Breast cancer risk increases with hormone imbalance and estrogen dominance. However, reducing the effects of many of these factors is well within our influence: we need not age before our time, stress can be reduced, good nutrition and exercise can become habit, exposure to cancer-causing toxins can be minimized, bioidentical-friendly health providers can provide simple hormone testing and guidance on healthy hormone balance. Even laughter and creativity are now recognized as important cancer prevention strategies! These lifestyle changes give us the opportunity to enjoy a healthy life and reduce breast cancer risk. For starters we can make sure that the stress in our lives does not take center stage, taxing our adrenal glands as they attempt to produce the hormone cortisol, immunities and hormone supplies; we can ensure that estrogen does not build up in our tissues by choosing organic, hormone-free foods and supplements that reduce the estrogen burden; and we can lower our daily exposure to toxins by ridding our cupboards of xenoestrogens, in household cleaners and personal care products that contain toxic chemicals instead of herbal or plant-based preparations.
Yet our efforts must not begin and end there. If we are following a bioidentical rebalancing program, it is essential that we work with a physician to monitor our hormone levels, so that we can be sure we are getting treatment tailored to our individual needs—no more, no less than the body requires.
Action Steps for Your Natural Hormone Balance
There are a number of key lifestyle initiatives we can follow to keep our hormones balanced and estrogen dominance at bay:
- Determine your symptoms of imbalance
- Find a bioidentical-friendly provider to work with
- Test your hormones to confirm symptoms and detect existing imbalance
- If you need to supplement hormone, consider bioidentical versions identical to those made naturally in the body
- Never use estrogen by itself—even after a hysterectomy; balance it with progesterone (bioidentical) the body’s accustomed way
- Eat hormone-free organic foods to avoid intake of growth hormones used in factory meat and dairy products
- Include phytonutrients and flax seed, fiber, and cruciferous vegetables in your daily diet to assist proper hormone metabolism and help your body clear itself of xenoestrogens
- Take hi-quality multi-vitamins that include the antioxidants A, B-complex, C, D and E, and key minerals like calcium, magnesium, zinc, and selenium
- Reduce excess caffeine, alcohol, cigarettes, and other stimulants that stress the adrenals
- “Go green” and banish xenoestrogens in pesticides, nail polish, hygiene, household cleaners, etc.
- Maintain an ideal weight to reduce insulin resistance and overproduction of estrogen in fat cells
- Boost hormones naturally with strength training or weight-bearing exercise
- Minimize needless stressors and do yoga, meditation or deep breathing to de-stress
- Exercise your creative juices: sing, paint, write, bead, play
- Get enough sleep—take cat naps to catch up!
- Make time for the people you love
- Hold on to your sense of humor!
Decrease Breast Cancer Risk with the Right Hormones
A relatively large 10-year study from France (Climacteric 2002;5:332-340) provides excellent clinical evidence that the use of bioidentical progesterone does not increase breast cancer risk. In it, B. de Lignieres and colleagues compared different categories of hormone replacement therapy (HRT) and found that women who had been using HRT long-term in bioidentical preparations had no increased risk of breast cancer compared to non-users.
In 2008 a large French study of 54,548 women (Fournier, A; Int J Cancer 2005) who were on average 53 years old, looked at breast cancer risk in relation to different types of hormone replacement therapy. The results showed that women on HRT combinations containing synthetic estrogens and progestins, had increased risks for breast cancer, while those using bioidentical combinations did not have any increase in risk for breast cancer. Fournier also concluded that when combined with synthetic progestins, even short-term use of estrogens might increase breast cancer risk.
A growing body of evidence points to a protective role of testosterone in slowing the growth of breast cells and actually decreasing the incidence of breast cancer. Animal studies and experiments on breast cancer cells, as well as studies of natural androgen replacement in postmenopausal women, suggest that testosterone may serve as a natural, internal protector of the breast.
Testosterone was found to significantly inhibit breast cancer in several breast cancer cells lines, of the type most often used in experimental studies of breast cancer (Gynecol Endocrinol 2002;16(2):113-20). It was also found to reduce the cancer-promoting effects of estrogen treatment on breast tissue in Rhesus monkeys (Menopause 2003;10(4):292-8). And in postmenopausal women receiving HRT (synthetic estrogen/progestin), the addition of bioidentical testosterone (not methyltestosterone) has been found to prevent breast cell proliferation induced by the HRT treatment (Menopause 2007;14(2):183-90).
In this study, breast cells collected from the women with a needle after six months of treatment showed a 5-fold increase in proliferation since the start of treatment in the estrogen/progestin only group, while the group treated with estrogen/progestin plus the testosterone had no increase in proliferation. Another observational study of testosterone in addition to standard HRT in postmenopausal women (Menopause 2004;11(5):531-5) found a similar incidence of breast cancer to that found in women who never used HRT in the Million Women Study, and a significantly lower incidence of breast cancer than that reported in HRT users in the Women’s Health Initiative study.
So we have good data to indicate that including a physiological dose (no more or less than what the body normally needs) of bioidentical testosterone in a hormone-balancing regime not only doesn’t increase breast cancer risk, it may even have the potential to protect against breast cancer. This is especially important for women who are prescribed testosterone treatment for androgen deficiency, particularly after surgical menopause when issues such as low libido are often experienced.
Keep in mind that testosterone can convert to estrogen in the body, so it’s important to retest your hormone levels every so often while supplementing with hormones and to use hormone therapy only as directed by a qualified physician. Bioidentical or not, hormones are powerful substances and we need to make sure they are working for us, and not against us!
Phytonutrients for Hormone Balance
Normalization of estrogen in the body can be achieved by balancing hormones naturally with phytonutrients, plant hormones found in whole foods and grains such as soy and flax seed. Using supplements such as DIM, an extract of cruciferous vegetables such as broccoli, Brussels sprouts and cauliflower, can encourage proper metabolism of estrogens in the body and help to clear excesses and xenoestrogens from the system.
Phytoestrogens, a form of phytonutrients, have been used for centuries for relief of menopausal and/or hormone imbalance symptoms in women. According to the National Cancer Institute (NCI), a phytoestrogen is an estrogen-like substance found in some plants. But it is not estrogen. This is an important distinction, since many women worry that using phytoestrogens like soy or red clover for relief will raise estrogen levels and risks for breast cancer. But plant estrogens are very benign and do not act the same way, nor do they have the same negative effects as the synthetic estrogens used in hormone replacement therapy (HRT). They do however, have a strong resemblance to the structure of a human estrogen molecule, which gives them the ability to loosely attach to estrogen receptor sites. That gives phytoestrogens a built-in balancing advantage, since they can stand in for estrogen when levels are low, or block it when levels are too high, thus keeping estrogen dominance and breast cancer risks at bay.
What is important for women to understand is that the phytoestrogens used in nutritional medicines, herbal remedies, and tinctures do not increase endogenous (naturally-occurring) estrogen production in the body. And there are no studies we know of confirming that these benign estrogens increase the risk for cancer. In fact, the National Cancer Institute acknowledges that the plant-based hormones “may have anticancer effects.”
Phytoestrogen-rich foods known to support hormone balance include (in order of amount): flax seed and breads; soy beans, soy milk, soy yogurt and tofu; sesame and sunflower seeds; multigrain and flax breads; hummus; garlic; mung and alfalfa bean sprouts; dried apricots and dates; olive oil; almonds; green beans and blueberries.
Phytoestrogen-rich tinctures and extracts shown to provide relief of both physical and psychological symptoms of hormone imbalance include:
- Black cohosh (Cimicifuga racemosa) was widely used by the Indians and American colonists for relief of menstrual cramps and by generations of women cross-culturally to relieve symptoms of hormonal imbalance in menopause
- Dong quai (Angelica sinensis) can be used for relief of menopausal symptoms especially hot flashes, as well as painful menstruation, lack of menstruation and/or too frequent menstruation.
- Red clover (Trifolium pratense) can bind weakly to estrogen receptors, standing in for estrogen when levels are low and/or blocking high estrogen levels, thus rebalancing and relieving symptoms of estrogen deficiency or dominance.
- Chaste tree (Vitex agnus-castus) as its name suggests was once used to suppress libido in women of childbearing age. It has an observed effect upon pituitary gland signals sent from the brain to the ovaries to produce hormone, with beneficial effects during menopause. It is thought to mimic the calming actions of progesterone
- Licorice (Glycyrrhiza glabra) root’s use as a medicinal dates back several thousand years, known in particular for relief of PMS. It is thought to lower estrogen levels while simultaneously raising progesterone, thus helping to relieve hormone imbalance and estrogen dominance symptoms
- Ashwagandha (Withania somnifera) is an herb with mood-soothing and libido-lifting properties. Recent studies suggest that it helps increase natural production of the androgens, DHEA and testosterone.
- Fermented soy (Glycine max) has benefits to bone, nail, skin and hair health that have been extensively studied. It has been shown to decrease frequency and severity of menopausal discomforts, particularly vaginal dryness, hot flashes and night sweats.
Partner with Health Care Providers and Compounding Pharmacists for Natural Hormone Balance
Women in Balance suggests that it is advisable to partner with an experienced provider and compounding pharmacist when exploring natural approaches to hormone balance. Keep in mind that what works for one woman will not necessarily work for every woman, since we are all individuals in body chemistry, mind and spirit. And remember always to “start low and go slow” as you integrate new therapies to support hormone harmony and balance in your life.