From the Guidelines
High estrogen levels in premenopausal women can be caused by several factors, including obesity, certain medications, and medical conditions such as polycystic ovary syndrome (PCOS) or estrogen-secreting tumors. The most recent and highest quality study, 1, provides guidance on endocrine therapy for hormone receptor-positive metastatic breast cancer, which may be relevant to understanding the effects of high estrogen levels. However, the provided studies primarily focus on postmenopausal women or hormone replacement therapy, which may not directly address the causes of high estrogen levels in premenopausal women. Some key factors that may contribute to elevated estrogen levels in premenopausal women include:
- Obesity, as fat tissue converts androgens to estrogen through aromatization
- Certain medications, such as hormone replacement therapy, some birth control pills, and fertility treatments
- Medical conditions, such as PCOS, which causes hormonal imbalances, and estrogen-secreting tumors in the ovaries or adrenal glands
- Liver disease, which may reduce the body's ability to metabolize estrogen, leading to higher levels
- Stress, which can impact hormone production by affecting the hypothalamic-pituitary-adrenal axis
- Environmental factors, such as exposure to xenoestrogens found in plastics, pesticides, and industrial chemicals
- Dietary factors, including consumption of foods with phytoestrogens (like soy products) or high alcohol intake. If experiencing symptoms of high estrogen, such as heavy periods, breast tenderness, mood swings, or weight gain, consulting with a healthcare provider is recommended for proper evaluation and treatment.
From the Research
Likely Causes of High Estrogen Levels in Premenopausal Women
High estrogen levels in premenopausal women can be caused by various factors, including:
- Polycystic ovary syndrome (PCOS), a common endocrine disorder that affects 5-10% of premenopausal American women 2
- Obesity and insulin resistance, which are common in women with PCOS and can lead to increased estrogen production 2
- Hormonal imbalances, such as increased luteinizing hormone (LH) and decreased follicle-stimulating hormone (FSH) 3
- Increased androgen levels, which can be converted to estrogen in the body 3
- Exposure to phytoestrogens, naturally occurring compounds found in plants that can have estrogenic and antiestrogenic activities 4
Role of PCOS in High Estrogen Levels
PCOS is a significant contributor to high estrogen levels in premenopausal women. Women with PCOS often have:
- Higher free androgen index 5
- Lower sex hormone-binding globulin (SHBG) levels 5
- Increased insulin resistance and obesity 2
- Hormonal imbalances, including increased LH and decreased FSH 3
Other Factors Contributing to High Estrogen Levels
Other factors that may contribute to high estrogen levels in premenopausal women include: