Whether during your yearly check-up or via one of the numerous direct-to-consumer lab testing services currently available, having your blood analyzed can provide valuable insights into your health, particularly if you’re experiencing troubling symptoms and cannot identify their cause. However, if your results show something atypical, such as elevated estrogen, it is natural to have questions!
Estrogen is a vital hormone (comprising estrone, estradiol, and estriol) since it regulates the menstrual cycle, helps preserve bone density, supports reproductive health, and impacts mood, explains Tamara Guichard, MD, an ob-gyn at Modern Urology. Furthermore, estrogen is crucial in maintaining the health of your heart, metabolism, and reproductive organs, she adds.
Estrogen levels vary naturally over your lifetime, beginning low at birth, rising sharply during puberty, and eventually declining after menopause.
Estrogen also fluctuates throughout the menstrual cycle, with peaks occurring during ovulation. Generally, “normal” levels of estradiol (E2) during reproductive years range from 30 to 400 pg/mL, states Irene Woo, MD, a reproductive endocrinologist at HRC Fertility. High estrogen is typically defined as “levels surpassing the normal range” for a particular age and menstrual phase, often alongside other symptoms (more on this shortly), she indicates.
However, “high estrogen” itself is not a diagnosis—instead, it usually relates to a specific medical condition, like polycystic ovary syndrome (PCOS), or lifestyle factors such as stress.
Doctors provide an overview of what you need to know regarding high estrogen. Yet, it’s crucial to consult your own physician about any symptoms you may be facing or health concerns.
What factors lead to high estrogen?
The concise answer is “it depends” since there isn’t a single universal cause for high estrogen levels. While genetics may play a minor role, high estrogen is more frequently linked to the following lifestyle factors or medical conditions, according to Dr. Woo.
Pregnancy
For those who are pregnant, estrogen levels naturally increase, as noted by Dr. Woo. Specifically, estriol rises during pregnancy to aid fetal growth and prepare the body for childbirth, she mentions. Symptoms such as breast tenderness, fatigue, nausea, mood swings, fluid retention, headaches, and shifts in sex drive may occur, but experiencing some or all of these symptoms isn’t necessarily indicative of a problem with estrogen levels during pregnancy, Dr. Woo clarifies. In fact, such changes are usually normal as the body adjusts, with estrogen levels significantly dropping back to baseline (or slightly lower if breastfeeding) after the birth, she explains.
Polycystic Ovary Syndrome (PCOS)
PCOS results from a hormonal imbalance that often causes elevated estrogen levels, states Dr. Guichard. Studies have found that estrogen and estrogen receptors are particularly high in individuals with PCOS, as reported in the journal Cells. In those with PCOS, estrogen levels can be persistently high due to additional factors like insulin resistance and varying hormone levels, though they may also change with menstrual cycle irregularities or medications used for symptom management, according to Dr. Woo.
Medication
Certain medications, including hormone replacement therapies and treatments for breast cancer, can influence estrogen levels. Birth control pills may also affect estrogen, especially when initially started, but doctors generally monitor your dosage to prevent potential spikes, adds Dr. Guichard.
Weight
Since fat tissue can produce additional estrogen, individuals with a higher body fat percentage may exhibit elevated estrogen levels, according to Dr. Guichard. There’s also a reciprocal relationship: higher estrogen levels can affect where fat is distributed in the body, often leading to concentration in the hips and thighs in women, Dr. Woo points out.
Environmental Factors
Exposure to chemicals that mimic estrogen (like xenoestrogens) present in pesticides, plastics/BPA, and some cosmetics can lead to increased estrogen levels, as they interfere with the body’s hormonal equilibrium, states Dr. Guichard. Specifically, cosmetics, hair dyes, and skincare items containing parabens, phthalates, bisphenol A (BPA), and triclosan can potentially disrupt hormonal balance, adds Dr. Woo. To minimize exposure and potential risks, she suggests choosing products labeled as “paraben-free” or “phthalate-free,” or opting for natural and organic alternatives.
Alcohol
Heavy drinking can disrupt liver function, which is essential for metabolizing estrogen, according to Dr. Woo, potentially leading to elevated estrogen levels.
Stress
Ongoing chronic stress can also upset hormonal balance, Dr. Woo explains. The reason? When the hypothalamus, a brain region linked to hormone regulation, detects stress, it prompts the adrenal glands to release cortisol, the hormone associated with stress. High cortisol levels might interfere with the primary hormone of the HPA axis, which governs reproductive hormones like estrogen. This can lead to irregular menstrual cycles or even a lack of ovulation, she notes.
Should you get your estrogen levels tested?
Estrogen levels can fluctuate greatly based on your age and the phase of your menstrual cycle, Dr. Woo states. Nevertheless, Jillian LoPiano, MD, MPH, a board-certified ob-gyn and chief health officer at Wisp, asserts that testing for estrogen isn’t generally required in healthy women. Physicians don’t commonly check estrogen levels unless a patient presents specific symptoms; then they will create a diagnosis and order the necessary hormone tests, such as measuring estradiol levels.
Many women, however, choose to undergo hormone testing these days, even if they are not experiencing symptoms. If you are concerned about high estrogen levels or simply wish to be tested, any gynecologist, endocrinologist, or primary care doctor can request a blood test to assess your hormone levels, according to Dr. Woo. Typically, they will analyze your estradiol (E2), as it is the primary type of estrogen evaluated, but estrone (E1) and estriol (E3) may also be assessed based on your symptoms, medical history, and age. These tests are often covered by insurance if deemed “medically necessary” by your healthcare provider; however, costs and coverage may vary based on your particular insurance policy.
If it turns out that your estrogen levels are too high—exceeding the “normal” range based on factors like your age, menstrual cycle phase, pregnancy status, and other variables—you might be referred to a reproductive endocrinologist who specializes in hormonal health and can interpret your results effectively, as stated by Dr. Woo. The specialist will investigate the underlying cause of elevated estrogen and recommend suitable treatment options.
Treating Conditions Related To High Estrogen
Making lifestyle changes can significantly assist in managing issues associated with high estrogen. Techniques like yoga, mindfulness, or therapy can help alleviate estrogen-related fluctuations, advises Dr. Woo. Reducing alcohol consumption can also help normalize estrogen levels by enhancing liver function, which is responsible for estrogen metabolism, adds Dr. Guichard.
Eating a balanced diet and engaging in regular physical activity might lower estrogen levels if excess production stems from fat tissue, according to Dr. Woo.
In certain scenarios, such as for those dealing with PCOS or other ongoing health issues, medications like aromatase inhibitors or hormone blockers may be prescribed based on your specific condition, says Dr. Woo. However, if you think your high estrogen levels are due to a prescribed medication, consult with your doctor about possibly adjusting your dosage or considering alternative medications, she recommends.
Addressing conditions related to high estrogen requires a comprehensive and personalized strategy tailored to the individual, making it important to discuss things with a doctor to identify the underlying issue, Dr. Woo emphasizes. Maintaining open communication with your healthcare provider is also wise, allowing them to track your symptoms and decide how frequently you should monitor your estrogen levels, suggests Dr. Guichard. Regular monitoring is typically not necessary, and estrogen levels are not generally kept under close observation, but it can be beneficial to keep an eye on a particular condition, assess your hormone levels, or make treatment adjustments as required, she concludes.