Estrogen Dominance, affectionately dubbed the 'monster,' certainly lives up to its name! This term is frequently used to characterize the negative symptoms experienced by both men and women when they possess elevated levels of estrogen. For women, this often occurs due to prolonged use of Hormone Replacement Therapy (HRT) and Contraceptives, resulting in diminished progesterone levels.

Initially, progesterone exerts a stimulating effect. This occurs because progesterone activates estrogen receptors, allowing estrogen to take precedence as the dominant hormone, which can lead to many men and women feeling worse.

Progesterone gradually establishes itself as the primary hormone, leading to a reduction in symptoms. Some women may never encounter estrogen dominance, while others may see its effects after several days, and for some, it may persist for a longer duration. The duration largely depends on the level of excess estrogen present.

Men can also experience estrogen dominance when first using progesterone.

When beginning progesterone therapy, it's crucial to administer an adequate dosage of approximately 200-400 mg per day or 6-12 ml daily to effectively counteract excess estrogen. A common misconception is that a lower dose of 20-40 mg per day will suffice; however, this is misleading and results in progesterone remaining in a constant stimulation mode, perpetuating a state of estrogen dominance. In cases of severe symptoms, such as significant, ongoing bleeding or intense hot flashes, a dosage of up to 400 mg per day may be necessary. It’s important to use no less than 100 mg (or 3 ml) of progesterone. Be sure to apply progesterone at least twice daily, as levels begin to decline after 12 hours.

Normally, men can gain advantages from using 10-20 mg per day of progesterone; however, if there is an elevated level of estrogen, it is recommended to increase the dosage to as much as 100 mg per day.

Once your symptoms have improved and you feel stable, it is fairly straightforward to lower your progesterone levels to better suit your needs. This reduction should always be carried out gradually over the course of several weeks. For guidance on the correct method of reduction, please read First Time Users.

• aches and pains
• anger
• anxiety
• bleeding which comes either earlier or later than usual
• bloating/weight gain due to water retention
• breast tenderness
• bruising
• constipation
• dizziness
• headaches
• foggy brain
• heart palpitations/racing heart - see here.
• chest pains/tight chest
• hot flushes

• hypoglycaemia
• dry eyes/sjogren's syndrome 
  
• increased appetite/cravings
• irritation
• itchiness
• migraines
• mild depression
• mood swings
• muscle weakness
• nausea
• skin problems/acne/melasma
• spotting
• tiredness/chronic fatigue
• weight gain/water retention

 Estrone (E1) - also spelled oestrone, is a serioid, a weak estrogen, and a minor female sex hormone. It is one of three major endogenous estrogens, the others being estradiol (E2) and estriol (E3). Estrone, as well as the other estrogens, are synthesized from cholesterol and secreted mainly from the gonads, though they can also be formed from adrenal androgens in adipose tissue. Relative to estradiol, both estrone and estriol have far weaker activity as estrogens. Previously, estrone was available as an injected estrogen for medical use, but it is now no longer marketed. This should be tested when in menopause, it rarely is.

Estradiol (E2) - also spelled oestradiol, is a steroid, an estrogen, and the primary female sex hormone. It is named for and is important in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is essential for the development and maintenance of female reproductive tissues such as the breasts, uterus, and vagina during puberty, adulthood, and pregnancy, but it also has important effects in many other tissues, including bone, fat, skin, liver, and the brain. While estrogen levels in men are lower compared to those in women, estrogens have essential functions in men, as well. It is found in most vertebrates and crustaceans, insects, fish, and other animal species.

Estradiol is produced especially within the follicles of the female ovaries, but also in other endocrine (i.e., hormone-producing) and nonendocrine tissues (e.g., including fat, liver, adrenal, breast, and neural tissues). Estradiol is biosynthesized from cholesterol through a series of chemical intermediates. One principal pathway involves the generation of androstenedione, which is converted into estrone by aromatase and then by 17β-hydroxysteroid dehydrogenase into estradiol. Alternatively, androstenedione can be converted into testosterone, an androgen and the primary male sex hormone, which in turn can be aromatized into estradiol. Estradiol in a menopausal woman is low, it should be low! It's the pre-menopause estrogen, only made by the ovaries. Once these stop functioning, estradiol diminishes. But, and it's a big but, our fat cells continue making estrone till we die, this is never tested for. It's the menopause estrogen, and it as potent a mitogen as estradiol. Make sure to test Estrone when in peri-menopause and menopause. 

Estriol (E3) - also spelled oestriol, is a steroid, a weak estrogen, and a minor female sex hormone. It is one of three major endogenous estrogens, the others being estradiol and estrone. Levels of estriol in women who are not pregnant are almost undetectable. However, during pregnancy, estriol is synthesized in very high quantities by the placenta and is the most produced estrogen in the body by far, although circulating levels of estriol are similar to those of other estrogens due to a relatively high rate of metabolism and excretion. Relative to estradiol, both estriol and estrone have far weaker activity as estrogens. Although it is less commonly used than other estrogens, estriol is available for medical use throughout the world in a variety of formulations, including for oral and vaginal administration.

How to wean off HRT, Estrogen, Progestin, and Testosterone Drugs

It is generally considered safe to discontinue HRT abruptly, unlike many other medications; however, withdrawal symptoms may reappear. A more gentle approach is to gradually taper off HRT while consistently using Natpro Progesterone Cream. Following this method, progesterone typically mitigates any withdrawal symptoms. It is advisable to apply the progesterone cream for a minimum of one month prior to reducing the HRT dosage. For optimal results, use between 100mg/3ml and 200mg/6ml of Natpro daily without interruption—there's no need for a break. If HRT has been in use for an extended period, a higher dose may be necessary. Should symptoms return during the tapering process, increase the progesterone dosage and slow the reduction of HRT.

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