
Most women know the obvious breast cancer risk factors; things like family history, smoking status, and pregnancy & breastfeeding history. But few have heard about estrogen metabolism, and how this can increase or decrease breast cancer risk. This is measurable in every woman’s urine.
Many scientists agree that cancer is something which develops slowly over time – processes that will eventually produce a tumour are in place for years, even decades, well before before pre-cancerous changes are detectible. Paying attention to signs and symptoms of hormonal imbalances, and having hormones checked (tip: urine and/or saliva are the best ways to assess) is important, so that we can change these processes early. Estrogen metabolism is one of those processes, because any abnormalities are almost always implicated in the development of breast cancer.
Thankfully, this means there is a huge potential for prevention of disease before it even begins.
Every woman has multiple forms of estrogen (estrone, estradiol, estriol), and her liver is responsible for eliminating these hormones once the body is finished using them. It does this by sending metabolites down one of three main pathways, good, bad, and neutral, which we can measure on a hormone test.
For example, this woman (Figure 1) has high-risk estrogen metabolism. Her detoxed estrogen has too much red (red = bad). This red pathway is considered the most “genotoxic” because its metabolites

create DNA damage (major cancer trigger). She should have no more than 11% of her estrogen detoxing this way. And, we would like to see at least 70% of her estrogen leaving via the green pathway instead.
The good news is, this is highly treatable once identified. Estrogen metabolism can be changed. The more a woman learns about her estrogen, the more she can help prevent this disease.
Knowing estrogen ratios is also important for any woman currently living with breast cancer and/or has had it in the past, and is additionally helpful for things like heavy periods, weight gain, fibroids, endometriosis, PMS, fertility and many other women’s health issues.
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