HRT & Dense Breasts: When are they okay & when are they a risk for breast cancer? | Felice Gersh, MD

[@marcywilkinson4310]

Thank you for this clear explanation Dr. Hirsh. I just had labs completed in November which confirmed low estradiol, and high estrone. Youre the 1st Dr. To mention that high estrone is due to inflammation. Im on a min. Amount of estradiol so time to request an increase.

[@SimonaDelean]

I was diagnosed with extremely dense breasts and fibrocystic breasts at the age of 25-lucky me, I have both! Now, at 50 years old, I have never taken any birth control pills. However, I started hormone replacement therapy (HRT) about three years ago to address my PMS symptoms. My breasts have remained extremely dense even before I began HRT.

[@amyrentzel8062]

Same!

[@amyrentzel8062]

I watched it again and now much clearer on the message! Thank you Dr Gersh 😊

[@anne-louisegoldie]

Superb information and clear explanations, thank you so much💛 I wish the majority of doctors knew all these important truths, and helped instead of hindered their mid-life women patients. Why don't they? 🤔😭 You're great, Dr Gersh, thank you 😊xx

[@phaedramartin1385]

Thank you so much for this video. I started HRT 5 weeks ago and was going to get off of it because I am having breast tenderness. I have been so scared I to thinking I will get breast cancer after taking HRT. Ironically after my last mammogram taken post menopausal I was shown to have breast dense tissue. My doctor never mentioned anything about it. It makes sense. After menopause all of a sudden my cholesterol went up, my blood sugar levels went up, etc. My body must have been suffering from so much inflammation. It is so sad that most doctors do not truly understand menopause, I had to fight to get on HRT.

[@intuitivediane]

I’m not doing HRT and not interested but look up iodine and how we need it and might help your cholesterol. Dr Janine here on KZbin talks about cholesterol and iodine in menopause. I wish you well

[@jessicahitchens6926]

Goo luck with aging just on iodine. You should be taking iodine anyway. Dr. Gersh is one of the best. And you know nothing about the endocrine system.

[@jessicahitchens6926]

Good*

[@evaimer3]

I,m so greatful to be her! 🙏 All You saying, it's so important and explaned for me and all womens, what hormones do or not do to as! The best blessings to You Felice Gersh! ❤

[@cm1906]

Wow! Thank you for this information, Dr Felice! 🫶🏼 A question: Can inflammation due to estradiol deficiency (menopause) be measured with the C-reactive protein test (CRP)?

[@msmc2685]

It’s been said that having optimal levels of estradiol, “pushes down” estrone?

[@TheFrankHummer]

A lot of this reasoning seems to be another good example of distinguishing, in health science, between X being a marker for Y vs. X being a cause of Y. This is a fabulous, brilliant video.

[@cintiaspataro3205]

Thank you so much Dr. Felice, This is a magistral class 🎉❤

[@Jesusiswatchingyou-123]

Hormone testing is too expensive for most women to keep an eye on estrone. How can we lower our estrone levels?

[@anne-louisegoldie]

I'd like to know more about estrone too 😊xx

[@olderandwiser127]

@@anne-louisegoldie fixaflash and womens health network are good resources.

[@Katepwe]

@@anne-louisegoldiecheck out info from Dr. Mary Claire Haver and Dr. Lisa Mosconi.

[@aggieag1866]

Try to slim down, because fat cells produce estrone.

[@audreyfischer8662]

Ok. So, I have extremely dense breasts. What is the next step? 1) confirm it’s caused by inflammation? 2) assume it’s inflammation, and reduce it? 2a) reduce it by physiological dose estradiol? 2b) try to figure out what caused the inflammation? Or is not having estradiol the cause of inflammation? I did not know that my body could make estrogen of any kind after a total hysterectomy at my 19th birthday (melon-size teratoma ovarian cancer). This discussion on top of the other Felice podcasts that I am intently listening to today (I just discoveredDrFelice today ), brings me a hundred questions. I’m celebrating 51 years cancer-free. I’d like to keep celebrating for more years to come, doing the best I can to be my healthiest self.

[@minatohid7855]

Thank you for being so updated!

[@cowdreyk]

Will you talk more on what the measurements would be if taking a "physiologic" level of estrogen? It keeps being mentioned, but not to degree of what it would look like in the blood work or even on a Dutch test. Also, discuss the blood work...which tests do you run? Is there a specific time of the month that you test for each hormone?

[@holisticdancer]

What about QT imaging? It's supposed to be safer than Mammograms and uses sound waves.

[@cowdreyk]

I would like to hear opinion on the QT imaging too

[@christylinsday3992]

What does qt imaging stand for

[@wendyward9547]

I got breast cancer 2 yrs ago . I was on hormone patches. Iam ER positive now have to take anti hormones 😢

[@intuitivediane]

Sad 😢. I’m so very sorry.

[@jessicahitchens6926]

It wasn't the hormones. Your gut health was probably awful. And you were insulin resistance.

[@milasobin7663]

Thank you. I am on HRT Patch (Estrogen only) and just got an Extremely Dense breast Mammogram at 55 years old. I am otherwise healthy. So, was freaking out.

[@Khan77777-sk]

Even without uterus, women need progesterone as it does not stop uterine lining proliferation but stop the cell proliferation triggered by estradiol in breasts too. Progesterone is not just for the uterus but for healthy breasts And having both cyclically is natural too

[@audreyfischer8662]

Wow! Why didn’t my doctors say anything about this?! And why for many years, patients were not even told they had dense or very dense breasts? All to save money, I’m sure.

[@snowps1]

Estrone is produced in your fat cells. It's why you can develop a belly after menopause. Your estrodial greatly decreases from your ovaries so your body replaces it with higher levels of estrone by increasing your belly fat. But bio-identical estrodial can reduce your estrone levels. They have an inverse relationship. When estrodial is up during your reproductive years, estrone is down. When estrodial goes down during menopause, estrone goes up.

[@wendymccleary1465]

Thank you for the share. I am on the 80/20 Bi Est and now have the belly fat I did not have before. I'm wondering if the estradiol needs to be higher than 20%? It's been a bit confusing to get this right.

[@audreyfischer8662]

This is very helpful. I never understood this.

[@audreyfischer8662]

This explains possibly why I had a skinny body everywhere except my belly.

[@jessicahitchens6926]

You need to be on high doses of Estradiol not Estriol. Your gut health is compromised too. Probably insulin resistant or the start of it. Estriol is localized its not systemic. You are getting no proliferation= growth

[@amyrentzel8062]

​@@wendymccleary1465yes, I believe so. Dr Gersh is a proponent of estradiol but not biest. I'm seeing more and more specialists saying not to use estriol for BHRT, altho estriol is being looked at for medical treatment for some issues now

[@audreyfischer8662]

I have “ extremely dense breasts” for many years. 70 years oldOnly in the past few months put on estradiol after decades of no hrt, preceded by estimate of 20 years of Premarin. None of my doctors, (GP, endocrinologist, gynecologist) nor radiologist ever mentioned any concernsnor mentioned possible inflammation, and especially never suggested any treatment or further testing to discover the “why” of my inflammation, and if it could be related to any other issues I’m experiencing.

[@jackiemansfield8325]

I’m 64 and have highly densed breasts. Just had inflammation test and it said I do not have inflammation, as I’m very health conscious. What say you?

[@amyrentzel8062]

Which test did you have to see about inflammation?

[@jackiemansfield8325]

@ CRP

[@debbiemarchbanks8538]

You are so helpful! What do you consider to be the physiological dose of Estradiol & Progesterone in a post menopausal woman?

[@saklan_territory]

Fascinating! Thank you, I learned so much from this video.

[@Hbd2002]

Thought somebody else had having dense breast doesn’t increase your risk of having breast cancer. It’s just that they’re harder to detect.

[@chinamoon6175]

Right which increases the chance of missing it early on.

[@tranquilityseeker581]

Dear Dr. Gersh - Thank you for your insight. I have been on estradiol and cycling progesterone since I was 51 - now 64. I've had no other diseases associated with age. I feel healthy and happy. I have only taken the .05 vivelle dot. Is it possible to go on the higher dose of estradiol to protect my bones? Like perhaps 1.00

[@bluejean-1968]

She has said in other videos that bone growth only happens in the .1 mg estradiol patch. The highest dose is needed.

[@wendymccleary1465]

​@bluejean-1968 Do you know where one can get this patch? I'm 66 and just found out I have osteoporosis 34% loss in my pelvis. Thanks!

[@bluejean-1968]

@@wendymccleary1465 I get my patches from Walmart pharmacy. You'll need a prescription.

[@jessicahitchens6926]

Your on Estriol... and no proper Progesterone. You also need to be on Magnesium Glycinate and VitD3 & VitK2 M7.

[@brendaglover1951]

What about weight gain after initiating BHRT? Does this mean that bad estrogen is proliferating in your fat tissues and causing inflammation?

[@doloresseames5067]

Why do I get tender, sore breasts on Biest? If I lower it, my breast’s feel better. Can estriol change into estrone?

[@lisbethshibley158]

Please talk about Duavee which blocks estrogen to the breasts. What are the pros and cons. And hw can you reduce inflammation in your breasts as you age!

[@lacincilla2533]

I am confused about whether I should stop HTR. I am 58 and have been on HTR for the past 10 years with extremely dense breasts.

[@Katepwe]

According to Dr. Mary Claire Haver author of The New Menopause (as well as numerous medically professionals specializing in women’s health, for most women there is no need to stop HRT.

[@rdiemidio65]

NO NO NO .

[@intuitivediane]

Aww my gosh please watch videos on iodine and how it helps breast and tissues. Most often fibrous breast are caused my low iodine. I did not think that being on HRT for a decade was good, but speak to your doctor. Don’t just go on KZbin. Everyone is unique with different risks

[@amyrentzel8062]

No

[@feeb812]

so what is the patient going to do with a dense breast mammogram? What is the next step????

[@CoolKidsSJJE]

I had to ask for a whole breast ultrasound which my obgyn did order for me

[@antoinettejurgens1177]

Why do they even still do mammograms? Just do an ultrasound and there's no discomfort and no radiation risk.

[@NinaRomanenkoSings]

If there is already DCIS or LCIS in the breast - Will taking estradiol promote it’s growth and possibly cause it to become invasive? What about estriol - does that carry a risk if there is DCIS or LCIS in the breast?

[@amyrentzel8062]

I've been seeing estriol as a possible cancer treatment!

[@nancyclarke4522]

If your breasts have already lost their structure on account of HRT that was too conservative can increasing estrogen improve the issue?

[@anonanonymous1970]

How do we reduce breast inflammation?

[@ArcturusAndromeda]

How does this work in cases of fibrocystic breasts?

[@stephaniebest9428]

Is it normal to have no estrone in your blood?

[@joanne4172]

Thank you.

[@glenlev]

Mammo doesn't always pick up lumps. Self exams crucial but now I hear govt doesn't recommend self exams. I strongly disagree.

[@rdiemidio65]

Ultrasound picks up things mammo's can't. Without any radiation.

[@glenlev]

@@rdiemidio65 I know! the problem is-- the doctors, med people, basically won't allow an order for ultrasound without first getting mammogram. Sick. Everyone should know that radiation can affect the cells ie in bone marrow ( I have some abnormality. I suspect from the radiation for malignant breast lump 2010.

[@rdiemidio65]

@@glenlev Geez awful

[@StayGold_MrsE]

What about women with naturally dense breasts by heredity? I've always had dense breasts. Both my mother and my grandmother had extremely dense breasts as do I now and saw them in my mammograms once I stated those. I live a completely healthy lifestyle. My grandma lived to 93 and my mom is currently 92. Now, at 55, I've lived my entire life eating healthy exercising minimally because I don't have any issues with weight and I have no issues with insulin resistance. I even stopped drinking any alcohol in 2022 because I didn't want any extra inflammation in my body or aging my face. Truth be told, I'm kinda a health fanatic. I take supplements, I eat all the foods that people are always told to eat that are anti-inflammatory. I prefer a Mediterranean diet over almost anything else and my doctor says I'm the pillar of Health. He says my lab numbers are in the top 1% of his entire panel. I have 97 HDL, 36 LDL, perfect fasting glucose, thyroid and all of my hormone numbers look right for now. My overall everything is in steller statistics. However my period is just starting to cycle down. I've skipped a few months so I'm heading into menopause and I'm concerned about taking over-the-counter creams where they mix the progesterone and the estriol just to stay ahead of the risks of stroke, heart attack and so forth. Not to mention osteoporosis which I've been diagnosed with already because being that I'm so fit I never exercised and I could still wear a bikini. So now that I know I have osteoporosis, I have to start because it's a matter of my bone health. What would you say are my risk factors if I've always had naturally dense breasts? PS, I see you are in Irvine. My cousins live there and I'm not far from you... I'm near Rancho Cucamonga!

[@amyrentzel8062]

I'm 63, with dense breasts and also osteoporosis. Her summary sounds like the estradiol (I need to get off estriol) is going to decrease our risk for everything and I know it is an excellent treatment for OP in high enough doses. Progesterone and testosterone are also important for bone health. Remember she points out that the highest risk factors involve lifestyle. Obesity and any kind of metabolic issue (like diabetes), alcohol and smoking seem to be the most common. I had to watch this again to grasp the message, and estradiol in high enough doses (always with progesterone) will lower our risk of cancers, putting our bodies into the state of hormonal mimicking of the younger years in which most are healthiest.

[@amyrentzel8062]

Estriol does NOTHING for bone health. Dr Gersh has something on that out there, but consider following Dr Doug. His specialty is reversing OP with bioidentical hormones!

[@asr9217]

Estriol does nothing for bone ... You do need estradiol ... I agree with you there must be more to breast density than just inflammation

[@PLT722]

Are dense breasts same as fibrous breasts?

[@olderandwiser127]

It is important to clearify that insulin resistance is the root cause of cancer which is why cancer is also called Type 4 Diabetes.

[@cpa7476]

Every year my mammograms require follow up ultrasounds/mammograms due to benign cysts/dense breast. Usually the cysts disappear on their own but it's been happening so much that I'm trying to decide if I should just give up on HRT altogether. I don't really want to but it's stressful.

[@Cass-gi4kk]

Or maybe give up mammograms

[@jessicahitchens6926]

Stop having mammograms!!

[@antoinettejurgens1177]

Agreed. Just do the ultrasound.

[@edievelenger3500]

I am 66 and have just started HRT because I didn’t know I should have been doing it for many years but hopefully better late than never. I have always been very healthy and maintain a lifestyle. I have dense breasts. What could be the cause of the inflammation? Can I change that?

[@canislupus7463]

I just turned 60 and not on any HRT. No one told me I should be on HRT.

[@Cwgrlup]

@@canislupus7463a lot of us use HRT. If you don’t, good for you but no one cares, really.

[@summerbird4288]

Actually there is an opinion HRT is more risky to start after 65. The sooner the better. Don’t want to fear monger you - study the topic probably it’s better for you not to HRT.

[@seczee411]

@@summerbird4288 That is based on the individual's health. They must get their heart checked (EKG, Echo-gram, and/or Stress test), bone density test, and brain activity. If 60 and up and are in good health, then HRT will be beneficial for them. Many doctors on KZbin have stated so.

[@beckyo489]

Started HRT finally after years of suffering. Mammogram last year indicated I had dense breasts. I'm 62. Very confused now.

[@olderandwiser127]

Low carb is the answer. Plus avoid all plants high in oxalic acid. Follow Sally K Norton.

[@lacincilla2533]

I am confused as well. I am 58 on HTR with extremely dense breasts.

[@whiteleopard1713]

Why she just explained your case here perfectly.

[@whiteleopard1713]

​@@lacincilla2533Why don't you do hormonal panel using urine and bloodwork with inflammation markers. Do you expose yourself to xenoestrogens in personal care products,perfumes "air fresheners "and all kinds of plastics (phthalates, parabens) they all contribute to toxic load.

[@MaryBethMcCoy]

There is no reason to be confused. This is an excellent presentation. The studies are clear. Women on HRT have lower rates of breast cancer than those who are not. It is better to replace lost hormones than not in most cases. Estrogen does not cause breast cancer and dense breasts are also not a root cause. What you should consider are other risk factors such as your lifestyle and whether or not you are insulin resistant. There are blood tests you can have, such as your fasting insulin level, which can help determine this, but overall, if you lead a healthy lifestyle, are not obese or diabetic, both of which cause inflammation and insulin resistance, you will most likely benefit by taking HRT, even if you have dense breasts. If you do insulin resistance, or are diabetic, you need to address that by modifying your lifestyle because both insulin resistance and diabetes are definite risk factors for cancer. Dense breasts do make it harder to evaluate a mammogram, but mammograms are not the end all and be all for breast cancer detection. It is a tool that may help in cancer detection, but it is not infallible or without its own risks. There are many false positives, and even if you don’t have dense breasts, mammograms often fail to detect cancer when it is there. The bottom line is you have to make an informed choice as to whether or not you believe HRT is right for you. It is an individual decision, but don’t be misled by some of the misinformation that many doctors who have not kept up with current research give you.

[@Mer179]

So is bioidentical vaginal cream something women shouldn’t use?

[@jessicahitchens6926]

What????? She never said that.

[@joanne4172]

Do you recommend wild yam as a more natural way than the estradiol bioidentical cream??

[@Katepwe]

There isn’t any real studies that promote wild yam. Today’s HRT is made to act body identical.

[@againsteveryoneswill1923]

Wild yam on its own will not give you any estro.

[@brushandshovel6512]

No, your body does not have what it takes to convert!

[@bcourtney4024]

So there is no option for women who are breast ca survivors - estrogen+, progesterone+ DCIS - who were on the combipatch during post menopause to be given the green light by the oncologists to go back on it. That is what is the gold standard. #HRTWASAWESOME

[@DeanPinsent]

NO children, 50+ if going by what you're saying my only purpose in life is to feed a child, wouldn't it make more sense to remove them? Thus no more induced "screening" causing breast cander, what is the point?

[@coachtanishamarie]

Yes if you listen to her but breast are also sexy lol 😂❤

[@jessicahitchens6926]

Are you seriously asking this question? You need your breasts. Its absolute butchery removing your breasts.