What is Estrogen Dominance?

“Estrogen Dominance” is a term coined by the late Dr. John Lee to describe the lack of progesterone available to balance estrogen. Estrogen dominance specifically refers to the blood levels of progesterone relative to estradiol (E2 estrogen), most accurately represented by testing in the middle of the luteal phase. There are multiple types of estrogen dominance and testing first is crucial to developing a plan to treat the imbalance, as each type requires different treatment.

Estrogen dominance can be any of the following:

  • Normal estrogen and low progesterone
  • High estrogen and low progesterone
  • High estrogen and normal progesterone
  • Low estrogen and low progesterone

How is estrogen dominance determined?

Estradiol and progesterone should be tested in the middle of the luteal phase, when progesterone is at its peak, for the most accurate results.

At this time of the cycle, estradiol should be between 75 and 100 pg/ml while progesterone should be a minimum of 10 ng/ml. Progesterone should be a minimum of 200 times higher than estradiol, and closer to 300 is ideal. In order to make this calculation, progesterone needs to be converted into the same measurement as estradiol, and then progesterone needs to be divided by estradiol to determine the ratio.

I have created a spreadsheet calculator where you can enter your results to have it automatically converted and calculated (I’ve done all the math for you!). You can download this spreadsheet from Google Sheets – US version here (ng/ml and pg/ml measurements) – International version here (nmol/l and pmol/l measurements). Make sure you’re double checking the measurements on your lab results and using the appropriate spreadsheet. This is not cut and dry, if you are in the US and have results showing the “International version” measurements that is the spreadsheet you should use, and vice versa.

I have this calculator set up so that you can track your results over a period of time. You can change the date of testing in the green boxes and enter your lab results in the yellow boxes. Please contact us if you encounter any problems or need help understanding any part of it.

Common conditions frequently related to, or caused by, Estrogen Dominance:

  • PreMenstrual Syndrome
  • PreMenstrual Dysphoric Disorder
  • Short luteal phase/Luteal Phase Defect
  • Endometriosis
  • Copper Dysregulation
  • Inflammation
  • PCOS
  • …and much more.

If you’ve determined the type of estrogen dominance that you have and want some ideas on how to treat this issue, consider working with me to build a personalized plan.

Dr. John Lee wrote several books on the topic of estrogen dominance, check out our Recommended Reading list to find them.


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