Small Intestinal Bacterial Overgrowth (SIBO) is a common disorder resulting in common gastrointestinal symptoms but is also a major clinical factor effecting estrogen metabolism and one of the root causes behind premenstrual symptoms, states of estrogen dominance and possibly polycystic ovarian syndrome. Genetic connections between estrogen excesses, anxiety and SIBO will be discussed. This will be a clinical presentation with case studies reviewing laboratory work-ups and treatments. Attendees of this lecture will: have a better understanding of SIBO effects to the gall bladder and liver. be able to diagnosis SIBO as a cause behind estrogen excess. have a better appreciation of genetic contributions to estrogen dominance and SIBO side effects of anxiety. learn how to get more training on the topic of SIBO.