Estrogen levels on hormonal therapy

GATulip

I am researching information for myself in making choices for how I choose to handle ongoing treatment after I finish chemo and have a double mastectomy. I am facing a 10 year usage of HT as a post menopausal women. Tamoxifen will not be used on me as it increases chances of uterine/ovarian cancer in post menopausal women. I am considering, not yet decided, going a potential homeopathic route instead. I am curious as to how low the HT brings our estrogen down? It's a blocker, but does it block all or most? For you ladies that are already taking an HT, how often are your estrogen levels tested?

Veeder14

Hi GATulip,

I was told Tamoxifen blocks estrogen in breast cells only. Unfortunately, I didn't understand this when I started taking it and it caused a very thick uterine lining because it was essentially giving estrogen to lining which is a cancer risk. I ended up getting a hysterectomy so I could continue taking it. I've never been offered to have my estrogen levels tested since taking this medication.

flashlight

Hi GATulip, I just joined this forum as well in the last couple of weeks. I am also post menopausal and my treatments were much different from yours. My estrogen levels were never tested and from what I have read they don't usually do this. I chose to be on tamoxifen due to osteoporosis. Tamoxifen acts like an anti-estrogen in breast tissue and like estrogen in the uterus and bones. My girlfriend who had chemo and radiation has been on arimidex for about 6 years and also receives Prolia for osteoporosis. She is doing well on those medications. From what I understand the arimidex works by preventing the production of estrogen. How much estrogen do we have stored in our tummy? Thinking of you and wishing you the best.

Beesy_The_Other_One

GATulip,

I'm ER- but had a radiation friend who was ER+ and wondering some of the same things you are, namely, why don't they test how much estrogen you have so they know how much to drop it?

I contacted one of the foremost authorities on this site, SpecialK, for her thoughts on this via private message, and her response was helpful:

As far as how much the mechanism of aromatase inhibitors reduces estrogen is less of a question that concerns oncologists, it is more that it is incumbent upon them to reduce it as much as possible with these drugs - there is no "safe" amount if your cancer was fed by estrogen. That is why the recommendation is for all ER+ patients to take either Tamoxifen, or an aromatase inhibitor. It is not possible to know which patients will be safe with which levels of estrogen. so the situation is currently not that individualized and there are no testing platforms that can answer that question. Thus the universal recommendation. If your friend is post-menopausal the assumption is that her ovaries are no longer producing enough estrogen to be a threat - none of the aromatase inhibitor drugs control estrogen produced by the female reproductive organs. Rather, the way aromatase inhibitors work is that they control the estrogen produced by the interaction between the adrenal glands and the enzyme aromatase that combines and produces estrogen. That is a harder thing to measure, but if your friend is curious, and her doctor will order the tests, she can have labs done to measure estradiol, and the other estrogens - what she needs is an extra sensitive panel. If her doc won't order these, she can do it herself by using this:

https://www.lifeextension.com/Vitamins-Supplements/itemLC140244/Estradiol-Sensitive-Blood-Test

I hope this helps. If you have further questions, I would suspect that SpecialK would be willing to answer any specific ones you have if you were to PM her.

The Other Beesy

GATulip

Hi Beesy,

I am amazed at the lack of research on how much is too much when it comes to estrogen and exactly what causes one person over the other to be more receptive to BC recurrence. Surely by now, medicine has learned a one-size-fits-all treatment is not the way to go. It’s like playing Russian Roulette, not really sure of what will work for whom... this is my second go a round with BC. I was triple neg stage 4 22 years ago, cancer free all these years until mammogram in April of this year. This time I am Er+ is the same breast, same location as before and I also have a lymph node ER+ under opposite underarm, hence the metastatic condition. I have been trying to do research on post menopausal women...trying to figure out what really lies ahead and if that is the path that is best for me.