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Estrogen levels normally fluctuate throughout the menstrual cycle and throughout a lifetime.
Some women experience a condition known as estrogen dominance, where they have higher than normal levels of estrogen.
Estrogen Dominance in Women With PCOS
PCOS is the most common cause of ovulatoryinfertilityand it’s believed that estrogen dominance plays a part, along with other hormonal imbalances, including elevated testosterone.
Lack of ovulation results in continuous high levels of estrogen and insufficientprogesterone.
A Guide to PCOS and Menopause
Heavy Menstrual Bleeding and PCOS
For women with excessively prolonged orheavy menstrual bleeding(previously called menorrhagia) the administration of estrogen in combination with progesterone may be recommended to temporarily stop the bleeding and stabilize the endometrial lining.
Synthetic estrogen is one of the main hormones found inbirth control pills, which usually contain both estrogen and progestin (synthetic progesterone).
Alternatively, progestins alone may be administered orally to control bleeding.
Low-dose oral contraceptive pills or intrauterine devices (IUD), such as Mirena (a levonorgestrel-releasing intrauterine system), are also options to reduce heavy bleeding.
In some cases, an endometrial ablation, a surgical procedure that removes most of the endometrial lining, is recommended.
Types of Drugs Used to Treat PCOS
Environmental Causes of Estrogen Dominance
Hormone dysfunction is a major factor in the estrogen dominance seen in women with PCOS. Environmental factors can also play a role.Chemicals in our environment, known as xenoestrogens, can mimic naturally occurring estrogen in our bodies and act asendocrine disruptors.
Some sources of endocrine disruptors include pesticides, Bisphenol A (BPA) and phthalates (found in plastic containers, water bottles, and paper receipts),andparabens(often found in skin and hair care products).
To minimize your exposure to environmental disruptors,follow these tips:
Does Freezing Plastic Water Bottles Cause Cancer?
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Delgado BJ, Lopez-Ojeda W.Estrogen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/Reed BG, Carr BR.The Normal Menstrual Cycle and the Control of Ovulation. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/Rasquin Leon LI, Mayrin JV.Polycystic Ovarian Disease(Stein-Leventhal Syndrome) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/Dennett CC, Simon J.The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment.Diabetes Spectr. 2015;28(2):116–120. doi:10.2337/diaspect.28.2.116Hickey M, Higham J, Fraser IS.Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev. 2000;(2):CD001895.Maybin JA, Critchley HO.Medical management of heavy menstrual bleeding.Womens Health (Lond). 2016;12(1):27–34. doi:10.2217/whe.15.100Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43–52. doi:10.2147/OAJC.S85565De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F.Genetic, hormonal and metabolic aspects of PCOS: an update.Reprod Biol Endocrinol. 2016;14(1):38. doi:10.1186/s12958-016-0173-xDiamanti-Kandarakis E, Bourguignon JP, Giudice LC, et al.Endocrine-disrupting chemicals: an Endocrine Society scientific statement.Endocr Rev. 2009;30(4):293–342. doi:10.1210/er.2009-0002Monneret C.What is an endocrine disruptor?C R Biol.2017 Sep-Oct;340(9-10):403-405. doi:10.1016/j.crvi.2017.07.004Rutkowska AZ, Diamanti-kandarakis E.Polycystic ovary syndrome and environmental toxins. Fertil Steril. 2016;106(4):948-58.Additional ReadingBarrett ES, Sobolewski M.Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role?Semin Reprod Med. 2014;32(3):166-76. doi: 10.1055/s-0034-1371088.Dumitrescu R, Mehedintu C, Briceag I, Purcarea VL, Hudita D.The polycystic ovary syndrome: an update on metabolic and hormonal mechanisms.J Med Life. 2015;8(2):142-5.Mayo Clinic.Polycystic Ovary Syndrome. www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Delgado BJ, Lopez-Ojeda W.Estrogen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/Reed BG, Carr BR.The Normal Menstrual Cycle and the Control of Ovulation. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/Rasquin Leon LI, Mayrin JV.Polycystic Ovarian Disease(Stein-Leventhal Syndrome) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/Dennett CC, Simon J.The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment.Diabetes Spectr. 2015;28(2):116–120. doi:10.2337/diaspect.28.2.116Hickey M, Higham J, Fraser IS.Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev. 2000;(2):CD001895.Maybin JA, Critchley HO.Medical management of heavy menstrual bleeding.Womens Health (Lond). 2016;12(1):27–34. doi:10.2217/whe.15.100Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43–52. doi:10.2147/OAJC.S85565De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F.Genetic, hormonal and metabolic aspects of PCOS: an update.Reprod Biol Endocrinol. 2016;14(1):38. doi:10.1186/s12958-016-0173-xDiamanti-Kandarakis E, Bourguignon JP, Giudice LC, et al.Endocrine-disrupting chemicals: an Endocrine Society scientific statement.Endocr Rev. 2009;30(4):293–342. doi:10.1210/er.2009-0002Monneret C.What is an endocrine disruptor?C R Biol.2017 Sep-Oct;340(9-10):403-405. doi:10.1016/j.crvi.2017.07.004Rutkowska AZ, Diamanti-kandarakis E.Polycystic ovary syndrome and environmental toxins. Fertil Steril. 2016;106(4):948-58.Additional ReadingBarrett ES, Sobolewski M.Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role?Semin Reprod Med. 2014;32(3):166-76. doi: 10.1055/s-0034-1371088.Dumitrescu R, Mehedintu C, Briceag I, Purcarea VL, Hudita D.The polycystic ovary syndrome: an update on metabolic and hormonal mechanisms.J Med Life. 2015;8(2):142-5.Mayo Clinic.Polycystic Ovary Syndrome. www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Delgado BJ, Lopez-Ojeda W.Estrogen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/Reed BG, Carr BR.The Normal Menstrual Cycle and the Control of Ovulation. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/Rasquin Leon LI, Mayrin JV.Polycystic Ovarian Disease(Stein-Leventhal Syndrome) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/Dennett CC, Simon J.The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment.Diabetes Spectr. 2015;28(2):116–120. doi:10.2337/diaspect.28.2.116Hickey M, Higham J, Fraser IS.Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev. 2000;(2):CD001895.Maybin JA, Critchley HO.Medical management of heavy menstrual bleeding.Womens Health (Lond). 2016;12(1):27–34. doi:10.2217/whe.15.100Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43–52. doi:10.2147/OAJC.S85565De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F.Genetic, hormonal and metabolic aspects of PCOS: an update.Reprod Biol Endocrinol. 2016;14(1):38. doi:10.1186/s12958-016-0173-xDiamanti-Kandarakis E, Bourguignon JP, Giudice LC, et al.Endocrine-disrupting chemicals: an Endocrine Society scientific statement.Endocr Rev. 2009;30(4):293–342. doi:10.1210/er.2009-0002Monneret C.What is an endocrine disruptor?C R Biol.2017 Sep-Oct;340(9-10):403-405. doi:10.1016/j.crvi.2017.07.004Rutkowska AZ, Diamanti-kandarakis E.Polycystic ovary syndrome and environmental toxins. Fertil Steril. 2016;106(4):948-58.
Delgado BJ, Lopez-Ojeda W.Estrogen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/
Reed BG, Carr BR.The Normal Menstrual Cycle and the Control of Ovulation. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/
Rasquin Leon LI, Mayrin JV.Polycystic Ovarian Disease(Stein-Leventhal Syndrome) In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/
Dennett CC, Simon J.The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment.Diabetes Spectr. 2015;28(2):116–120. doi:10.2337/diaspect.28.2.116
Hickey M, Higham J, Fraser IS.Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation. Cochrane Database Syst Rev. 2000;(2):CD001895.
Maybin JA, Critchley HO.Medical management of heavy menstrual bleeding.Womens Health (Lond). 2016;12(1):27–34. doi:10.2217/whe.15.100
Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43–52. doi:10.2147/OAJC.S85565
De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F.Genetic, hormonal and metabolic aspects of PCOS: an update.Reprod Biol Endocrinol. 2016;14(1):38. doi:10.1186/s12958-016-0173-x
Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, et al.Endocrine-disrupting chemicals: an Endocrine Society scientific statement.Endocr Rev. 2009;30(4):293–342. doi:10.1210/er.2009-0002
Monneret C.What is an endocrine disruptor?C R Biol.2017 Sep-Oct;340(9-10):403-405. doi:10.1016/j.crvi.2017.07.004
Rutkowska AZ, Diamanti-kandarakis E.Polycystic ovary syndrome and environmental toxins. Fertil Steril. 2016;106(4):948-58.
Barrett ES, Sobolewski M.Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role?Semin Reprod Med. 2014;32(3):166-76. doi: 10.1055/s-0034-1371088.Dumitrescu R, Mehedintu C, Briceag I, Purcarea VL, Hudita D.The polycystic ovary syndrome: an update on metabolic and hormonal mechanisms.J Med Life. 2015;8(2):142-5.Mayo Clinic.Polycystic Ovary Syndrome. www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
Barrett ES, Sobolewski M.Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role?Semin Reprod Med. 2014;32(3):166-76. doi: 10.1055/s-0034-1371088.
Dumitrescu R, Mehedintu C, Briceag I, Purcarea VL, Hudita D.The polycystic ovary syndrome: an update on metabolic and hormonal mechanisms.J Med Life. 2015;8(2):142-5.
Mayo Clinic.Polycystic Ovary Syndrome. www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
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