…that estrogen used in women who are menopausal:  improves sleep, lowers heart attack risk (by 50%), lowers the risk for colon cancer (by 50%), helps to maintain memory, reduces the risk of osteoporosis and maintains skin integrity? 

Patients who are candidates for hormone replacement therapy need to be counseled in detail on the risks and benefits of treatment.  A thorough review of family history for breast cancer should be performed prior to starting estrogen replacement therapy.  All patients on replacement should consider taking DIM (diindolylmethane) to reduce the liver’s production of an estrogen metabolite that has been shown to increase the risk for breast cancer (4-OH estrogen).  This metabolite can be measured in a simple urine test. 

It is important to note that even patients who are not on hormone (estrogen) replacement therapy are at increased risk for breast cancer if they make this metabolite in excess.  Patients make estrogens from peripheral fat cells and from the adrenal glands.