Thanks to high school biology, many women know that as they near 50, their ovaries start closing up shop and estrogen levels drop. According to the stereotypes of pop culture, this leads to midlife women being sweating, grouchy, and chubby around the middle. 

But it doesn’t have to be!

While these stereotypes can be, many women don’t know that these unpleasant symptoms are often the result of high estrogen during perimenopause.

How can this be?

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Hormone Health in Midlife

When discussing hormone health, it isn’t just about the amount of volume of hormones your body is producing. Instead, it is the relative amounts of the sex hormones estrogen and progesterone (and, to a lesser extent, testosterone) that matter.

The early years of perimenopause– and that is sometimes as early as 35– are marked by a sharp decline in progesterone with only a slight lowering in estrogen. This means that estrogen is dominant because the ratio to progesterone is so great.

See the deep dive the green line (progesterone) makes, while the purple line (estrogen) makes a more gentle slope? The widening gap between these two lines shows how estrogen dominance is so common in midlife.

What are common Estrogen Dominance Symptoms?

There are nine common estrogen dominance symptoms women can look out for:

• Irregular (in days, heaviness, or duration) menstrual periods
• Breast tenderness, especially just before menstruation
• Unusual (for you) weight gain in hips and thighs
• Fibroids
• Bloating or water retention, not just part of PMS
• Increased insomnia
• Brain fog
• Increased irritability or moodiness
• Rising anxiety, even about “the little things” that used to not bother you

Understanding how the changing hormones of midlife play into these symptoms is important for your health.

Irregular menstrual periods

If your period is significantly shorter or longer than it used to be, take note. If your period is suddenly much heavier than it used to be, take note. Either of these factors can indicate that you are estrogen dominant.

Your menstrual cycle has all kinds of clues about your health. Learn how to decode your menstrual cycle and empower yourself with body wisdom.

Breast tenderness

Because estrogen stimulates breast tissue growth, higher levels of estrogen correlate with increased breast tenderness. This tenderness is especially noticeable in the 2-3 days immediately before your menstrual period.

The increased breast tissue also means that many women who are estrogen dominant find that they need to go up a cup size in their bra. 

Weight gain in hips and thighs

Estrogen dominance is a well-documented cause of weight gain. Not only does the hormone imbalance mean that your body is working less efficiently, but it suppresses your metabolism, too. Read more about why metabolism slows in middle age.

While abdominal weight gain is a common complaint for women in perimenopause, high estrogen is most closely linked to weight gain specifically in the hips and thighs. If you’re noticing a widening at your pelvis and upper legs, this may be a symptom of estrogen dominance.

Fibroids 

Fibroids are common non-cancerous tumors that grow either in the uterus (most common) or breast tissue. Although fibroids aren’t usually dangerous themselves, they often present with unpleasant symptoms. Common symptoms of fibroids include heavy menstrual bleeding, low back pain, or painful sex.

Because high levels of estrogen fuel uterine fibroid growth, women in perimenopause with estrogen dominance often have fibroids. If you are suddenly experiencing pelvic discomfort, ask your healthcare provider to check for fibroids. 

Heads up: If you were diagnosed with fibroids during pregnancy, recurrence of fibroids in perimenopause may be one of your first clues that you are estrogen dominant.

Bloating or Water Retention

Maybe you’re one of the lucky women who never experienced bloating during PMS. But, suddenly, you’re feeling “full” and your jeans aren’t fitting right more often than not. Estrogen is linked to increased water retention, and this is what gives the body the unpleasant bloated feeling. 

And because estrogen peaks right before your period, that familiar PMS bloating finally makes sense!

Increased Insomnia– Especially middle-of-the-night wakings

Many midlife women are so tired they crash as soon as their head hits the pillow. But then 3am comes, and they’re wide awake! Sound familiar?

The imbalance between estrogen and progesterone is likely to blame. Your body needs progesterone– a calm down hormone– to stay asleep. And if your estrogen levels are too high relative to progesterone, your body can’t hear the message to relax and stay asleep. Oh, there’s also night sweats to blame, too…..

Brain Fog

What was I going to look up? Why did I come into the kitchen?

Not only does your poor sleep affect your ability to do complex tasks, but it means your brain isn’t getting the necessary rest, either. 

Increased irritability or moodiness

While progesterone is the “calm down hormone” estrogen is the hormone responsible for exciting your brain and nervous system. And when you have too much of that excitement, it makes your body a little edgy. It’s too much of a good thing, and estrogen dominance plays out as moodiness because your hormonal body and logical brain are trying to agree on how to act.

Yeah, poor sleep quality doesn’t help your mood, either.

Rising Anxiety

When your body lives in this estrogen dominant state for too long, it puts a tremendous amount of stress on your nervous system. This stress often shows up in your behaviors as anxiety. Worrying about the little things that never used to bother you can be unnerving, which further upsets your body and brain. It’s a vicious cycle.

What do I do if I have these Estrogen Dominance Symptoms?

A woman does not need to be experiencing all 9 of these symptoms of estrogen dominance in order to have out of balance hormones.

In fact, it is almost more important to recognize that if you have just a few of them– but have not regularly been experiencing them before– you should have your hormone levels tested. It is very likely that you have high estrogen.

Recognizing estrogen dominance symptoms is a great first step to a happier, healthier perimenopause. I encourage you to raise your concerns with your healthcare provider. If s/he is unwilling to listen to your concerns, please find someone who will!

Getting Smart About Hormones

Remember that high estrogen is not referring to an absolute amount of estrogen hormone. Rather, it is that the amount of estrogen in your body is high relative to your progesterone.

I know it is confusing, because the popular story has always been “menopause is when your estrogen levels decline.”

But, hey, you’re smart enough to know the difference between perimenopause and menopause.

And now you’re smart enough to know that even though your estrogen levels are declining, you still might have high estrogen. Calling it estrogen dominance can help to clear up the confusion. You’ve got this!

The Well Balanced Women blog is for educational purposes only and is not medical advice. Please discuss your health issues with a licensed medical practitioner.