Natural Estrogen Supplements & Pills to Balance your Sex Hormones

Dysregulation of estrogen levels is incredibly common among women. 

High and low estrogen levels contribute to conditions such as low sex drive, weight gain, PMS/PMDD, depression, mood changes, and even other hormonal problems.

The good news is that there are targeted supplements that you can take to influence and manage your estrogen levels.

Use this guide to help determine if you have low estrogen, high estrogen and what kind of estrogen supplements may help you and your symptoms: ​

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Why you need normal estrogen and sex hormone levels

All sex hormones are important for women, but estrogen may be at the top of that list. 

While women tend to have more testosterone and progesterone (in absolute values) in the body, it is really the balance of these hormones that matters most.

High (or low) estrogen tips that balance and promotes the symptoms that people associated with various issues.

estrogen levels change over time

For instance:

High estrogen levels (relative to progesterone) can lead to symptoms such as PMS, PMDD, menstrual irregularities, fibrocystic breast disease, breast cancer, etc.

On the other hand, low estrogen can lead to various symptoms such as vasomotor issues (hot flashes), weight gain, increased risk for bone loss (1) and even an increased risk of cardiovascular disease (2).

Hopefully, this makes clear the point that you NEED estrogen in the body for proper function, but you also don't want too much or little at all. 

It's helpful to think of estrogen and progesterone ​as polar opposites to one another. 

While estrogen helps build up tissues and glands, progesterone is needed to balance that effect to make sure it doesn't go out of control.

This also helps explain why the female body goes through hormonal cycles throughout the month where each hormone is higher for a short period of time.

This balance must be maintained to help the proper growth of the female body and changes to this system can result in dramatic changes overall. 

You can think of estrogen as a "growth hormone" in your body...

Meaning that it helps build up endometrial, breast (3), and even fat tissues. 

This explains why many women with higher than normal estrogen levels tend to develop weight gain - predominately in the hips/thighs/glut region.

Progesterone, on the other hand, helps balance this effect and can reduce growth in these tissues (yes, it can even help with fat loss!).

This insight can help us understand how to treat estrogen related issues, knowing that hormones MUST be in balance with one another.

Often treatment needs to be focused on both estrogen and progesterone in order to maintain balance. ​

If you are having issues with your estrogen you will know it because you will have symptoms.

Below I am going to go over what causes changes in estrogen levels and what symptoms tend to be associated with these various changes in estrogen levels.

Once we know what the problem is we can talk about how to address these estrogen levels with various supplements and treatments...​

  • Bottom line: Estrogen and progesterone must be maintained in balance with one another. Changes to either can tip the balance and result in symptoms and dysregulation of the estrogen/progesterone ratio. 

What causes High Estrogen

​Having too much estrogen is probably more common than having too little estrogen (at least for pre-menopausal women). 

High estrogen levels are quite common in many patients simply due to the biochemistry of the body.

As women gain weight several factors occur that lead to high estrogen:

1. Weight gain contributes to insulin resistance which causes further weight gain.

2. Insulin resistance causes high androgens and high testosterone​ (leading to PCOS like syndromes).

3. High levels of testosterone can be converted into estrogens through aromatization.

​4. Weight gain reduces thyroid function leading to reduced circulating thyroid hormone contributing to low progesterone and thus higher estrogen levels. 

​This process occurs as a result of weight gain, but these steps can happen whether you are overweight or not. 

As a result, many women have a higher than normal estrogen level and a condition known as estrogen dominance (meaning higher than normal estrogen levels compared to progesterone levels). 

Aside from these very common hormonal changes, other factors can increase estrogen levels like the standard American diet, a diet high in soy-based foods, exposure to chemical xenoestrogens and even high levels of stress. 

​This constellation of conditions and syndromes usually occurs in pre-menopausal women (meaning women who are in their 20-40's), but even menopausal women can have more estrogen than they need due to excess weight gain. 

Excess weight after menopause can act as a reservoir for estrone production through the fat cells.

So women can end up with higher than normal estrogen levels before and after menopause.

​Causes of high estrogen levels in women:

Symptoms of High Estrogen​ or having too much estrogen relative to progesterone

​While estrogen levels can change dramatically in women due to their cycle (making diagnosis difficult) there are several symptoms that tend to accompany this dysregulation of estrogen/progesterone. 

If you aren't sure if you have high levels of estrogen use the list below to help guide you.

Having this information will also help to determine which treatment and which supplements you should use to balance your estrogen. ​

  • Breast tenderness
  • Breast fullness
  • Malaise or fatigue
  • Depression or anxiety
  • Abnormal bowel movements
  • Bloating
  • Water retention especially swelling in the fingers or legs
  • Increased irritability or impatient but with a clear mind
  • Nipple tenderness
  • Pelvic cramps
  • Hot flashes (if VERY high)
  • Symptoms of PMS/PMDD
  • More prolonged exposure may lead to fibrocystic breast disease, uterine/endometrial growth

While these tend to be the most common symptoms of high estrogen levels each patient may react differently. 

These symptoms result from excess estrogens (including estradiol, estrone, and estriol) relative to progesterone levels.

That means having LOW progesterone with NORMAL estrogen levels may also contribute and cause these symptoms.

Look to your ratio, not the absolute number of your estrogen when evaluating these hormones. ​

What causes Low Estrogen

High estrogen is much more common in pre-menopausal women while lower estrogen levels are more common post-menopause.

All women will eventually develop low estrogen levels when ​compared to menstruating women. 

The decline of the estrogen largely depends on other factors including how much metabolic damage is present prior to menopause, what other hormone imbalances do these women have and how much weight they have going into menopause. ​

While high estrogen is more common than low estrogen levels, it's still very important to understand and to diagnose.

Because all women will eventually go through menopause it's still very important to talk about how to treat low estrogen levels.

Causes of low estrogen:

  • Menopause
  • Hysterectomy (chemical or surgical)
  • Extreme dieting, extreme weight loss or extreme metabolic damage (usually a result of starvation type diets or eating disorders)
  • Extreme stress (prolonged and constant)
  • Pituitary failure
  • Extreme exercise

​Symptoms of low estrogen

Estrogen is felt to have inhibitory effects on body weight through various mechanisms.

Estradiol helps maintain control over fat regulating hormones (11) like insulin and leptin.

When estradiol levels fall after menopause these systems tend to favor higher levels of both insulin and leptin.

If you've read my blog before you know that both leptin resistance and insulin resistance contribute significantly to weight gain.

This may explain, at least in part, why postmenopausal women tend to gain at least 10+ pounds at the onset of menopause (12).

In the case of leptin, estradiol actually helps sensitize the brain to this hormone which helps to increase its effectiveness.

When your body is sensitive to leptin your metabolism will remain normal and regulated.

Once this sensitization decreases, as a result of menopause or hysterectomy, the brain becomes more resistant to leptin which results in weight gain and weight loss resistance (13).

leptin resistance and estrogen levels


Estradiol also helps to reduce food intake (appetite) by modulating serotonin levels in the brain (14).

​This may explain why women get food cravings throughout their cycle and during pregnancy! 

Normal estradiol levels help you know when you should stop eating and actually helps reduce overeating (AKA hyperphagia). ​

The importance here is that once estrogen levels fall (either from menopause or hysterectomy) your appetite loses some of that regulation through serotonin.

This change may result in increased cravings for foods that may lead to weight gain long term.

​These certainly aren't the only symptoms of low estrogen levels (there are many more which we will go over below), but weight gain tends to be one of the most concerning symptoms of low estrogen. 

Symptoms of low estrogen: ​

  • Warm rushes
  • Hot flashes
  • Night Sweats
  • Temperature swings
  • Sleep disturbance & insomnia
  • Racing mind especially at night
  • Mental fogginess or forgetfulness
  • Dry vagina, dry eyes & dry skin
  • Pain during intercourse
  • Loss of "glow" to the skin
  • Diminished sensuality and sexuality
  • Episodes of heart palpitations or rapid heartbeat
  • Fatigue, low energy or reduced stamina
  • Headaches and/or migraines
  • Weight gain in the thighs/hips or buttocks region
  • Intestinal bloating
  • Back and joint pain

Use the list of symptoms above to help guide you to determine which type of estrogen problem you may be suffering from. 

Then you can match your symptoms to the treatment outlined below.

It's also important to note that some women can have higher than normal estrogen levels even after menopause.

This has to do with the fact that women can still create some estrogen through androgens (aromatization), while progesterone levels are almost always zero in postmenopausal women. 

age related decline of estrogen and progesterone

You can see this concept illustrated above, where progesterone levels drop and stay very low compared to estrogen levels through pre-menopause and post-menopause. 

The more fat you have on your body, the more estrogen you will produce even after ovarian failure. ​

​Remember it is the ratio of progesterone to estrogen that is most important and determines how your body will react. 

Supplements to help Lower and Balance High Estrogen Levels

​We will start discussing how to help balance estrogen levels if you know you already have higher levels. 

Most women will fall into this category as a result of weight gain, hypothyroidism, insulin resistance, etc.

These conditions are far more common nowadays and represent the majority of younger females.

​There are 3 strategies that we can employ to help balance and lower estrogen levels in women: 

First:

Help the body metabolize and get rid of the estrogen.

Estrogen actually has complex metabolism in the body and in the liver. 

Estradiol is broken down into other smaller estrogen products that have estrogenic properties and can sit on and activate estrogen receptors in the body (in some cases these estrogen breakdown products can actually reduce the risk of breast cancer (15)).

estrogen metabolism

​This makes elimination of excess estrogen very important and it's something that we can directly impact. 

Second:

Help reduce the impact that other hormone imbalances have on estrogen levels.

As we mentioned before other hormones either directly or indirectly impact estrogen levels. 

One of the most obvious targets is testosterone and other androgens.

These androgens can directly turn into estrogenic compounds through fat cells.

By reducing this conversion process (and by reducing fat cells) we can effectively help to lower estrogen levels throughout the body. ​

Third:

​Indirectly help estrogen levels by directly increase progesterone levels. 

By directly taking progesterone you can counteract some of the high levels of estrogen.

By itself, this isn't the best option, but it can absolutely be very helpful if combined with the other therapies listed above and in women who have very low progesterone levels.

To get the best results, make sure you employ multiple therapies listed below. Doing just 1 or 2 of these will not result in dramatic results. 

#1. DIM & Indole 3 Carbinol

DIM stands for Diindolylmethane which is a bioactive compound derived from cruciferous vegetables.

Indole ​3 carbinol is an earlier breakdown product of DIM but both have been shown to help your body naturally metabolize and get rid of estrogen levels. 

Studies have shown (16) that DIM and indole 3 carbinol can help the body eliminate estrogen levels and even promote the healthier estrogen breakdown products of 2-hydroxy estrone and 2 methoxy estrone. 

Estrogen metabolism and estrogen dominance

By encouraging this metabolism your body can get rid of estradiol faster and more efficiently. 

How to Supplement with DIM & Indole 3 carbinol
Why I like it

Helps promote proper estrogen metabolism

May promote healthy estrogen metabolites

Helps treat estrogen dominance

Generally works within 1-2 months

How to Use

  • Take 100 to 300mg per day of this supplement
  • You may benefit from taking more DIM right before ovulation and towards the end of your cycle when estrogen levels are highest
  • Monitor your symptoms while taking DIM to ensure that you tolerate the supplement
  • Take this supplement in addition to consuming more cruciferous vegetables like broccoli, cabbage, and bok choy
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#2. Zinc picolinate & Saw palmetto

Zinc and saw palmetto act through a backdoor mechanism to help reduce estrogen levels. 

Testosterone metabolism

As I mentioned previously you can get high estrogen levels from high levels of testosterone and DHEA. 

​These androgens can be metabolized into estrogens in fat cells, so having high testosterone and/or lots of fat will both indirectly lead to high estrogen. 

Zinc and saw palmetto act by helping increase the metabolism of testosterone and help the body eliminate the testosterone.

An added benefit of zinc and saw palmetto is that they also act to help reduce the symptoms of high testosterone such as hair loss, acne, low energy, and weight gain.

Zinc and saw palmetto both act by reducing the activity of the enzyme 5 alpha reductase (17) which turns testosterone into the potent androgen (5x more potent than testosterone) Dihydrotestosterone. 

Instead of going down the 5a pathway, zinc and saw palmetto help the body prefer the 5B pathway to create less androgenic metabolites. ​

How to Supplement with Zinc & Saw palmetto
Why I like it

Helps promote proper Testosterone and androgen metabolism

May also increase thyroid conversion

May help with hair loss, if related to excess androgens

Many people are deficient in zinc

How to Use

  • Take up to 60mg per day of zinc (max) - Zinc can also help promote proper thyroid function and immunity 
  • Take up to 600mg per day of Saw palmetto
  • Combine both therapies for maximum benefit
My Recommended Brand and Product:

Use 30-60mg of Zinc bound to picolinic acid per day and use it in conjunction with saw palmetto to help lower testosterone levels: 

Use 600mg of Saw palmetto along with 30mg of zinc per day:

#3. Calcium D-Glucarate

This supplement helps your body directly eliminate excess estrogens but it also helps with proper metabolism of testosterone/androgens AND cortisol/glucocorticoids. 

​Calcium d-glucarate is a substance derived from glucaric acid which is found in fruits and vegetables. 

It works by inhibiting an enzyme in the body known as beta-glucuronidase which is ​involved in the phase II liver detoxification pathway

In a nutshell: higher levels of Glucaric acid and calcium d-glucarate help the body change the chemical structure (18) of pretty much everything your body comes into contact with to help your body eliminate it. 

glucoronidation elimination pathway

In order for your body to get rid of something very large (like a hormone) it has to be cut into smaller pieces, and your body does this primarily in the liver.

Glucuronidation is one of the ways that your body changes the structure of chemicals and "cuts" them into smaller pieces.

Unfortunately, the enzymes responsible for these reactions can be influenced (or slowed down) by medications, chemicals, hormones (including hypothyroidism) and age. 

This specific pathway is responsible for the elimination of estrogens and other hormones.

So when this system gets "slowed" by various conditions, your body may accumulate more estrogen and/or estrogen metabolites.

Taking calcium d-glucarate has been shown to unblock the system (19) and help it function more efficiently by helping the body eliminate excess estrogen. 

How to Supplement with Calcium d-glucarate
Why I like it

Helps promote proper sex hormone metabolism (estrogen + testosterone)

May help detox other substances and chemicals

Helps treat estrogen dominance

Also acts as an antioxidant in the body

How to Use

  • Higher doses of calcium d-glucarate may be necessary for the best results. Start off by taking 500mg per day and slowly increase your dose up to 3,000mg per day. 
  • While increasing your dose monitor for negative side effects or "detox" like reactions: flu-like symptoms, muscle aches, acne, etc. 
  • Calcium d-glucarate helps the body eliminate more than just estrogen metabolites - this will also help your body eliminate medications, cortisol, testosterone/androgens and bile acids (anything that is eliminated via glucuronidation
  • Calcium d-glucarate can also be used in short bursts to help eliminate medications, chemicals, etc. that you may have come into contact with and this method may be superior to taking it daily
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​#4. Maca Root

Maca is another supplement that has the potential to improve multiple conditions in both men and women. 

While studies have shown that it has the potential to improve sexual behavior, fertility, mood, memory, osteoporosis, and even metabolism (20) - the exact mechanism is still not well understood. 

​Maca root seems to help by balancing issues with your sex hormones:

If your estrogen level is higher it tends to help lower it, if your testosterone is low it tends to help increase the effectiveness of what testosterone you do have.

Much of these effects likely occur at a cellular level because supplementation doesn't appear to alter serum levels of sex hormones (21).

Having said that many people who do supplement with maca report impressive results (22).

​If you are having issues with estrogen AND other symptoms like low sex drive OR issues with low testosterone, then supplementation with maca would be a consideration. 

Maca also has the added bonus of acting as an adaptogen which means it can improve energy levels and may balance cortisol levels. ​

How to Supplement with Maca root
Why I like it

Helps promote proper estrogen metabolism

Helps promote normal testosterone and androgen levels

May also increase sex drive/libido

May also increase energy levels

How to Use

  • Start with 1 tablespoon of maca powder per day, increase dose up to 1 tablespoon 2-3x per day as tolerated
  • Maca is generally well tolerated, most patients notice a difference when supplementing within 3-4 weeks
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#5. Ashwagandha

​Ashwagandha is a powerful adaptogen that can help women with high estrogen in multiple ways:

First:

Ashwagandha appears to have some effect as an anti-estrogen compound.

Meaning that taking this supplement can help balance and reduce estrogen levels in the body. ​

It appears to do this by downregulating estrogen receptor alpha (23) (an estrogen receptor that turns "on" estrogen-related genes). 

Second:

It helps to reduce symptoms of high estrogen like weight gain, depression, and low energy. 

Ashwagandha is another adaptogen which means that it has powerful effects on other systems in the body.

Supplementation with ashwagandha has been shown to increase libido (24) (low libido is usually a sign of sex hormone imbalance) and decrease symptoms of depression. 

Third: ​

Lastly, ashwagandha can help to regulate cortisol levels.

Remember when we discussed how all hormones in your body are intertwined?

Well, high cortisol levels can certainly impact estrogen levels and ashwagandha helps to balance cortisol levels which indirectly alters estrogen.

Taking this adaptogenic herb has also been shown to increase energy levels and treat symptoms associated with low/high cortisol. ​

How to Supplement with Ashwagandha
Why I like it

May Improve Thyroid + Adrenal Function

Naturally occurring and generally safe

May also improve Mood + Depressive symptoms

Generally works within 4-8 weeks

How to tell if you Need it

I recommend checking the following lab tests prior to supplementation: 

  • Serum 8 am cortisol: For best results, this level should be somewhere between 4-16. Levels higher than 20 may require different treatment. 
How to Use

  • Dosage varies from 500-2,000 mg per day depending on tolerance and degree of symptoms
  • Length of treatment varies by condition, for adrenal fatigue supplementation as long as 6+ months may be required.
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Supplements to help Increase Estrogen and help Women in Menopause

​While many women suffer from too much estrogen, there are still many women who suffer from not enough estrogen. 

This usually occurs in patients post-menopause who start to see the signs of low estrogen on their body.

Increased aging of the skin, increased pain during intercourse, increased risk of urinary tract infection and so on.

Many women even suffer from the more debilitating symptoms of having low estrogen such as insomnia, hot flashes, and depression that can really impact quality of life.

Using these supplements can act as a buffer to help balance estrogen levels either directly or indirectly. 

While these supplements may potentially help women with low estrogen, they will not necessarily work for everyone. 

In some cases, women may benefit from the use of bio-identical estrogen compounding with both estradiol and estriol. 

These supplements should act as a first line therapy though due to their low-risk profiles and ease of use. 

If, however, they do not work within 3-6 months it may be worth pursuing prescription options. 

#1. Flaxseed

​Flaxseed has been shown in multiple studies to help reduce the symptoms associated with menopause: 

Flaxseed does NOT appear to reduce the risk of cardiovascular disease, however, and that should be considered if you are at high risk or have a family history of heart disease.  

How to Supplement with Flaxseed
How to Use

  • Start with 2-4 tablespoons of organic flax seed per day
  • You can add this to your breakfast smoothies, sprinkle over your food or fresh fruit, add it to salads, etc. 
  • Flax is a source of healthy fats and omega fatty acids, don't be afraid to use it due to the fat content
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#2. Black Cohosh

Black cohosh is another supplement that has been shown in clinical studies to help reduce the symptoms and severity of menopause (29).

Black cohosh is felt to alter estrogen levels by acting as a selective estrogen receptor modulator.

It also appears to lower inflammation, act as an anti-inflammatory agent and increase/balance serotonin levels (30). 

benefits of black cohosh in menopause

Through these effects patients taking black cohosh (who are also menopausal) have shown a reduction in hot flashes and other vasomotor symptoms associated with menopause. ​

Taking black cohosh during menopause has also been shown to be safe (31).

How to Supplement with Black Cohosh
How to Use

  • Start with 250mg per day (you may go up to 500mg depending on tolerance and your symptoms) - if you don't have relief of your symptoms within 2-4 weeks then consider increasing your dose
  • For best results, women in menopause should use for 3-12 months
  • Taking for this length of time has been shown to reduce menopausal vasomotor symptoms by up to 35%
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#3. Evening Primrose Oil

Taking evening primrose oil has been shown in studies (32) to help reduce mild symptoms of menopause such as hot flashes. 

​These studies show that evening primrose oil actually helps reduce the severity and intensity of hot flashes. 

In addition, women taking EPO also noted to have a better quality of life while on this supplement. 

How to Supplement with Evening primrose oil
How to Use

  • Start with 250mg per day
  • Increase dose up to 1,000mg per day as tolerated
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#4. Vitamin K2 + D3

Vitamin D3 and K2 are added here because they are very important for calcium regulation in the body.

While they won't help with your estrogen levels directly they may help fight off ​or reduce your risk of developing calcium related issues like bone loss which IS related to low estrogen levels. 

Vitamin K2 should be taken with vitamin D3 (make sure it's in the D3 form) because both are involved in calcium regulation in the body (33).

Vitamin K2 helps direct calcium stores to where they should be (in your bones) and away from places they shouldn't be (like in your coronary arteries). 

Having normal vitamin D levels are required for proper immunity, energy levels, and regular mood. 

Most patients I test have low levels of vitamin D due to lack of sun exposure during optimal times of the day. ​

How to Supplement with Vitamin D3 + K2
How to Use

  • Use 2,000 to 5,000 IU's of D3 per day, make sure to follow your serum vitamin D levels
  • Take these vitamins with a meal high in fat to help increase absorption
  • Use up to 15mg per day of vitamin K2 liquid as necessary (but at least 1mg to start)
  • Most people take too much D3 and not enough vitamin K2
My Recommended Brand and Product:

Use up to 1-15mg of Vitamin K2 liquid (either MK2 or MK7 form) for best results. Use higher doses if you have a personal history or family history of cardiovascular disease: 

Use up to 5,000 IU's of liquid vitamin D3. Keep your serum vitamin D levels around the 40-50 range for best results (higher vitamin D levels without associated K2 may result in an INCREASE risk of calcium-related issues): 

#5. ​DHEA

DHEA makes the list because it is an androgen which can actually help and improve testosterone and estrogen levels indirectly.

DHEA is a precursor hormone in your body.

Your body uses DHEA to create estrogen AND testosterone metabolites.

DHEA, along with testosterone, tend to decrease as we age.

This indirectly results in reduced levels of testosterone and estrogen due to decreased conversion to these hormones.

high testosterone from high DHEA

You can supplement with DHEA to increase your reservoir of this hormone.

One of the downsides to supplementing with DHEA is that you don't have control over what your body will do with it. 

Meaning your body may take the DHEA and turn it into estrogen or it may go and turn it into testosterone (or an equal amount of both).

Most patients take it with one goal in mind, but it doesn't always work out that way so keep that in the back of your mind if you choose to supplement with DHEA. ​

DHEA is available over the cou​nter, but it is a powerful androgenic hormone so don't let that confuse you into thinking that it is harmless. 

How to Supplement with DHEA
How to Use

  • Start with 25mg used every 3 days
  • If you tolerate 25mg every third day you can slowly increase to every other day and eventually daily if you find that is the most beneficial to you
  • Watch for side effects like acne, hair loss or mood changes - this may indicate higher metabolism towards testosterone and other androgens
  • If you experience symptoms such as breast tenderness, increase emotions, etc. then discontinue the use or reduce your dose as this may indicate more estrogenic metabolism
My Recommended Brand and Product:

#6. Bio-identical progesterone cream (over the counter)​

Another method to influence menopausal symptoms is the use of bioidentical hormones.

Many women are concerned about the potential risk for breast cancer and other issues while using bioidentical hormones after menopause. 

Generally, when using the right type of hormones (meaning bioidentical) and in doses that are appropriate (low and not supraphysiologic doses), the use of these hormones does NOT result in an increased risk of breast cancer (34).

risk of breast cancer using estrogen and progesterone

You can see from the image above that the major increase risk of developing breast cancer comes from using the synthetic estrogen hormones like norethisterone acetate, etc. 

Often times people lump bioidentical estrogen and progesterone into the same category but they are quite different. 

There is a difference between synthetic estrogens and bioidentical estrogen/progesterone. 

When women go through menopause they basically have VERY little to zero progesterone in their body, while estrogen levels may fluctuate or remain high due to aromatization from fat cells. 

Taking progesterone can help combat estrogen levels and may actually ease the symptoms of menopause (remember not all symptoms of menopause are due to estrogen levels).

Taking progesterone has other benefits as well including the potential to improve your sleep, help your body flush out water, increase your metabolism and improve your cardiovascular profile (35).

HDL levels while using progesterone

Like all therapies, you should make sure you research and consider all options before using supplements or hormones. 

Due to various reasons, I find many women with depleted progesterone levels (starting at around age 30) which continues through menopause and into later years. 

Progesterone is available over the counter (like DHEA), compared to estrogen which requires a prescription from a physician. ​

How to Supplement with Bioidentical progesterone
How to Use

  • If menstruating: Use 20-40mg per day on days 14-28 of your cycle (the latter half of the month)
  • If in menopause: you can use 20-40mg per day either 6 days per week (with rest on the 7th) or 26-28 days per month (with 1-3 days off per month)
  • Make sure to monitor your symptoms while using and discontinue use if you experience any negative side effects
  • Discuss the use of bioidentical hormones with your physician
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Wrapping it up

If you believe that you are suffering from abnormal estrogen levels make sure you get a proper evaluation. 

In most cases that means getting your blood tested and then monitoring your symptoms to determine which kind of problem you have.

Most menstruating women suffer from estrogen dominance (or high estrogen levels), while menopausal women may suffer from low or high estrogen levels.

Certain supplements have been shown to alter estrogen levels by either directly changing serum estrogen levels, by influencing estrogen metabolism, or by enhancing other hormones that directly or indirectly alter estrogen.

Now it's your turn:

Are you suffering from high estrogen? Low estrogen?

What have you tried?

What has worked?

Leave your comments below! ​

References (Click to Expand)

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

38 thoughts on “Natural Estrogen Supplements & Pills to Balance your Sex Hormones”

  1. Hello Dr.childs
    I have been following your website for the past one month. You are doing a great job. Your posts are useful and detailed. I have a doubt endometriosis comes under estrogen dominance right. Could you please give a detailed post for patients who have both endometriosis and hasimoto thyroiditis. Thanks.

    • Hey Kathy,

      Endometriosis does fall under the umbrella of estrogen dominance syndromes. Thanks for the suggestion, I will put it on the list!

  2. I just finished a round of B12 shots and am for the most part very pleased with them. I do suspect a histamine reaction because the injection sites would become warm red and itchy the red spot lasting 2 plus weeks. I also experienced chest pains/angina- possibly due to a combination of methylfolate supplements. I know reactions are rare but have no other suspects for the chest pains and wonder if you have had any experience here. I also have no estrogen, normal progesterone and testostrone and probable hypoglycemia- i am interested in DHEA and other supplements to raise the estrogen, and wondering if I am more likely to have the DHEA convert to testosterone.

  3. hello doctor

    I have a lot of weight oh my waist n thighs… I have almost all symptoms of low estrogen… n breast tenderness during pms…

    what should be the desired ratio of progesterone/estrogen

  4. I had both my ovaries and Fallopian tubes removed recently due to symptoms from an ovarian mass. Dr. recommended it. Waiting for test results actually now. I’m turning 63 next month. I have been post menopausal for some time now. My question is, do I need to supplement with a natural hormones even though I have been post menopausal for several years? I have read that women produce hormones even after menopause until they are 80 years old. I’m not sure what exactly to do. Will my health get worse in other aspects since now I have no hormones at all because of the surgery?

    • Hi MaryEllen,

      Most women do benefit from using hormones after menopause and some women are hit harder than others if they have their ovaries removed – how much is often unknown.

  5. Do you recommend taking progesterone and Dhea for someone who’s mother died of breast cancer? I am a 70 year old woman with severe osteoporosis, low dhea, low T3 (2.2), high cortisol at night, and most probably SIBO and yeast. Was told by my endocrinologist not to take anything for low T3 because it could promote more osteoporosis. I also have MGUS, which can probably cause some osteoporosis.

    I prefer not to take meds for osteoporosis, and am taking many herbal teas, vit k, vit d3, using a Biodensity machine, vibration machine and PEMF mat. I also walk hard on the treadmill, do yoga for osteoporosis, and other osteoporosis exercises. I just ordered a homeopathic remedy for osteoporosis..symphatum.

    Any help would be appreciated!!!

    • Hi Adrienne,

      Supplementing with sex hormones is highly individualized and it’s something that usually requires a dialogue between physician and patient regarding potential benefits and risks.

  6. Hi Dr. Childs,

    Thank for the article as it helps explain a lot! I have a friend in her late 40’s that is struggling with insulin resistance and weight loss and I’ve been trying to get her on DIM and calcium d-glucarate but she is hesitant. I’m going to pass this on to her. As for me, I just had serum hormone testing and I’m low on progesterone and estrogen with a ratio of around 18% so even though I’m low, I’m still estrogen dominant. My testosterone and DHEA is low normal. I’m 49 and slightly overweight but losing slowly. But I’m a huge fan of DIM which saved my sanity when estrogen levels were high in peri-menopause along with calcium-d glucarate. These supplements also eliminated the hormonal cystic acne I had developed after years of no breakouts. Now for the last couple of months, I’ve been experiencing all the symptoms of low estrogen; I got the first UTI I’ve had in 12 year for no good reason, horrible night sweats and insomnia to name a few so I dropped the DIM and CDG and this week, started breaking out again. I’m thinking of adding DHEA to support estrogen production (hoping that my body will convert to estrogen since I need it) but I’m scared of the acne side effect if my body decides to convert it to testosterone. If I add back the DIM, that should block the effects of the androgenic activity of the DHEA while converting the estrone produced by my body fat to estradiol. Am I correct in my thinking here? One last question that I have and perhaps this is the subject of a future article but my IGF-1 came back at 75 which I consider low. Do you know what can cause low IGF-1 at my age? I eat a lot of meat protein in general so I’m surprised this came back in so low. Thank you in advance!

  7. Hello Dr Childs or…

    I’m in desperate need of HELP. I am a 56 years old female and a breast cancer survivor (2012 mastectomy no chemo/radiation therapy needed) Last menstrual was 10/2007. I’m a diabetic my A1c is 12.5, TSH and T4 are normal but my T3 is low. I’m obese and can not loose weight even though I’ve changed my eating lifestyle. I have a fatty liver. FSH is 59, Estradiol is 9.8, glucose is 293, Testosterone is 30, D3 is 23.4 With my estradiol being low should I take Dim supplements? I’m searching for a Bio identical Doctor to assist me with my thyroid and other complications. Meanwhile, please share your expertise on which supplements I should take. Please! thank you

  8. I am 53 and use estrodial patch and bio-identical progesterone cream for low estrogen and progesterone. I used testosterone cream for a while, but didn’t get any benefits from it. Can I add DHEA and calcium d-glucarate for more energy, light depression, low libido, and weight loss. Will the calcium d-glucarate counteract the estrodial I am taking.

    • Hi Lily,

      You can take calcium d-glucarate with estradiol (it shouldn’t cause any problems). It’s unlikely however that DHEA will help with all of those symptoms if testosterone didn’t.

  9. I had a complete hysterectomy over 5 years ago, and have not been able to find a stable, steady BHRT ever, and have, in fact, had some horrifying experiences with various doctors who put me on questionable synthetic hormones. I have been in and out of the hospital 12 times this year because of suddenly soaring blood pressure. After many months of trial and error on my own due to lack of a reasonable doctor, I have found that my BP soars (175/110) equally when my estradiol level is high but all bound (currently have very high SHBG) OR if my estradiol level is low. (If I can hit a ‘reasonable estradiol level, my BP is low/normal at 115/75). This situation basically leaves me with the severe symptoms of literally ZERO estradiol despite regular, religious, supplementation. I haven’t slept more than an hour or two at a time in almost 2 years. I have debilitating anxiety, no appetite, and at one point I gained 40 lbs in 2 months, and then lost 20 in 3 weeks as doctors changed my HRT. At the moment, I remain consistently and stubbornly 10-15 lbs overweight.

    Currently I am using generic Vivelle Dot .1 2x/week (down from .166 2x/week). For most of the year I was using no progesterone, but have now started using 12 mg USP compounded in vaginal suppository form each night. I was also using no testosterone for most of the year mainly due to one doctor having overdosed me on a synthetic, injectible type last year. I am currently using 20 mg USP compounded vaginal suppository 3 times per week.

    Things have improved but are still not steady and I still have severe anxiety and have intractible insomnia (along with pretty much every symptom you have listed above for ‘low estrogen’ despite my high lab values as follows).

    My last labs showed that my serum estradiol is over 260 (high end of ranges for pre-meno women; i.e. TOO MUCH), my progesterone is less than .07 (off scale below range), and my testosterone was 21 (range 9-35); my SHBG is 110 (range 18-114). It is this very high binding globulin level that prompted me to pursue supplementing testosterone (along with absolutely zero libido, vaginal atrophy, muscle loss, and severe skin dryness). It is my understanding that testosterone will help lower SHBG. It also seems that when my estradiol and SHBG are so high, my thyroid gets overstimulated to the point that I actually have constant thyroid PAIN! (Yet doctors tell me that’s not possible.)

    I have had numerous thyroid workups in the past year, and while I was hyper-thyroid due to massive administration of various synthetic hormones late last year and earlier this year, it has since corrected and is now within normal (if slightly low) ranges for FT4, FT3 and FSH; however my reverse T3 is still elevated at 17, but down from 19. My current FT3 to RT3 ratio is 0.16.

    My fasting glucose level was 86 mg/dL and my fasting insulin level was 4 mIU/mL therefore my HOMA-IR is 0.849 (an extremely low insulin resistance).

    At this point, I just want to get things in balance so that I can have some quality of life. I have no quality of life whatsoever right now.

  10. Hi Doctor,
    GREAT article!

    I am on HRT and going through menopause–not yet stopped periods although they of course are erratic and i had terrible night sweats and hot flashes and they were immediately alleviated by going on estrogen and progesterone…these are not bioidentical as i cannot afford them, they are low dose synthetic that my insurance pays for. i still have dry eyes and am now having to go on a topical vaginal estrogen cream (despite being on estrogen for 5 months) for some vaginal atrophy.
    My question is about DIM… would that benefit someone like me that had the symptoms of low estrogen but is now on HRT? Would it make the estrogen i’m on now more “friendly” so to speak? I really don’t know if i have some estrogen dominance or not.. THANKS!

  11. Hi Doc, Thanks a lot for this information. I am not sure if I have high estrogen or low estrogen, I have heavy period as well as hot flash in the early morning when I wake up. In case I take calcium d glucorate will help , In my country Its difficult to get estrogen level tested . Please suggest

  12. Hi,

    I am 27 (5’ 7) and stopped taking birth control 2 months ago. I was on beyaz/yaz for 11 years. Since I stopped taking the pill, I have gained 7-10 pounds. On BC I was 138-140, after BC 147-150. The weight gain is mostly in my thighs and hips. I have tried researching about my situation but there is no information except on blogs/forums from other women experiencing the same side effects. What do you think? I think has to do something with my hormone levels..
    Thank you in advance.

  13. I love your articles. Extremely helpful. My latest labs show I’m in post menopause age 53, and my estradiol is 170.0 while my progesterone is 0.2. Testosterone at 5.6 was flagged as high, though I don’t think it is? Several years ago before I started eating lots higher protein and working out, my total T was far lower, as in borderline deficiency.

    I think this is estrogen dominance. My symptoms don’t correlate to the ones you’ve listed for high estrogen and low progesterone, but I also just learned my TSH catapulted to 4.7 in the last few months. My dr says I’m is starting on .25mcg of levothyroxine two days a week til I can see an endo. My issues are hair loss for 3 years, when my TSH was on the low end of the normal range, thin regrowth, excessively wrinkled and sagging skin on the arms and weight gain around the middle and upper thighs — all of these maladies resist all exercise and healthful diet with a caloric limit based on losing 1 lb a week. I avoid processed foods and I’ve added more protein and only good fats. All of this came on in the last 2-3 years. As I wait for an appointment with an endo, I’m hoping the addition of a B complex, along with selenium and magnesium, focused attention on a thyroid supporting meal plan, and 2% progesterone cream can help. The sagging arms and thinning hair, and shapeless overweight body are killing me! I also suffer from zero energy and serious depression from all of the above.

    I will also push for a more thorough thyroid panel as I see just getting TSH and Free T4 is a fraction of the picture. Do you think my skin and hair troubles are all hormonal and thyroid related? I think I am going to lose my mind if approaches to regulate hormones and my throid don’t work. Thanks again for your insight!

  14. Dear Dr. Childs, I am most concerned about excessive weight gain in breasts and my waist, post menopause. Will focus on anti high estrogen supplements. However, I also have insomnia, and am post menopause. Should I also take supplements for low estrogen as well? Would these supplements contribute to higher estrogen, which I am trying to combat?

  15. Hi – I’m actually postmenopausal and have read that DIM and Calcium D-Glucarate are beneficial because they help balance estrogen. I’m fortunate in that I have experienced very few hot flashes. I’m a vegan, eat very well and exercise a lot (5 days per week for an hour and a half to two hours, cardio, and weights). That said, I’m still experiencing weight gain around my middle which is driving me a little crazy. I don’t mind eating less and exercising more, but am hoping that DIM and Calcium D-Glucarate might help.

    Any thoughts?

  16. Dr. Childs, can you offer any suggestions…

    I am 68 years old and have been suffering from some hair loss for the past several years. After receiving pellets with estriol and testosterone, I felt terrific, but my hair loss greatly worsened. Needless to say, I stopped all testosterone (I now have almost none) and later tried DHEA but once again experienced significant hair loss. I am still on Estradiol lozenge and oral progesterone. Can you suggest something which would help with libido, energy, weight loss, muscle definition which would not cause hair loss?
    Thanks so much!

  17. Good day Dr. Westin CHilds. First off, thank you for this article. It was really informative. I know you’re not a gynaecologist but you seem to be quite knowledgeable of certain topics that fall within the field. I’m hoping you can help me with my situation. I have PCOS but I’m not troubled with many symptoms. The doctors tell me that I have low progesterone levels. I’d really like to know what are some natural/healthy ways of increasing my progesterone? I’m trying to stay away from contraceptives given that I want to get pregnant. Also, from reading this I realize that I do face some symptoms of low estrogen. Are these symptoms the same as for low progesterone?

  18. Is it better to take dim and calcium-d-glucarate in LH phase and not on FSH phase? I have fibroids. These supplements seem to reduce my pain. Thank you so much doc.

  19. Hello! I started taking DIM a week ago, and this is the FIRST information I have come across which is helping possible make sense of why I am reacting poorly.
    I take Armour for hypothyroidism. My latest labs show my estradiol at 269.5 (pg/Ml) and my Progesterone at 187 (ng/dl), however, my Human sex binding hormone is at 187 nmol/L). I have read rave reviews about DIM and my Dr. recommended it for my high estradiol. I have all the symptoms of high estradiol, but after taking DIM I feel like I have chronic PMS< bloating and no sex drive. This is exactly how I feel two days before My period but instead extended for this entire week. I am a 42-year-old female. I am about ready to quit DIM (I am taking a liver support supplement) and I crashed horribly when my thyroid medicine was reduced a year ago. I would love to have some help figuring this out. I am frustrated and desperate.

  20. Hello Dr Childs,

    I have been to 2 different doctors this year (2018) My salivia test are saying my Estrone, testosterone & progesterone are all high. The only thing one doctor told me to to do is lower(slowly) my progesterone oil from 42 mg a day to 7-21 mg a day. I have lowered it 7 mg a day. However, they upped my dosage of vit d3, now taking 7000 IU’s a day. I read d3 & k increase estrogen. I am not sure what to do seeing how i am in a constant estrone dominance state. I have tried CDG,raw carrots, bamboo shoots and haven’t noticed any change, DIM makes me constipated. Should i stop d3 & k. I cant seem to find a doctor that will address this. I also dont eat soy, use any plastic, or any thing that would increase my estrogen. Been dealing with this for over 3 yrs.

  21. Hi Dr. Childs,

    would you recommend taking DIM or Indole for Hashimoto patients with estrogen dominance? Which one do you prefer, if you have a preference?

    Thank you for your help!

    Ana

  22. Hi Dr. Childs, love your website and well-researched articles. What is your opinion in using maca for those who have low testosterone but normal estradiol levels? I’ve read about alot of benefits of maca, and that it also helps increase DHEA levels. I’ve got low testosterone and low DHEA but normal estradiol so trying to figure out if this is a viable avenue for me. Maybe too soon to tell with the available research?

    • Hi Sarah,

      Like most nutritional supplements, it’s hit or miss in terms of whether or not it will work for your body. You can give it a try and see, but you also want to be looking for the cause of your hormone imbalance otherwise you’re just masking the problem with a supplement.

  23. Hi Doc, I am 26yrs old, just recently I have been diagnosed that I have PCOS after I had my blood test, and my symptoms, I am considering to take ESTROGEN PILLS to boost my estrogen as my female hormones level are pretty low, my Estradiol level is 390.10, progesterone 0.56, and my testosterone is really high like 2.56, therefore, I am considering to take estrogen pills so I can balance it with my testosterone levels, Do you think I am doing the right decision? Do you think I really need estrogen pills,? Because I think I really do, but I need your opinion. Thank you, looking forward to hearing from you soon! Good day.

    • Hi Angelica,

      Using estrogen to increase your estrogen is likely not going to work out well. Typically, you want to focus on balancing your sex hormones without adding other hormones in to try and brute force your way. Brute force tends to be accompanied by various other unwanted side effects.

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