OUCH – My Breasts Hurt! The Role of Hormone Balance in Fibrocystic Breasts Do you suffer regularly with painful or sore, full, tender-to-the touch breasts? Does the soreness or swelling get worse before your period comes and better once it has arrived? Do you notice that sometimes your breast tissue feels lumpy or bumpy, then “magically” smooths out at different times of the month? If you answered yes to some or all of these questions, you may be dealing with a common condition known as fibrocystic breasts. In the past, this has been referred to as Fibrocystic Breast Disease. Acknowledged now that it’s not an actual disease, the newer terminology you might hear is “Fibrocystic Breast Change.” While fibrocystic breasts may not indicate an actual disease state, they are still a signal from your body of an underlying imbalance that must be addressed. Your breasts are asking you to pay attention! Approximately half of all women between the ages of 20-50 will at some point experience fibrocystic changes in the breasts. That’s a lot of women. But again, common as it may be, fibrocystic breasts are still not normal and do not represent an optimal state of health. The Influence of Estrogen and Progesterone Normal cyclical changes occurring in the breast tissue during a woman’s reproductive years are due to the effects of fluctuating estrogen and progesterone levels. These hormones work together as a team to prepare the body for pregnancy (and breastfeeding) should the opportunity arise. Estrogen is responsible for stimulating the growth of milk ducts in the breasts during the first half of the menstrual cycle. It is a hormone that promotes cellular growth and proliferation. If ovulation occurs during the cycle as it should, progesterone will take over as the predominant hormone for the remainder of that cycle. Progesterone stimulates maturation and development of cells and the formation of the milk glands in the breast tissue. It also serves the essential function of opposing the excess growth and proliferative effects of estrogen on cells and tissues. Excess estrogen levels that are unopposed by the protective effects of progesterone may not only contribute to fibrocystic changes in the breasts, but also promote carcinogenesis and the eventual growth of cancer. There’s More to the Story Now it may be easy to get the impression that estrogen is bad and progesterone is good, but as with most things in life, it’s not quite that simple. Both are necessary for the proper functioning of the body. It all comes down to balance, and having the optimal proportions of each. Without this balance, health problems and symptoms will begin to emerge. Estrogen actually comes in three main forms - estradiol, estrone, and estriol. Each of these must eventually get processed by the liver through Phase I and Phase II detoxification pathways. Multiple types of estrogen breakdown products or “metabolites” get formed during this process, and some are more favorable to have than others. We can get into those details in a future article. Estrogen dominance is a term commonly used to describe the skewed estrogen-progesterone and estrogen metabolite ratios found in women experiencing fibrocystic breasts (and other hormonal imbalances such as heavy menstrual bleeding, fibroids, endometriosis, PCOS, etc). Women may have high estrogen levels with low or normal progesterone, normal estrogen with low progesterone, and/or simply produce higher amounts of the less favorable estrogen metabolites. Many will also have a high exposure or total body burden of xenoestrogens or metalloestrogens. These are nasty, often man-made, chemical compounds from the environment that have estrogen-mimicking effects in the body. The great news is that we do have the power to change hormonal imbalances that may be going on. There are many natural solutions to dramatically improving our body’s hormone system and estrogen metabolism. Uncovering the root cause(s) of fibrocystic breasts in each individual can require some detective work. Every woman’s history, daily habits, nutrient status, genetics, stress level, and environmental circumstances are different. In our work with patients, these are some of the major areas we examine in order to determine how best we can optimize breast and overall health. More and more we are utilizing a fantastic urine test called the DUTCH test in order to assess status of hormone production and metabolism. Not only does this test provide us with valuable information on sex hormones (3 types of estrogen, progesterone, testosterone, DHEA) and adrenal hormones (cortisol, cortisone), it also sheds light on how a woman (or man) is metabolizing her (his) estrogens. There are several other valuable markers on the test that we won’t get into now. Overall, the data from the DUTCH test is useful in helping us create the most comprehensive and individualized wellness plan for each individual. The Bottom Line If you suffer with fibrocystic breasts or other estrogen dominance related health conditions, your body is trying to send you a message. And it’s time to listen up! These types of issues don’t tend to go away on their own, and will often get more severe over time if ignored. Know that you have the power to improve your health and to support your body’s natural hormone balance. But you don’t have to figure it out all on your own – We are here to help. Reach out to us so we may help you “decode” that message your body is trying to send. Dr. Shana McQueen, N.D.