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Estrogen to Progesterone Ratio: Why it's Important?

Medically reviewed by 
Estrogen to Progesterone Ratio: Why it's Important?

Hormone balance involves more than simply maintaining ideal levels of individual hormones. The significance of estrogen-to-progesterone ratios is more important than many people realize, as about 80% of women experience hormone imbalance during their lifetime. This affects physical, mental, and overall health. 

This article explores comprehensive insights into what the estrogen-to-progesterone ratio means, its implications, and how to optimize estrogen-to-progesterone ratios to enhance well-being. 


What Are Estrogen and Progesterone?

Estrogen and progesterone are hormones (chemical messengers) often thought of as female hormones, though men also require specific amounts of these two hormones to maintain optimal body functioning. 

Some of the functions estrogen and progesterone provide involve reproductive health, metabolism, mood, bone density, and much more.


Estrogen is a sex hormone responsible for reproductive functioning and bone, muscle, heart, skin, brain, and nervous system health. The different forms of estrogen include:

  • Estrone (E1): women’s bodies make E1 before and after menopause; both men and women make these hormones in their adrenal glands and body fat.
  • Estradiol (E2): E2 is the main form of estrogen in nonpregnant women of childbearing age. It supports reproductive, bone, and brain health. Men can make E2 in their testicles.
  • Estriol (E3): E3 is the type of estrogen that increases during pregnancy in women. Nonpregnant women and men also have low levels of E3.

These forms of estrogen are all vital for ideal body functioning and to prevent bothersome symptoms and health problems.


Progesterone is another hormone that plays a key role in women’s and men’s reproductive health.

Studies show that non-reproductive functions of progesterone include supporting the central nervous system, immune system, cardiovascular system, respiratory system, adipose tissue, kidney functioning, and even behavior. It also plays a role in appetite and weight management.

Why Is the Estrogen-Progesterone Ratio Important? 

The balance between estrogen and progesterone (the estrogen-progesterone ratio) may be more important than each level individually.

Lab tests measure the progesterone: E2 ratio, which provides important insights into an individual’s hormonal health.

Variations from this range may indicate estrogen dominance, low estrogen, or progesterone deficiency.

Factors Affecting the Estrogen to Progesterone Ratio 

Numerous factors may contribute to abnormal estrogen-to-progesterone ratios, including:

Life Stages and Hormonal Changes 

Estrogen-progesterone ratios can change with pregnancy, menstrual cycles, menopause, perimenopause, and other life stages in women. Polycystic ovary symptoms (PCOS) may also alter this ratio. These hormone changes impact an individual's symptoms and any complications linked to hormone imbalance.

External Influences 

Potential external influences on the estrogen-to-progesterone ratio include:

  • Diet
  • Stress
  • Environmental toxins
  • Some medications
  • Hormonal contraceptives
  • Hormone replacement therapy (HRT)

Poor dietary habits, hormone treatments, and exposure to endocrine disruptors can contribute to estrogen dominance or progesterone deficiency. Examples of endocrine disruptors include:

  • Some pesticides and herbicides (atrazine)
  • Bisphenol A (BPA) is a chemical used to make epoxy resins and polycarbonate plastics found in food packaging, toys, manufacturing, and the lining of certain canned food and beverage products.
  • Perchlorate, a colorless salt found in some groundwater
  • Dioxins, a byproduct of certain manufacturing processes
  • Phthalates, compounds found in certain cosmetics, food packaging, toys, medical device tubing, fragrances, hair spray, nail polish, cleaners, shampoos, and aftershaves
  • Per- and poly-fluoroalkyl substances (PFAS): a group of chemicals used in paper, textile coatings, nonstick pans, and firefighting foam
  • Polybrominated diphenyl ethers (PBDE): substances used to make flame retardants
  • Phytoestrogens: naturally occurring phytochemicals with hormone-like activity. Present in some plant foods, they behave similarly to estrogen in the body. Examples include soy products (tempeh, tofu, soy milk, soybeans, etc.)
  • Hormones in some meats or dairy foods

Eating a well-balanced diet and adopting other healthy lifestyle habits, including avoiding toxin exposure whenever possible, can enhance estrogen-to-progesterone ratios.

Symptoms and Consequences of Imbalance

An imbalanced estrogen-to-progesterone ratio can cause undesirable symptoms or other consequences.

Estrogen Dominance 

The symptoms of high estrogen relative to progesterone (estrogen dominance) in women include:

In men, high estrogen levels can lead to:

  • Infertility
  • Erectile dysfunction (ED)
  • Gynecomastia (enlarged breasts)

Treating estrogen dominance reduces the risk of complications, including the worsening of:

These conditions may develop or worsen because without progesterone to balance estrogen in the body, this hormone often becomes out of whack. 

Progesterone Deficiency 

Like estrogen dominance, progesterone deficiency also upsets estrogen-to-progesterone ratios in the body.

The symptoms and complications linked to low progesterone relative to estrogen include:

Too much or too little hormone production may cause a chain reaction with other hormones, which is why low progesterone often contributes to high estrogen levels.

Because progesterone is vital for a healthy pregnancy, low levels increase the risk of:

  • Preterm labor
  • Ectopic pregnancy
  • Miscarriage 

Women could also develop low blood sugar, fatigue, or spotting (light bleeding) if they experience low progesterone while pregnant. 

Low progesterone levels in men may cause:

Potential causes of low progesterone include high stress, extreme dieting, overexercising, thyroid disorders, and perimenopause. 

Diagnosing and Testing 

The different methods for testing hormones include saliva, blood, and urine tests. While individualized hormone tests are helpful, it’s important to also obtain a ratio-based analysis to get the full scope of an individual’s overall health.

Examples of progesterone to estrogen ratio (Pg/E2) tests include:

  • Saliva Profile III (male/female): includes a baseline test that analyzes waking levels of testosterone, estradiol (E2), progesterone, and DHEA-sulfate — and a full diurnal cortisol profile in the morning, noon, evening, and night (four-time points).
  • Saliva profile I (male/female): measures the waking levels of testosterone, estradiol (E2), progesterone, and DHEA-S — and one cortisol analysis.
  • Saliva profile II (female/male): evaluates testosterone, estradiol (E2), progesterone, and DHEA-S — and two cortisol measurements, typically in the morning and at bedtime.
  • Weight management profile: The weight management profile consists of a blood or saliva sample that identifies hormone imbalances linked to weight gain, obesity, and difficulty losing weight or maintaining an ideal weight. 
  • NeuroHormone complete plus profile: collects saliva or urine to analyze diurnal cortisol, neurotransmitters, and various other hormones. 

These tests are simple, painless, and accurate. The type of hormone testing that’s right for each patient depends on their symptoms, medical history, and potential underlying cause of hormone imbalance. 

Managing and Correcting Imbalances

Ways to properly manage and correct hormone imbalances include:

Lifestyle Adjustments

Lifestyle changes that promote a healthy estrogen-to-progesterone ratio include:

Foods that support progesterone balance include:

  • Spinach, carrots, poultry, walnuts, and other foods containing B vitamins 
  • Shellfish, organic beef, eggs, lentils, cashews, chickpeas, and other zinc-rich foods
  • Nuts, seeds, beans, green vegetables, and other foods high in magnesium
  • Peppers, broccoli, strawberries, citrus fruits, peppers, and other sources of vitamin C

Foods that promote healthy estrogen balance include:

Choose organic produce, meats, and dairy foods when possible to minimize the risk of added hormones, pesticides, and herbicides. 

Medical Interventions 

If a patient still experiences hormone abnormalities after making healthy lifestyle adjustments or if their levels are concerning, they may be a candidate for hormone replacement therapy (HRT) or dietary supplements. It’s important to personalize treatment plans based on a patient’s individual hormone testing results and goals. 


Key Takeaways

It’s vital to understand the importance of maintaining a healthy estrogen-to-progesterone ratio because:

  • An ideal estrogen-to-progesterone ratio is responsible for proper body functioning.
  • Early detection and treatment of hormone imbalance minimizes problematic symptoms and potential health complications.
  • Adopting healthy habits and seeking medical guidance at the first sign of high estrogen or low progesterone can restore a patient’s quality of life.

Individuals should consult with a healthcare professional for personalized testing and treatment recommendations to optimize estrogen-to-progesterone ratios.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
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