Doctor's Note

Another way to rid ourselves of excess estrogen is in the way nature intended: Relieving Yourself of Excess Estrogen. We can also stop consuming steroid hormones; see Anabolic Steroids in Meat, and Acne & Cancer Connection. For other ways to decrease breast cancer risk, see The Answer to the Pritikin PuzzleBreast Cancer Survival and Soy; and Broccoli Versus Breast Cancer Stem Cells.

For more context, check out my associated blog posts: Stool Size and Breast Cancer RiskMushrooms for Breast Cancer PreventionTreating Breast Pain with Diet; and Are Bioidentical Hormones Safe?

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  • HemoDynamic, M.D.

    Just what the Doctor ordered. . . Knowledge!!
    Thank you for that piece!

  • jylle

    Dr. John Lee did some excellent work on progesterone therapy for post-menopausal women. Anecdotally he relates amazing reversal of debilitating osteoperosis (sp) in elder women. Are you familiar with his work?

  • veggiegirl78

    I have been vegan for almost two decades. I have extremely heavy, long, painful periods (since onset of menses) and hypothyroidism and my doctor put me on oral bioidentical progesterone about a year ago. It has been very helpful to me. Are you saying that it is not safe to be taking that?

    • Jo

      For dysmenorrhea, look into taking vitamin B1 (thiamine) and vitamin B6. Just do a Google search: vitamin B6 dysmenorrhea thiamine B1.

      Too, have you seen Dr. Greger’s video on PMS: and

      You can buy saffron capsules on Amazon

    • Jo

      Also, drinking green tea daily helps. Google: green tea menstrual cramps. Just watch your iron, as green tea can reduce your iron intake.

      • veggiegirl78

        Thanks Jo, I will look into that. I currently take a B complex that contains B1 and B6, but I don’t know what the amounts are. I also take a green tea extract supplement as I don’t like the taste of green tea (I take it 4 hours apart from my iron supplement). My iron has been low since it was first checked 15 years ago. I was borderline anemic before starting the iron supplements. It’s still chronically low, and I do include vegan sources in my diet (lentils, spinach, quinoa, soy, etc). I do sometimes wonder if red meat might improve my iron status, but I am sickened by the thought of actually eating it.

        • Veganrunner

          Hi Veggiegirl,

          Late to your post but I am borderline anemic whether I eat meal or not. I guess we are just the unlucky ones who don’t absorb iron well.

          • Sophie

            Study in India asked women not to drink tea around their meals and eat one orange after each meal – their iron levels went right up – vit c increases iron absorption..

          • Veganrunner

            Yes. Those are important things to be cognicent of.

    • Dose, vehicle (oral or skin), and age of person all make a huge difference as to safety. I take estradiol and synthetic progesterone via skin patch at low dose and it has totally cured my excessive bleeding. You may want to talk to your doctor about the patch. Good luck. I’m a vegan too, btw.

    • Khari

      I have always been anemic. Even the entire time I ate meat. It’s taken a bit to get my iron up since I became vegetarian and now vegan. But I find steeping raw organic stinging nettle dried loose leaf (you could use fresh leaves as well) over night and consuming once I wake up in the morning has helped immensely. My iron levels are perfect now.
      Google nettle infusion (Susan Weed has a infusion that I use) and it is very high in iron plus many other nutrients.

  • DonnaJay

    Dr. Greger, I’m wondering about what I should do in regards to my hypothyroidism. I was diagnosed with Graves disease in 2006 and shortly took the radioactive iodine treatment which left my thyroid non-functioning. I have since been taking levothyroxine off and on for several years now. Levothyroxine makes my T4 numbers look good when I get tested but I don’t feel any better when i take it. I have been a vegetarian for many years now and a plant-based vegan for a short time now and am not sure what I should do in regards to my thyroid, as the only time I feel better is when I monitor my diet and eat plant-based. My endocrinologist swears that I need to take the hormone but I really don’t feel any better when I do. Please help. Thank you.

  • Ann

    Thank you for this one. My doctor gave me a yam compound that I smeared on for a month. I had horrible results. It did nothing to rid me or night sweats or hot flashes. It did nothing for my mood except worsen it.
    I told him I was afraid of hormones but he said this was harmless. I doesn’t seem harmless to me.

  • Lesley Jacobs-Keeler

    At the age of 35, I had a total abdominal hysterectomy and bilateral salpingo-oophorectomy. I take compounded BHT and thank goodness I do!! I would rather know the risks and take the plant derived hormones over horse piss any day. Without the BHT, I would be in the loony bin with the electroshock therapy!! Women have had to suffer through so much!

    • Roger T

      Isn’t bht butylated hydorxytoluline, a synthetic antioxidant used for preserving cooking oils? What hormonal effect does it have. I have read that it may antiviral activity since it can disrupt the fatty coat of some species.

      • Lesley Jacobs-Keeler

        BHRT – sorry forgot the R

  • Roger T

    I don’t know about the long-term safety of bio-identical hormones- but my girlfriends can tell you from personal experience that they’re effective. They stopped her hot flashes and depression, helped her sex drive and energy and made her skin more youthful- including the skin inside her legs that used to be all dried up.

  • Roger T

    I also wanted to point out that bio-identical hormones are not identical to the synthetic hormones that big pharma patents and doctors prescribe. They are unpatentable natural substances with well-established effects. It is the synthetic unnatural chemicals derived from horse urine which we have reason to suspect.

  • John

    Dr Greger,
    Do you have any information on treatment with single agent bioequivalent progesterone given without estrogen
    treatment? I know there have been some small studies indicating that
    treatment with progesterone alone can help ameliorate symptoms, but
    haven’t seen anything about decreased risk of cancer with progesterone
    alone versus estrogen or estrogen + progesterone. Thanks in advance.

  • Susan Lavelle, FNP

    From my understanding of the literature, we just don’t have enough studies in the US of women using strictly bio-identical hormones to say much of anything. We are all an experiment! I think there is more and more evidence, both in Europe and here, that synthetic progesterones (progestins) may have harmful effects. But what is more striking to me is the practice of placing women on a static doses of estrogen, progesterone and testosterone hormones, with no variation in dose with the cyclic rhythm of the month. There is nothing biologically “natural” about this practice. I think it is here that we may be way off the mark. Many women take hormones after menopause for very legitimate reasons that make a significant difference in their quality of life. Hopefully someday we’ll have some decent studies that really look at these issues.

    • Christy Begley

      I agree completely! There are some real quality of life issues that some women would like to avoid.

    • Vivian

      Recent long term studies in France, that looked at women exclusively on bio-identical hormones showed a decrease in strokes. There is also a US study showing lack of hormones has a link to atheriosclerosis. Probably why cardiovascular disease increases after menopause???

      • Birt

        Please reference the studies you refer to from France and USA.

  • Mirador

    What hormones are we talking about here? Estrogen only? Estrogen plus progesterone? Estrogen plus progestin? Progesterone only? Testosterone? Thyroid hormones?

  • Christy Begley

    “Patients should be discouraged from taking them”. Hmmmm…. What about those women who would like to continue enjoying sex, but are concerned about vaginal atrophy? If this were a men’s issue, it wouldn’t even be being discussed, because of course men want to continue having sex. But women should be discouraged from taking bio-identical hormones due to the (not huge) increased risks of certain diseases…

    • Pat

      Coconut oil! I was using a bio-ID progesterone and still had horrid atrophy. I desperation I grabbed my virgin coco oil and smeared it in my labia. I also made “pellets” to push up. The next time I saw my gyne she said she would never know my age by my tissues and asked what I was doing. Now I just put a little on externally. She knows tells all her older patients about it.

      • Birtha

        How do you make the pellets? How often do you use them?

  • Amanda

    Dear Dr.Greger, please please answer my question because Ive been wondering forever and my doctor is no help at all.
    I have had higher than normal androstenedione levels since I was 17 (only got tested then, so dont know earlier), I am now 26. I was vegetarian, then became vegan, even tried raw veganism but failed, so now am vegan half-raw half-cooked. I have had back acne since 14-15, hairgrowth on my body is increasing with every year… I have little bumps all over my face but you only see them in certain lighting.Ive been tested for PCOS but they saw nothing. So my question is: what else can this be :S
    I was low in vitamin D and B 12 but am supplementing this daily.
    I am in good shape, exercise, bmi 19.5, oh and female ofcourse. My testosteron is to the high side as well but not too high.

    Thx in Advance

    • Hi Amanda, Congratulations on the diet sorry to read about your difficulties. Of course there are normal variants between patients and if you are following a good whole plant based diet with Vitamin B12 supplements you should be avoiding many of the dietary and chemical contaminants that contribute to acne and hair growth. In addition to the level of hormones in the body patients cells actually respond differently to the same hormone levels. I would suggest that you continue to be followed by a knowledgeable endocrinologist as there are other conditions other then PCOS that may cause your difficulties. A good dermatologist might have other suggestions both as to the underlying cause and to help treat the acne. Good luck and sorry I couldn’t be of more help.

      • Amanda

        Thx a lot for your reply :) I appreciate it

      • MARIA

        you need iodine …….no more acne no more hair try LUGOL

  • Amy

    What would be recommended, then, for young women who have to have their ovaries removed? I have a BRCA-1 mutation and have been vegan since finding out 2.5 years ago. I am 37 and recommended to get bilateral mastectomy and oophorectomy ASAP, or at least before age 40. This is a really hard thing to go through, and I’d like to know anyone’s advice on what would be the best way to remedy the hormone loss.

  • Obviously the study did not consider the danger of trying to function on less than 2 hours sleep every night for months/years! I woke up every 90 minutes for years until I discovered bioidentical hormones. A very low dose gives me 8 hours of rejuvenating sleep at night and I’m not giving them up until something else works. Believe me, I’ve tried every other natural insomnia remedy out there.

    • lea

      I have had the opposite happen to me. Been on Bioidenticals for 6 yrs and I still have to take a sleeping pill. But it does help with the hot flashes. Have my blood work done every so they say I am on the right dose but….no sleep without a pill which I don’t want to be on.

    • Gail England

      Oh gosh, I hear you Pam. When I go off mine, I do NOT sleep. This info scares the crap out of me. And at 60, it’s quality of life that i am interested in, but don’t want to end up with cancer.

  • Jodashde

    Your advice, Dr. Greger, is almost always very understandable to me, but I do want to know what you recommend for women who have vaginal atrophy or other issues that bio-identical hormones can help? What is your opinion about a cream? Not a vaginal cream, but a topical cream that is smoothed onto a woman’s inner thighs or inner upper arms, so it bypasses the liver? I would think as a middle-aged man that this issue would affect you as well, so what works for your sexual partner?

  • Combipatch- Bioidentical estradiol and synthetic progestrone – taken via a patch is fairly safe, especially for women who are still going through menopause, has been a miracle for me. Insomnia, anxiety, hot flashes, excessive bleeding, depression…all controlled from patch. I am a vegan who eats a very balanced diet of whole foods, gets her blood levels checked often, takes supplements, etc. But only the patch worked for me. I also have to stay away from soy, flax and most legumes as they mess with the balance of estrogen and progesterone and cause symptoms. (I get my protein now from veggies, whole-grains and some seeds and nuts, particularly almonds.

  • matt

    For those talking about dysmenorrhea I find chaste tree berry is great to help normalize the menstrual cycle via the HPO axis

  • Kim

    What about the Wiley Protocol? It is not only bio-identical but bio-mimetic.

  • Kay

    I had such bad symptoms when I weaned myself off bio-identicle hormones, that I started taking them again….and feel much better. Having a good, compounding pharmacy is important.

  • Tia Haenni

    Dr. Greger, please advise. I just had a bi-lateral hysterectomy with complete oophorectomy (sp) due to enlarged uterus, large fibroids and a septated ovarian cyst. I was not having any menopause symptoms prior, however I had stopped having periods since a D&C in 2011. I am having severe “hot flashes” with exacerbated asthma to the point of being almost non-functional. Prior to the hysterectomy I had no asthma attacks in 40 years. I’ve also had a pre- cancerous breast mass removed in 2007. That along with a family history of blood clots makes me uncomfortable with synthetic/equine estrogen HRT or ERT. I’ve heard that soy may be effective in regards to estrogen replacement. I’m also concerned about preventing Osteoporosis. Are fortified calcium and Vitamin D such as that added to plant milks safe? What do you suggest? Thank you so much in advance.

    • Thea

      Tia: I’m not a doctor and can’t comment on most of your questions. However, I thought you might appreciate a reference to a book about preventing osteoporosis.
      “Building Bone Vitality” by Amy Joy Lanou, Ph.D. and Michael Castleman.–Without/dp/0071600191/ref=sr_1_1_title_0_main?s=books&ie=UTF8&qid=1392152304&sr=1-1&keywords=building+bone+vitality

      Dr. Greger would take issue with some of the theories in the book, but I think the overall recommendations and bottom line for the book is valid and helpful.

      Good luck.

      • Tia Haenni

        Thanks! I’ve read several books, including Suzanne Somers “I’m too young for this”. I’m perusing BHRT as I think this is the healthiest option for both men and women when they experience “the change”. Unfortunately, you really have to dig deep and educate yourself, then insist on a better answer from your doctor! Mine first wanted to give me Premarin, which I refused (see the WHI study if 2002), then I was given the estrogen patch that “works for most people” who apparently are ok with the serious risks. I declined that ad well. I’m getting by with a natural estrogen cream until my BHRT is properly formulated. For that, you have to seek out a compounding pharmacy.

        • Thea

          Tia: Good for you for standing up for yourself and what you know would be bad decisions. I think you saved yourself some trouble down the line by doing your research. I don’t know anything about BHRT or issues around supplementing with estrogen, but like you, I do know that Premarin is a bad idea.

          • citrus1

            Thea, Do have thoughts on MACA for menopause? and if so can you comment on its safety ( cancer risk)…Much Thanks..I think someone else on this tread asked a similar question…..

          • Thea

            citrus1: I like how you worded your question, re: “…thoughts…” I often have thoughts. ;-) In don’t always have the concrete info I wish I would have.
            As for maca, my thoughts are: I’ve heard of maca and even had a doctor recommend it to me once (though not for reasons of menopause). However, this same doctor had recommended licorice, because he had been unaware of the potential danger of licorice. So, I’m pretty sure the doctor was not aware if there was any research, positive or negative, specific to maca.
            A dog trainer who I particularly like once said something to the effect of: If something has the power to effect change, it has the power to hurt as well as help, or both. So, I think it is especially wise of you to ask what the downside to maca might be. I don’t know the answer. I hope that one of our medical moderators or research-wise community members will answer that question. In the meantime, my thought it (lame as it is) is to be cautious.
            What do you think?

      • Andy G

        Its important to use the terms “claim” or “hypothesis” in statements such as the above. In science a theory is an explanation for a phenomenon in the physical universe that is supported with an overwhelming and substantial amount of evidence to support a hypothesis and none to refute it. Old science teachers never stop trying to grow scientifically literate minds. So our choice of words is critical.

  • Rivka Freeman

    The way to not need prescription HRT or compounded bio-identical hormones adjusted to your personal physiological needs is to eat at least 2 tablespoons of ground flax seeds in something good and tasty every day for the rest of your life, and pumpkin seeds, avocados and olives and be as green vegetarian as you can possibly be. Don’t consume any oils except very small amounts of extra virgin olive oil and coconut oil for baking or sautéing, everyday oil competes with omega 3. Drink water as your primary beverage with unsweetened electrolye salts added. Take bathes with lots of Himalayan salt crystals, get alkaline. Don’t ever eat anything #GMO. Check me out on where I try to teach nutrition therapy.

    • Ann

      Yeah don’t teach it here.

  • Natasha

    Thank you for these videos, they are so inspirational and eye opening….it is so great to discover all of this wonderful insight. I’ve also found this video helpful because I have recently considered trying bioidentical hormones because i am finding the ones I am on seem to be causing some depression.

    I feel curious what is the best treatment for premature ovarian failure ?

    I am 34 and I had menopause at 26 and I have only just been put on an estrogen patch a month ago after a hospital admission however, because I have had heart issues in the past i am really interested to discover the best treatment so that I can protect the health of my heart in the future.

    This site has been helping me in many ways in terms of changing my diet to a plant based one and taking responsibility to improve my health ,overcome a food addiction and turn many things around for the better…11 months ago…I had some paralysis in my left side and now i am walking around and living life again. It is amazing what good nutrition and self care can do. So I am immensely grateful for the information that is here. This site is so helpful , it gives us the freedom to make well informed decisions based on science and it is also great for motivation and inspiration to stay on track with these great nutritional principles.. This information save lives.,. Thank you. :-)

  • Arnold

    Try armour thyroid or Nature-Thyroid. It gives you t3 and t4 and is by prescription. You of course can get it
    online without one. Do your own research, ask your doctor. It may change your life!!!!!! It has mine and millions of others.

  • martina staal

    I am wondering about maca powder for menopause and andropausefor. I am a almost 3 year whole plant,no oil vegan and still have to fight hot flashes and insomnia to some extend. How long will it take until my body gets used to the maca and my sleeping gets better? I would love to hear your insides!Thank you.

  • Karen

    I am 53 years old and went into menopause 2 years ago and started terrible hot flashes 1 year ago… But what is more troubling than that is I’ve had consistent painful intercourse. Western med docs prescribed Premarin (which I refused to take) and then Estradiol + Progesterone. I am wondering if you know of a natural way. This has been very upsetting to me. I have been vegan for 4 years.

  • Angela

    Is there any research on the effects of testosterone treatment on trans individuals? What would you recommend to those who are looking to block estrogen and increase the testosterone levels in their bodies?