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Female sex hormone balance: key to breast cancer prevention.

As October approaches, another "breast cancer awareness" month will come and go. We have to ask ourselves, "Are we really raising awareness in our clients/ patients?" A leading national women's magazine revealed last October that Americans have collectively raised $6 billion for breast cancer awareness. Yet the average woman is "not aware" that an imbalance in sex hormones is key for the most common type of estrogen-sensitive breast cancer. 1 tell women daily in my health center that balancing sex hormones will not only prevent this deadly disease but it is also key to weight management, sleep, mood, and prevention of virtually all PMS and menopausal symptoms while also keeping other female health issues (ovarian fibroids/cysts, endometriosis, heavy periods) at bay. Let's face it; a woman doesn't just wake up one day with breast cancer. This deadly disease is a culmination of physiological and psychological stressors that is now being understood as having a foundation in adrenal fatigue/exhaustion and a female sex hormone imbalance. Genetics, toxicity levels, and immune system capacity all come into play but the fact remains that no doctor can show you a woman with breast cancer who has balanced sex hormones. It is also an obvious fact that women who are genetically predisposed to breast cancer do not always get the disease and women who have no genetic predisposition often do get the disease. So, we must look beyond genetics and also look at a woman's lifestyle and her total stress load factors that result in adrenal fatigue/exhaustion and an imbalance between estrogen and progesterone.

I had the experience of working with hormone specialist, Mr. Joeseph Beldonza C.C.N, ND, who had done over 20,000 saliva hormone tests while starting a hormone testing lab years ago. He used this experience to educate doctors in interpreting saliva hormone profiles. With all this lab experience, Mr. Beldonza saw obvious trends in saliva profiles of women with female-related cancers. I knew this information would be more credible if a small pilot study was done to validate it. I facilitated the study at my health center, The Rejuvenation Center, in Lancaster, Pa. Bio Health Lab from California evaluated the saliva test and Dr. Lorraine Bernotsky, research director, West Chester University, (West Chester, Pa.) tabulated the study results.


A small sample of 25 local women, who had breast cancer in the last 5 years, was compared to 20 women who never had breast cancer. The parameters of the study required that the breast cancer survivors were not currently on chemotherapy, radiation or any type of medication such as the commonly used estrogen blocker, Tamoxifen.

The goal of the study was to show trends in saliva hormonal profiles of women who have had breast cancer. These trends could then serve to aid women who want to prevent breast cancer by allowing them to compare their saliva test results to these in an effort to detect at the earliest time the possible manifestation of the disease.

The growing national trend is to remove the breast even before the woman is diagnosed with breast cancer as a way of prevention of the disease if breast cancer runs in her family. This is obviously extremely invasive and does not change the underlying hormonal imbalance that contributed to her cancer. We decided to do this pilot study in hopes that our research will someday allow women to test their hormones with a simple saliva test as an early detection tool in order to avoid this type of surgery. Looking ahead at the hormonal trend towards breast cancer is true early detection as opposed to a mammogram that is considered early detection of an already existing tumor in the beginning stages of development!

The main findings of the study:

* Low levels of progesterone are linked to breast cancer

* High levels of estrogen (specifically estrodiol) in relation to progesterone (an imbalance), is linked to breast cancer as shown in specific estrogen to progesterone ratios.

* All women with breast cancer have a sex hormonal imbalance

* More research is warranted to see specific ratios of the three main estrogens and breast cancer occurrences

These are interesting findings not often brought to women's attention via their doctor, the media or even more holistic health practitioners because these facts are not commonly known.

This is mainly due to the fact that although some biomedical literature recognizes the importance of the relationship between progesterone levels and the incidence of breast cancer, mainstream medical practice does not. However, some medical professionals have investigated and tracked this relationship in their own patients (see for example, Dr. John R. Lee's work) and have suggested that the use of estrogen therapy to address symptoms of menopause puts patients at risk for female-related cancers with respect to decreased levels of progesterone. In fact, the American Cancer Society's webpage does not differentiate between estrogen and progesterone when citing hormones that could be related to the incidence of breast cancer. In this manner, it would seem that traditional medical opinions do not recognize or emphasize the potentially important role of progesterone in women's health, including breast cancer among various other health concerns.

Details of the Study Results:

There appears to be a relationship between the incidence of breast cancer and low progesterone levels when comparing the 25 women who had breast cancer to 20 similar aged women who never had breast cancer. All of the women with breast cancer had low progesterone levels based on "normal/healthy" levels as well as poor estrogen to progesterone ratios needed for health. When comparing the cross-sample of 45 women, over 69% of women with extremely low levels of progesterone (under 100 pg/ml) had breast cancer, while only 42.9% of those with slightly higher levels of progesterone (over 100 pg/ml) had breast cancer. It is important to note that those with levels over 100 pg/ml still were low overall as far as healthy levels; however, the lower the progesterone levels were, the risk of breast cancer was increased.

This is compounded by the relationship between the incidence of breast cancer and the ratio of progesterone to estrodiol (an estrogen) when comparing women with ratios under 50 to those with ratios over 50. The study showed that 73.1% of women with progesterone to estrodiol ratios lower than 50 had breast cancer, while only 31.3% of those with ratios over 50 had breast cancer.

More interesting, were the trends that require further research in the specific levels and ratios of the three estrogens tested. It was found that 64% of these women had an estrodiol level lower than their estrone level. Almost all of the women (96%) had an estriol level that was lower than their estrodiol level, while 76% had an estrodiol level that was different by less than 1 point from their estriol level. "While not being statistically significant at this point, this finding is worth further research" reports Dr. Bernotsky as she tabulated the results.

More research is obviously needed into the exact estrogen profiles but a strong link exists between progesterone levels and breast cancer as well as the ratios of high estrodiol to progesterone levels as an indicator of breast cancer.

Conclusion and Education on Hormones:

Naturally balancing estrogen to progesterone levels before breast cancer can develop would be the most preventative advice at this point for women who fear developing the disease. Please note that estrodiol is 12 times more potent than estrone, and in the presence of adequate progesterone, estrodiol will often be converted to estrone sulfate, an essentially inactive form that is stored mainly in the fat cells for later use as needed. Progesterone also induces the production of an enzyme used to convert estrodiol to estrone. This seems to be a natural checks-and-balances system to ensure natural estrogen does not get too high, which could eventually cause diseases like breast cancer. A study in the American Journal of Epidemiology found that women with a progesterone deficiency had 5.4 times the risk of premenopausal breast cancer; while a Mayo Clinic study showed that women with a history of progesterone deficiency had 3.6 times the risk of post-menopausal cancer. This further establishes that there are trends to be observed with women who get breast cancer. Dr. Reiss, Natural Hormone Balance for Women, agrees with this same concept of the "progesterone protection factor" by showing the conversion of estrodiol into estrone can only take place in the presence of progesterone, coupled with a specific enzyme. This shows that progesterone is involved in converting excess estrogen (estrodiol) into a safer, weaker form (estrone).

It is important for women to raise their progesterone levels to balance out estrogen and relieve a condition dubbed by Dr. Lee, (foremost researcher on progesterone therapy) as "estrogen dominance". Some symptoms of "estrogen dominance" are PMS, depression, anxiety, irritability, insomnia, headaches, hot flashes, night sweats, mood swings, food cravings, fluid retention, heavy periods, fibroids, endometriosis, etc. Now we can add increased incidence of breast cancer to this 1ist.

The main reason for depleting progesterone levels in American women is the conversion of progesterone to cortisol when women are under chronic psychological or physiological stress. What Mr. Beldonza has seen as a trend in his analysis of over 20,000 hormone saliva tests and what I have seen in the thousands of women I have worked with over the years, is that initial adrenal fatigue due to chronic stress, demanding high cortisol output (shown by elevated cortisol on saliva tests), will be associated with lower progesterone levels and hence "estrogen dominance". Therefore, it is ineffective to try to build a woman's progesterone levels without addressing the main factor of adrenal fatigue/exhaustion. I find that pure-sourced adrenal glandulars are essential to repair and rebuild the adrenal glands to allow for full endocrine balance. The only caution here is to be sure that the animal source from where the glandular is derived has not been tainted with hormones, steroids, and antibiotics. I have found the purest sources come from New Zealand. This supplementation combined with the fast acting affects of a trans-dermal* adrenal support cream, that goes directly into the bloodstream (bypassing the digestive system), will provide fast relief of almost all PMS and menopausal symptoms as well as long-term healing benefits. Proper ingredients in a trans-dermal adrenal support cream will give the body the "building blocks" to make the cortisol it needs while under chronic stress. This prevents the body horn converting progesterone to make more cortisol when the demand for it is so high. Over time, progesterone levels can be raised, allowing the given supplemental progesterone to reach adequate "normal" levels to balance out "estrogen dominance". It is this foundation that is needed for a trans-dermal progesterone cream to be effective in quickly relieving symptoms of PMS and menopause while providing the underlying hormone profile that is healthy and balanced to prevent female related cancers.

It is important to note that even after ovarian production of estrodiol has stopped (around menopause), keeping cortisol levels stable and progesterone levels adequate provides the basis for the body to produce estrone as the primary postmenopausal estrogen which will keep postmenopausal symptoms (bone thinning, thinning vaginal walls, low libido, etc.) at bay.

Standard progesterone hormone creams that have an alcohol delivery system and that recommend rotating points of application can have the tendency of building up in the fatty tissue and reaching saturation points, allowing excess progesterone to build up in the body. I have seen this happen with health food store brands as well as doctor compounded bio-identical mixtures. Excess progesterone will give the same returning symptoms as the original condition of "estrogen dominance".

It is vital that if you choose to use progesterone in a cream form that it is a true trans-dermal delivery system. Oral forms of progesterone tend to need higher dosages due to some of their potency being lost through the digestive system.

* Microscopic membrane-formed sacs, often from naturally derived phospholipids; used to allow special molecular ingredients to be able to bypass the barrier of the skin and get into the bloodstream.

Other areas to advise clients/patients in are to avoid excess processed foods, sugars (to stabilize foods they are sensitive to (mainly wheat, dairy and peanuts), caffeine and alcohol. Increased consumption of cruciferous vegetables is advised as they are JO of nutrients and have been proven to convert the more potent estrogen (estrodiol) into the weaker less active form of estrogen (estrone).

Less intense exercise such as yoga, walking, and light resistance training is preferred over more intense cardiovascular exercise such as running, which will elevate cortisol levels and exacerbate the existing hormonal imbalance. A final word of advice for cell women is to take time daily to break the sympathetic 'fight or flight" stress cycle. Dr. Herbert Benson, The Relaxation Response, advocates taking 20 minutes per day to do this. I have 'blind amongst my clients that a simple relaxation CD that uses "sound wave therapy" can relax brain wave patterns from the highly active beta waves down through the slower alpha wave and theta wave patterns to reach even the slowest Delta wave patterns, where healing and regeneration begin. This relieves mental and emotional stress in a short time with cell the physiological and psychological benefits connected to it, including lowering the demand for cortisol (aiding female sex hormone balance).

As holistic healthcare practitioners, we can provide testing and supplementation for subclinical issues which provides a true foundation for the prevention of even deadly diseases like breast cancer. This, coupled with basic hormone education for the client/patient, can inspire lifestyle changes that will synergistically support the body in the prevention of diseases--even through the aging process. We must strive to educate our female clients/patients in the simple fact that chronic stress (and the adrenal fatigue/exhaustion effect) once again seems to be a key factor in a deadly disease that affects so many American women.


Benson, Herbert et al. (1975). Relaxation Response. New York: Avon (reissue 1990).

Cowan, L.D. et al. (1981, August). Breast Cancer Incidence in Women with a History of Progesterone Deficiency. American Journal of Epidemiology, 114 (2), 209-217.

Maxson, W.S. (1987). The Use of Progesterone in the Treatment of PMS. Clinical Obstetrics and Gynecology, 30, 465-77.

Reiss, Uzzi. (2001). Natural Hormone Balance for Women. New York: Pocket Books.

Schwartz, Erika, M.D. (2002). The Hormone Solution: Naturally Alleviate Symptoms of Hormone Imbalance from Adolescence through Menopause. New York, NY: Warner Books.

Lee, John R. and Virginia Hopkins. (2004). What Your Doctor May Not Tell You about Menopause. New York: Wellness Central.

Lee, John R. and Virginia Hopkins. (2006). Hormone Balance Made Simple. New York: Grand Central Life & Style.

by: Dawn Cutillo Hiestand, B.S. Health & Nutrition; Author, The Hormone "Shift"

About the Author:

Dawn Cutillo Hiestand has been in the health field for 23 years and has her B.S. in Health, Nutrition & P.E. and took course work in Advanced Nutrition. from Clayton School of Natural Healing. Her start was in corporate fitness as a CSCS (Certified Strength and Conditioning Specialist) then she progressed to managing a franchised women's weight loss center. She currently owns and operates The Rejuvenation Center located in Lancaster, Pennsylvania where she focuses on hormone health, detoxification, weight loss and cellular nutrition with clients. She owns Infinity Health LLC, a national consulting company that provides weight loss franchises and doctors with education and supplements to aid their clients/patients in balancing hormones.

Her main area of interest is the connection between stress and weight gain, allowed her to be the "Stress and Weight Gain" expert for Ediets. She was published internationally in Aromatherapy and Wellbeing magazine for her original work in developing the "Conditioned Response " program which utilizes meditative visualization, aromatherapy and sound-wave therapy to aid in stress hormone balance and behavior modification for weight management. Her interest and years of work with hormones has culminated in her new book, The Hormone "Shift' (Balboa Press).
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Author:Hiestand, Dawn Cutillo
Publication:Original Internist
Date:Sep 1, 2012
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