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The conventional dogma for the use of HRT is that if you have a uterus you should take estrogen and progesterone together. The logic is that when patients are given estrogen in the absence of progesterone (or progestins) it can lead to estrogen dominance and a number of unwanted side effects, including an increase in the risk for breast cancer. Balancing a hyper-estrogenic state in the body with progesterone has been thought to be important. Many hormones are synthesized from cholesterol in the liver. Phase I liver metabolism of fat soluble hormones, involving cytochrome P-450 results in modifications in fat-soluble toxins into water-soluble intermediates. The 2, 4, and 16 hydroxyestrone metabolites of estrogen molecules are produced in estrogen conjugation. Various toxins (ex: alcohol, pesticides) can influence the production of the carcinogenic 4 OH and 16 OH estrogen molecules, increasing the risk of breast and cervical cancer. Consequently, a shift toward the production of these metabolites is not desirable. Indole-3-Carbinol, a natural product derived from cruciferous vegetables shifts the metabolism away from the 4 and 16-hydroxyestrones to the more desirable 2-hydroxyestrone metabolite. |