Assessment and Approach to the Estrogen Dominant Female

With stress, insulin resistance, inflammation, and increased adiposity at the root of many patient presentations these days, associated estrogen dominance symptoms often lead patients to seek care.
With 3 main sources of endogenous estrogen production in the female body, it’s helpful to be able to figure out where excess estrogens are most likely coming from, to assess relative balance between estrogen and progesterone, and understand the routes of estrogen metabolism to determine a well-informed treatment plan.
Key Moments:
0:00 Introduction
2:34 Webinar Outline
4:00 Estrogen and Progesterone Balance
4:32 Signs of Estrogen Dominance
5:20 Some Estrogen Dominance is Normal and Healthy
5:50 DUTCH Cycle Map of a Normal Menstrual Cycle
8:29 Normal Menstrual Cycle Nutritional and Hormonal Requirements
9:50 Progesterone and Estradiol Units in Serum and Urine
11:00 Estrogen Dominance Defined
11:32 Optimal Urinary Pg/E2 Ratios
13:58 Low Luteal Pg/E2 Ratios on the DUTCH Test
16:24 Why Look at a-Pregnanediol?
18:50 A Cautionary Note about Progesterone and Negative Mood
21:00 Recap on Progesterone
21:50 Step 1: Ways to Raise Progesterone to Counter Estradiol
28:15 Assessing Estrogens Directly
34:49 Why do hormone metabolites matter?
35:50 Step 2: Treat the Transitional States of Estrogen
42:49 16-OHE1 Drivers and Busters
46:20 DUTCH Report Samples
54:50 Benefits of Sulforaphane
56:21 Step 3: Identify the Source of Estrogen and Treat There
1:04:37 Is Estrone a “Bad Estrogen”?
1:05:37 How Insulin Resistance and Inflammation Might Present on a DUTCH Test
1:08:34 Tips on Approaching High Prolactin Patients
1:10:24 Gut-Source Estrogens
1:14:21 Estrogen Dominance Assessment/Plan Sheet
1:17:14 Webinar Conclusion