Do you know what it’s like to experience anxiety? Surely you’ve experienced it before, with the nausea and butterflies in the stomach, sweats, beating heart, and shortness of breath. It’s normal to feel anxiety for short periods of time leading up to a big event, such as a speech you’ll be giving to a roomful of strangers, or in preparation for a big exam. As funny as it seems, anxiety is adaptive, and actually beneficial in such instances.

It’s when anxiety is chronic that it becomes a problem. It’s damaging to the body and is an indicator of an underlying problem.

While it’s easy to put feelings of anxiety down to purely psychological or emotional stressors, sometimes the cause is actually biological. This is true for anxiety caused by estrogen dominance, which is what I want to talk about today.

What estrogen dominance is

Estrogen dominance occurs when estrogen levels are higher than progesterone levels, resulting in estrogen “dominating” progesterone. This happens when levels of both hormones decline, but progesterone declines faster, leaving estrogen dominant. You can also think of it as a progesterone deficiency.

Many of the consequences (or symptoms) of estrogen dominance are related to fertility and sexual function, including:

  • severe menstrual cramps
  • heavy periods with clotting
  • irregular menstrual cycles
  • uterine fibroids
  • ovarian cysts
  • endometriosis
  • infertility
  • multiple miscarriages
  • premenstrual breast tenderness
  • premenstrual mood swings and headaches
  • decreased libido

However, many other symptoms aren’t related to fertility and sexual function, including:

  • anxiety
  • panic attacks
  • depression
  • migraines

How estrogen dominance leads to anxiety

Why would estrogen, which is thought of primarily as the main female sex hormone, have anything to do with anxiety? Because hormones have wide-ranging effects in the body, and a small change in one can lead to a myriad of consequences.

When progesterone levels decline and are out of balance with estrogen, anxiety appears. Progesterone is important for brain health and is the “feel-good” hormone.  Research shows that an increase in progesterone resulted in improvement of premenstrual anxiety. (1) Research also shows that progesterone produced a clear dose-dependent anti-anxiety response. These results demonstrate that progesterone was most potent against anxiety when compared with all steroids evaluated. (2, 3) Studies have shown that progesterone treatment in ovariectomized rats produces an anti-anxiety response similar to that observed after the administration of typical anti-anxiety benzodiazepine compounds.(4) A significant improvement was found in symptoms of premenstrual syndrome (PMS) relating to tension, mood swings, irritability, and anxiety. Metabolites of progesterone may play a physiologic role as anti-anxiety agents, perhaps modifying mood and anxiety, alleviating some PMS symptoms relating to anxiety and irritability. (5)

Another consequence of high levels of estrogen is a higher level of cortisol-binding globulin, or CBG. As the name suggests, this globulin binds to cortisol. By doing so, CBG stops cortisol from entering cells and functioning normally. So a woman may have seemingly adequate amounts of cortisol in her blood, but not enough free cortisol – that is, the kind that can be taken in and used by cells for energy.

As you may know, cortisol is the hormone released by the adrenal glands that helps the body produce glucose for energy. It’s the main hormone responsible for helping us adapt to stressful and ever-changing environments. When cortisol is low, our ability to roll with the punches is drastically reduced. We feel stressed out, and filled with anxiety. That’s not the only way that estrogen can lead to anxiety. High levels of estrogen can actually impede the release of cortisol from the adrenal glands in the first place by interfering with the signal from the brain.

Finally, chronically high estrogen can lead to functional hypothyroidism, which in turn causes anxiety. Hypothyrodism causes a decrease in GABA, a neurotransmitter with a calming effect. Because GABA isn’t as plentiful with hypothyroidism, it doesn’t exert its calming effect, and anxiety appears instead.

Research found that people with hypothyroidism had significantly higher anxiety scores than those with normal thyroid function. (6) Another research study investigated the correlation between thyroid function and severity of anxiety or panic attacks in patients with panic disorder. The more severe current panic attacks were, the higher the TSH levels were, indicating that those people have hypothyroidism. (7)

What to do about anxiety caused by estrogen dominance

Once you’ve identified the cause of your anxiety, you can do something about it. If that happens to be estrogen dominance, I recommend bioidentical hormone therapy. I’ve had great success with a combination of bioidentical progesterone and small amounts of bioidentical cortisol to both rebalance the estrogen and progesterone and to replenish the body’s cortisol.

Do you think your anxiety might be caused by estrogen dominance, or do you have questions about what is causing it? If so, contact us at the Hotze Health & Wellness Center at 281.698.8698 to talk to a wellness consultant today.

1. Nutritional Factors in the Etiology of the Premenstrual Tension Syndromes
2. Anxiolytic Activity of the Progesterone Metabolite 5 Alpha-Pregnan-3 Alpha-o1-20-one
3. Anti-Anxiety Effects of Progesterone and Some of its Reduced Metabolites: An Evaluation Using the Burying Behavior Test
4. Anxiolytic Effect of Progesterone is Mediated by the Neurosteroid Allopregnanolone at Brain GABAA Receptors
5. Efficacy of Progesterone Vaginal Suppositories in Alleviation of Nervous Symptoms in Patients with Premenstrual Syndrome
6. Assessment of Anxiety in Subclinical Thyroid Disorders
7. Relationship Between Anxiety and Thyroid Function in Patients with Panic Disorder