With the focus on women’s health each October, I am taking a closer look at the topic this month on my blog. It’s time to talk hormone health. This week I’m addressing hormone health in women under 50 years, and next week we turn the hormone discussion post-menopause.

Estrogen Dominance

There are two main sex hormones secreted by the ovaries in women: estrogen and progesterone. These two hormones counterbalance one another throughout the months and years of a woman’s life. There are two phases of the menstrual cycle: the luteal phase, which occurs after ovulation and before the onset of menses; and the follicular phase, which occurs after the onset of menses and before ovulation.

In a healthy woman, estrogen is at its highest just before ovulation when progesterone is at its lowest. Progesterone is at its highest in the middle of the luteal phase while estrogen is at its lowest. The two hormones are both low for a couple days at each phase change, but in general, they work opposite each other.

Estrogen dominance occurs when estrogen levels are proportionally high compared to progesterone. In today’s world, we are exposed to an array of estrogen-like compounds, which increase estrogenic activity in the body. This can throw the estrogen/progesterone ratio out of balance and, in younger women, can affect how we experience menstruation.

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) refers to a range of symptoms including irritability, anxiety, anger, sadness, mood changes, bloating, abdominal cramps, breast tenderness, headaches, gastric discomfort, and more. The symptoms vary from woman to woman, but the timing of the symptoms is what determines the condition: they occur premenstrually, beginning a few days to two weeks prior to the beginning of a woman’s period and ending at the onset of menses or a couple days after onset.

Fully 80 percent of women experience PMS, although 20 to 40 percent report the changes to cause difficulty. And up to five percent report a significant negative effect of PMS that interferes with daily life. Estrogen dominance is an underlying factor for many of these women.


To balance estrogen dominance, some women who experience significant PMS symptoms find relief by using a natural progesterone cream beginning about two weeks before or after menstruation, and stopping once menstruation begins. A small amount of cream (follow product instructions and look for “USP progesterone”) can be rubbed into thin-skinned areas of the body, rotating between areas like the neck, chest, palm inner arm, or face. Pay attention to symptoms. If PMS symptoms ease and you don’t experience headaches, drowsiness, nausea, or breast pain, progesterone cream may be a good product for you to use. Talk to your health care practitioner about it.

Diet Check

Diet can have a big impact on PMS symptoms. Diets high in sugar, refined carbohydrates, dairy, and caffeine have been linked to PMS. I recommend a diet that includes plenty of non-starchy vegetables and low-sugar fruits, healthy proteins, beneficial fats, and foods that feed the beneficial bacteria in the gut. Shifting your diet in that direction can make a big difference in your symptoms.

A Note on Estrogen Metabolism

Estrogen is metabolized in three main pathways in the body: 2-hydroxylation pathway, 4-hydroxylation pathway, and 16-hydroxylation pathway. The 2-hydroxylation pathway creates “good” estrogen and is known to have an anti-cancer effect. The 4- and 16-hydroxylation pathways create estrogens with carcinogenic potential. Higher ratios of 2/16-hydroxyestrone in urine during the luteal phase have been associated with a decreased breast cancer risk in some studies. This relationship becomes even more clear after menopause.

Certain nutrients have been shown to promote the “good” 2-hydroxylation pathway as well as reduced carcinogenic activity. Your best bet is a diet high in cruciferous vegetables like broccoli, cabbage, Brussels sprouts, cauliflower, etc. One supplement I recommend, which contains nutrients that promote healthy hormone function, is Natural Factor’s WomenSense EstroSense.

Hormone health is a complicated topic. If you experience PMS, endometriosis, fertility issues, or any other hormone-related conditions, find a health care practitioner who is versed in the many nuances of hormone health throughout a woman’s lifecycle. A natural-minded or integrative practitioner can make all the difference.