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I always advocate self-care as the first step in preventing and treating health challenges. When it comes to breast health, the importance of self-care is a message I can’t share often enough. It is great to see pink ribbons everywhere in October during National Breast Cancer Awareness Month! If I had my wish, every pink ribbon would carry an additional important message for women.

That message would read “You can improve your breast health and reduce the risk of breast cancer right now with a few simple lifestyle changes.”

We may not be able to control where we live or our genetic risk factors- it’s true. However, a growing body of research is showing us that women really can make a difference in their breast health through diet, exercise, and weight management.

These simple steps can help optimize your body’s hormonal balance and reduce the risk of developing breast cancer, and provide additional health, anti-aging, and disease-prevention benefits.

We need to emphasize that everyone should be focusing on what we can control not what we can’t.

- We can evaluate our hormone levels with a saliva test. The best way for premenopausal and postmenopausal women to know if their bodies have an imbalance of estrogen, progesterone and testosterone is to do a saliva test. Saliva Testing is the most accurate and easy way to this. – We can use bio-identical hormones if we need hormone supplementation. Bio Identical means that the molecular structure of the hormones identically match the hormones made by our body as opposed to Pregnant Mare’s Urine which is natural to horses not humans.

- We can change our habits: reduce alcohol consumption and quit smoking.

- We can manage our weight and exercise daily. Studies also show that maintaining a healthy, average weight is just as important in favorably influencing the estrogen/progesterone ratio. Regular exercise is equally important. On the other hand, obesity, high insulin levels, alcohol intake, smoking, oral contraceptives, hormones from meat and meat products, pesticides, and herbicides can swing this ratio in the wrong direction.

- We can eat a balanced diet choosing Eat organic to avoid pesticides, herbicides, and estrogens in meat and dairy products. Include one to three servings of cruciferous vegetables like broccoli, bok choy, cauliflower, brussel sprouts, and cabbage in your diet each day. Studies show that Indole 3 Carbinol the active ingredient helps balance estrogen levels.

- We Can supplement wisely with EFA’s, essential fatty acids and use a fruit and vegetable concentrate if you do not eat 5 – 8 servings of fruits and vegetables daily.

- We can do BSE’s- breast self exams becoming more familiar with our own body

- We can become better informed – read Dr. John Lee’s “What Your Doctor May Not Tell You About Breast Cancer” as a start.

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There is only one drug in the world so well known that it’s called “the Pill.” For more than forty years, more people have taken “the Pill” than any other prescribed medicine in the world.

Sex, pregnancy, and contraception have been hot topics for millennia. It wasn’t until the U.S. government approved the birth control pill in 1960 that possibilities for contraception changed dramatically. The majority of women — and plenty of men — welcomed “the Pill”.

The birth control pill was the first medication ever designed for purely social, rather than therapeutic purposes. At the height of the drugs popularity, U.S. Senate hearings focused the nations attention on potentially deadly health risks posed by the high-dose Pill. As a result of the hearings, pharmaceutical companies lowered the dosages and doctors advised women who were obese, smoked, had high blood pressure or a family history of blood clots against taking the Pill.

In the 1980s, the high dosage 10-milligram pill was removed from the market and biphasic and triphasic oral contraceptives were introduced. Today, women can get a prescription for a Pill containing 1 milligram of progestins, one tenth of the original dose, and containing as little as 20 micrograms of estrogen.

From the very beginning, a significant number of women complained of discomfort from the Pill and switched to other methods. When women wanted to discuss the side effects with their doctors, they often met with frustration. It was common for their complaints to be dismissed as exaggerated. In other cases their ailments were just considered the price that women had to pay in return for such an effective contraceptive. The problem was compounded by that fact that female patients were not always informed about the potential for strokes, heart attacks or blood clots while on the Pill. For the most part sharing “the Pills” risk has become a part of the information provided by health care practitioners who prescribe the Pill.

Today, the safety of the Pill is assumed. However, it is important to remember that the pill contains identical hormones to those found in Hormone Replacement Therapy (HRT). HRT has come under question because of the Women’s Health Initiative Study showing an increase in breast cancer and heart disease for those women who were on HRT.

In October 20, 2004 headlines read “Birth Control Pill Cuts Cancer, Heart Disease Risk: Study – A new study, yet to be published, suggests women who use oral contraceptives have lower risks of heart disease, stroke, and cancer.”

This study has now been denied as accurate by the WHI. Analyses by the WHI have made it clear that the recent findings were not correct?

The low dose pill today although deemed to be safe has never undergone a large government-funded study similar to the WHI study on HRT. According to Dr. John R. Lee in his book “What Your Doctor May Not Tell You About Breast Cancer” women up to age 21 who use the Pill increase their lifetime risk of Breast Cancer by 600%. Caution when considering the use of Birth Control Pill should still be used.

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Many postmenopausal women are looking for alternatives to hormone therapy, especially in light of the recent Women’s Health Initiative research findings concerning the risks of combined estrogen and progestin therapy. Of particular interest are phytoestrogens, which have been gaining popularity due to their “natural” status, alleged health claims, and availability in a wide range of foods and supplements.

What are Phytoestrogens?

Phytoestrogens are naturally occurring plant compounds that have some similarities to estradiol, the most potent naturally occurring estrogen. However, phytoestrogens tend to have weaker effects than most estrogens, are not stored in the body, and can be easily broken down and eliminated.

Observational studies have found a lower prevalence of breast cancer, heart disease and hip fracture rates among people living in places like Southeast Asia, where diets are typically high in phytoestrogens. In North America, knowledge of these reported health effects has stimulated great interest in the health benefits of phytoestrogens. According to the Food and Drug Administration, the sale of soy foods, a major source of phytoestrogens, has increased dramatically in the past decade.

Dietary Sources of Phytoestrogens

Phytoestrogens consist of more than 20 compounds and can be found in more than 300 plants, such as herbs, grains and fruits. The three main classes of dietary phytoestrogens are isoflavones, lignans and coumestans:

1. Isoflavones (genistein, daidzein, glycitein and equol) are primarily found in soy beans and soy products, chickpeas and other legumes.

2. Lignans (enterolactone and enterodiol) are found in seeds (primarily flaxseed), cereal bran, legumes, and alcohol (beer and bourbon).

3. Coumestans (coumestrol) can be found in alfalfa and clover. Most food sources containing these compounds typically include more than one class of phytoestrogens.

The Skeletal Effects of Phytoestrogens

Much of the evidence concerning the potential role of phytoestrogens in bone health is based on animal studies. In fact, soybean protein, soy isoflavones, genistein, daidzein and coumestrol have all been shown to have a protective effect on bone in animals who had their ovaries surgically removed.

In humans, however, the evidence is conflicting. Compared to Caucasian populations, documented hip fracture rates are lower in countries such as Hong Kong, China and Japan where dietary phytoestrogen intakes are high. Yet reports suggest that Japanese women have a greater risk of sustaining a vertebral fracture than Caucasian women.

Several studies have explored the effects of soy isoflavones on bone health, but results have been mixed, ranging from a modest impact to no effect. Most of these studies have serious limitations, including their short duration and small sample size, making it difficult to fully evaluate the impact of these compounds on bone health.

Ipriflavone Supplements

Ipriflavone, a synthetic isoflavone, has shown some promise in its ability to conserve bone in postmenopausal women. Ipriflavone has also been shown to have a protective effect on bone density in pre-menopausal women taking gonadotropin-releasing hormone (GnRH), a treatment for endometriosis that triggers bone loss.

However, a definitive three-year study of more than 400 postmenopausal women concluded that ipriflavone did not prevent bone loss. Additionally, the compound was linked to lymphocytopenia (a reduction in lymphocytes) in a significant number of study participants. Lymphocytes are a type of white blood cell that helps the body fight infection.

Risks and Benefits Are Unclear

Some studies suggest that, unlike estrogen, phytoestrogens do not appear to target breast or uterine tissue. This suggests that they may act more like SERMS (selective estrogen receptor modulators such as raloxifene and tamoxifen) than actual estrogens. However, in other studies high isoflavone levels have been linked to an increased risk of breast cancer.

Clearly, additional research is needed to further evaluate the effects of phytoestrogens before judgments regarding their safety and usefulness can be made.

Key Points

Based on information available at this time, it is reasonable to make the following conclusions concerning phytoestrogens and bone health in postmenopausal women:

1. Moderate amounts of foods containing phytoestrogens can be safely included in the diet but do not expect it to help build bone. Keep to the basic rule – eat the least processed forms.

2. Due to a lack of evidence and concerns about safety, supplementation with synthetic isoflavones (ipriflavone) is in question.

3. Postmenopausal women are encouraged to view evidence concerning phytoestrogens and bone health as conflicting and incomplete. For women who are estrogen dominant increasing their phytoestrogen intake may not improve their bone position.

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