Beyond the Pink Ribbon: Breast Health, Hormones & Prevention
October 23, 2026
What 45 years as a pharmacist and more than 25 years in hormone consulting have taught me about women’s health.
October is Breast Cancer Awareness Month, and I recently listened to a fascinating conversation on my favorite podcast Women Talking Frankly featuring Dr. Kenna Stephenson and author of “A Bean in my Breast” Angela M. Grout.
Their discussion reminded me why I’ve devoted so much of my professional life to understanding hormones, healthy aging, and the science behind women’s health.
One message continues to guide my work:
Be aware of your symptoms, get educated, and take a proactive role in your health.
I recently had my own mammogram, which got me thinking about the importance of breast cancer screening—and everything else we can do to support our health.
Breast health is about much more than a mammogram.
It’s about understanding our hormones, knowing our individual risk factors, nourishing our bodies, staying physically active, and paying attention to the environment around us.
And it’s about understanding the SCIENCE!
Let’s begin with one of my favorite subjects.
Progesterone: The Great Balancer!
If there is one hormone I have come to appreciate profoundly throughout my years of hormone consulting and pharmaceutical compounding, it is PROGESTERONE!
I call it The Great Balancer, and for good reason.
I have witnessed remarkable improvements in women navigating perimenopause when progesterone therapy was appropriately incorporated into their individualized care.
Women struggling with sleepless nights, irritability, breast tenderness, and unpredictable menstrual cycles sometimes experienced dramatic improvements.
Why?
Because progesterone does much more than prepare the uterus for pregnancy!
Progesterone helps regulate the menstrual cycle, supports pregnancy, and balances estrogen’s effects on the uterine lining. It also influences the nervous system, breast physiology, and other hormone-responsive tissues.
One of its metabolites, allopregnanolone, interacts with GABA receptors in the brain. GABA is our primary inhibitory neurotransmitter, helping regulate nervous system activity.
This is one reason progesterone has attracted considerable interest in sleep research.
And during perimenopause, the relationship between progesterone and estrogen becomes particularly interesting.
As ovulation becomes less predictable, progesterone production may decline or fluctuate while estrogen levels remain substantial—or fluctuate dramatically themselves.
Suddenly, women may experience symptoms they’ve never had before.
I’ve spent decades helping women understand these changes rather than simply accepting them as an inevitable part of aging.
Progesterone truly is a remarkable hormone. And understanding its relationship with estrogen is essential.
Estrogen: We NEED It!
Let’s give estrogen the respect it deserves!
Estrogen is essential for reproductive health, bone maintenance, cardiovascular physiology, and BRAIN function.
Estradiol (E2), our principal estrogen during the reproductive years, acts through receptors found throughout the body.
And some of the most fascinating research involves estrogen and the female brain.
Neuroscientist Lisa Mosconi, PhD, has spent years investigating the relationship between menopause, brain metabolism, and Alzheimer’s disease.
Her research has highlighted the important role estrogen plays in brain energy metabolism and neurological function.
Could estrogen have a protective role in brain aging?
Possibly! It’s an exciting area of research.
But while estrogen has important effects on brain physiology, hormone therapy has not been proven to prevent Alzheimer’s disease and should not be prescribed solely for that purpose.
The point is that estrogen is not the enemy.
We need estrogen. We need progesterone. And we need to understand how they work together.
Estrogen Dominance: It’s About BALANCE!
Throughout my hormone consulting career, I’ve frequently discussed the concept of estrogen dominance.
It’s a term used in integrative medicine to describe circumstances in which estrogen’s effects may be relatively unopposed by progesterone.
Although estrogen dominance is not a standardized medical diagnosis, the hormonal fluctuations of perimenopause are very real.
Breast tenderness, irregular menstrual cycles, bloating, and sleep disturbances may accompany these changes.
But there’s another important part of the story.
Our bodies must not only produce hormones—they must metabolize and eliminate them!
Estrogen undergoes metabolism primarily in the liver, where several enzyme systems transform it into compounds that can be eliminated through urine or bile.
Glutathione plays an important role in liver antioxidant defenses and certain detoxification pathways.
Some estrogen metabolites enter the intestinal tract through bile, where gut bacteria can influence their reabsorption.
This is one reason I emphasize good bowel habits and adequate dietary FIBER!
Vegetables, fruits, legumes, and other fiber-rich foods help support regular elimination and a healthy digestive system.
I also encourage women to eat cruciferous vegetables—broccoli, Brussels sprouts, cauliflower, cabbage, and kale—which contain compounds studied for their effects on cellular health and estrogen metabolism.
My message has always been simple:
Hormone balance isn’t about eliminating estrogen or automatically adding progesterone. It’s about understanding the relationship between these hormones, how they change throughout life, and what each individual woman needs.
Test. Don’t Guess.
For nearly 26 years, I’ve worked with ZRT Laboratory, founded by biochemist David Zava, PhD, whose scientific interests have included breast cancer and hormone physiology.
I’ve valued that longstanding relationship and the laboratory’s work in hormone testing.
Throughout my consulting career, I’ve used salivary and dried blood-spot testing, together with detailed symptom histories, to help women better understand their hormonal changes.
Testing can provide useful information when selected and interpreted for an appropriate clinical purpose. However, a hormone ratio alone does not establish a diagnosis or determine breast cancer risk, and routine saliva or blood-spot measurements have not been validated as universal menopausal hormone dosing targets.
I believe in listening carefully to the woman, understanding her symptoms, considering her medical history, and using appropriate evaluation to guide informed decisions.
The woman—not just the laboratory report—must always remain at the center of her care.
Natural Progesterone vs. Synthetic Progestins: Why the Difference Matters
Here’s something I’ve emphasized for decades.
Natural progesterone and synthetic progestins are NOT identical!
Micronized progesterone is chemically identical to the progesterone produced by our bodies.
Synthetic progestins are medications designed to produce some progesterone-like effects, but their chemical structures and biological actions can differ.
Many birth control pills contain synthetic progestins. Hormonal IUDs contain levonorgestrel, another synthetic progestin, while copper IUDs contain no hormones.
Hormonal contraception has important benefits, but studies have also found a small increase in breast cancer risk among current or recent users of certain hormonal contraceptives. For most younger women, the absolute increase is small.
These findings are separate from research on menopausal hormone therapy.
What Did the French E3N Research Discover?
This is where the science becomes particularly interesting!
Researchers in France followed thousands of women and studied breast cancer diagnoses among those using different types of menopausal hormone therapy.
They discovered that the specific hormone used alongside estrogen appeared to matter.
Women using estrogen with micronized progesterone had more favorable breast cancer findings than women using estrogen with certain synthetic progestins.
In other words, the researchers found important differences between hormone formulations.
That’s significant!
The studies did not prove that progesterone prevents breast cancer. They identified differences in risk among groups of women using different treatments.
But they reinforced something I have always emphasized:
Not all hormone formulations are the same.
The type of hormone, the dose, the delivery method, the woman’s medical history, and the duration of treatment all deserve consideration.
This is why informed, individualized hormone care matters so much.
Iodine: More Than a Thyroid Nutrient!
Now here’s something that surprises many women.
Iodine isn’t important only for the thyroid. Breast tissue uses iodine, too!
Iodine is essential for thyroid hormone production, but it is also taken up by breast tissue, especially during pregnancy and lactation.
Iodine deficiency remains a significant public-health issue worldwide, although many Americans obtain adequate amounts and individual needs vary.
What particularly interests me is the research exploring iodine’s relationship with breast tissue, estrogen receptors, and fibrocystic breast changes.
Laboratory studies suggest that iodine can influence estrogen-related signaling in breast cells.
Researchers have also investigated iodine supplementation for fibrocystic breast tenderness, with some studies reporting improvements.
These findings are intriguing, although we don’t yet have evidence that iodine supplementation reliably balances estrogen activity in women or prevents breast cancer.
My Experience in the Compounding Laboratory
This research was especially meaningful to me during my years as a compounding pharmacist.
I developed a topical breast cream incorporating iodine and glutathione for individualized treatment of fibrocystic breast symptoms and general breast-health support.
I loved compounding!
There was something deeply satisfying about bringing together pharmaceutical chemistry, physiology, and individualized patient care.
That experience continues to influence how I evaluate ingredients, formulations, and scientific research today.
Iodine supplementation requires thoughtful evaluation because excessive intake can interfere with thyroid function. When iodine deficiency is suspected, dietary history and appropriate clinical assessment are important; a single urinary iodine test may not accurately reflect an individual’s usual status.
The science connecting iodine and breast physiology is fascinating—and deserves continued investigation.
Glutathione: The Master Antioxidant!
If you know my work, you know I could talk about GLUTATHIONE all day!
I’ve spent more than 25 years studying this remarkable molecule and its importance in healthy aging.
Glutathione is one of the body’s most important intracellular antioxidants.
It is composed of three amino acids—glutamate, cysteine, and glycine—and is found throughout the body.
Its roles include supporting cellular antioxidant defenses, maintaining normal redox balance, and participating in enzyme systems that help protect cells from oxidative damage.
And one of its most important jobs involves the LIVER!
Think about what our liver processes every day.
Medications, metabolic byproducts, hormones, environmental chemicals, and countless other substances pass through this extraordinary organ.
Glutathione participates in important detoxification reactions, including conjugation processes that help the body transform and eliminate certain compounds.
It’s fundamental biochemistry!
My interest in acetyl-glutathione has always centered on healthy aging, cellular antioxidant protection, and supporting the body’s normal defense and detoxification systems.
I believe in understanding how these processes work—not accepting vague promises that a supplement can magically “detox” everything.
And while glutathione is essential to normal cellular function, supplemental glutathione has not been established as a breast cancer prevention treatment.
Healthy aging begins at the cellular level. And glutathione is a remarkable part of that story.
Breast Health: What Can We Do Every Day?
Now let’s move from the laboratory to everyday life!
Because understanding hormone physiology is important—but so are the choices we make each day.
MOVE!
Regular physical activity is associated with a lower risk of breast cancer.
Movement supports metabolic health, weight management, muscle strength, and overall well-being.
Walking, hiking, cycling, swimming, dancing, and strength training all count.
I love walking and hiking Pittsburgh’s beautiful trails, especially during our spectacular autumn season.
We don’t need to become marathon runners.
We need to KEEP MOVING!
Eat Real Food—and Don’t Forget Fiber!
A diet rich in vegetables, fruits, legumes, whole grains, healthy fats, and adequate protein supports overall health.
Fiber also supports normal bowel function, which is particularly interesting when we consider how some estrogen metabolites are eliminated through the intestinal tract.
I encourage women to focus on food first rather than chasing every new supplement trend.
What About Alcohol?
Alcohol is an established breast cancer risk factor.
Why?
Our bodies metabolize alcohol into acetaldehyde, a compound capable of damaging DNA. Alcohol can also influence estrogen concentrations and other biological processes involved in cancer development.
The American Cancer Society advises that avoiding alcohol is best for cancer prevention. Women who choose to drink should limit themselves to no more than one standard drink per day.
Even that amount isn’t risk-free.
Understanding WHY alcohol affects risk helps us make more informed choices.
Sleep, Stress & Shift Work
Sleep is essential for healthy aging.
Our bodies operate on circadian rhythms that help regulate hormones, metabolism, and sleep-wake cycles.
Researchers have investigated how disruption of these rhythms—particularly among people who work night shifts—may influence cancer risk.
The International Agency for Research on Cancer classifies night shift work as probably carcinogenic to humans, based on evidence involving circadian disruption and cancer mechanisms.
This doesn’t mean every shift worker will develop cancer. It means the relationship deserves serious scientific attention.
For all of us, consistent sleep habits, stress management, and opportunities for relaxation support overall health.
And don’t forget to make time for activities you enjoy!
What We Put On Our Bodies—and What We Bring Into Our Homes
As a pharmacist, chemist, and skincare formulator, I care deeply about ingredients.
Our skin is an extraordinary protective barrier, but certain substances can penetrate it and, depending on their properties and formulation, enter systemic circulation.
This is the same principle behind transdermal medications.
Of course, not every skincare ingredient is absorbed to the same degree.
Molecular structure, concentration, formulation, and skin condition matter.
That’s why I believe skincare should be developed with a real understanding of chemistry and skin physiology—not marketing hype!
I’m equally interested in reducing unnecessary environmental exposures.
Scientists continue to investigate endocrine-disrupting substances found in certain plastics, packaging materials, fragrances, and consumer products.
The evidence linking individual exposures to breast cancer varies, but practical choices can reduce unnecessary contact.
Avoid heating food in plastic containers. Choose glass or stainless steel when practical. Read ingredient lists. Be thoughtful about unnecessary fragrances and other exposures.
This philosophy is central to my Pharmacist-Developed LabNaturalsSKINcare.
A product doesn’t become safe or effective simply because it says “natural.”
Science matters. Ingredients matter. Formulation matters!
Mammograms & Breast Self-Awareness
Breast cancer screening remains an essential part of preventive healthcare.
The U.S. Preventive Services Task Force recommends mammography every two years for women ages 40 through 74. Other organizations recommend different schedules, and women with higher-than-average risk may need additional screening.
Breast density is another important consideration because dense tissue can make abnormalities harder to identify on mammograms.
I also encourage breast self-awareness.
Know how your breasts normally look and feel. Report new lumps, nipple discharge, skin changes, or other concerning symptoms promptly.
Formal monthly self-examination hasn’t been shown to reduce breast cancer deaths, but recognizing changes in your body remains important.
I’ve explored thermography over the years, but it has not been shown to reliably detect early breast cancer and should not replace mammography.
Screening helps detect cancer. Healthy lifestyle choices can help reduce risk. Both deserve our attention.
Breast Health Matters for Men, Too!
Although breast cancer is far less common in men, it does occur. The American Cancer Society estimates that approximately 2,670 men in the United States will be diagnosed with invasive breast cancer in 2026. Men should also be aware of unusual breast changes, including a lump, nipple discharge, or changes in the skin.
Breast awareness is everyone’s business!
Beyond the Pink Ribbon: Take Charge of Your Health!
After 45 years in pharmacy practice, I remain convinced that education is one of the most powerful tools we have.
I have spent more than 25 years helping women understand their hormones, recognize symptoms, ask better questions, and become informed participants in their healthcare.
And I still get excited when I discover research that helps explain how our bodies work!
That scientific curiosity has guided my entire professional journey—from compounding individualized formulations in my laboratory to developing LabNaturals products and educating women about hormone balance and healthy aging.
Breast health isn’t about fearing estrogen, chasing the latest supplement, or believing every headline we read.
It’s about understanding our bodies, knowing our risk factors, making informed decisions, and taking advantage of the preventive tools available to us.
Be curious. Ask questions. Understand your hormones. Know your body. And never stop learning.
Because informed women are empowered women.
To your health,
Susan Merenstein, RPh
Holistic Consultant Pharmacist
Founder & Owner, LabNaturals, Inc.
The Vital Health Pharmacist™
Continue Learning with LabNaturals, Inc.
Hormone Balance & Healthy Aging Consultations
VitalHealthPharmacist.com
At-Home Hormone & Wellness Testing
Explore testing options through VitalHealthPharmacist.com.
Progesterone — The Balancing Hormone
Read My Progesterone Master Class
How Progesterone Protects Against Breast Cancer Blog
Estrogen Dominance — Help Is Here!
Read My Original Hormone Education Article
Glutathione: The Master Antioxidant
Explore My Glutathione Education
My Pharmacist-Developed Non-Toxic SKINcare
LabNaturalsSKINcare.com
Cannabis, Menopause & the Endocannabinoid System
Explore the Connection Between Hormones and the Endocannabinoid System
LabNaturals Professional Supplement Dispensary
Professional-quality nutritional supplements and individualized wellness resources.
Scientific & Clinical References
1. Fournier A, et al. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Research and Treatment. 2008;107:103–111.
2. Fournier A, et al. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. International Journal of Cancer. 2005;114:448–454.
3. Micheli A, et al. Endogenous sex hormones and subsequent breast cancer in premenopausal women. International Journal of Cancer. 2004;112:312–318.
4. Cowan LD, et al. Breast cancer incidence in women with a history of progesterone deficiency. American Journal of Epidemiology. 1981;114:209–217.
5. Foidart JM, et al. Estradiol and progesterone regulate the proliferation of human breast epithelial cells. Fertility and Sterility. 1998;69:963–969.
6. Chang KJ, et al. Influences of percutaneous administration of estradiol and progesterone on human breast epithelial cell cycle in vivo. Fertility and Sterility. 1995;63:785–791.
7. Mosconi L, et al. New Horizons in Menopause, Menopausal Hormone Therapy, and Alzheimer's Disease: Current Insights and Future Directions. Journal of Clinical Endocrinology & Metabolism. 2025;110:911–921.
8. National Institutes of Health, Office of Dietary Supplements. Iodine: Fact Sheet for Health Professionals.
9. Ghent WR, et al. Iodine replacement in fibrocystic disease of the breast. Canadian Journal of Surgery. 1993;36(5):453–460.
10. Kessler JH. The effect of supraphysiologic levels of iodine on patients with cyclic mastalgia. The Breast Journal. 2004;10(4):328–336.
11. Stoddard FR II, et al. Iodine alters gene expression in the MCF7 breast cancer cell line: evidence for an anti-estrogen effect of iodine. International Journal of Medical Sciences. 2008;5(4):189–196.
12. U.S. Preventive Services Task Force. Breast Cancer: Screening. 2024.
13. American College of Obstetricians and Gynecologists. Compounded Bioidentical Menopausal Hormone Therapy. Clinical Consensus. 2023.
14. American Cancer Society. Guideline for Diet and Physical Activity for Cancer Prevention.
15. International Agency for Research on Cancer. Night Shift Work. IARC Monographs, Volume 124.
16. U.S. Food and Drug Administration. Breast Cancer Screening: Thermogram No Substitute for Mammogram.
17. American Cancer Society. Key Statistics for Breast Cancer in Men. Updated January 13, 2026. Read source.
Educational disclaimer: This article provides general health education and does not replace individualized medical evaluation, diagnosis, or treatment. Discuss hormone therapy, supplements, breast symptoms, and screening decisions with an appropriate healthcare professional.