Estrogen Dominance

Estrogen dominance describes a hormonal imbalance where estrogen's effects are insufficiently counterbalanced by progesterone, creating a relative excess of estrogenic activity—this can occur when estrogen is elevated, progesterone is low, or both are true simultaneously. In PCOS, estrogen dominance typically develops because chronic anovulation means the body produces little to no progesterone (normally released after ovulation), while estrogen production continues from multiple developing follicles and from the conversion of androgens to estrogen in fat tissue. This progesterone-deficient state contributes to symptoms like heavy or prolonged bleeding, breast tenderness, water retention, and mood changes, and importantly, increases the risk of endometrial hyperplasia—making cycle regulation and progesterone restoration important aspects of PCOS treatment.