Ask Barbie! Barbara Taylor MD's Q&A addressing your burning questions about Menopause

Ask Barbie – Is It Possible to Have Too Much Estrogen?

Could I overdose?

Welcome to “Ask Barbie,” where I answer your most burning questions about menopause and other things related to your female health and well-being.

Today’s question is as follows: Is it possible to have too much estrogen?

Now this question raises several different issues. As usual, I will address all of them.

  • The various issues of interest include:
  • The three kinds of estrogen your body produces
  • The quantities of estrogen your body produces at various times during your lifetime
  • The interaction between estrogen and progesterone in your body
  • So-called “estrogen dominance”
  • Dosages of estrogen in birth control and hormone replacement therapy (HRT) products
  • Symptoms of estrogen excess versus symptoms of estrogen deficiency
  • Misplaced focus on having too much estrogen versus having too little estrogen

Let’s go through these.

The Three Kinds of Human Estrogen

Our first issue addresses the three kinds of estrogen your body produces. There are three human female estrogens:

  • Estrone
  • Estradiol
  • Estriol

Your fat cells produce an estrogen called estrone. O-N-E means one. So estrone is E1.

Because estrone is produced by your fat cells, the more fat there is in your body, the more estrone you have.

Estrone does nothing beneficial for you at all. It has zero positive effects, but two negative effects.

The two negative effects are:

  • It creates cellulite.
  • It over-thickens the lining inside your uterus, putting you at high risk for uterine cancer.

So estrone is the estrogen your body hates. And you can have too much of it.

Your ovaries produce estradiol. D-I means two. So estradiol is E2.

Estradiol has many positive effects. They include:

  • Acting as your fountain of youth to keep you young
  • Enabling you to ovulate an egg for the possibility of pregnancy
  • During pregnancy, thickening the lining inside your uterus to act as a cushion for a baby
  • Preventing all the symptoms of estradiol deficiency
  • Preventing the three fatal diseases of estradiol deficiency; heart attack, osteoporosis, and Alzheimer’s Disease

Estradiol is the estrogen your body loves. And, by definition, menopause is when you lose your beloved estradiol.

This ‘Ask Barbie’ question will dwell on the question of whether or not it’s possible to have too much estradiol.

Your placenta produces estriol during pregnancy. T-R-I means three, so estriol is E3. Estriol is for the benefit of the baby. It does nothing whatsoever for you, so your body is indifferent to estriol. It’s not possible to have too much of it because the placenta produces just what’s necessary to protect your baby only during pregnancy.

So now, we’ll focus primarily on estradiol.

Quantities of Estradiol During Your Lifetime

Before puberty, your body does not produce any estrogen. Puberty is the time when your body begins producing both estrone and estradiol. At puberty, you gain weight. You begin to form breasts and hips for a womanly figure, and your fat cells produce estrone.

During puberty, your ovaries also start producing estradiol, which sets the stage for the beginning of your menstrual cycles and your ability to become pregnant.

In order to address our ‘Ask Barbie’ question, we need to consider how much estradiol your body produces at various times over the course of your lifetime. And the quantities of estradiol in your body are as follows:

Estrogen Levels by Hormone Phase (list)

Interaction Between Estradiol and Progesterone in Your Body

Your menstrual cycles are a result of interaction between estradiol and progesterone. And each cycle has a first half and a second half.

In the first half of your menstrual cycle, your estrogen rises. It serves to make an egg ovulate and to thicken the lining inside your uterus so that the egg has a cushion for implantation, should you get pregnant.

In the second half of your menstrual cycle, your progesterone rises. It serves to keep the lining in your uterus thick for your baby if you do get pregnant. So progesterone is all about the baby. If you get pregnant, progesterone stays high in order to protect the baby during pregnancy. If you don’t get pregnant, progesterone drops to a very low level because it has no baby to protect.

So every single menstrual cycle entails high estrogen in the first half of your cycle and high progesterone in the second half of your cycle.

A graphic depiction of a single menstrual cycle looks like this:

Estradiol levels during pregnancy

Since you have menstrual cycles for about 30 or 40 years, this single menstrual cycle repeats itself over and over and over again, every month … throughout your entire reproductive life.

What this means is that, for half of your reproductive life, your estradiol is higher than your progesterone. And for the other half of your reproductive life, your progesterone is higher than your estradiol.

If you get pregnant, both your estradiol and progesterone skyrocket. They increase 15 times over their non-pregnant levels. So, if you were to add a pregnancy onto our graph of menstrual cycles, it would look like this:

This means that you have exorbitant quantities of estradiol in your body throughout each pregnancy. And that taps into our Ask Barbie question, which is: Is it possible to have too much estrogen?

Well, if it’s possible to have too much estrogen, it would happen during pregnancy. And the specific estrogen of interest would be estradiol.

So-called “Estrogen Dominance”

This brings me to a term I hear from women all the time—“estrogen dominance.” This term is just about the looniest thing I’ve ever heard, and the reason it’s loony is because, as a female, your primary sex hormone is estrogen.
There are only three sex hormones. They are:

  • Estrogen
  • Progesterone
  • Testosterone

The three sex hormones are like the three bears in Goldilocks and the Three Bears. Just as each bear had his or her own bed, chair, and bowl of porridge, each sex hormone belongs to a different member of the family.

Estrogen is what makes Mama Bear Mama Bear. It is the female sex hormone. In order to be Mama Bear, your estrogen has to be dominant.

Progesterone is the hormone in support of pregnancy. It is for the benefit of Baby Bear only. It has to be dominant during pregnancy.

  • “Pro” means in support of
  • “gest” means gestation (or pregnancy)
  • “sterone” means hormone

Testosterone is what makes Papa Bear Papa Bear. It is the male sex hormone. In order to be Papa Bear, a man’s testosterone has to be dominant.

This means that all women are, by definition, estrogen dominant. Again, the first half of every menstrual cycle you ever have entails estrogen dominance.

The problem with this term is that women interpret it as a bad thing. But how can it be a bad thing if the very hormone that makes you you is dominant?

The whole theory of estrogen dominance was made up by Dr. John Lee of the alternative community. He created the term in order to get women to blame estrogen for all of their gynecologic problems. And his goal was to sell progesterone, which he promoted as the safer and more beneficial hormone. Of course, that’s true for Baby Bear, but not Mama Bear. It was all merely marketing and scare tactics for purposes of selling progesterone. And boy, did it work!

But it’s a complete fallacy.

If you are Mama Bear, you are estrogen dominant. Estrogen is your hormone. You are also estrogen dominant during peri-menopause, when you start losing your progesterone before you start losing your estrogen.

But at post-menopause, you lose all your estradiol. And then you become estrogen deficient. And estrogen deficiency brings with it symptoms of estrogen deficiency and diseases of estrogen deficiency.

But, if deficiency of estrogen causes symptoms and diseases, how can it be a bad thing to be estrogen dominant?

And, for purposes of the idiotic term “estrogen dominance,” the specific estrogen of interest is estradiol, of course. Estradiol dominance is a very good thing, indeed.

Dosages of Estradiol in Birth Control and Hormonal Replacement Therapy Products

The next issue to consider is the dosages of estradiol in birth control and HRTproducts.

And in order to make sense of this, we need to compare the dosages in these products to the dosages of estradiol your body produced.

As you can see, your body produces 100 to 300 µg (micrograms) of estradiol during each menstrual cycle. At pregnancy, it skyrockets to 4000 to 6000 µg.

Birth control products that consist of both estradiol and progestin contain 10 to 35 µg of estradiol. Hormone replacement therapy products for menopause contain 2.5 to 10 µg of estradiol. And local vaginal products contain less than 2.5 µg of estradiol.

Dosages of Estradiol in various hormone products

I have denoted the “minimal necessary dosage” of estradiol as 5 µg. This is the lowest possible dosage that can theoretically begin to prevent heart attack, osteoporosis, and Alzheimer’s. But there is no guarantee that it is enough for you, personally.

Factually and logically, most women discover that they need significantly more estradiol than the “minimal necessary dosage” designated as the lowest possible dosage that can begin to prevent heart attack, osteoporosis, and Alzheimer’s.

To depict this another way, here’s a graph of what happens to your estradiol as you progress from having menstrual cycles … to enduring peri-menopause … to reaching post-menopause:

As you can see, your body produces 100 to 300 µg (micrograms) of estradiol during each menstrual cycle. At pregnancy, it skyrockets to 4000 to 6000 µg.

Birth control products that consist of both estradiol and progestin contain 10 to 35 µg of estradiol. Hormone replacement therapy products for menopause contain 2.5 to 10 µg of estradiol. And local vaginal products contain less than 2.5 µg of estradiol.

I have denoted the “minimal necessary dosage” of estradiol as 5 µg. This is the lowest possible dosage that can theoretically begin to prevent heart attack, osteoporosis, and Alzheimer’s. But there is no guarantee that it is enough for you, personally.

Factually and logically, most women discover that they need significantly more estradiol than the “minimal necessary dosage” designated as the lowest possible dosage that can begin to prevent heart attack, osteoporosis, and Alzheimer’s.

To depict this another way, here’s a graph of what happens to your estradiol as you progress from having menstrual cycles … to enduring peri-menopause … to reaching post-menopause. (Estrogen is pink, progesterone is multi-colored):

Hormones: Peri- and post-menopause

Envisioning Estradiol Ratios the Easy Way

What happens to your estradiol during menopause
  • Your non-pregnant body produced a bucket of estradiol during menstrual cycles, while each pregnancy increased your single bucket of estradiol to 15 buckets of estradiol.
  • Your peri-menopause began when your bucket of estradiol dwindled down to a big water bottle of estradiol.
  • The estradiol in birth control gives you one glass of estradiol.
  • The estradiol in HRT for menopause gives you only drops of estradiol

Well, if your own body is used to a range of dosages between 100 and 6000, how are you going to get too much estrogen from birth control or HRT products that contain only 2.5 to 35 µg of estradiol?

Remember, you are Mama Bear. Your sex hormone is estradiol. Estradiol is what makes you … you. And when you become estradiol deficient, you don’t feel like yourself anymore. This is precisely what women experience in the process of becoming post-menopausal.

Symptoms of Estradiol Excess

Of course, anything is possible. So it is possible to have too much estrogen. And if you do have too much estrogen, your body will let you know that you have too much estrogen.

Here are the symptoms of estrogen excess:

  • Heavy periods
  • Nausea
  • Vomiting
  • Yeast infections
  • Leg cramps 
  • Cravings

But the vast majority of women don’t have those symptoms, either at the time of menopause or any other time (except during pregnancy). In fact, most women have quite a different list of symptoms. They have symptoms of estrogen deficiency. And again, if you have too little estrogen, your body will let you know you have too little estrogen.

Symptoms of Estrogen Deficiency

Here are the symptoms of estrogen deficiency:

  • Anxiety
  • Hot flashes
  • Night sweats
  • Heart palpitations
  • Insomnia
  • Fatigue
  • Forgetfulness
  • Mood swings
  • Irritability
  • Depression
  • Joint pain & stiffness
  • Dry skin
  • Hair loss
  • Vaginal dryness
  • Urinary tract infections
  • Urinary incontinence
  • Weight gain
  • Decreased sex drive 
  • Headaches

Which list of symptoms is more common for women during peri-menopause and post-menopause? Hands-down it’s the list of symptoms of estrogen deficiency.The problem is that most women have these lists mixed up. They label symptoms of estrogen deficiency as symptoms of estrogen excess. And that will get you nowhere.

The Answer: A Misplaced Focus

In my consultations with women for achieving all their goals for successful menopause management, I have discovered that they tend to focus on all the wrong things. And this is a perfect example of this misplaced focus.

You need to worry about getting enough estrogen. You don’t need to worry about getting too much.

If you have ever been pregnant, your own body has already proven to you that it has no problem with the super-high levels of estradiol during pregnancy. 

Even if you have never been pregnant, your own body has proven to you that it has no problem with the high levels of estradiol during menstrual cycles.

If you take birth control or HRT for your menopause management, you will not be taking anywhere near the quantities of estradiol that your own body produced.

So focus on getting enough estradiol rather than worrying about getting too much estradiol.

I hope this has allayed your fears and answered your question.

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