The Girls' Best Friend

Balancing your hormones naturally addresses the root cause of monthly symptoms while significantly reducing breast-cancer risk.
By Lauri Heap, MD

It’s October and we have all been fortunate enough to know at least one amazing woman who has helped us along our life’s journey. That means it’s time to contemplate all the unique and wonderful qualities of these women we love, and who have enriched our lives.

We are grateful for their profound strength wrapped in gentleness, their warmth and untiringly generous hearts, their intuitive ability to put everyone around them at ease, their ability to multitask and make it seem effortless, and their deep spirituality. In times of adversity, these amazing women rise to the occasion and do not fold under the weight of life’s burdens. We appreciate and recognize this greatness of spirit in these wonderful women, especially those who have courageously fought the battle against breast cancer.

During breast-cancer awareness month, we honor these women by telling their stories, by increasing our understanding of the disease, and by informing women of natural ways to prevent it.

Breast cancer in the United States has increased exponentially over the past 60 years. It has gone from affecting one in 20 to one in eight women. There are many theories as to what has caused the dramatic increase in this devastating disease; an increase in the rate of detection; the rise in obesity; smoking; and an increase in exposure to synthetic hormones and estrogens from plastics, pesticides, hormone-fed meats, hormone replacement therapy, and contraceptives are just a few suspects.

Risk Factors

There are two types of known risk factors for breast cancer: non-modifiable and modifiable.

Non-modifiable risks include age, gender, ethnicity, early onset of menstruation (before age 12), late onset of menopause (after age 54), and family history of breast cancer in a close relative. Genetics are very significant and certain genes, called BRCA genes, are associated with a 60- to 80-percent lifetime chance of developing breast cancer. For women with this inherited risk, awareness and vigilance—to improve chances of early detection—and aggressive efforts to decrease modifiable risk factors are required to minimize an already heightened likelihood of developing breast cancer.

Modifiable risk factors are things we can control like smoking, alcohol consumption, diet, low physical activity, poor sleep, and environmental exposure to chemicals and synthetic hormones.

Number of children, the decision to breastfeed, age at the birth of a woman’s first child, and where a woman lives are risk factors that can be argued as modifiable or non-modifiable, depending on your point of view.

For health-conscious women, most of these risk factors are common knowledge. What is not broadly known is that when it comes to breast cancer, it is all about our hormones.

How Does Cancer Form?

In order to understand how our hormones increase our risk for breast cancer, we first need to look at how cancer develops in our bodies.

Every cell in our body has genetic material called DNA. The genetic material determines what function the cell performs. Cells grow by making an exact copy of their DNA and then dividing into two new cells. If a mistake is made in the copying process and goes undetected, a cancer cell can result. Some substances make cells grow faster than normal and, therefore, increase the probability of a “copying mistake.” Other substances actually attach themselves to the DNA and directly cause inaccuracies in the duplication process.

Estrogen, one of the two major female hormones, does both in the breast.

The Elephant In The Room

Scientists and researchers have known that estrogen is a cancer- causing substance since the early 1900s. The doctor who discovered the Pap Smear, Dr. Papinicoula, published articles in the Journal of the American Medical Association (JAMA) in the 1930s and 40s about the risk of cancer with the prescription of extra estrogen for the treatment of menopause.

Since the 1930s, we have learned a lot about the role of estrogen in cancer. There are three different forms of estrogen produced by the ovaries. These forms of estrogen, as they leave the ovaries, are completely safe. The problem arises when the estrogens enter a breast cell, are changed to a more reactive form, and bind to the breast cell’s DNA in a way that causes a copy mistake.

Estrogens are converted to these cancer-causing agents in greater amounts when free radicals are present. Free radicals are like tiny little sledgehammers in our cells and can cause a tremendous amount of damage. They are responsible for many of the problems associated with aging, like cardiovascular disease, lines and wrinkles in the skin, and cancer. When our bodies have too many free radicals, we live in a state called “oxidative stress.” Estrogens, when combined with oxidative stress, spell trouble for breast cells and indicate a high risk for cancer.

If estrogen was the only female hormone, we would all be in big trouble. But, fortunately, our bodies perform an amazing balancing act.

When it comes to overall health, women have a love-hate relationship with estrogen. Although estrogen has some negative effects in the breast, it has profoundly beneficial effects on the heart, bones, and brain. The body balances estrogen’s negative impact with progesterone.

Progesterone counteracts the negative effects of estrogen by stopping cell growth and multiplication—processes that increase the risk of cancer cells forming in the breast. It also converts a more active form of estrogen called estradiol to a less-active form of estrogen called estrone. Scientists believe—and research indicates—these actions of progesterone protect a woman from the formation of cancer.

Because progesterone opposes the detrimental effects of estrogen in breast cells, the number one risk factor (after gender and genetics) for developing breast cancer is “unopposed exposure to estrogen”—meaning estrogen that is not balanced by enough progesterone. Living in a state of natural hormonal balance is “the elephant in the room,” often overlooked when it comes to breast-cancer prevention.

Women Are Complicated—Hormonally

A woman’s menstrual cycle is divided into two parts, the follicular phase and the luteal phase. The follicular phase is the first half of a woman’s cycle. It begins on the first day of the woman’s period and ends with ovulation. The luteal phase, the second half of the the menstrual cycle, begins with ovulation and ends with the beginning of the next period. During the follicular phase, the level of estrogen is high and progesterone is low. The hormones reverse during the luteal phase, and progesterone rises dramatically shortly after ovulation and estrogen levels drop.

Women often sense these dramatic fluctuations and think, “No wonder I feel so crazy!” It is often surprising for women to learn that, in reality, these dramatic fluctuations give a woman a profound sense of well-being. It is only when estrogen and progesterone fail to radically change during our cycles that we feel “off” or “hormonal.”

Out-of-Balance Warning Signs

Women are very intuitive about their bodies. We often know when our hormones are “out of whack.” PMS, irregular cycles, cyclical depression, cyclical headaches, painful periods, and infertility are all obvious symptoms associated with hormonal imbalance. Sometimes, hormone imbalance is more subtle and manifests itself as a feeling in our gut. We mumble, “I just don’t feel like myself.” When we feel “off,” but can’t put our finger on the problem, we can look to our bodies to tell us we have a hormonal imbalance. Subtle, often-overlooked signs include:

 

Abnormal Menstruat ion Extremely light periods, three or more days of brown bleeding after menstruation, three or more days of spotting leading up to menstruation

 

Abnormal Luteal Phase The normal number of days between ovulation and the start of a woman's next cycle is very stable. If a woman has a 15-day luteal phase, then it is always very close to 15 days. Another woman may have a 9-day luteal phase and it is always close to 9 days. Both are normal. Abnormal would be for a woman to have a 9-day luteal phase one cycle and then a 15-day luteal phase the next cycle. This kind of variability is a sign of an underlying hormonal imbalance and has a high association with infertility issues. Although other symptoms of an abnormal luteal phase may be vague, women recognize this problem easily when they are in tune with their bodies and monitor for the day ovulation takes place.

Roadblocks To Balance

There are two main obstacles women encounter when trying to live in a state of natural hormonal balance. Women are offered a limited number of birth-control options that do not disrupt her natural hormonal balance, and treatment for gynecological problems is focused on masking symptoms rather than getting to the root of the underlying cause—hormonal imbalance.

Free To Be Me!

During the reproductive years, highly effective, reversible methods of birth control that do not disrupt the normal hormonal function in a woman’s body are not offered as viable options. Few women know that natural methods of birth control are available, which have a proven effectiveness similar to the pill, and do not involve drugs, synthetic hormones, or devices. Expanding women’s options to include these methods is important in preventing breast cancer, since research has linked the hormones in the pill to cancer of the breast, cervix, and liver. In 2005, a subcommittee of the World Health Organization (WHO) concluded that synthetic hormones contained in combined hormonal contraceptives are “carcinogenic to humans.” (Carcinogenic chemicals cause DNA damage in cells, leading to cancer development and accelerating growth, once it forms.) According to studies, cancer risk is proportional to the length of use and is greater in women who take hormonal contraceptives before their first pregnancy.

Natural forms of birth control have been studied all over the world. Studies have been done in Africa, the US, Europe, China, and Australia. Research has shown these methods are anywhere from 95 percent to 99.4 percent effective at avoiding pregnancy. Natural methods are easy to learn and empower women to maintain control of their fertility without disrupting the normal function of their bodies. The goal is to cooperate with the woman’s body and not work against it to avoid pregnancy.

Natural methods of birth control have been developed and researched at Marquette, Georgetown, and Creighton Universities, as well as by the WHO and several institutes in Europe. These methods require women to identify days that pregnancy is possible by observing for the presence of a fluid produced by the cervix around ovulation. These days, during which pregnancy is possible, are called the “fertile window.”

Cervical fluid makes a woman’s cervix act as a biological valve and, if present, the valve is open for pregnancy to occur. If the fluid is absent, pregnancy is impossible. Scientists have shown that observing for the cervical fluid is enough for a woman to avoid pregnancy, but methods have been developed to include a fertility monitor or basal body temperature. Both adjuncts help confirm for women that ovulation has taken place and the fertile window is over.

Although these methods take around 30 days to learn, women gain confidence quickly and discover how beneficial these methods are to use. Most women feel much more in tune with their bodies, and it is simple to monitor for the more subtle, physical signs of hormone imbalance.

"I Just Don’t Feel Like Myself!"

The standard approach to women’s health problems like PMS, cyclical depression, and irregular cycles is to mask the symptoms with medications. The root of women’s health problems is typically a hormonal imbalance. Correcting the underlying problem, by restoring the natural rise, fall, and interaction between estrogen and progesterone is good for health (including breasts) and is more effective at treating the problem. Evaluation and treatment is called cooperative hormonal evaluation and cooperative hormonal supplementation with bioidentical hormones. Cooperative hormone evaluation involves timing blood work with ovulation. Progesterone and estrogen are highest seven days after ovulation and this is an ideal day for an initial test. If the hormone levels are low, then a woman can supplement after ovulation with bioidentical hormones to restore natural hormonal balance.

Too many women go to their doctor for hormonally related issues and end up finding themselves on three, four, or even five chronic medications. Treating symptoms causes tail-chasing because women need medication to treat the side effects of medications. Getting to the root of the underlying hormonal defect is the only way to avoid this vicious cycle and restore our sense of well-being.

With conventional medicine’s approach to women’s health, it’s not surprising that so many of us frequently say, “I just don’t feel like myself!” Natural hormonal balance, timed cooperatively with the cycle, restores us to ourselves and protects us from breast cancer. Treatment options, along these lines, are worth looking into and women deserve to know they exist.

Breast-Friendly Treatment

Despite PMS, irregular cycles, and menopause, every woman can live a breast-friendly lifestyle using bioidentical hormones and supplements. The following are some simple natural preventative measures to implement.

Cancer Risk A study published in 2010 showed that blueberries have a significant effect in decreasing cancer formation in the breasts. The antioxidants in blueberries decrease the number of free radicals, which enhance estrogen’s harmful effects on the DNA of breast cells, and, therefore, decrease the conversion of normal cells to cancer cells. Other foods rich in flavonoids include black raspberries, strawberries, apples, apricots, pears, black beans, cabbage, onions, parsley, pinto beans, and tomatoes. When preparing these foods, it is better to eat them raw or be careful not to overcook them. Overcooking can deactivate the antioxidants. In recent research, vitamin C has shown a positive effect on preventing cancer formation in the breast. This is consistent with older studies. The Nurse’s Health study showed that consuming 205 mg/day of vitamin C from food sources decreases women’s risk of developing breast cancer by 63 percent.

Treat ment of PMS Close to 80 percent of women report struggling with mood swings, irritability, headaches, bloating, and other PMS symptoms in the days leading up to their period. Ten percent of these women report symptoms severe enough to interfere with daily life. The most common treatment for PMS is antidepressants and some form of hormonal contraceptive. Neither treatment corrects the root of the problem: a hormone imbalance.

PMS is associated with abnormally low progesterone in the second half (luteal phase) of a woman’s cycle. Research has shown, if progesterone supplementation is timed cooperatively after ovulation, the symptoms diminish or disappear in 85 to 95 percent of women.

Treatment involves identifying the day of ovulation by learning a natural method of birth control or investing in a fertility monitor. Once the day of ovulation has been identified, begin 20 to 40 mg bioidentical progesterone cream three days after ovulation and continue this amount for 12 days. Other supplements that are helpful include 200 mg of sustained-release vitamin B6 and 1000 mg of calcium in the luteal phase. Identifying the day of ovulation is key to treatment because progesterone supplementation started too early in the cycle can make PMS symptoms worse.

Long and Iregular Cycles Long and irregular cycles are often a sign of estrogen dominance and may be associated with an underlying disease called polycystic ovarian syndrome (PCOS). PCOS is a well-known cause of infertility, but is also associated with an increased risk of breast cancer. Some reproductive experts believe that correcting the underlying problem of estrogen dominance by progesterone supplementation will lower this risk in women with PCOS. Treatment for long and irregular cycles includes the following:

>> Start bioidentical supplementation three days after ovulation or, if the day of ovulation cannot be identified, begin supplementation on day 23 of the cycle and continue for 12 days.

>> Start a low-glycemic-index diet: Women with PCOS often have problems with control of their blood sugar and require more insulin than normal—this is called insulin resistance. A low-glycemic-index diet is helpful in maintaining a more normal level of insulin in the body. Some women begin cycling more regularly if the problem with insulin resistance is addressed. Medication or a combination of lifestyle and dietary changes can be effective in achieving this.

>> Women with a cycle longer than 38 days and who struggle with excess hair growth on the face, upper chest, upper arms, and back usually have elevated levels of testosterone circulating in their bodies. Nutritional supplements to lower testosterone in women include:

Diindolymethane (DIM) 120 mg, daily

Calcium-D-Glucarate 200 mg, twice daily

Dietary and herbal solutions to high testosterone include:

Spearmint tea 2 cups per day

Black cohosh 20 to 40 mg per day

Saw palmeto 160 mg, twice daily

Chaste tree 20 to 40 mg per day

Treatment of Menopause Since the Nurse’s Health Study in 2001 concluded that the risks of hormone replacement therapy outweighed the benefits, partially because of an increased risk of breast cancer, menopausal women faced a dilemma: How do we safely ease menopausal symptoms? More and more women are turning to natural solutions, but navigating through the vast amount of information and ideas can be overwhelming and frustrating—especially while experiencing a hot flash.

Although synthetic hormones have been proven to be detrimental, research shows that bioidentical progesterone and plant-based sources of estrogen are safe.

Menopausal symptoms can start as early as five years before the ending of a woman’s periods. This is called the perimenopausal era. For perimenopausal women, natural progesterone supplementation is the same as for women with long and irregular cycles.

For women who have ceased having periods, the following hormone regimen is helpful:

>> Day 1–5: No hormones

>> Day 6–20: Phytoestrogen cream, 1/8 teaspoon two times a day, and natural progesterone cream, 20 mg at bedtime

>> Day 21–28: Estrogen cream, 1/8 teaspoon three times a day, and natural progesterone cream, 40 mg at bedtime

Herbal and dietary supplements for the treatment of menopausal symptoms include:

>>Foods containing phyoestrogens Fennel, celery, parsley, nuts, whole grains, apples, alfalfa, soy, and flax seeds (25 g/day).

>>Vitamin E at 800 IU per day.

>>Sweet oranges and tangelos Eaten as rich sources of hesperidin. Hesperidin taken with 1000 mg of vitamin C has been shown to reduce menopausal symptoms.

>>Thyroid support ca ps As women go through menopause, the thryoid declines along with estrogen and progesterone levels. Thyroid support in the form of iodine and a combination of vitamins can be helpful.

The following remedies are commonly found to be beneficial, but have limited evidence on the effectiveness of treatment:

>> Evening primrose oil 2 grams twice a day for mood swings, irritability, and breast tenderness.

>> Kava kava, St. John's Wart, & Sage for mood symptoms.

>> Black cohosh 40 mg one to two times per day is commonly taken for hot flashes, but women with breast cancer have been advised not to use this plant extract because of a question with regards to safety. It is believed that black cohosh acts like estrogen in the body and may feed the cancer.

>> Dong quai 1.5 grams three times a day for mood and hot flashes.

Unless a woman has undergone a hysterectomy, the body naturally produces small amounts of estrogen and progesterone after menopause, and it is good to only take supplemental hormones for a limited amount of time. Gradually decreasing the amount of supplementation is usually possible with minimal discomfort.

Natural Balance: Worth The Effort

When it comes to breast cancer and prevention, the bottom line is that we cannot improve upon nature. Taking the time to learn about and care for our hormones is worth the effort.

Caring for our hormones involves minimizing our exposure to synthetic hormones, which disrupt our body’s natural hormonal balance.

Given the development of natural methods of birth control, this does not mean relinquishing our reproductive freedom. These methods can also be the basis of natural treatments aimed at getting to the root of and correcting the underlying hormonal problem. Making minor changes like getting plenty of sleep, minimizing stress, and being wise about alcohol and caffeine use can affect the hormonal milieu and are all part of a holistic approach to breast cancer prevention.

Living in a state of natural hormonal balance is the foundation of a “breast-friendly" lifestyle. So, ladies, just remember: If you take care of your hormones, your hormones will take care of you and become “The Girls’” best friend.