Estrogen – The Double-Edged Sword

Estrogen is one of the most important hormones for women as it regulates our menstrual cycle and reproductive system. But it can also become the enemy in hormone receptive breast cancer. What you need to know about estrogen and its role during your life.

The Primary Female Sex Hormone

As we hit puberty, women’s bodies begin producing estrogen. It’s what makes us grow breasts, begin menstruating/ovulating, and regulates our reproductive system and menstrual cycle. Estrogen also helps with mood, building and maintaining bone strength, cholesterol levels, hair growth, lubricating the vaginal lining, and thickening the vaginal walls.

Estrogen is produced in the ovaries, a female’s primary sex organ. However, estrogen is also produced in fat cells and the adrenal glands in both men and women. Maintaining a healthy weight is crucial for keeping hormones like estrogen in balance.

How Much is Too Much?

Our bodies are meant to regulate estrogen and other hormones, but there are factors that can affect the amount of estrogen we produce.

• Age – As we age and progress through menopause, our ovaries produce less estrogen. This lower level of estrogen can cause a variety of annoying symptoms like night sweats and hot flashes. But it can also affect mood, bone loss, and a thinning vaginal wall. It can also cause headaches, urinary tract infections, breast tenderness, painful sex, and even depression.
• Ovulation – Estrogen gets us through our reproductive years and prepares our bodies for reproduction. Estrogen levels are highest just before menstruation and during ovulation. The levels drop dramatically after ovulation. This is why some women are affected more than others by symptoms of PMS as they are more sensitive to the fluctuation of estrogen levels. Sometimes estrogen-containing birth control pills are prescribed to women with severe PMS to stabilize their estrogen levels.
• Lifestyle – We mentioned above that maintaining a healthy weight is important in estrogen production. Eating a diet high in sugar will affect not only insulin, but also increase estrogen that is produced from fat cells.

Eating disorders, extreme dieting, and excessive exercise can all contribute to low estrogen which can disrupt your menstrual cycle. Low estrogen caused by low nutrition (including not getting enough sugar from fruits and whole grains), can mimic menopausal symptoms including trouble concentrating, headaches, and depression.

Hormone replacement therapy (HRT) has historically been a common treatment method for symptoms of menopause, and other causes of low estrogen, as you are replacing the estrogen and progesterone you lose during perimenopause. However, HRT should not be taken lightly or without precautions.

When Estrogen Works Against Us

Women need estrogen. It’s one of the hormones that makes us female. But like most things, too much is not a good thing.

Estrogen dominance occurs when we produce too much estrogen in contrast to progesterone, the other female sex hormone. Progesterone is the hormone that prepares the body for pregnancy after ovulation, but its levels drop if pregnancy doesn’t happen, causing menstruation.

When levels of estrogen become too high, estrogen dominance can cause many undesirable symptoms such as worsened PMS, low sex drive, weight gain, irregular menstrual cycle, and insomnia.

Chronically high levels of estrogen can cause thyroid problems, heart disease and stroke, and breast cancer.

The majority of breast cancers are estrogen (er) receptive, meaning that they feed off the hormone estrogen. So, when our estrogen levels are elevated due to hormone replacement therapy, or poor diet, we are at risk for developing hormone receptive breast cancer. About 65% of er positive cancers are also pr receptive, which means it feeds off the hormone progesterone.

Although chronically low estrogen levels are not healthy, limiting the amount of time that you have high levels of estrogen can be beneficial.  Women who have their first full-term pregnancy before the age of 30, or breast feed for 6 months or longer lower their risk of developing hormone receptive breast cancers for those with a higher risk of hormone receptive cancers.

Women who begin menstruating later than age 12, or complete menopause before the age of 55 also have a lower risk of developing breast cancer.

Is Hormone Replacement Therapy Bad?

Not necessarily. If you have menopause symptoms that are bothersome, talk to your physician about whether HRT would be beneficial, and what your risks may be, including your risk of developing hormone receptive breast cancer.

HRT use should be monitored as some risks like heart disease may increase after 10 years of use. Other benefits to HRT may stop once you stop taking the treatment.

Keeping it in Check

Balancing your hormones is the most important thing you can do to stay healthy and decrease your risk of breast cancer. Menopause can throw off that balance, but many women are opting against hormone replacement therapy because of the risks.

Estrogen doesn’t have to be the enemy, but you do need to keep it in check, especially for those in the higher risk category of hormone receptive.