Hyperestrogenism

Did You Know?

• Treatment may involve surgery for tumors, lower estrogen doses for exogenous causes, or estrogen-suppressing medications like gonadotropin-releasing hormone analogues and progestogens.
• Androgens may be supplemented in males with hyperestrogenism.

Signs and symptoms

Hyperestrogenism involves too much estrogen, often estradiol or estrone. This suppresses certain pituitary hormones and, in males, can lower testosterone. For women, signs include irregular periods, missed cycles, abnormal bleeding, and enlarged uterus or breasts. Children may experience early puberty. Men might develop breast tissue, lose libido, or show feminization and impotence. Without treatment, the risk of estrogen-sensitive cancers like breast cancer increases.

Causes

Hyperestrogenism can arise from ovarian tumors, genetic conditions such as aromatase excess syndrome, or overconsumption of exogenous estrogens from hormone replacement therapy or hormonal contraception. Liver cirrhosis may also cause it through reduced estrogen metabolism. Two types exist: absolute hyperestrogenism, where estrogen concentration is higher than usual, and relative hyperestrogenism, where normal estrogen levels are high relative to progesterone. An example of absolute hyperestrogenism is persistent follicles that undergo atresia without ovulating; relative hyperestrogenism can result from luteal insufficiency.