Hormone BlissTest Kit
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Hormone Imbalance Score Calculator

Tap the keypad or just type your numbers in. Your Pg / E2 ratio appears instantly.

Have saliva results? Tap Saliva β€” units and reference ranges update automatically.

Pg / E2 Ratio
Progesterone Γ· Estrogen Β· Serum (blood)
Progesterone
Γ·
Estrogen
Hormone Imbalance Score
96.0
Estrogen dominant
Tap a field to edit it, or just type. Editing: Progesterone

Progesterone is low relative to estrogen

A mid-luteal ratio below ~100 suggests insufficient progesterone to balance estradiol. Common in PCOS, perimenopause, anovulatory cycles, and high-stress states. Consider luteal phase symptoms, cycle length, and discuss confirmatory testing with a clinician.

Where you sit on the spectrum
Estrogen dominant
96
0 Β· Estrogen dominant
100 Β· Borderline
300–500 Β· Optimal
600+ Β· Pg high

What this number actually means

The progesterone-to-estradiol ratio (Pg/E2 or P/E2) is one of the most useful ways to assess hormonal dominance in women whose individual lab values fall inside the "normal" reference range. Estradiol is the most potent estrogen and the one routinely measured β€” it's what we compare progesterone against.

Drawn in the luteal phase (roughly 7 days after ovulation), these ranges are considered typical:

  • β€’ Progesterone: 11–29 ng/mL (35–92 nmol/L)
  • β€’ Estradiol: 19–160 pg/mL (70–600 pmol/L)

In healthy, ovulating women the Pg/E2 ratio generally falls between 100 and 500. That's the sweet spot where progesterone is doing enough to balance estrogen's growth-and-stimulation signal.

How to read your result

  • Ratio below 100 β†’ estrogen dominance is more likely

    Progesterone isn't strong enough to balance estrogen. This pattern is commonly associated with PMS, PMDD, heavy or painful periods, breast tenderness, fibroids, endometriosis, anxiety, insomnia and perimenopausal flare-ups.

  • Ratio 100–500 β†’ balanced range

    Estrogen and progesterone are working together the way they're designed to. This is the range associated with a healthy luteal phase and successful conception.

  • Ratio above 500 β†’ progesterone dominant

    Less common, but can show up with supplemental progesterone or low estrogen states. May cause fatigue, low mood, low libido, or bloating.

Note: in IVF the ratio is often inverted (E2/Pg) because estradiol levels are the priority metric before egg retrieval. For everyday hormone-balance work, the Pg/E2 direction shown here is what you want.

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Hormone Imbalance Score Calculator

Is estrogen running the show?

Your body was designed for hormones to work like a team β€” not a tug-of-war. Estrogen builds, grows, and stimulates. Progesterone calms, balances, and protects. When that balance tips, your whole rhythm gets thrown off.

This isn't here to diagnose you. It's here to help you understand whether your hormones may be working with you or against you.

Find out who's driving: estrogen or progesteroneTake the symptom quiz
Woman experiencing hormone imbalance symptoms
Why we built this

Because "your labs are normal" isn't an answer

Most women are told their hormones are "fine" because each lab number falls inside a wide reference range. But hormones don't work in isolation. Estrogen and progesterone are dance partners β€” and when one is leading too hard, the whole rhythm gets thrown off.

The Pg/E2 ratio gives us a better look at that balance. A low ratio may suggest progesterone isn't strong enough compared to estrogen β€” leaving the body feeling inflamed, overstimulated, emotional, heavy, tired, wired, or just plain not like yourself.

Conditions linked to a poor Pg/E2 balance:

PCOS Β· heavy or irregular periods Β· PMS Β· PMDD Β· endometriosis Β· fibroids Β· adenomyosis Β· breast tenderness Β· bloating Β· mood swings Β· anxiety Β· insomnia Β· weight gain Β· perimenopause symptoms.

This tool is a starting point β€” a way to connect the dots and ask better questions.

02 Β· Insulin & HOMA-IR

Why insulin matters for estrogen

Insulin resistance is one of the biggest hidden drivers of estrogen dominance. When insulin runs high, the liver makes less SHBG (the protein that binds estrogen) β€” so more free, active estrogen circulates. High insulin also stimulates ovarian androgen production, slows hepatic estrogen clearance, and feeds the PCOS pattern of anovulation, low progesterone, and stubborn weight gain.

HOMA-IR is a quick, validated estimate of insulin resistance from a fasting blood draw. Optimal is under 1.0; anything above 1.9 is worth addressing before β€” or alongside β€” progesterone work.

  • High insulin β†’ low SHBG. More free estradiol reaches tissues.
  • High insulin β†’ high androgens. Ovaries shift to testosterone, ovulation stalls.
  • No ovulation β†’ no progesterone. Estrogen has nothing to balance it.
  • Slower liver clearance. Conjugated estrogens recirculate.
Typical: 70–99
mg/dL
Optimal: 2–6
Β΅IU/mL
HOMA-IR
β€”
β€”

Formula: (fasting glucose mg/dL Γ— fasting insulin Β΅IU/mL) / 405.

03 Β· The basics

What is estrogen dominance?

Estrogen dominance describes a relative imbalance: estradiol is too high for the progesterone you're producing. Absolute estrogen can be normal, low, or high β€” what matters is the ratio between the two hormones during the luteal phase.

It shows up most often in perimenopause, PCOS, anovulatory cycles, after long stretches of chronic stress, and alongside insulin resistance β€” because high insulin lowers SHBG and slows hepatic estrogen clearance.

Common drivers

  • Anovulation. No ovulation β†’ no corpus luteum β†’ no progesterone surge.
  • Insulin resistance. Raises free estrogen, lowers SHBG, fuels PCOS pattern.
  • Sluggish liver Phase II. Poor methylation/glucuronidation recycles estrogen.
  • Gut & estrobolome. Ξ²-glucuronidase from dysbiosis reactivates conjugated estrogen.
  • Xenoestrogens. Plastics, parabens, pesticides β€” additive estrogenic load.
  • Chronic stress. Cortisol competes with progesterone synthesis (β€œpregnenolone steal”).
04 Β· Symptom quiz

How loud are your symptoms?

Rate each symptom over the last 2–3 cycles. Severity is weighted β€” moderate symptoms count more than mild ones. Your score correlates loosely with the degree of estrogen excess.

01
Premenstrual mood swings, irritability, or anxiety
02
Breast tenderness or swelling, especially before period
03
Heavy, clotted, or prolonged periods
04
Mid-cycle or premenstrual spotting
05
History of fibroids, endometriosis, or fibrocystic breasts
06
Weight gain around hips, thighs, or lower belly
07
Cyclical water retention or bloating
08
Hormonal headaches or migraines
09
Trouble falling or staying asleep, especially luteal phase
10
Low libido
11
Persistent fatigue not explained by sleep
12
Brain fog or trouble concentrating
13
Cold intolerance, dry skin, or thinning hair
14
Sugar or carbohydrate cravings, particularly luteal phase
0 / 14 answered
05 Β· Symptoms

What it actually feels like

Cycle & reproductive

  • Β·Heavy, clotted periods
  • Β·Short luteal phase (<10 days)
  • Β·Mid-cycle spotting
  • Β·Fibroids, endometriosis, fibrocystic breasts
  • Β·PMS / PMDD

Mood & nervous system

  • Β·Irritability, anxiety, weepiness premenstrually
  • Β·Insomnia, especially luteal phase
  • Β·Hormonal migraines
  • Β·Brain fog

Body composition

  • Β·Hip/thigh fat gain
  • Β·Stubborn lower belly
  • Β·Water retention & bloating
  • Β·Sugar cravings in luteal phase

Skin, hair, thyroid

  • Β·Cyclical acne along jaw
  • Β·Thinning hair
  • Β·Low thyroid pattern (high estrogen raises TBG)
  • Β·Cold hands & feet
06 Β· What to do

Moving the needle

Work top-down: confirm with labs, address insulin and stress, support estrogen clearance, then consider progesterone with a clinician. Skipping the foundations and jumping to hormones rarely sticks.

A
Play

Progesterone options

Bioidentical (micronized) progesterone is the standard. Synthetic progestins (medroxyprogesterone, norethindrone) do not behave like progesterone in the brain and breast and are not interchangeable.

FormTypical doseNotes
Oral micronized (Prometrium)100–200 mg at bedtimeSedating β€” good for sleep. First-pass metabolism.
Vaginal100–200 mg nightlyHigher uterine delivery, less sedation. Used in luteal support.
Topical / transdermal20–40 mg/dayVariable absorption; not reliable for endometrial protection.
Sublingual troche50–100 mgCompounded, fast onset, shorter half-life.

Doses are illustrative β€” your clinician should individualize based on symptoms, labs, cycle status, and whether you have a uterus.

B
Play

Cycling strategy

Still cycling: luteal-phase only β€” typically cycle days 15–28 (or for 12–14 days after ovulation).

Perimenopause with irregular cycles: calendar-based, e.g. days 1–25 of the month off, last 5 days off β€” pick a pattern and keep it.

Postmenopausal on estrogen therapy: continuous daily progesterone to protect the uterus.

C
Play

Diet & estrogen clearance

  • Cruciferous vegetables daily. Broccoli sprouts, kale, cabbage β€” supply I3C/DIM for 2-hydroxylation.
  • 30–40 g fiber/day. Binds estrogen in the gut, prevents Ξ²-glucuronidase recycling.
  • Protein 1.6 g/kg. Stabilizes blood sugar; supplies amino acids for liver Phase II.
  • Minimize alcohol. Each daily drink raises estradiol ~5–10%.
  • Magnesium glycinate 200–400 mg. Cofactor for COMT methylation of catechol estrogens.
  • B-complex with active folate & B6. Supports methylation; B6 modestly raises progesterone.
  • Reduce plastic, fragrance, paraben exposure. Cuts xenoestrogen load β€” biggest gains from food storage and personal care.
D
Play

Lifestyle leverage

  • Strength train 2–4Γ—/week. Improves insulin sensitivity β†’ restores SHBG β†’ lowers free estrogen.
  • Walk after meals. Blunts glucose spikes that worsen the HOMA score.
  • Protect sleep 7–9 h. Sleep loss tanks luteal progesterone the following cycle.
  • Down-regulate stress. Cortisol pulls pregnenolone away from progesterone synthesis.
  • Sauna 2–3Γ—/week (if tolerated). Sweat is a minor but real route of estrogen excretion.
07 Β· Supplements

Targeted supplement support

These are the supplements with the strongest evidence for shifting the progesterone-to-estrogen balance. Layer them onto food, sleep, and stress work β€” not in place of it. Always loop in your clinician, especially if you're on hormones, thyroid medication, or trying to conceive.

DIM (Diindolylmethane)

100–200 mg/day with food

Shifts estrogen metabolism toward the protective 2-hydroxy pathway and away from 16-hydroxy. Best for symptomatic estrogen dominance with breast tenderness or fibrocystic changes.

Note: Can lower estrogen too far if overused β€” start low.

Calcium-D-Glucarate

500–1,500 mg/day

Inhibits Ξ²-glucuronidase in the gut, preventing conjugated estrogen from being reactivated and recycled. Pairs well with DIM.

Note: Generally well tolerated; take with meals.

Magnesium glycinate

200–400 mg at bedtime

Cofactor for COMT methylation of catechol estrogens, supports progesterone, calms the nervous system, and improves insulin sensitivity.

Note: Glycinate is best for sleep; citrate if also constipated.

Vitamin B6 (P5P)

25–50 mg/day

Modestly raises progesterone, supports luteal phase, eases PMS and hormonal headaches.

Note: Stay under 100 mg/day long term to avoid neuropathy.

Active B-complex (methylfolate + B12)

Once daily with breakfast

Fuels Phase II methylation in the liver, the main route for clearing 2-OH estrogens safely.

Note: MTHFR variants benefit most from methylated forms.

Vitex (Chaste tree berry)

400–1,000 mg morning

Acts on the pituitary to support luteal progesterone and regularize cycles in PMS and short luteal phase.

Note: Avoid with hormonal contraception or in pregnancy.

Inositol (myo + D-chiro 40:1)

2 g twice daily

Restores ovulation in PCOS, improves insulin sensitivity, and indirectly raises progesterone by re-establishing the corpus luteum.

Note: Give 3 months for full effect.

Omega-3 (EPA/DHA)

1–2 g combined EPA/DHA

Lowers inflammation, supports SHBG, and softens cyclical mood and migraine symptoms.

Note: Choose a third-party tested fish or algae oil.

Probiotic / estrobolome support

Multi-strain, 10–50 B CFU

A healthy gut microbiome keeps Ξ²-glucuronidase activity low and supports estrogen elimination through stool.

Note: Pair with 30–40 g fiber/day for real effect.

Adaptogens (Ashwagandha, Rhodiola)

300–600 mg/day

Modulate cortisol so pregnenolone isn't stolen away from progesterone production.

Note: Ashwagandha can stimulate thyroid β€” monitor if Graves' or hyperthyroid.

You don't have to figure this out alone

If your numbers look off β€” or you just feel out of whack β€” let us help.

Heavy periods, PMS, weight that won't budge, sleep that won't come, mood swings, low libido, perimenopause chaos β€” these aren't things you're supposed to "just live with." Hormone Bliss can help you get to the root.

Work with Hormone Bliss β†’
Meet Dr. Tammy
Dr. Tammy of Hormone Bliss

I've lived this β€” that's why I built it

I'm Dr. Tammy, and I know hormone imbalance from both sides: as a physician and as a woman who lived it.

I struggled with PCOS, endometriosis, dysfunctional uterine bleeding, infertility, complicated pregnancies, miscarriage, and fibroids. I did not become "pretty up on this stuff" because I wanted to. I became educated because I had to.

When symptoms are mild, they may be manageable. But when your hormones start affecting your bleeding, mood, fertility, pain, energy, weight, and quality of life β€” and no one has real answers β€” you start digging.

That is why I created this calculator. Your Pg/E2 ratio is not a diagnosis, but it can be a powerful clue. It helps show whether estrogen and progesterone are working together β€” or whether estrogen may be running the show.

This is information women deserve before they are dismissed, medicated, or told "everything looks normal" when they know something is not right.

A note from the desk. This site is for education, not medical advice. Hormone interpretation depends heavily on cycle timing, age, medications, and individual history. Use the numbers and quiz as a conversation starter with a clinician who knows you β€” especially before starting or stopping any hormone therapy.