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July 20, 2017

Estrogen Dominance: Why are the Rates of These 5 Cancers Rising?

Exercise reduces the risk of breast cancer, estrogen dominanceWhat do These 5 Cancers Have in Common?

Guess what is happening to the rates of these five cancers – breast cancer, ovarian cancer, endometrial cancer, cervical cancer, and prostate cancer? The rates are actually increasing despite enhanced public awareness and emphasis on early diagnosis and treatment. One of these is a pure male cancer (prostate) and the other four are female cancers, though men can get breast cancer, too. But, they are all linked by potentially something else. Relatively high estrogen levels. Now, that does not mean that all cases of these cancers are related to higher levels of estrogen (more accurately speaking – estrogen dominance in women).

Estrogen Dominance: What is It?

Estrogen dominance can be a confusing term because it can occur in the face of low estrogen. Estrogen dominance means there is more estrogen relative to progesterone than there typically is when both hormones are optimized. Progesterone counter balances the proliferative effects (tissue growing) of estrogen.

In estrogen dominance both estrogen and progesterone can be lower than “normal”, but progesterone is far lower than estrogen creating an imbalance. Some estrogen is produced by the conversion of testosterone to estrogen by the enzyme aromotase. Aromotase is found in higher concentrations in fat tissue. As men get fatter as they age they can convert more testosterone to estrogen and this may place them at risk for prostaste cancer – not the testosterone that goes down with age.

Is it Really Preventive Medicine?

Much of what we call “preventive medicine” is not preventive but rather “early detection medicine”. Mammograms, pap smears, and colonoscopies do not prevent cancer. They simply enable us to detect cancer sooner and at earlier stages when they are easier to treat.  But, it would be more desirable if these cancers were actually prevented.

Despite all the attention and all the pink ribbons breast cancer is increasing, and that may be because the focus is misplaced. Now some of these “additional” cases of cancer are the result of early detection, so some rise in the numbers initially should not be too surprising but at some point the number of new cases should go down, but that is not what is happening with breast cancer as research shows shows more than 30 years of mammogram screenings have not reduced its incidence.

The Susan G. Komen Foundation raised $472 million for breast cancer in 2011 with 16% of that money going to research and the remaining for screening and education – but screening and education do not prevent cancer from occurring – they bring it to our attention sooner. Big difference! Maybe the focus should be on true prevention.

Estrogen Dominance

Estrogen dominance may be the reason these cancers have not declined. Estrogen is good for health, but it has to be in balance with progesterone in women and kept at certain levels in men. Estrogen is everywhere. It’s in your cosmetics, the plastic water bottles you drink from, household products, and more. The ubiquity of estrogen may explain why young girls seemed to be developing secondary sexual features much earlier than in generations past.

All of us would be wise to reduce our use of plastics. Hormone disruptors (mainly estrogen) leach from the plastic into whatever product a plastic container contains. Another area where plastic is used extensively is in medicine. All the IV tubing, IV bags, syringes, gloves, and more, are made of plastics.

Some of the metabolites of estrogen increase the risk of cancers. One is 16-alpha-hydroxyesterone. On the other hand 2-hydroxyesterone decreases the risk of breast cancer. Cruciferous vegetables promote the breakdown of estrogens into 2-hydroxyesterone. DIM or indole-3 carbinol supplements can do the same and maybe something women should consider taking if they do not eat enough cruciferous vegetables. Also, exercise promotes the breakdown of estrogen into the healthy 2-hydroxyesterone.

Men and Estrogen

Some estrogen is good for men in that it protects bone density just as it does in women. Some men naturally make too much estrogen secondary to excess body fat. Also men receiving testosterone replacement may see a rise in estrogen. To protect men from the harmful effects of excessive estrogen DIM and indole-3 carbinol supplements can be taken as well as medications (aromotase inhibitors) to reduce estrogen to safe levels.

The role of estrogen in men as a factor in prostate cancer development is getting more attention. For men receiving testosterone replacement therapy it is important the estradiol (estrogen) levels be monitored on a regular basis.

So if we really want to prevent these cancers we should focus on keeping estrogen levels in a safe range for both men and women.


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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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