Why Estrogen Is Big Pharma’s Darling..
and Progesterone Got Ghosted
For decades, estrogen has been framed as the star of hormone therapy, glamorized, widely studied, and positioned as the primary solution to women’s midlife symptoms. While access is still a challenge for many women, those who do get treatment are often handed estrogen first, without much conversation about what it’s being balanced with or whether it’s even the right starting point.
Meanwhile, progesterone the calming, balancing counter part, equally critical for sleep, mood, and breast protection, is barely mentioned, misunderstood, or dismissed altogether, or worse, lumped in with synthetic imposters that don't behave anything like the real thing.
It’s not a coincidence that suddenly your feed is crawling with white coat influencers preaching the gospel of estrogen like it’s holy water. You can’t scroll for two seconds without some smug IG doc telling you to shove estrogen into every orifice and smear it on every wrinkle as if it’s the secret to eternal youth, orgasmic bliss, and protection from everything from Alzheimer's to heartbreak.
And their justification? A dramatic overcorrection to the WHI study which they now claim was so flawed it set women’s health back decades. So instead of seeking balance, they’ve whipped around in the other direction, treating estrogen like it’s the miracle cure that got unfairly canceled.
Some even insist with a straight face, that estrogen is so magical it escapes the laws of exogenous metabolism altogether. According to them, low doses “stay local,” defying all known pharmacokinetics. But when you point out the very obvious flaw like, say, if that were true, how do nicotine patches work? They don’t engage in scientific discussion. Oh no.
They call you a fear monger.
They say you're “anti-woman.”
They unleash the Estrogen Mafia, complete with pearl-clutching and ad hominems.
And just for fun, they’ll dismiss your 2024 studies as “old”, while citing their own data from 2002 like it’s hot off the press.
But here’s my question;
Why? Why the aggressive estrogen evangelism? Why now?
Is it really about women's health? Or is something else, something a little more lucrative driving the estrogen obsession?
(We’ll get to that.)
Women are told they’re "estrogen deficient" the moment they hit their 40s. Hot flashes? Estrogen. Mood swings? Estrogen. Vaginal dryness? You guessed it. Estrogen is cast as the cure-all despite decades of evidence that many women actually suffer from too much estrogen in relation to progesterone, not too little overall. God forbid you bring up tissue estrogen — you’ll be told it doesn’t matter. “Who cares how much estrogen is stored in the tissue? My patient’s vaginal dryness is gone, and that’s a win!” As if that one symptom fixes everything.
Completely dismissed is the fact that the vast majority of estrogen-driven cancers occur in menopausal women, and guess what? They’re almost always found in tissues, not in the blood. Many of these women show normal or even low serum estrogen levels while their tissues tell a very different story.
But sure… let’s keep pretending bloodwork is the whole picture.
And progesterone? It's often prescribed as an afterthought or not at all. Even when it is offered, the dose is minimal, the delivery ineffective, or it’s replaced by a synthetic progestin that has none of progesterone's protective, brain-loving, metabolism-supporting benefits.
And then there’s Estrogen Matters.
The book that launched a thousand estrogen prescriptions.
It set out to redeem estrogen’s image, but in doing so, it managed to completely ghost progesterone and ignore half the story.
Estrogen Matters by Dr. Avrum Bluming and Carol Tavris was written to rehabilitate estrogen’s reputation after the WHI study cast doubt on hormone therapy. While it makes some valid points about how estrogen was unfairly demonized, it drops the ball in a few key ways, especially for women who’ve dealt with estrogen dominance, poor detox pathways, or progesterone neglect.
Here’s where the book misses the mark:
1. It Treats Estrogen Like It’s Universally Beneficial
The book assumes that more estrogen is generally better, especially after menopause.
It downplays the fact that many women already struggle to clear estrogen, especially if they have methylation issues, sluggish liver function, or a history of estrogen dominance.
It ignores that adding more estrogen without addressing those imbalances can make things worse — even dangerous.
2. It Minimizes the Role of Progesterone
Progesterone is barely mentioned and when it is, it’s lumped in with progestins, which are not the same.
It fails to acknowledge that progesterone is essential for balance, especially in menopausal and perimenopausal women who are estrogen dominant.
There’s no discussion of how progesterone protects tissues, counteracts estrogen’s proliferative effects, and calms the nervous system.
3. It Ignores Tissue Estrogen Load
The authors focus almost entirely on serum (blood) levels of estrogen.
But estrogen-driven cancers (like breast and uterine) often occur in women with “normal” or low serum estrogen because the estrogen is stored in tissues.
There’s no exploration of exogenous estrogen metabolism, or how estrogen patches, creams, and pellets can accumulate in tissues over time.
4. It Downplays Risk
While the book argues that estrogen therapy is safer than previously thought (which may be true for some), it makes sweeping claims that don’t account for individual variability, detox capacity, or genetic risk factors.
It essentially says: “Don’t worry, estrogen is fine!”, without caveats or nuance.
5. It Reinforces the Medical Monoculture
By presenting estrogen as the star and brushing off progesterone, detox pathways, and metabolic health, the book upholds the conventional medical model that treats symptoms with prescriptions instead of looking at root causes.
Basically,
Estrogen Matters, but only if you’re reading it with a critical eye. It’s a pro-estrogen book written in response to anti-estrogen panic. But in trying to swing the pendulum back, it swings too far, ignores real risks, and completely leaves progesterone behind.
So why all the estrogen worship and why now?
Why do women continue to be overprescribed estrogen and undereducated about the very hormone that could help them feel balanced, rested, sane? The word “balance” is mysteriously missing from the conversation.
Here’s the sneaky, unspoken reason no one really talks about and it has nothing to do with what works best for women.
It has everything to do with what works best for business.
Estrogen is easy to market. It’s framed as youthful, sexy, and powerful. But more importantly? It can be packaged into patentable delivery systems, patches, gels, sprays, rings, and pellets, all proprietary, all billable, all easy to scale.
Progesterone? Not so much. It’s a fat-soluble molecule that doesn’t absorb well through the skin without specific carriers. A patch that actually delivered effective doses would have to be the size of your back. A pellet would be the size of an egg. Not exactly market-friendly.
Most people don’t realize just how potent estrogen is compared to progesterone. A tiny amount, just micrograms, of estradiol can have a powerful systemic effect, while natural progesterone often requires 100 to 200 milligrams or more to create balance. That’s a potency gap of at least 100 to 1 and some experts suggest it’s closer to 500 or even 600 to 1, depending on the tissue and delivery method.
That’s why it’s so easy to pack estrogen into sleek delivery systems like patches, rings, and gels, it doesn’t take much to make a big impact. But progesterone? Real, bioidentical progesterone needs actual volume to work. And because it’s not as potent (but far more calming and protective), you can’t shrink it down into a micro-dose patch.
It also explains why hormonal birth control uses 1–2 mg of synthetic progestins, which are far more potent than natural progesterone, and not remotely the same in how they act on the body.
And the reality is, bioidentical progesterone, the kind your body actually recognizes, can’t be patented. It’s naturally occurring. You can’t slap a trademark on nature.
That’s the secret.
That’s why progesterone got ghosted.
Because you can’t build a blockbuster drug campaign around something nature already perfected. (Though they won’t stop trying. Trust me, the FDA already classifies bioidentical progesterone as a drug, even though it’s not. They’re squeezing compounding pharmacies, and it won’t be long before they find a way to make it nearly impossible to access without a prescription).
So they gave us synthetic progestins instead. Ones that can be patented. Ones that don't act like progesterone in the body but look close enough on a chart. Ones that carry increased risks of cancer, stroke, and mood issues. And when those failed in clinical trials? They threw progesterone under the bus too as if it was guilty by association.
But it wasn’t. And most doctors and research still conflates progestins and progesterone!
Progesterone didn’t fail us. The system failed progesterone.
And now? It’s up to women, the ones asking questions, reading between the lines, and refusing to settle to bring this quiet hormone back into the spotlight where it belongs. To stop chasing trends and start making balance the goal.
That means resisting white coat worship syndrome, no matter how charming the IG doc in scrubs may be. It’s tempting to buy into the slick reels and the confident promises, but just listen for the missing words. Are they talking about balance? About progesterone, not progestin? Are they even mentioning the role of the liver, gut, and detox pathways? Or is it just, “You feel like crap because you need estrogen and you’ll never make it again”?
The truth is, what the body needs as it ages isn’t just more hormones, it’s more fuel, more slow, daily movement, strength-building that works for your body type, and most importantly, open detox pathways. Because if you’ve ever struggled with estrogen dominance, that’s a sign: your body hasn’t been handling estrogen well. And if you decide to supplement you want to be doing healthy things with that estrogen.
Estrogen grows things. That’s its miraculous job. But if it’s not being properly cleared by your liver and gut, it can also feed the wrong fires. That’s not fear, that’s wisdom. That’s seeking balance. And balance is the goal. Always.
Interested in supporting your body’s natural detox pathways — especially before jumping into hormone therapy?
Check out my Detox Essentials Mini Course — just $25 for over 4 hours of foundational content you can watch at your own pace. It comes with PDF course materials, supplement guidance, and even a gentle colon cleanse protocolto help you start clearing what your body no longer needs.
If you're ready to go deeper into the nuances of estrogen detox, hormone metabolism, and advanced strategies for hormone balance, join the waiting list for my Advanced Detox Course!
Because before you start supplementing, you need to make sure your body knows how to safely remove excess estrogenand other built-up waste.
"Beloved, I pray that all may go well with you and that you may be in good health, as it goes well with your soul." -3 John 1:2
Join us in the Estrogen Dominance Support Groupon Facebook and listen to my Podcast “Stuff Your Doctor Should Know” on all podcast platforms.
Disclaimer: Please note that the information shared in these articles is for educational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional for personalized guidance regarding your health concerns.
It’s absolutely insane how most medical professionals push estrogen. It’s very clear that progesterone is the one that’s deficient starting around age 35. Maybe, and this is a stretch, it’s part of a deep population. Because if you don’t have enough progesterone, you will miscarry.
Yes! I've been saying this for years. Why does the western medical community not like the words, hormone balance and estrogen dominance?
Have you read Dr. John Lee's book from the 90's?
What Your Dr May Not Tell You About Menopause. And later he wrote one with the same title except it was Perimenopause. Both are good.
Both talk about the need for progesterone.
In my Substack I educate about menstrual cycle awareness. I truly believe our health starts with this vital sign. Living with the cyclical nature of our phases we will see the areas that we need more self care in our month.
But first- awareness.
Thank you for this article. I have only read this one and now I subscribed. Looking forward to what you share. Really important work.