In a previous blog, we dove into the connection between endometriosis and gut health. If you haven’t read that yet, go back HERE and get caught up—because today, we’re building on it.
Estrogen Dominance and Progesterone Resistance: The Bigger Picture
The term "estrogen dominance" is often thrown around in relation to endometriosis, but what does it actually mean? Estrogen dominance is commonly described as having "too much estrogen," but this oversimplification misses the mark. It also perpetuates the misleading narrative that estrogen is the root of all your problems—which, honestly, is exhausting. Estrogen dominance isn’t just about having too much estrogen on its own; it’s about the relative relationship between estrogen and progesterone, which fluctuates throughout the menstrual cycle, rather than existing in a constant, perfect state (hormones pulse, they don't flow in a constant, perfect stream HERE is an instagram post I did a while back this discusses this more with a great visual of what people expect hormone balance to be). And while we're at it, can we please stop treating hormone numbers like a one-size-fits-all measurement? Just because estrogen levels are in the 200s, 300s, 400s or beyond, doesn’t automatically mean they’re “too high.” Without context, those numbers don’t mean much—and they certainly shouldn’t be used to point fingers at air.
Additionally, some women have a metabolic preference for certain estrogen metabolites (metabolites are the byproducts of hormone breakdown and processing within the body) , such as a stronger tendency toward the 16-OH pathway, which can amplify estrogenic symptoms. In the context of someone with endometriosis, this could contribute to more severe inflammation, tissue proliferation, and pain. A preference for the 16-OH pathway may also point toward underlying gut health issues. To give a bit more context—If the liver and gut aren’t efficiently detoxifying estrogen, the body may have a higher conversion of estrone (E1) to 16-OH estrone, which is linked to conditions like endometriosis, fibroids, and estrogen-sensitive cancers. Before I go on, it is VERY important you read that statement again and hear me when we say “is linked”. This does not mean “will or must cause”—but we’re going to address it specifically today as well.
Estrogen and progesterone work in a yin-yang relationship, look at estrogen as Thelma and Progesterone as Louise or if we have any Grey’s Anatomy fans Estrogen is Christina Yang and Progesterone is Meredith Grey or Look at estrogen as Beyonce’ while progesterone is Adele or Estrogen is Doja Cat while Progesterone is Taylor Swift (kinda depends on which album we are talking about because Taylor was not holding back in Bad Blood) all this to say and when that dynamic shifts, the communication system in the body shifts thus symptoms can become more pronounced.
Under normal circumstances, progesterone acts as a regulator. It prevents excessive tissue growth, promotes a stable uterine environment, and counteracts estrogen’s proliferative effects. But in endometriosis, that regulation can break down. Why?
Progesterone Resistance
Endometrial lesions may have a damped response to progesterone from the way they should. That means:
Tissue that should stop growing keeps growing.
Inflammation runs unchecked.
Lesions become more aggressive.
Pain, scarring, and cyst formation become more severe.
The exact reasons behind progesterone resistance are still being studied, but here’s what we know is possible:
Altered progesterone receptors: The cells in endometrial lesions don’t express progesterone receptors properly, making them less responsive to the hormone.
Chronic inflammation: Inflammatory cytokines (which, by the way, are heavily influenced by gut health—see the last blog HERE) can interfere with progesterone signaling.
Environmental toxins: Think of this like a threshold. An inflamed body has only so much bandwidth to detox and regulate hormones before it’s like “okay this is just silly and something must give girl”. This is a massive “control the controlables” moment.
Genetic factors: Some women may be predisposed to progesterone resistance, making management even trickier.
So, while estrogen dominance fuels tissue growth, progesterone resistance prevents the body from keeping that growth in check. It’s a perfect storm that can make endometriosis a nightmare to manage.
So, What Can We Do? Practical Action Steps
Read: This Blog: Could Gut Health and Inflammation Be Impacting Your Endometriosis?
Reduce chronic inflammation (gut health matters here—again, go read the above blog and THIS ONE too ).
Manage stress (chronic stress disrupts progesterone production).: Read Overwhelmed and Exhausted and Adrenal Recovery: Heal from Chronic Stress
Address nutrient deficiencies (magnesium, B vitamins, Omega’s).: Read The Truth About : Superfoods
Optimize Gut Health:
Prioritize digestion: Chew your food thoroughly, eat in a relaxed state.
Increase fiber intake to support estrogen elimination.
Consider probiotic-rich foods or targeted probiotics for support.
Support Liver Detoxification:
Get our FREE Liver Love Guide HERE
Focus on cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) to support Phase 1 detox.
Ensure adequate protein and healthy fats to support Phase 2 detox.
Optimize bile flow for excretion (bitters, dandelion root, lemon water).: Read this for Great tips!
Contact us for a Professional Consultation and/or Information about our Mentorship Program HERE
Coming Next: The Gut-Hormone Connection in Endometriosis
We’ve talked about estrogen and progesterone, but what happens when your gut and liver aren’t clearing out estrogen properly? If you’ve been focusing only on hormone levels without addressing your digestion and detox pathways, this next post is a must-read.
If you’re a coach looking to deepen your understanding of hormone health or a woman navigating endometriosis and looking for real, actionable guidance—reach out. Whether through mentorship or professional consultation, education is power, and it’s time to take control of your health.
This blog was inspired by our Biweekly Group Mentorship Call and ongoing inquiries from coaches and clients looking to level up their understanding of endometriosis. If this or other conversations resonate with you, let’s connect.
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