From the list above, let’s take migraines as an example.

This isn’t saying that estrogen = migraines.

It’s saying that more estrogen than progesterone = migraines.

See, in a balanced state, the properties of progesterone help to prevent migraines. The scale is balanced.

Here are some other roles of progesterone.

Progesterone can:

• prevent autoimmune disease
• help turn fat into energy
• prevent migraines
• act as a natural anti-depressant
• promote normal sleep patterns
• restore libido
• stabilize mast cells

So, you can see that when the scale is tipped in estrogen dominance, all the good that progesterone does just isn’t enough to create a balance. Estrogen “weighs” too much.

In other words, the dominant estrogen is more than enough for the progesterone to handle.

That’s one way you can have estrogen dominance.

Another way is when the different estrogens are out of balance.

2. Estrogen Metabolites Are Out of Balance

This type of estrogen dominance looks at your E1 and E2 levels in comparison with your E3 levels.

This isn’t a straightforward case of more E1+E2 than E3 = estrogen dominance.

It’s a bit more complex than that.

You may have run across the term “estrogen quotient.” That’s what’s used to look at the relationship between these three estrogens.

Estrogen quotient is a way of comparing the ratios of “dirty” estrogens to the protective ones. Remember that E3 is protective.

The estrogen quotient is determined by this formula:

Estrogen Quotient (EQ) = E3/(E1+E2)

The ideal estrogen quotient is 1.5 or higher. Using my Dutch Hormone Test from above, let’s see how to use this formula.

You’ll see that at the time of my test:

• E1 was 15
• E2 was 3.14
• E3 was 7.5

So, using the formula above, we first add E1+E2:

3.14 + 15 = 18.14. That’s my value for E1 plus E2.

Now I divide my E3 value of 7.5 by 18.14. The result is an estrogen quotient of .41.

Generally speaking, the higher your estrogen quotient, the better. But mine is well below the optimal of 1.5 or higher!

This low estrogen quotient is another form of estrogen dominance. You can see why testing all 3 types of estrogen is important.

Next, let’s look at one more form of estrogen dominance.

3. The Breakdown of Estrogen into Damaging Molecules

Estrogen dominance can also be the result of how the body is breaking down estrogen.

Your liver is responsible for breaking down estrogens. This is part of the process of eliminating estrogen from your body.

Estrogen can be broken down into these molecules (called metabolites):

• 2-hydroxyesterone (2-OH)
• 4-hydroxyesterone (4-OH)
• 16-alpha-hydroxyesterone (16-OH)

2-OH is a more protective metabolite. It works to block stronger estrogens that promote possible cancer growth.

4-OH can convert into something called quinones. These have been shown to damage DNA. It is thought to promote cancer by damaging DNA. It’s also sometimes called a “dirty” estrogen.

16-OH has been associated with inflammation, excess levels of the bad Omega-6 fatty acids, obesity, and hypothyroidism. It’s also been associated with an increased risk of breast cancer. For this reason, it’s also called a “dirty estrogen.”

If your liver is not able to break down the estrogens to eliminate them properly, it will generate too many “dirty” estrogens. You can end up with more 4-OH or 16-OH if your liver needs support.

What you really want is more 2-OH than 4-OH and 16-OH.

This imbalance of estrogen metabolites is another way to experience estrogen dominance.

So, you’ve seen how estrogen dominance can really bring about some unwanted symptoms and conditions even if you don’t have Mast Cell Activation Syndrome.

But if you do have Mast Cell Activation Syndrome, estrogen dominance can be contributing to those symptoms, too.

I told you earlier that I started experiencing symptoms like hives, itching, and insomnia when I was ovulating. It turns out, these were mast cell symptoms. And they were being triggered by estrogen dominance.

Let’s look more at the connection between hormones and mast cells next.

What to Know About Estrogen, Progesterone, Mast Cells, and Histamine

The human body is a complex network. Have you even stopped to consider all the little things that have to happen just to be able to do even the simplest of things?

So many different systems have to work together!

So, it’s really no wonder that when you look at any one thing about your body, you’ll find all kinds of connections to other things.

Your mast cells are part of your immune system. What’s interesting is your immune and hormone systems are strongly interlinked.

This means your hormones can affect your mast cells. In fact, the mast cells have receptors on them for both progesterone and estrogen.

So, estrogen dominance may be contributing to estrogen dominance symptoms AND to both mast cell activation and histamine intolerance symptoms.

Estrogen is a mast cell trigger when it’s out of balance. It stimulates mast cells to make more histamine (along with other mast cell mediators). AND histamine plays a major role in hormone balance.

This is one of those loops that continues to feed on itself.

Estrogen causes mast cells to release histamine. The rising histamine levels produce more estrogen. And then the loop comes back around again. Estrogen triggers the mast cells to make more histamine. And on and on…

Here’s another way estrogen may be contributing to your histamine intolerance.

Estrogen can reduce an important histamine-degrading enzyme called Diamine Oxidase (DAO). DAO is produced naturally in your body to break down histamine.

If your body doesn’t produce enough DAO to keep up with the histamine load, that can lead to histamine intolerance.

And remember that with estrogen dominance, it’s not just about having elevated levels of estrogen. It’s about having an imbalance of hormones.

You read about the kind of estrogen dominance that occurs when estrogen levels are higher than progesterone levels.

But when balanced, progesterone is like the counterbalance to estrogen when it comes to histamine and mast cells.

Progesterone can help stabilize mast cells AND

Progesterone helps stop mast cells from making histamine.

This is because progesterone sends a signal through the mast cell hormone receptors to calm down.

This is a big reason the estrogen-progesterone balance is so important. Supporting your progesterone will likely help with your histamine levels.

Keep in mind, though, that we’re talking about natural or bioidentical progesterone here. Synthetic progesterone medication doesn’t usually have the same mast-cell calming effect.

Now, I get a lot of questions from women asking why they tend to get an increase in mast cell reactions during certain times of their menstrual cycle.

Some of these problems tend to happen around the time of ovulation (when the ovaries release the egg). That happens to be when estrogen levels peak.

This could be putting you in an estrogen dominant state. And this estrogen dominance could trigger mast cells causing an increase in reactions.

Estrogen tends to be more dominant a couple days before your period starts, too. This is another common time women will have mast cell flares.

Does this make sense now as to why your mast cell symptoms can flare when your estrogen is out of balance?

Now, if any of this sounds like it might relate to you, I want you to know something really important. Testing is crucial. It’s not enough to go by symptoms alone.

Keep reading to learn why testing for estrogen dominance is so important.

Testing for Estrogen Dominance

It’s always important to test and not guess. This is because in Mast Cell Activation Syndrome all kinds of things can be happening. And some of your symptoms and conditions may not always be what they seem.

For example, I’ve worked with a few women who had classic estrogen dominance symptoms. But their tests showed they actually had low estrogen and high progesterone. So, something else was going on there.

If these women had just gone forward based on symptoms, the protocol wouldn’t have worked. It may have even made them feel worse.

So, you see how important it is to look at test results! Plus, if you know what kind of estrogen dominance you’re dealing with, you can target better what to do about it.

In an upcoming blog post, I’m going to share more about supports that can help you get your hormones balanced.

But, you’ll want to test first and check these different pathways.

Now, with steroidal hormone testing, you’ll find several options.

There are saliva tests, blood tests, and urine tests that can test hormone levels.

It helps to know the pros and cons of testing methods to decide how to test. Different testing methods can have certain limitations.

Many people look at blood levels of hormones, which a lot of practitioners use. Blood testing doesn’t account for how your hormone levels change throughout the day, though. And you rarely get the levels for E1, E3, and the various metabolites

And blood testing isn’t always accurate for cortisol. Especially if you’re feeling stressed when you get the blood draw. This stress can spike the cortisol in your blood and make it look higher than it is normally.

You can also test for hormones with a saliva test. It can work well for estrogen, progesterone, DHEA, and testosterone. But the saliva test may not give the best results for your cortisol status.

As you can see, there are many options and pros and cons. Each practitioner has their preferences.

I really like the Dutch Hormone Test. It’s a different type of urine test that is comprehensive. The Dutch Test checks four or five dried urine samples over a 24-hour period.

What is a dry urine test? Instead of collecting liquid in a container, with a dry urine test you saturate a filter card with your urine sample. These samples are stable for several weeks and easy to ship.

The Dutch Test looks at the following:

• Estrogens: E1, E2, E3
• Estrogen metabolites: 
  • 2-hydroxyesterone (2OH)
  • 4-hydroxyesterone (4OH)
  • 16-alpha-hydroxyesterone (16OH)
• DHEA-S
• Testosterone (though metabolites)
• Progesterone (also through metabolites)
• Cortisone (storage form of cortisol)
• Cortisol
• Melatonin levels
• 8-OHdG (looks at DNA damage from quinones)

The hormones we’re talking about are more stable in urine. This means you can get a picture of what your hormone levels are like day to day.

You also get a 4-point cortisol measurement. This means you can see your cortisol (and cortisone) patterns throughout the day. Here’s a look at the cortisol measurements from my test.