How to Flush Out Excess Estrogen: A Clinician’s Take

If you’ve searched “how to flush out excess estrogen”, you’ve probably been told you need an estrogen detox. In my experience, that’s often a misguided place to start.

Many women who think they have excess estrogen actually have normal, or even low, estrogen levels. Others have an imbalance between estrogen and progesterone rather than too much estrogen overall.

That’s why I don’t recommend trying to lower estrogen until you understand what’s actually causing your symptoms. The goal isn’t to eliminate estrogen. It’s to restore healthy hormone balance.

In this article, I’ll explain the difference between high estrogen and estrogen dominance, what commonly causes these imbalances, and the diet, lifestyle, and supplement strategies I find most helpful for supporting healthy hormone health.

Identifying the Problem: High Estrogen vs. Estrogen Dominance

Before you try to lower your estrogen levels, it’s important to understand whether excess estrogen is actually the problem.

High estrogen and estrogen dominance are often used interchangeably, but they aren’t the same thing.

High estrogen means your estrogen levels are elevated, regardless of your progesterone levels. This is less common and may contribute to symptoms such as irregular periods, dense breast tissue, decreased sex drive, and, over time, an increased risk of conditions like endometriosis, insulin resistance, or certain hormone-sensitive cancers.

Estrogen dominance describes an imbalance between estrogen and progesterone. You can have normal estrogen levels but still experience estrogen dominance if your progesterone is too low. It may also occur when both hormones are elevated but estrogen has become disproportionately high. Although estrogen dominance isn’t an official medical diagnosis, it’s commonly used to describe symptoms such as heavy or painful periods, premenstrual syndrome (PMS), breast tenderness, mood changes, headaches, fibroids, acne, and weight gain around the hips and buttocks.

Importantly, it’s possible to have estrogen dominance while your estrogen levels are actually normal or even low due to low progesterone. That’s one reason I don’t recommend assuming estrogen is the problem based on symptoms alone.

I’ve seen many women prescribed progesterone or encouraged to lower their estrogen when the real issue was something else entirely. Stress, perimenopause, poor metabolic health, or gut imbalances can all contribute to hormonal symptoms, and treating the wrong problem can make matters worse.

The goal isn’t simply to lower estrogen. It’s to understand what’s driving the imbalance and restore healthy hormone function.

Common Symptoms of High Estrogen and Estrogen Dominance

High estrogen and estrogen dominance can cause many of the same symptoms, which is one reason they’re often confused. Symptoms alone can’t tell you which imbalance you have, but they can help you recognize when it’s time to take a closer look.

Common symptoms of high estrogen and estrogen dominance 1:

• Heavy or irregular periods
• Breast tenderness
• PMS or mood changes
• Headaches or menstrual migraines
• Bloating
• Weight gain, particularly around the hips
• Acne
• Low libido

Less commonly, persistently elevated estrogen levels may also contribute to conditions such as endometriosis, insulin resistance, PCOS (recently renamed PMOS or polyendocrine metabolic ovarian syndrome), and certain hormone-sensitive cancers.

How to Flush Out Excess Estrogen and Balance Your Hormones

Step 1: Address the Root Cause

Whether you have high estrogen or estrogen dominance, the goal isn’t simply to lower estrogen. It’s to identify and address the underlying cause of the imbalance.

Some causes, like perimenopause, are a normal part of life. Others are often modifiable. In my experience, improving gut health, metabolic health, stress, diet, and other lifestyle factors often has a much bigger impact on hormone balance than chasing an estrogen detox.

Here’s where I recommend starting.

Gut Imbalance

Poor gut health can also contribute to estrogen dominance. Estrogen dominance and its symptoms, including irregular menstruation, mood swings, painful or heavy periods, bloating, and conditions including PMOS, may actually be caused by imbalances in the gut microbiome, which have been shown to disrupt estrogen levels 2 3.

Xenoestrogens

The least invasive factor to assess is exposure to synthetic xenoestrogens, which are chemicals that act like estrogen when they get into the body. These can lead to high estrogen levels. Bisphenol A (BPA) and phthalates in plastics and/or components of pesticides, cleaning products, soaps, cosmetics, and shampoos are all areas of exposure that can be eliminated by replacing the offending products 1. Here’s a list of common endocrine disruptors from the Environmental Working Group to use as a reference. 

Body Fat and Stress

Root causes that occur because of the physiology of your body, lifestyle choices, or external stressors will require a somewhat more nuanced approach. For example, excess body fat secretes estrogen, so reducing body fat can help reduce overall estrogen levels 1. Obviously, if losing body fat were simple and easy, everyone would have exactly the correct and healthy amount of body fat. However, taking small steps to gain muscle and lose fat may help balance your estrogen levels.

However, it’s possible that the excess estrogen can make it harder to lose weight. It’s also possible that excess cortisol (the stress hormone) could be impeding fat loss and making it more difficult for the body to make adequate progesterone, creating further imbalance 1. Stress can dramatically impact sex hormones. Much like weight loss, mitigating stress can feel challenging as well. Finding the right stress management tactics that work for you and your lifestyle is a critical piece of the puzzle.

Alcohol and Poor Liver Function

Drinking too much alcohol can raise estrogen levels and damage your liver, which functions in part to break down and eliminate estrogen 1. Your liver also plays an important part in sugar metabolism (fructose), and a damaged liver can increase the likelihood of insulin resistance from metabolic syndrome.

Blood Sugar, Insulin Resistance, and PMOS

Metabolic syndrome, including PMOS, have symptoms of weight gain, insulin resistance, and elevated blood sugar. Insulin resistance is also an often-overlooked contributor to high estrogen levels. As the body’s cells become less responsive to insulin, the pancreas produces more insulin to compensate. Elevated insulin stimulates aromatase, the enzyme that converts testosterone into estrogen, leading to increased estrogen production 4. Insulin resistance also lowers sex hormone-binding globulin (SHBG), allowing more estrogen to circulate in its active form, further contributing to hormone imbalance 4.

Step 2: Find the Best Diet to Flush Out Excess Estrogen

Diet is one of the most effective places to start. Rather than trying to “detox” estrogen, I recommend focusing on foods that support gut health, blood sugar regulation, regular bowel movements, and healthy estrogen metabolism. These changes help address many of the underlying factors that contribute to hormone imbalance. 

Interestingly, foods that contain phytoestrogens may actually help your body get back into balance without adding even more estrogen into the mix. While you should consult your doctor before eating too much soy, flaxseeds have been shown to help balance female sex hormones, reduce symptoms of menopause like hot flashes and bone loss, and also slightly lower the risk of breast cancer 5. 

Flaxseeds and chia seeds are also rich in anti-inflammatory omega-3 fatty acids, so grind those up and add them to your fruit and veggie smoothie, or find a healthy chia seed pudding recipe.

Supporting liver detoxification and gut health through your diet is also a super important step in flushing out excess estrogen. If you tend to experience constipation, it’s important to know that regular bowel movements are needed to avoid reabsorbing estrogen through your waste. Eating fiber-rich foods, like fruits, vegetables, and legumes, is a great place to start. Fiber not only encourages healthy bowel movements, but it also feeds the healthy bacteria in your gut. 

You may also want to take a magnesium supplement, especially if you’re experiencing constipation frequently. There are also foods that naturally contain magnesium that can aid in gastrointestinal motility.

Foods that support your liver, especially cruciferous vegetables, like broccoli, cauliflower, kale, and Brussels sprouts, should be regularly in your diet (these are also high in fiber). These foods also contain a compound called indole-3-carbinol, which encourages certain metabolic pathways that protect against cancer. Flaxseed contains indole-3-carbinol, too 4.

In addition to increasing your intake of healthy plant foods, eating healthy fats is also crucial. That’s because healthy fats are required to make cholesterol, and cholesterol is required to make adequate sex hormones 6. 

You need the proper ingredients to make the hormones if you plan to balance them out, so don’t be afraid of fat, even if you have a fat loss goal. By changing your diet in the ways I’ve outlined, you will likely begin to lose body fat naturally. Healthy fats include coconut oil, extra virgin olive oil, all sources of omega-3 fatty acids (fatty fish, fish oil, flax oil, and walnut oil), avocados, and avocado oil.

Step 3: Lifestyle Changes

In addition to reducing your exposure to xenoestrogens, exercise, stress management, and proper sleep are all critical to hormonal balance.

Exercise often results in sweating which is one of your body’s natural detoxification mechanisms. It can also aid in fat loss, improve your overall sense of well-being, improve insulin resistance, reduce your risk of developing metabolic syndrome, and it’s been shown to reduce estrogen levels 7.

Stress management will look different from person to person. You may not always have time to do a yoga class. You can’t control the stressors coming at you and life might feel relentless. But there are small things that even the busiest of us can manage. Taking deep breaths while doing the dishes, listening to relaxing music in the car, using part of your exercise time for quiet, gentle stretching, or starting the day with a simple 5-minute meditation are all simple relaxation techniques. You might be surprised at what spaces open up in your life when you begin to make yourself a priority.

Sleep is another critical piece for supporting detoxification and hormonal reset. It’s also linked to a healthy gut microbiome. If you need to take melatonin or herbal sleep aids to get quality sleep, start there. Proper sleep hygiene (including staying away from alcohol) will also help get you closer to a good night’s sleep. Sometimes hormonal imbalances can actually cause sleep disturbance, so be patient with yourself on this one.

Step 4: Supplements

Supplements to support gut health, detoxification, and reduce inflammation are all foundational pieces of not only flushing excess estrogen, but also helping with your overall health and wellness. There are also certain supplements that can address your production of estrogen in its various types (estradiol and estrone).

Probiotics can improve the biodiversity of your gut, which can lead to a major cascade of health benefits, including reducing insulin resistance, reducing gut inflammation, and improving estrogen metabolism 2 8 9 10 11. Research also shows that gut dysbiosis can disturb estrogen levels 2. Additionally, PMOS 12, obesity 13, endometriosis 14, cardiovascular disease 15, and breast cancer 16 are associated with low bacterial diversity in the digestive tract.

Vitamins and minerals are rich in antioxidants, which are also anti-inflammatory and have been shown to improve hormonal balance and reduce the adverse symptoms of conditions like PMOS and PMS. Although diet is the preferred way to obtain vitamins, if you find that dietary changes aren’t enough, taking a daily multivitamin (or individual vitamins as needed) can help. The following nutrients have specifically been shown to aid in reducing symptoms of estrogen dominance:

• Vitamin B1, supports energy production and healthy hormone metabolism 17 
• Boron, may help regulate estrogen and vitamin D metabolism 17
• Vitamin B6, helps metabolize estrogen and supports progesterone production 18 19 
• Vitamin D, supports hormone regulation and may improve insulin sensitivity 17 20
• Vitamin E, antioxidant that may help reduce breast tenderness and inflammation 17
• Vitamin K, works with vitamin D to support bone and hormone health 17
• Magnesium, supports insulin sensitivity, PMS symptoms, and stress response 17 21 22
• Zinc, supports ovarian function and healthy sex hormone balance 17 21 23 24
• Selenium, antioxidant that supports thyroid and estrogen metabolism 25 26 27
• Calcium, may reduce PMS symptoms and supports bone health 17 28 29 30
• Iron, replenishes iron stores and supports energy if deficient* 31

*Recommended to discuss with your physician as it is only recommended when ferritin levels are lower than a certain threshold and no insulin resistance is present.

Herbal supplements, like fenugreek, dong quai, cohosh, resveratrol, licorice, white peony, and chaste tree berry, can all balance out your hormones, depending on what your condition and symptoms are. 

In the case of estrogen dominance (where you don’t necessarily need to lower your overall estrogen levels but may need a progesterone boost) fenugreek, licorice, white peony root, and chaste berry will serve to bolster your natural progesterone levels 32 33 34. In the case where estrogen-related symptoms need support, cohosh, dong quai, licorice, and resveratrol may be helpful, though cohosh appears to work through non-estrogenic pathways rather than directly raising or lowering estrogen levels 35 36 37 38 39. 

EstroHarmony brings several of these botanicals together, including black cohosh and dong quai, to make it easier to support healthy estrogen balance without piecing together multiple supplements on your own.

Step 5: Other Considerations

If you haven’t had your thyroid checked, it might be time to do that, as a number of symptoms overlap with a thyroid imbalance. Your thyroid regulates body temperature, energy production, digestive function, body weight, nervous system function, and even fertility 40. So knowing your numbers and how well your thyroid is functioning is an important part of hormonal balance. Furthermore, women are more likely to be thyroid patients than men, so it’s possible that your thyroid could be causing some underlying issues 41 42.

The final consideration is hormonal birth control. Some doctors actually use hormonal birth control to help balance estrogen production. However, these hormones are synthetic and are not without side effects. They can affect your gut health, create nutrient deficiencies, and ultimately create additional hormonal problems down the line. This isn’t to say that no one should ever take hormonal birth control, but be wary of using it as a quick fix.

The Bottom Line

As in pretty much all of life, balance is key. Whether you have too much estrogen or estrogen dominance, the approach to balance involves improving your diet, exercising, sleeping, and generally taking care of your mental health and well-being. 

Supplements to support gut health and hormonal balance are also a big piece of the puzzle, especially as you reach perimenopause and menopause. Taking progesterone on its own or putting a bandaid on the problem with hormonal birth control will not serve to solve the root cause of your imbalance, and it could make things worse.

If you’re struggling with your hormonal health, we’d love to help. Reach out to our clinic to set up an appointment.

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