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Estrogen Dominance… or Estrogen Deficiency? Is It Safe to Start Estrogen in Perimenopause?

Estrogen Dominance… or Estrogen Deficiency? Is It Safe to Start Estrogen in Perimenopause?

Welcome to the very first Hormone Hotline episode of The Hormone Solution! I’m getting straight into your real-life questions about estrogen—because why, in 2026, are we still being told we’re “estrogen dominant” with rock-bottom levels? If your doctor has warned you against HRT, this episode is for you.

Have you been told you can’t start estrogen until you hit full menopause? Or that perimenopause is just too much of a “hormone rollercoaster” to treat? I break down what’s actually happening in your brain and ovaries during late perimenopause and why adding estrogen might calm the chaos instead of fueling it.


And what about those scary detox pathways and DUTCH test results? Does favoring a certain estrogen metabolite mean you’re disqualified from HRT? I unpack the myths around estrogen metabolism, aging, bone loss, mood, and even biological age. Could estrogen be one of the most powerful anti-aging tools we have?

In this episode, we uncover:

  • Why “estrogen dominance” in menopause often makes no physiological sense.
  • How estrogen therapy can stabilize perimenopausal hormone rollercoasters.
  • What DUTCH test results really mean for HRT candidacy.
  • Why waiting until menopause may accelerate aging and bone loss.
  • How estrogen impacts mood, metabolism, and long-term mortality risk.

If you’ve been confused, dismissed, or flat-out denied estrogen, you need to hear this episode!

Have a question for our next Hormone Hotline episode? Fill out our form here.

Or leave us a voice note on our Speak Pipe Channel here.

Download in iTunes or on your favorite podcast platforms.