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Understanding Estrogen & Its Role in Fatigue

Estrogen has made a name for itself when it comes to hormonal imbalance. It’s often even prescribed to help stabilize thyroid hormones or other hormonal imbalances, but is it really calming the chaos for the surrounding hormones or just causing an excess? Let’s look at how estrogen dominance plays a role in common conditions as well as fatigue.

Estrogen is produced by our ovaries and it is the hormone that basically gives us our curves and plays a major role in reproduction. It has many roles. It controls the menstrual cycle, manages cholesterol levels, protects our bone health, and plays a role in our mood, affects the brain, heart, skin, and other tissues. Hence, why women are more prone to osteoporosis as menopause sets in.

Estrogen also works hand in hand with our thyroid and adrenal hormones, and when in excess, can lead to decreased amounts of thyroid hormone as well as cortisol output. Our wonderful bodies make 3 types of estrogen in different phases of our lives (estradiol, estriol, and estrone). (5) Estradiol is often prescribed to help reduce the symptoms of menopause.

As you are probably already aware, our estrogen levels change throughout the month. They are highest during the menstrual cycle, and lowest during our period, and drop throughout menopause (which is why some physicians may prescribe estrogen, despite this being the body's natural rhythm).

When there is excess estrogen, just know that progesterone (the hormone that keeps estrogen in check) is likely to be deficient. Excess estrogen or estrogen dominance can develop from excess belly fat (thanks to cortisol & stress), environmental estrogens (found in plastics, skin products, cleaning products, and fragrances), poor digestion & elimination (constipation), stress, adrenal issues, birth control, and even autoimmune disease. (3,5) And this is where the problem lies.

Common Signs of Excess Estrogen Include:

Here are a few symptoms that can be indicative of too much estrogen: (1,3,5)

  • Irregular or heavy periods

  • Worsening of PMS

  • Water retention

  • Breast swelling and tenderness

  • Headaches

  • Loss of Sex drive

  • Fatigue

  • Fibrocystic breast changes

  • Weight gain -mainly in the waist, hips, and thighs

  • Mood swings- feeling depressed and anxious

  • Hair loss

What’s tricky is that estrogen dominance and estrogen deficiency can both result in very similar symptoms including hot flashes and PMS,

Estrogen’s Role in Fatigue and Adrenal Imbalance

Often, when there is a hormonal imbalance identified by your doctor, the route of treatment typically focuses on rebalancing estrogen with a prescribed estrogen replacement. As a result, the adrenals are overlooked. Why are the adrenals important when it comes to estrogen dominance or deficiency? Let’s review a few of the roles the adrenals play and then tie it all together.

The adrenal glands control vital functions such as:

  • Regulation of other hormones

  • Balance of electrolytes

  • When to turn off inflammation (a vital part of our immune system)

  • Fight-or-Flight Response ( our parasympathetic & sympathetic nervous system)

  • Sleep and waking cycles ( sleep hormones such as GABA, Melatonin, Cortisol)

  • Blood Sugar ( Insulin and Kidney Function)

  • Body Weight

Let’s focus on the first one. The adrenal glands keep your system working well by regulating how the other hormones actually get used. For example, once a hormone has been released, it has to be able to absorb into a cell before it can do anything. The gatekeeper known as cortisol (which is released by the adrenal glands) is the hormone that opens the door and makes the decision of how much of the hormone is to be used. (2)

This means that if the other surrounding glands are working perfectly if the adrenals are not working properly, the other glands (like the thyroid) may seem off-kilter and present with symptoms like fatigue or weight gain. The adrenals can decide whether or not the cells will use the thyroid hormones that are released.

When the root cause of symptoms like estrogen dominance/excess or hormonal imbalances aren’t found and estrogen is used to replace it or balance other hormones in the form of birth control, estradiol, HRT, etc, the excess estrogen and chronic build-up circulating in the blood wreak havoc to the surrounding system, especially the Adrenals.

High Levels of estrogen can lead to a corresponding increase in the cortisol-binding globulin proteins, which in turn interferes with cortisol being active at all.

Balancing our Hormones

Earlier, we mentioned that if there is estrogen dominance, that is usually, if not always results in a progesterone deficiency, as Progesterone keeps estrogen in check.

Here are a few examples of what that balancing effect looks like:

Estrogen Effect

  • Causes breast stimulation that can lead to breast cancer

  • Increases body fat

  • Increases blood clot risk

Progesterone Effect

  • Protects against fibrocystic breast, prevents breasts cancer

  • Helps use fat for energy

  • Normalizes Blood Clotting

Finding and creating a balance between our hormones takes time, patience, and the help of a practitioner who looks to address the root cause of your symptoms along with a DUTCH Hormone test, bloodwork, and Bioenergetic test is key.

Along with understanding your hormones, paying special attention to the adrenals coupled with healthy lifestyle changes can not be overlooked or dismissed.

If you have had issues with chronic fatigue, be sure to take the Burnout Quiz and start addressing it today to help you take steps in the right direction.


1. Encyclopedia of Natural Medicine

2. Christianson, A. The Adrenal Reset Diet

6. Lam, M. Adrenal Fatigue Syndrome

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