The National Institutes of Health has stopped a major clinical trial of the risks and benefits of combined estrogen and progestin in healthy menopausal women 3 years early due to a 26% increased risk of invasive breast cancer over placebo.

This recent news (1) has shined new light on the question of what options are available to perimenopausal and menopausal women. The study of 16, 608 women also found a 29% increase in heart attacks and a 41 % increase in stroke, making the traditional medical protocol much less than a desirable course of action. In fact, the link between excessive estrogens and increased breast and other hormone-related cancers has been known for some time. (2, 3, 4)

This is why it is so important to understand how excess estrogens accumulate in the body and what you can do to maintain a health hormone balance.

First, men and women alike are exposed to exogenous or external-to-the-body sources of estrogens routinely in this country. Consuming the standard American diet high in non-organic meat, eggs and dairy products that are produced from animals that have been fed estrogens is one source. Environmental toxins such as pesticides, herbicides, plastics, refrigerants are another potential source.  And of course, prescription hormones such as the ones used in the study mentioned above or from birth control pills are another source.

Women, of course, also have their own endogenous or internally-produced hormones. These hormones are produced in the ovaries, the adrenal glands, and in the adipose (fat) cells of the body. The liver has the job of metabolizing these estrogens (as well as other hormones in the body). It removes active estrogens from circulation, conjugating them and passing them to the gastrointestinal tract for elimination. When the liver is overloaded with jobs such as processing many hormones, emulsifying fats and cholesterol, removing toxins, drugs, alcohol, etc, it may be unable to completely handle the full job of metabolizing estrogens. And if the bowels are constipated or under-eliminating, estrogens that have been conjugated for eliminating are unconjugated in the intestine and reabsorbed, returning to the liver for a second or even third time, adding further to the liver’s work load.

But there are many holistic solutions to the problems and risks of excess estrogens that can help you keep healthy breast tissue.

1. Reducing or eliminating exposure to estrogens in foods and pharmaceuticals

2. Improving liver function

3. Improving bowel function

4. Improving lymphatic function

5. Breast self massage

6. Increasing foods high in factors that have the ability to influence estrogens

You can work on numbers 1-4 above very simply yourself or in a more focused manner with a nutritionist or other holistic health practitioner. I will give you the overview of breast self massage here and you can consider reading further on the subject of holistic breath health at your leisure. (5)

Breast tissue is largely lymphatic tissue. The lymph system, which functions primarily as your body-wide “septic system,” does not have its own pump. It relies on the movement of your muscles as its “pump.” For this reason, to help eliminate toxin from the body, everyone needs to exercise daily.

Breast tissues, however, are essentially the last on the list to benefit from this exercise pumping because they are somewhat isolated from the muscles used in common exercise (rebounding or jumping on a trampoline are the best exercise to help pump the lymphatic tissue of the breasts).

Breast tissue also suffers from the stagnation of blood and lymphatic flow caused by tight, binding bras. Bras with wires in them not only increase breast congestion but also act as an antenna to attract extra low electromagnetic frequencies, which in their own right can have adverse health effects. Look for all-fabric bras that support but do not bind the breasts. And wear your bras as seldom as possible.

For these reasons, self breast massage is a wonderful tool for helping the breast tissue remain healthy and uncongested from toxins. It will also keep you very familiar with the status of your breast tissue and essentia lly functions as an optimal form of self breast examination. The technique is very simple and can be done standing up or lying down, in the shower, or fully clothed.

· Begin with index and middle fingers at the nipple area. Press down toward the ribs and work in a circular fashion. Continue expanding the circles until you have covered the entire breast area, including the underarm area. Repeat the massage several times.

· Never massage to the point of pain. But know that soreness and tenderness are not unusual with breast congestion and will subside with consistent massage over time.

Nutritional options for the healthy breast are very powerful and effective. And better yet, they have no negative side effects. Consider evaluating your own diet regarding these components.

· Dietary Fiber: Increasing fiber in the diet to 35-50 gms/day is crucial to preventing the re-circulation of estrogens. Emphasize flaxseeds, whole grains, beans such as pintos, lentils, garbanzos, black, etc., and seeds)

· Complex Carbohydrates: The main point here is to limit simple carbohydrates such as those found in white flour products (cereal, bread, crackers, bagels, pasta, etc.) and sweet things (candy, cookies, cakes, soda, etc.). These foods raise blood sugar levels, which in turn stimulates insulin release, which in turn has an adverse effect of estrogen balance.

· Fats: Ensure adequate beneficial fats in the diet. These would include those from fish and fish oil supplements as well as from flax seed oil. These omega-3 essential fatty acids promote the healthy metabolism of estrogens.

· Protein: Inadequate protein may inhibit full liver function. Focus on the beans mentioned above, nuts and seeds, eggs, fish, and organic chicken and turkey.

· Phytoestrogens: These are plants compounds that have the capacity to bind to estrogen receptor sites and have both estrogenic and anti-estrogenic effects depending on the body’s needs. In this way, they can be very helpful in balancing estrogen levels. The two main classes of phytoestrogens are isoflavones and lignans. Isoflavones are found in soy, legumes, alfalfa, clover, licorice root, and kudzu root. Lignans are found in high fiber foods such as flaxseeds and other seeds, whole grains, legumes, and vegetables.

· Vitamin E: Low vitamin E levels are associated with elevated estrogen levels and may further impair liver function. D-alpha tocopherol and mixed tocopherols are a natural form of vitamin E. Dl-alpha tocopherol is a synthetic form of vitamin E and has been associated with increased health risks. Read labels carefully.

· Magnesium: Magnesium improves the excretion of toxic estrogens. Sources of magnesium include dark green vegetables, nuts, seeds, legumes, soy products such as tofu and soy flour, and whole grains such as millet, wheat, and brown rice.

· Indole-3-Carbinol (I3C): I3C occurs naturally in cruciferous vegetables such as broccoli, Brussels sprouts, and cabbage, and is protective of estrogen-sensitive tissues. It is difficult to eat enough of these foods to get the protective levels necessary for improving estrogen metabolism, so you may want to consider a supplement.

· B Vitamins: The B vitamins are important in health estrogen detoxification. B vitamins are water soluble and completely non-toxic to the human body. Consider supplementing with a high potency B vitamin.

· Calcium D-Glucarate: This form of calcium has been found in animal research to lower toxic estrogen levels and inhibit cancer growth. This is available in supplement form.

Recently (6) researchers working in Sweden reported that genetic factors make a minor contribution to an individual’s susceptibility to cancer. They found the environment plays the principal role in causing cancer. In this case, the environment they are referring to includes the air you breathe, the water you drink, and the food you eat, the exercise you give your body; the way you manage stress, the amount of joy you feel each day, and more. All of these things are choices we each make every day. Feel powerful knowing you have such a big role to play in your health outcomes.

1 The National Heart, Lung, and Blood Institute and the National Institutes of Health stopped this study on July 9, 2002.  You can read a complete description of the study and its conclusions in the July 17, 2002 issue of the Journal of the American Medical Association.

2 Yaeger JD, Liehr JG. Molecular mechanisms of estrogen carcinogensis. Annu Rev Pharmacol Toxicol, 1996; 36: 203- 32.

3 Colditz, GA. Relationship between estrogen levels, use of hormone replacement therapy, and breast cancer. J Natl Cancer Inst, 1998; 90(11): 814-23.

4 Hankinson SE, Willett WC, Manson JE, et al. Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women. J Natl Cancer Inst,1998;90 (17):1292-99.

5 Health Breasts: Every Woman’s Birthright, by Iris Ann Michael and Breast Cancer? Breast Health!, by Susan S. Weed

6 Lichetenstein P, Holm NV, Verkasalo PK, et al. Environmental and heritable factors in the causation of cancer. N Engl J Med, 2000; 343:78-85.