This is a general post, not aimed at any poster or post in particular.
The whole concept of “oestrogen dominance” is based on the premise that there is a magic ratio of oestrogen to progesterone needed for well-being and when this gets out of balance, as it does in peri-menopause, then what is needed is extra progesterone, for therapeutic reasons.
We first discussed this may years ago on the forum and I think all the earlier posts were archived, but from what I recall this term and this theory was invented by John Lee to sell natural progesterone cream. That was from memory. Since then there have been numerous proponents and equally many practitioners and products all making money of the back of it notably in US where there is no NHS and all sorts of people set up to promulgate all sorts of treatments and products in an unregulated fashion.
Having just googled it again for the first time for years I found this:
https://www.medichecks.com/blogs/news/oestrogen-dominance-too-much-of-a-good-thing“The term was originally coined by Dr John Lee in the 1990s [1] and was based on his experiences of treating women with natural hormone therapy. His theories have been criticised because they are based on anecdote rather than scientific evidence [2]. There are still very few published scientific papers on oestrogen dominance and no widely accepted criteria that doctors can use to diagnose the condition.”
So what is actually meant by oestrogen dominance? To me the most obvious time when oestrogen predominates is during part of our natural menstrual cycle during our fertile years. For the first part of the menstrual cycle oestrogen rises and reaches a peak around the time of ovulation. At this time, oestrogen dominance ie the ratio of oestrogen to progesterone, is at its highest. Once a woman has finished the main part of the bleed then this is the time when most women feel at their best – obviously, otherwise we would never reproduce! Post ovulation, oestrogen crashes and progesterone start to rise, and later oestrogen rises again and then both fall and then the period starts when oestrogen and progesterone are at their lowest. Women usually feel at t heir worst during the last part of the menstrual cycle – either when progesterone is high relative to oestrogen or oestrogen has fallen or because of the progesterone withdrawal. During the whole of the second part of the cycle the ratio of oestrogen to progesterone will be lower than the first half and around ovulation.
If oestrogen dominance was a thing, the reverse would be true, surely ie we woud feel at our worst during the first part of the cycle and around ovulation?
It’s important to distinguish between “oestrogen dominance” (high oestrogen relative to progesterone), and very high oestrogen per se, both of which occur during peri-menopause.
The lack of ovulation during some peri-menopause cycles means that the ratio of oestrogen to progesterone remains high for some time and progesterone is needed here to regulate the cycle and protect the endometrium, but not because the progesterone is needed for well-being.
The very high spikes of oestrogen which undoubtedly occur during the peri-menopausal hormone fluctuations are a different matter altogether. As I understand, the side effects/symptoms of very high oestrogen at this time, have nothing to do with oestrogen dominance but purely because of the oestrogen itself – sudden high levels ( as we notice during pregnancy) can cause amongst other things very tender breasts – but adding progesterone won’t prevent this. Only suppressing or controlling the cycle can dampen these fluctuations eg through the pill, some types of mini pill, or the Mirena coil (which doesn’t always suppress the cycle) or very high consistent doses of oestrogen. Of course eventually the oestrogen levels continue on their downward trajectory, no longer spike very high, and that’s when HRT comes in. A progestogen is always needed to protect the womb.
Also progesterone has been used in pharmaceutical quantities (rather than physiologically for “balance”) – but this is not because of its role in alleviating “oestrogen dominance”, but due to its sedative effects - though I don't think it is indicated for this?
That being said if anyone feels they want to take progesterone for whatever reason, in the doses used for HRT or less, then why not, though as far as I know there is only anecdotal evidence for its efficacy? However no need to go to an expensive private clinic to get it prescribed.
As always wishing everyone the best, but trying to see the wood for the trees….
Hurdity x
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Topic: Oestrogen dominance - stopped oestrogen gel (Read 4710 times)