What You Need to Know About Hormones and Your Healthy Breasts

woman holding up a pink ribbon to represent breast cancer awareness

Raise your hand if you sometimes experience irritability, hot flashes, sleep problems, fatigue and/or vaginal dryness. Don’t worry; no one’s watching you!

Is your hand raised? (And not just to cool off after that most recent hot flash)!  Hey, don’t be shy - I’ve been there too, that’s why I’m The Girlfriend Doctor.  You can ask and tell me anything.  No shame or judgement here.  I want you to live your best life! So many of my clients start feeling better within 2 weeks.  I want that for you too.

Regardless of your age, these very common symptoms – which can dramatically affect your quality of life - are all signs of hormonal imbalances associated with premenstrual syndrome (PMS), perimenopause, menopause, the effects of a heavy daily/many toxins, or simply a less-than-healthy lifestyle.

We know the best way to improve upon these types of maddening hormone fluctuations is to eat an anti-inflammatory diet and to live an anti-inflammatory lifestyle.

But we also know that endocrine disruptors (found in your food, cosmetics, and environment) play a major role in hormone imbalances, especially xenoestrogens, which are endocrine disrupting chemicals that have estrogen-like effects in your body.  

Xenoestrogens have the capability to alter hormonal function in tissues, including the uterus, cervix and breast. Indeed, estrogen exposure has been associated with an increased risk of breast cancer.

Your ability to both avoid and detoxify excess estrogens and other toxins is paramount to optimizing your hormone balance and greatest breast health.

Today I’ll be talking about how you can achieve both of these important health goals! We’ll talk about,

  • The connections between xenoestrogens, obesity, your gut microbiome and breast health
  • Nutrients that help balance your hormones (and are good for breast health)
  • Maca for hormone balance (without estrogenic activity)
  • Preventative things you can do to take an active role in reducing your breast cancer risk!

Excess estrogens, obesity, your gut microbiome and breast health

Increased lifetime exposure to estrogens is associated with an increased incidence of breast cancer. (1,2)  In one 2002 review encompassing nine separate studies (all focused on postmenopausal women) a doubling of breast cancer risk was seen associated with the highest serum estrogen levels. (3)  

There are a number of things which increase estrogen exposure over a woman’s lifetime including estrogen hormone replacement therapy (HRT), some hormone contraceptives, endocrine disruptor exposure, poor methylation and detoxification of hormones and toxins, and even obesity.

Hormone Replacement Therapy

Concern over excess circulating estrogen is the reason women having had breast cancer are not typically given estrogen hormone replacement therapy to address hormone imbalance symptoms such as vaginal dryness and irritation (you can click to read how my topical feminine cream Julva®  provides a safe and effective solution for vaginal dryness and other vaginal atrophy symptoms (including involuntary leaking) – even for women having had breast cancer). 

“My breast cancer was estrogen positive, so this type of cancer strips all the moisture from your system. Your hands get dry, everything dries up. And I went to my primary care physician and she said, ‘You have vaginal atrophy. There’s nothing I can do for you. Bless your heart, I love you to death, but you need estrogen treatment, and I can’t give you estrogen treatment because of your history of positive estrogen breast cancer.’  

So, I tried things like coconut oil, Vagisil, and I kept getting recurring yeast infections because, as a golfer, I’m out in the heat. So the day after playing a round or two of golf I’d have to fight these symptoms. I’d even stop and change my underwear half-way through! But the real symptom was that the tissues were dry, constantly uncomfortable.

And I think women tend to be stoic about it and just say, well, you know, this is all normal. Normal, not good. But normal, not good. And we are alive and we are still functioning and so we tolerate it. 

But Julva has been amazing! I’ll be happy to talk to anyone you want me to talk to about this, any groups you want me to talk to about this. I’m a firm believer!”

Nancy, 57. Read her full story here


Xenoestrogens (Endocrine Disruptors)

You likely wear gloves when dealing with toxic cleaning chemicals, but what do you do to protect yourself from the synthetic and potentially toxic chemicals in everyday skincare products? Synthetic preservatives (used to inhibit mold growth or kill bacteria), fragrances, dyes and other ingredients are often contained in soaps, shampoos, skincare products, and many other personal care products that we routinely slather on our very absorbent skin! Many contain ingredients shown to be toxic to your body’s cells and are also known to disrupt hormone levels and behavior.

The Environmental Working Group (EWG) has found that American women use an average of 12 such products a day (containing about 168 different chemicals). (4) 

Some of these chemicals are known endocrine disruptors which can affect how women’s bodies metabolize estrogen and some have been linked to breast cancer. (5) 

You can read more about this important topic on the EWG  website. Note that phthalates and parabens in particular have been linked to both disrupting hormones as well as causing damage to women and men’s reproductive systems. (6) 

Xenoestrogens can also influence estrogen dominance, which occurs when the ratio of estrogen to progesterone gets out of balance with greater levels of estrogen.

Many of my clients having polycystic ovary syndrome (PCOS) are dealing with estrogen dominance symptoms when they start my programs; it is often the cause of painful periods, endometriosis, fibroids and ovarian cysts. More often than not I start off these women with my progesterone cream, Balance. This helps balance hormones, improves stress response and helps improve mood as well! (All benefits my family is grateful for.  :-) With cases of estrogen dominance I also focus on estrogen detoxification through diet and particular nutrients (which we’ll talk about in a moment). 


Research tells us that obesity is a risk factor for postmenopausal breast cancer as well as for a negative impact on prognosis when either a premenopausal or postmenopausal woman is diagnosed with breast cancer.

The adipose tissue (fat tissue found in the body and breast) in obese postmenopausal women is the main source of estrogen biosynthesis (versus the ovaries). Adipose tissue contains aromatase which is an enzyme that converts androgen hormones to estrogens (this conversion is the primary estrogen source within the body after menopause); it has been found in breasts as well as within breast tumors (where estrogen levels have been measured to be as much as 10-fold). (7)  

Obesity is a risk factor for developing metabolic conditions such as insulin resistance and Type 2 diabetes, both of which have been found to increase estrogenic effects and be a risk factor for breast cancer as well! (8-11) 

And if increased breast cancer and Type 2 diabetes risk weren’t good enough reasons to get to a healthier weight, note that obesity is also a risk factor for involuntary leaking (and I know that no-one wants to have to deal with sanitary pads, incontinence products or diapers!) 

Your Gut Microbiome Health 

More recent research has also found that the specific makeup of the microorganisms in the gut (your gastrointestinal tract or “gut microbiome”) impacts the level of estrogen in the body and how well that estrogen is detoxed out of the body (versus being recirculated, increasing overall estrogen levels, and potentially exerting a negative, stimulatory effect on breast tissue). (12,13)  The gut microbiome and breast cancer connection is significant and I’ve written an entire article about it you can find referenced below.

The good news is that the makeup of these microorganisms (having a healthy and diverse population of friendly bacteria) is greatly influenced by modifiable factors such as diet (you need an anti-inflammatory, alkaline and detoxifying diet), exercise (gotta move!), specific nutrients (we will discuss) and many lifestyle factors you have control over (stress being just one). (14,15) 

You can read much more about the microbiome and its potential estrogenic effects relating to breast cancer at this article, What You May Not Know About Breast Cancer. It is a fascinating and emerging topic that is highly relevant and beneficial for you to know about. 

All of this tells us that for hormone balance and best breast health you need to minimize estrogen exposure over your lifetime as well as embrace a diet and lifestyle that,

  • Helps you maintain a healthy weight (weight loss itself has been shown to lead to a reduction in circulating estrogens) (16) 
  • Keeps you in an anti-inflammatory and alkaline state (shown to lower risk for diseases including cancer)
  • Healthfully detoxes excess estrogens and other toxins
  • Reduces your risk for insulin resistance and other metabolic conditions
  • Balances your microbiome with friendly and diverse bacteria that keep your hormones in balance, work to minimize excess estrogen levels and help keep you more resistant to disease

My Keto-Green® diet and lifestyle meets all of these goals, providing an anti-inflammatory, alkaline, detoxifying and gut healthy path to balanced hormones and reduced risk for inflammatory diseases. 

Keto-Green living focuses on achieving both an alkaline and ketosis state, each having tremendous amounts of supportive research behind them relating to their positive health effects.

An alkaline state has been linked to reduced inflammation and lower rates of cancer as well as other chronic conditions. In laboratory studies tumor growth has increased in acidic environments.

The state of ketosis has been scientifically shown to reduce overall inflammation, support weight loss, and to improve insulin resistance and blood sugar issues. 

Intermittent fasting for periods greater than 13 hours (part of the Keto-Green program) has been shown to decrease breast cancer risk (as well as improve glucose regulation and sleep). (17)  

Nutrients that help balance your hormones (and are good for breast health)

There are several identified nutrients that can help you regain and optimize your hormone balance; and fortunately, one of my own favorite hormone balancing regimens is also supportive of breast health.

Zenful provides a blend of quality ingredients that:

  • Helps modify xenoestrogen activity (promoting healthier estrogen detox)
  • Encourages overall hormone balance
  • May ease symptoms associated with PMS and menopause (hot flashes, fatigue, insomnia, vaginal dryness)
  • Provides antioxidant support
  • Supports improved methylation (which improves many biochemical reactions relating to neurological, cardiovascular, reproductive and detoxification systems in the body)
  • Helps restore tranquility (these days we all need this!)

I call it my “Calm, cool, confident” little helper as so many women tell me it has helped with their hot flashes, sleep problems, anxiety and mood swings. Perhaps even more importantly it helps support your body in detoxifying excess estrogens.

Here’s some more information.

Ingredients that promote healthy estrogen detoxification

Zenful contains several ingredients which have been clinically used to support healthy hormone balance and to promote estrogen detoxification activities including DIM, 8-prenylnaringenin and calcium D-glucarate.

  • Diindolylmethane (DIM)
  • Diindolylmethane (DIM) has been found to support hormone metabolism and immune activity as well as to stimulate antioxidant and detoxification systems.  

    DIM helps maintain safe estrogen levels by aiding the conversion of dangerous estrogen fractions to more favorable metabolites and by promoting restoration of healthy hormone ratios.  Research has found that the detoxification mechanisms DIM initiates may provide protection from xenoestrogens and other toxins. (18) 

  • 8-prenylnaringenin (8-PN)
  • In studies 8-prenylnaringenin (8-PN) appears to ease common menopausal discomforts and reduce vasomotor symptoms. It appears to affect aromatase (remember that is the enzyme responsible for converting circulating androgens into estrogens) and positively affect estrogen biosynthesis and levels. (19-21) 

    •  Calcium D-glucarate

    Calcium D-glucarate (CGT) supports detoxification and elimination of toxins (including carcinogens) and steroid hormones (including estrogen).  (22)  It is also found in cruciferous vegetables such as broccoli, Brussels sprouts, and cabbage; as well as other foods I emphasize as part of my Keto-Green diet.

    Ingredients that provide antioxidant support

    Zenful contains several ingredients which have been clinically used to provide antioxidant activity as well as to promote estrogen detoxification activities including grape seed extract, green tea extract, turmeric (curcumin), resveratrol, Calcium D-glucarate and rosemary. 

    Turmeric is a wonderful anti-inflammatory and antioxidant (which is why it is a key ingredient in my Mighty Maca® Plus keto superfoods drink!). Turmeric contains one particular component, curcumin, which has been shown to have anticancer effects in laboratory studies. It reduces existing inflammation throughout the body but can also help stop inflammation from even occurring in the first place.

    Green tea appears to provide some protection against breast cancer in limited studies. (23) There has been some evidence from animal studies regarding grapes having an aromatase inhibiting effect (decreasing estrogen synthesis) although specific findings relating to dose requirement is still needed. (24) 

    Ingredients that provide hormone balancing support and symptoms relief

    Zenful contains several ingredients which have been clinically used to support women with hormone-related gynecologic complaints.

  • Chaste Tree Berry Extract (Vitex agnus-castus
  • Chasteberry is well known for its hormone balancing effect on female hormones, helping improve symptoms related to PMS, breast tenderness as well as prompting more regular cycles. It is thought to have indirect effects on progesterone levels as well. (25,26) 

  • Black Cohosh Extract (Cimicifuga racemosa)
  • Black Cohosh is commonly used to address menopausal vasomotor symptoms (hot flashes, night sweats), sleep disturbances, and mood as well as for menstrual cramping and lower-back pain. It is thought to have some low level of phytoestrogen (inhibiting aromatase, blocking estrogen receptor sites) activity. It has been found to be safe for the breast and endometrium. (27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390141/  .

    Ingredients that provide methylation support

    Zenful also contains a number of other ingredients which support methylation. These include Vitamin B6, Folate, and Methylcobalamin (B12).

    Optimal methylation is important as it supports many important biochemical reactions throughout your body including reproductive and detoxification systems (including estrogen metabolism). Some people also have a genetically acquired deficiency regarding methylation.

    Zenful does not contain wheat, soy, gluten, animal or dairy products, fish, shellfish, peanuts, tree nuts, egg, ingredients derived from genetically modified organisms (GMOs), artificial colors, artificial sweeteners, or artificial preservatives. The product has a 4.9 rating (out of 5) with 100% of respondents indicating they’d recommend to a friend.

    ** These product statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. 

    Maca for hormone balance without estrogenic activity

    Maca is such a powerful hormone balancing superfood that I built my Mighty Maca® Plus greens drink around it. I wrote a very informative article about “everything you wanted to know about maca.”. Maca is helpful in addressing hormonal imbalances, menstrual irregularities, PMS, menopausal symptoms, fertility and libido issues, mood concerns and fatigue. 

    Sometimes I say, “what doesn’t maca do?” It is anti-inflammatory, alkaline and detoxifying. It truly is a superfood!

    And better yet it is NOT estrogenic.

    Maca root and flour

    Maca root and flour

    Maca has been found in research to exhibit no estrogenic effects, meaning it is not hormone stimulating, but instead has been found to be hormone balancing or hormone regulating when it comes to estrogen. 

    This is very important and makes maca a beneficial herb for a wide range of women (those who can’t metabolize estrogen well; those that may need higher levels; those who have had breast cancer, etc.) and men. 

    You can read more about the specific research behind maca. This research includes studies showing it is not estrogenic as well as studies supporting its effectiveness at balancing hormones and reducing a wide variety of symptoms for all ages of women and men.

    "I am seriously loving Mighty Maca Plus right now! I even signed up for the recurring shipments. Been taking it daily just over 1 month now.  I turned 31 this year, and was noticing hormone imbalance issues.  I have been having very painful PMS symptoms with a heavy period. When I saw that the maca root assists with balancing hormones; I decided to take a giant leap and try your product to see if I notice any differences. So far, I have noticed an exciting difference! My monthly pms and period are much lighter! 

    Also - I used to run a lot but haven't been able to in years because of an achy knee. Your product has several natural anti-inflammatories and this has helped me significantly. Last weekend I almost ran 3 miles without stopping. It was a milestone for me, and I about fell over with excitement!!

     I also have improved energy

    Thank you. I am very impressed with your service to others and products." 

    ~Ashley McMullin

    Preventative things you can do to take an active role in reducing your breast cancer risk

    The key word here is “Preventative!” There are five things you can and should do.

    1. Follow preventative screening guidelines and know your risk factors – read this earlier article on breast cancer prevention  which outlines genetic and other lifestyle factors that increase your risk. Learn what you can influence and what you can’t, and commit to tackling some things that you can. Diet and estrogen exposure (over a woman’s life) can be addressed! Later in this article there is a section on preventative screening you should do and when you should do it to reduce your breast cancer health risks.  In the article there are links to additional resources to help you pay for a mammogram, sign up for automatic reminders, learn statistics relating to your age group, and so much more. You can also take the National Institute of Health’s breast cancer risk assessment tool  which estimates a woman’s risk of developing invasive breast cancer over the next 5 years. (28)
    2. Eat the right diet: anti-inflammatory, alkaline, and detoxifying (and supportive of a healthy and diverse gut microbiome). As stated earlier, my Keto-Green diet addresses all of these health goals and more. It is nutrient-rich and will help you maintain a more optimal weight (remember, obesity increases your risk for breast cancer). Intermittent fasting is an important aspect as well.

    Additionally, my Keto-Green diet involves lifestyle elements such as increasing movement, stress management, addressing insomnia issues, increasing your positivity and gratitude, and more…all shown to help with out-of-balance hormones. You can learn everything there is to know about both diet and lifestyle changes you should make – and be provided with dozens of helpful tools along the way – in my book, The Hormone Fix

    1. Eat/drink supportive nutrients that help strengthen your immune system, provide anti-inflammatory support, help with your stress response, detoxify toxins and excess estrogens, and that taste great! Drinking enough water is really important to your hydration but also your body’s ability to detox! (8-10 glasses of filtered water each day). Along with healthy fats and Omega-3s consider maca, green tea, walnuts, raspberry leaves, turmeric and broccoli sprouts.
    2. Minimize excess estrogen exposure. Hopefully from this article you can see how vital this is. Here are some things you can do:
    • Discuss oral contraceptives and estrogen hormone replacement therapy alternatives with your doctor with regard to risks and benefits; consider other natural means to address symptoms such as hot flashes  and try my restorative cream for the vulva, Julva®, to address vaginal dryness and itching, irritation, involuntary leaking, pain during intercourse and more.      
    • Maintain a healthy weight, insulin sensitivity and a healthy diverse gut microbiome: Go Keto-Green!
    • Reduce your exposure to endocrine disruptors! Look up the personal care products you use on the Environmental Working Group’s database, eat organic when possible, use fewer chemicals in your home, yard, food and skincare!
    1. If you are over the age of 40 take these four tests, annually (along with preventative breast cancer screenings, of course). (“The Four Lab Results You Absolutely Must Know”). These four simple tests can provide so much helpful information relating to your overall inflammation state, blood sugar control, stress response, hormone health, immune health and more. They typically cost under $125 and can be self-ordered if your doctor won’t write you a lab order. I always say, “Test, don’t guess,” and the lab results you get with these four tests are particularly good as they allow you to monitor key biomarkers as you age (or as you change your lifestyle, diet or deal with a particular health issue such as diabetes, thyroid conditions, etc.). The four tests discussed in the linked article are:
    • Vitamin D levels (25-hydroxy vitamin D)
    •  hsC-reactive protein (sometimes referred to as highly sensitive CRP or cardio-CRP)
    • Hemoglobin A1C
    • DHEA-sulfate

    Remember girlfriends, your health shouldn’t be an after-thought. Make YOUR first right step now towards greater hormone balance and optimized breast health. 

    And please keep in touch with me and let me know how you are doing. I love hearing from my community and sharing people’s successes as well as talking about their challenges. Remember, you can ask me anything.


    1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775086/

    2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121903/

    3)    https://pubmed.ncbi.nlm.nih.gov/11959894/

    4) https://www.ewg.org/californiacosmetics/toxic12

    5) https://www.ewg.org/californiacosmetics/toxic12

    6) https://www.ewg.org/californiacosmetics/toxic12

    7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689796/  

    8) https://pubmed.ncbi.nlm.nih.gov/25555473/

    9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088296/  

    10) https://pubmed.ncbi.nlm.nih.gov/17981890/ 

    11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121903/

    12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121903/ 

    13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017946/ 

    14) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264051/

    15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017946/

    16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689796/

    17) https://pubmed.ncbi.nlm.nih.gov/27032109/

    18) https://pubmed.ncbi.nlm.nih.gov/16267208/

    19) https://pubmed.ncbi.nlm.nih.gov/17088409/  

    20) https://pubmed.ncbi.nlm.nih.gov/16321485/

    21) https://pubmed.ncbi.nlm.nih.gov/18201740/

    22) https://www.mskcc.org/cancer-care/integrative-medicine/herbs/calcium-glucarate#references-2

    23) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635178/

    24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932855/

    25) https://pubmed.ncbi.nlm.nih.gov/23136064/ 

    26) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494412/

    27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390141/

    28) https://bcrisktool.cancer.gov/  

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    Dr. Anna Cabeca

    Dr. Anna Cabeca

    Certified OB/GYN, Anti-Aging and Integrative Medicine expert and founder of The Girlfriend Doctor. During Dr. Anna’s health journey, she turned to research to create products to help thousands of women through menopause, hormones, and sexual health. She is the author of best-selling The Hormone Fix, and Keto-Green 16 and MenuPause.

    Learn more about my scientific advisory board.