this therapy? 

Many doctors will prescribe birth control pills to control estrogen level and it will likely work while a woman is on the pill. The biggest factors to consider here are:

  • If you are young and plan on having children in the future at some point, you will have to stop taking the pill, and your estrogen dominance will likely return. Without this consideration, it can lead to trouble getting pregnant and other symptoms, such as excessive periods and cramping, that impact your quality of life.
  • If you are over 40, the pill carries some significant risks, such as blood clots and cardiovascular concerns. It would likely be recommended for only a short time, and then once removed, you are right back at square one. Why not correct the situation first?

There are also other medications that suppress hormone production from the pituitary gland (such as Orilissa), which essentially put you into a menopause state. Considering your age, this may pose risks as well and the side effects are significant.

In this situation, I would recommend a hysterectomy, as it will also put you into menopause, but you can replete some hormones at low levels rather than suffer through the side effects of lower hormones prematurely. Be sure to discuss all options with your healthcare provider.

Alternative Estrogen Dominance Treatments

Below I’ve provided a list of several natural estrogen dominance treatment recommendations and “home remedies” for endometriosis that I use with my patients.

You may want to consider if any of these estrogen dominance supplements and other suggestions may work for you. Be sure to discuss your unique situation with your healthcare provider first.

  • DIM supplement [8]
  • Vitex supplement [9, 10]
  • Liver support herbs/supplements: milk thistle, dandelion root, burdock root, methionine
  • Bioidentical hormone replacement therapy (BHRT)
  • Plant-based diet
  • Weight loss and exercise (shedding fat)

Note that it is not always possible to reverse endometriosis with natural therapy, depending on the severity of your condition. But by correcting the estrogen dominance, you can halt the progression. And then if surgery is required you won’t have other estrogen dominant symptoms in the future.

Being prepared by knowing the cause of your condition and correcting it gives you better odds for success

Key Takeaways

  • Estrogen dominance occurs when your estrogen levels are out of balance with progesterone, favoring an estrogen dominant state.
  • Endometriosis means that endometrial tissue grows in other parts of the body besides the uterus.
  • Estrogen dominance is often common in those with endometriosis.
  • The key to creating a treatment plan for estrogen dominance is to “rebalance” estrogen and progesterone.
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