Should We All Be Worried About Estrogen Dominance?

As a trans woman, I get asked all sorts of odd questions about my body. One question I hadn't encountered until recently, though, is "Aren't you concerned about estrogen toxicity?"

The question came after a discussion of the typical hormone regimen of trans women, a hormone replacement process that artificially elevates estrogen levels while suppressing testosterone. The doctor who prescribed my hormones had never mentioned anything about "estrogen toxicity," and since toxicity is always a red flag for me when it comes to health claims, I asked for clarification. I was given a link to a website that described the dangers of estrogen toxicity and offered to help me find a naturopath in my area to treat it.

Ah, a naturopath. I was beginning to understand.

It turns out that estrogen toxicity is more commonly called estrogen dominance, or ED. It is a term originally coined by Dr. John R. Lee in his book What Your Doctor May Not Tell You About Menopause. You can still read Lee's full description of the illness on the website dedicated to his work. In short, Lee's hypothesis is that many of the symptoms of menopause were the result of the loss of progesterone -- the other female hormone -- to levels far below those of estrogen, and that it was this imbalance that needed to be treated. Lee promoted the use of natural progesterone creme as an alternative treatment to standard hormone replacement therapy undertaken by some women during menopause.

Lee's hypothesis never caught on in science-based medicine, but it was picked up by alternative health practitioners. The hypothesis was quickly broadened and tied to general fears about phytoestrogens and xenoestrogens in the environment, and pretty soon it became a full blown "syndrome." Anyone, not just women with menopause, could suffer from ED. Today, a search of Google for "estrogen dominance" or "estrogen toxicity" brings up a laundry list of alternative medicine websites and blogs like Natural News, all warning about the dangers of ED.

Here's a typical passage from one of these ED websites:

During the last century mankind has created and released over 80,000 synthetic, persistent chemicals into the environment, many of which act like estrogen inside the human body!

These chemicals have been sprayed onto our food, released in the air, and dumped into the rivers, lakes, streams and aquifers all over our country. They do not degrade and they stay around in the environment for hundreds and even thousands of years. If they did no harm then that would be one thing. But we are finding out that many of these common chemicals â€" found in your carpet, your car, your plastic containers, etc. â€" have estrogen-like activity in the human body. And when men get high levels of fake, toxic, poisonous estrogen into their systems, it starts to cause health problems!

You might be thinking that these toxins are so diluted that it doesn’t cause a problem. However, these chemicals are strong enough to causefish to be born with two headsand to causemale fish to grow female sex organs. If they are strong enough to do that to fish, what can these toxins do to humans?

Oh, my! What can they do? Apparently a lot. Depending on the website, ED is supposedly "associated with" or "correlated with" (none of them go so far as to say "causes") everything from cancer and lupis to depression and hair loss. It also "accelerates the aging process," whatever that means. In truth, the symptoms are vague enough and broad enough that any "symptoms of life", as well as symptoms of aging, can be attributed to ED. This is, of course, a common red flag of pseudoscience.

It's not the only one, though. There's the fearmongering language -- "toxins in the environment" and "toxic chemicals" -- as well as the connection of ED to other popular alternative health topics like Bisphenol-A and soy. It's a lot of the same weasel-wordy rhetoric we hear connected to any pseudoscience health claim, such as arguments for organic foods and cleansing diets.

Then there's the predictable lack of identifiable victims. Those who warn about ED spend a lot of time scaring you with the possible effects, but providing an actual case study is beyond their ability. There's only anecdotes and vague claims that victims of other conditions have ED to blame as an underlying cause.

And like many pseudoscience health claims, proponents of ED all cite the same handful of resources, including Dr. Lee's book and a number of self-published research articles. One doctor's page on ED was loaded with references ... to other things she'd written on ED!

Mainstream online health reference WebMD only mentions it on one page, a discussion of progesterone creams. The Mayo Clinic, also a popular online health reference, only has two pages with the words "estrogen" and "dominance" on them, and not next to each other. When you search more scholarly health science resources like PubMed or the Health Reference Center Academic database, you get a small handful of journal articles, some from "alternative medicine" publications and several written by the same person (and focusing on veterinary medicine), as well as some magazine and newspaper articles, including some obituaries of the late Dr. Lee. There simply isn't any medical evidence, nor any real medical recognition of, "estrogen dominance."

That's not to say that there isn't legitimate research and discussion about hyper- and hypometabolic estrogen levels or legitimate evidence that xenoestrogens in the environment may effect things like precocious puberty in young people and reproductive health in adult women. But these are known medical issues that have or are curently undergoing legitimate mainstream testing, and neither of these is the same thing as, nor do they justify the invention of, a made-up condition used to sell people on alternative health products and lifestyles.

So, no, women, neither cis nor trans, should be worried about ED, and nor should anyone else. If youdo have concerns about your estrogen or progesterone levels, talk to an endocrinologist -- your primary physician will almost certainly be able to give you a referral -- and listen to the advice they give. And bring your "correlated" symptoms to a real doctor, who can provide real treatment for what actually ails you.