# Estrogen Metabolites in Urine: Key Indicators of Hormone Metabolism

Written By

[Dr. Emilie Wilson ND, L.Ac.](/content/author/emilie-wilson/index.html)

Medically Reviewed by

Updated On

February 28, 2025

Your body processes and eliminates estrogen through metabolic pathways that influence overall hormonal balance.

Proper estrogen metabolism is associated with various aspects of health, including bone density and menstrual cycle regulation. Ongoing research explores how differences in estrogen metabolism relate to hormone-related conditions and highlight the usefulness of estrogen metabolite testing.

In this article, we’ll explore how urine estrogen metabolite testing works, why it’s valuable, and how both patients and practitioners can use the results to better understand hormonal health.

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## What is Estrogen?

[Estrogen](https://www.ncbi.nlm.nih.gov/books/NBK538260/) is an important hormone that affects many parts of the body. It works by attaching to [estrogen receptors](https://www.ncbi.nlm.nih.gov/books/NBK538260/) in the body, which send signals to cells to help them function properly.

Estrogen is a [key hormone](https://www.mdpi.com/2227-9059/10/4/861) for women's health, but it also has essential roles for men and overall well-being.

Here's a simple explanation of [how it works](https://www.ncbi.nlm.nih.gov/books/NBK538260/) and [what it does](https://www.mdpi.com/2227-9059/10/4/861):

### Reproductive Health

Estrogen is [essential](https://www.ncbi.nlm.nih.gov/books/NBK279054/) for the [menstrual cycle](/content/post/how-to-support-a-healthy-menstrual-cycle/index.html) and ovulation. It helps the body prepare for pregnancy by thickening the lining of the uterus. It also plays a key role during [puberty](https://www.ncbi.nlm.nih.gov/books/NBK534827/), helping develop secondary female characteristics like breasts and wider hips.

### Bone Health

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC7913980/) helps keep bones strong by promoting the growth of new bone and preventing bone loss. It protects against [osteoporosis](/content/post/a-functional-medicine-approach-to-osteoporosis/index.html), a condition that makes bones weak and more likely to break.

### Brain and Nerve Health

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC4491541/) interacts with brain cells, supporting cognitive function and mood regulation. Some research suggests an association between estrogen levels and [memory](https://pmc.ncbi.nlm.nih.gov/articles/PMC4491541/) or [neuroprotection](https://pmc.ncbi.nlm.nih.gov/articles/PMC4491541/).  Estrogen may also be associated with a [lower](https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1260427/full) risk of brain diseases like [Alzheimer’s](/content/post/to-functional-medicine-labs-that-help-individualize-treatment-for-alzheimers-disease/index.html), though individual responses vary.

### Heart and Blood Vessel Health

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC5688223/) supports the heart and blood vessels by keeping them healthy and relaxed, reducing the risk of [heart disease](/content/post/understanding-your-risk-of-cardiovascular-disease-with-functional-medicine-labs/index.html). It also [helps manage](https://pmc.ncbi.nlm.nih.gov/articles/PMC5688223/) [cholesterol](/content/post/high-cholesterol-causes-implication/index.html) levels by raising the more protective cholesterol (HDL) and lowering the high-risk cholesterol (LDL).

### Metabolism and Fat Control

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC3964739/) helps the body control fat by reducing belly fat and improving how the body uses insulin. This lowers the chances of developing [type 2 diabetes](/content/post/complementary-and-integrative-medicine-approaches-to-type-2-diabetes-management/index.html) and supports overall metabolic health.

### Skin and Hair Health

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC2685269/) keeps skin soft, hydrated, and elastic while also supporting collagen production. It helps prevent [hair thinning](/content/post/a-functional-medicine-approach-to-addressing-hair-loss-in-women/index.html), especially before menopause, keeping hair healthy and strong.

### Mood and Sleep

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC6843314/) supports a balanced mood and may help improve [sleep](/content/post/how-to-have-a-good-night-sleep-top-proven-strategies-for-better-rest/index.html). These benefits are especially noticeable during times of hormonal changes, like menopause.

### Immune and Body Repair

[Estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC8870346/) helps [lower inflammation](/content/post/a-root-cause-medicine-approach-to-chronic-inflammation/index.html) and supports a strong immune system. It also aids in tissue repair and keeps skin and blood vessels healthy.

## What Is Urine Estrogen Metabolite Testing?

Urine estrogen metabolite [testing](/content/post/how-to-test-for-female-hormones-a-comprehensive-guide/index.html) measures how estrogen is broken down in your body. When estrogen is metabolized, it goes through two major detoxification phases in the liver:

### Phase I Detoxification

During phase I metabolism, specific enzymes convert estrogen into molecules called metabolites. Generally speaking:

- [CYP1A1](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) and [CYP1A2](/content/biomarkers/2-hydroxyestradiol/index.html) primarily produce the " [protective](https://academic.oup.com/endo/article/144/8/3382/2502066)" 2-hydroxy metabolites (2-OH-E1 and 2-OH-E2).

- [CYP1B1](https://pubmed.ncbi.nlm.nih.gov/15126349/) primarily produces the " [potentially harmful](https://academic.oup.com/endo/article/144/8/3382/2502066)" 4-hydroxy metabolites (4-OH-E1 and 4-OH-E2).

- CYP3A4 produces [2-OH and 4-OH](https://academic.oup.com/endo/article-abstract/144/8/3382/2502066?redirectedFrom=fulltext) estrogen metabolites, as well as the “proliferative” [16-OH-E1](https://pubmed.ncbi.nlm.nih.gov/9635876/) metabolite.

### Phase II Detoxification

The liver [converts](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) these metabolites to even less harmful chemicals (e.g., by methylation), making it easier for the body to eliminate them through urine.

- [COMT](https://repositorio.uchile.cl/xmlui/bitstream/handle/2250/135040/Parada-Alexis-Role-of-2-methoxyestradiol.pdf?sequence=1) typically converts the phase I estrogen metabolites into their methylated forms.

## How the Test Works

Patients provide a urine sample, generally either samples collected over 24 hours or as dried urine strips.

The test measures levels of different metabolites and their ratios to evaluate the efficiency of estrogen detoxification.

## When to Consider This Test

Urine estrogen metabolite testing provides insight into estrogen metabolism and may assist in evaluating detoxification pathways. However, its applicability varies based on individual health conditions and treatment approaches.

### Hormonal Imbalance Symptoms

Symptoms like heavy periods, PMS, bloating, mood swings, and low libido [may indicate](/content/post/a-functional-medicine-approach-to-estrogen-imbalance/index.html) problems with estrogen metabolism. Testing can help uncover underlying imbalances that contribute to these issues.

### Cancer Risk Assessment

Certain estrogen metabolites have been studied for their potential role in [DNA interactions](https://pmc.ncbi.nlm.nih.gov/articles/PMC4030134/). Research is ongoing to understand their associations with [hormone-sensitive](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) conditions, including breast health.

This test may be helpful for individuals with a family history of estrogen-sensitive cancers.

### Detoxification Pathway Function

Estrogen is [processed](/content/post/how-the-liver-affects-female-hormones/index.html) through two detoxification phases in the liver. If these pathways aren’t working efficiently, it can [lead to](/content/post/how-the-liver-affects-female-hormones/index.html) hormonal problems.

Testing estrogen metabolites may provide insights into liver detoxification function, which is particularly important for patients with [hormone imbalance](/content/post/a-functional-medicine-approach-to-estrogen-imbalance/index.html) symptoms.

### Perimenopause and Menopause

During [perimenopause](https://pmc.ncbi.nlm.nih.gov/articles/PMC4834516/#:~:text=In%202005%2C%20an%20NIH%20workshop,%2C%20and%20vaginal%20dryness%2Fdyspareunia.&text=Several%20years%20later%2C%20adverse%20mood,linked%20to%20the%20menopausal%20transition.) and [menopause](https://www.who.int/news-room/fact-sheets/detail/menopause#:~:text=changes%20in%20the%20regularity%20and,in%20mood%2C%20depression%20and%20anxiety.), hormonal shifts can cause symptoms like hot flashes, night sweats, vaginal dryness, sleep problems, mood swings, and [weight gain](https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058).

Estrogen metabolite testing helps manage these symptoms and [guides](/content/post/functional-medicine-labs-that-help-monitor-bioidentical-hormone-replacement-therapy/index.html) the use of hormone replacement therapy (HRT); however, it is important to note that urine testing for hormone metabolites is [not appropriate](/content/post/functional-medicine-labs-that-help-monitor-bioidentical-hormone-replacement-therapy/index.html) for all forms of bioidentical hormone replacement therapy.

### Chronic Conditions

Conditions like [endometriosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC7215544/), [fibroids](https://pmc.ncbi.nlm.nih.gov/articles/PMC4701845/), [PCOS](https://pmc.ncbi.nlm.nih.gov/articles/PMC7924872/), and [autoimmune diseases](https://pubmed.ncbi.nlm.nih.gov/17261796/) may be influenced by estrogen metabolism. Testing can provide insights into estrogen’s role in these conditions and monitor treatment progress.

### Weight and Metabolism

[Estrogen imbalance](https://pmc.ncbi.nlm.nih.gov/articles/PMC2889220/) can contribute to stubborn [abdominal weight gain](https://pmc.ncbi.nlm.nih.gov/articles/PMC3964739/) and other [metabolic issues](https://pmc.ncbi.nlm.nih.gov/articles/PMC9677105/).

Testing provides data on estrogen metabolites, which, when considered alongside clinical history and other diagnostic tools, may contribute to a broader understanding of metabolic health.

### Bone and Heart Health

Estrogen is essential for maintaining [strong bones](https://pmc.ncbi.nlm.nih.gov/articles/PMC7913980/) and a healthy [cardiovascular system](https://pmc.ncbi.nlm.nih.gov/articles/PMC5688223/). Testing can identify metabolite patterns that might increase the risk of osteoporosis or heart disease.

### Inflammation and Detox Support

Imbalances in [estrogen metabolites](https://academic.oup.com/edrv/article-abstract/28/5/521/2355015?redirectedFrom=fulltext) can worsen [inflammation](https://d1wqtxts1xzle7.cloudfront.net/40176975/Estrogen_is_a_modulator_of_vascular_infl20151119-15197-ce6tlz-libre.pdf?1447952264=&response-content-disposition=inline%3B+filename%3DEstrogen_is_a_modulator_of_vascular_infl.pdf&Expires=1737662335&Signature=g4EmzGUUmKnSZmdsNpTAm0I9AJs6YtTaujqJBs-WcSZ9bQNSEhd9z4tm2rbJg-clbaApmznEw3d56rng6A2F1MK0vOagkvEJAVa0yXSOx6bHb7x06gUABKp2rEhq3cj97PpdyCljXbCr7clkK0jEweQlqv1uoZqGqi04MxQ5JxLo0wldd2pykK3ZkVAkPKA0jP1VxdjbUCfZYc7B~nVxtgl-JnFiasFDN8NmhCsFeFquVgACzz1CCPax~CeZiTc16P1rzRPVOMbgOwO69TM8KkBCKcUKdz0WmzwJ0e09KTcC2hQDmEnww65AiCIx4wvu1TbT0hglPvwtCshI6msDFg__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA), which is often seen in conditions like [migraines](/content/post/integrative-medicine-treatments-for-migraines/index.html), [fibromyalgia](/content/post/fibromyalgia-causes-symptoms-treatments/index.html), or [chronic fatigue syndrome.](/content/post/6-natural-therapies-that-can-help-with-chronic-fatigue-symptoms/index.html) Testing helps practitioners recommend detoxification strategies to reduce inflammation and symptoms.

### Environmental Toxins

[Xenoestrogens](https://pmc.ncbi.nlm.nih.gov/articles/PMC8395949/) are chemicals found in plastics, pesticides, and personal care products that can mimic estrogen in the body. This test can shed light on the impact of these toxins on estrogen metabolism.

### Genetics

Certain genetic variations, such as those in the [COMT](https://pmc.ncbi.nlm.nih.gov/articles/PMC3665426/), [CYP1A1](https://pmc.ncbi.nlm.nih.gov/articles/PMC9036542/), or [CYP1B1](https://pmc.ncbi.nlm.nih.gov/articles/PMC5058821/) enzymes, can affect how the body processes estrogen. Testing helps uncover whether certain genetic variations may be causing less-than-optimal estrogen metabolism.

### Gut Health and Estrogen Metabolism

The gut microbiome, particularly the [estrobolome](https://pmc.ncbi.nlm.nih.gov/articles/PMC5017946/), is [key](https://www.maturitas.org/article/S0378-5122(17)30650-3/fulltext) in regulating estrogen levels. Estrogen metabolite testing can identify whether additional testing for gut imbalances, such as dysbiosis, is warranted, especially in patients with digestive symptoms or concerns.

### Unexplained Symptoms

For patients with symptoms like migraines, fatigue, acne, or hair loss that don’t have a clear cause, testing estrogen metabolites can uncover hidden imbalances and guide treatment.

## Key Estrogen Metabolites to Test

Urine testing looks at specific estrogen metabolites to give a complete picture of estrogen metabolism. The key metabolites are:

### 2-Hydroxyestrone (2-OH-E1)

[2-OH-E1](/content/biomarkers/2-hydroxyestrone/index.html) is considered a “ [protective](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/)” metabolite of estrogen with weak estrogenic activity. It is linked to a [lower risk](https://www.sciencedirect.com/science/article/pii/S0147651320315906?via%3Dihub) of hormone-related cancers.

### 2-Hydroxyestradiol (2-OH-E2)

[2-OH-E2](/content/biomarkers/2-hydroxyestradiol/index.html), a breakdown product of estradiol, is considered a [protective](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) metabolite because it has a weaker effect on estrogen-sensitive tissues, which may reduce the risk of problems like estrogen-driven excessive cell growth.

2-OH-E2 reflects [how efficiently](/content/biomarkers/2-hydroxyestradiol/index.html) estradiol, the most active estrogen, is detoxified.

### 4-Hydroxyestrone (4-OH-E1)

[4-OH-E1](/content/biomarkers/4-hydroxyestrone/index.html) is a metabolite of estrogen. Although it has weak estrogen effects, it can cause DNA damage and increase the risk of hormone-related cancers, like [breast cancer](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/), if the body [doesn’t detoxify](https://pmc.ncbi.nlm.nih.gov/articles/PMC6731443/) properly.

### 4-Hydroxyestradiol (4-OH-E2)

[4-OH-E2](/content/biomarkers/4-hydroxyestradiol/index.html) is a metabolite of the hormone estradiol. If not properly processed into a safer form (4-methoxyestradiol), it can form [harmful substances](https://d1wqtxts1xzle7.cloudfront.net/75649452/s0960-0760_2803_2900377-720211203-25870-1aikk42-libre.pdf?1638549882=&response-content-disposition=inline%3B+filename%3DGenotoxic_metabolites_of_estradiol_in_br.pdf&Expires=1737652338&Signature=AILOROfu54MYTZbQA-G4Ice8-fTP-bA-hETJnvO1nb93e1nsfw8hpf3ZJn31jr1L3ZRKnZrGzEhOLM8~BgCDLUz3~tEwBM4kvRK6PGUJIfHR0AAyp1zv-tFbVH3va~1OI7AvqFAtf6vBMD44Bunfdo4B68RLsDuYL4X5GdqaVjLS70C9bAscbRbwqzqr1DXZQQG4qKmkav2J12q~1cQYY6lGFc~uKpOa2Tjghorfqo8STCUE6cLkIIzB~jrMRVV4jrxkQL18wub1r2A-KX~Nm2FKW4yZXqEGqFeD5cLu82Hrln18oiTGtfICayiGNonVE7FQYIFNAbTVmm9XWshTzw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA) called quinones that damage DNA, [increasing the risk](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) of breast cancer.

### 16α-Hydroxyestrone (16α-OH-E1)

[16α-OH-E1](/content/biomarkers/16-hydroxyestrone/index.html) is an estrogen metabolite with [estrogenic effects](https://aacrjournals.org/cebp/article/17/8/2029/162488/Circulating-2-Hydroxy-and-16-Hydroxy-Estrone). It helps support [bone health](https://pmc.ncbi.nlm.nih.gov/articles/PMC9036541/), but high levels can [raise the risk](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) of hormone-related [cancers](https://pmc.ncbi.nlm.nih.gov/articles/PMC5722219/) like [breast cancer](https://pubmed.ncbi.nlm.nih.gov/3186693/).

### 2-Methoxyestrone (2-MeO-E1)

A neutralized metabolite of 2-OH-E1, [2-MeO-E1](/content/biomarkers/2-methoxyestrone/index.html) is formed through methylation during phase II metabolism.

High levels suggest effective detoxification and may be linked to a [lower risk](https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr3416) of certain hormone-related cancers, while low levels may indicate methylation problems.

### 2-Methoxyestradiol (2-MeO-E2)

[2-MeO-E2](/content/biomarkers/2-methoxyestradiol/index.html) is a neutralized metabolite of 2-OH-E2, also formed during phase 2 metabolism.

2-MeO-E2 may block the growth of new blood vessels that tumors need to grow, causing abnormal cells to die. It [may also help](/content/biomarkers/2-methoxyestradiol/index.html) [lower inflammation](/content/post/a-root-cause-medicine-approach-to-chronic-inflammation/index.html) and control oxidative stress.

## Interpreting Estrogen Metabolites in Urine Testing

Interpreting test results helps identify whether estrogen is being metabolized efficiently. Both individual metabolite levels and their ratios are important.

It is always important to interpret these findings within the context of a person’s medical history and comprehensive estrogen metabolite panel.

### High Levels

- **4-Hydroxyestrone (4-OH-E1) and/or 4-Hydroxyestradiol (4-OH-E2):** elevated levels of [these metabolites](https://pmc.ncbi.nlm.nih.gov/articles/PMC6731443/) may suggest a need to optimize hormone levels.

- **16α-Hydroxyestrone (16α-OH-E1):** [high levels](https://pubmed.ncbi.nlm.nih.gov/19250192/) may indicate estrogen imbalance and can be associated with conditions like [estrogen-positive cancers](https://pmc.ncbi.nlm.nih.gov/articles/PMC2562592/), although results must be interpreted within the context of other clinical data.

- **2-Hydroxyestrone (2-OH-E1) and/or 2-Hydroxyestradiol (2-OH-E2):** while these are generally considered more protective forms of estrogen metabolites, [higher levels](https://www.sciencedirect.com/science/article/abs/pii/S187778211200046X) have been [associated with](https://biosignaling.biomedcentral.com/articles/10.1186/s12964-024-01583-0) health concerns. Additional insight may be gained by examining metabolite ratios.

### Low Levels

- **2-Hydroxyestrone (2-OH-E1) and/or 2-Hydroxyestradiol (2-OH-E2):** [low levels](https://pmc.ncbi.nlm.nih.gov/articles/instance/1518879/pdf/envhper00367-0142.pdf) may mean inefficient Phase I detoxification, limiting the production of protective metabolites.

- **2-Methoxyestrone (2-MeO-E1) and/or** [**2-Methoxyestradiol**](https://repositorio.uchile.cl/xmlui/bitstream/handle/2250/135040/Parada-Alexis-Role-of-2-methoxyestradiol.pdf?sequence=1) **(2-MeO-E2):** low levels of these [health-associated metabolites](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) may signal poor methylation, increasing risks associated with harmful metabolites.

### Key Ratios to Understand

- [**2-OH/16-OH E1 Ratio**](https://pmc.ncbi.nlm.nih.gov/articles/PMC4454805/) **:** compares protective (2-OH-E1) to proliferative (16α-OH-E1) metabolites. A low ratio may be associated with an increased risk of hormone-sensitive conditions.

- **2-OH/4-OH E1 Ratio:** [compares](https://academic.oup.com/endo/article/144/8/3382/2502066) the protective (2-OH-E1) metabolite to the potentially harmful (4-OH-E1) metabolite. A [low ratio](https://biosignaling.biomedcentral.com/articles/10.1186/s12964-024-01583-0) may indicate a higher risk for DNA damage and hormone-related cancers.

- [**Methylation Ratio**](https://pmc.ncbi.nlm.nih.gov/articles/PMC9891204/) **:** indicates the efficiency of Phase II detoxification by comparing 2-MeO-E1 to its precursor, 2-OH-E1.

## Factors Influencing Estrogen Metabolism

Your body’s ability to process estrogen can be affected by several factors:

### Genetics

Variations in genes like [CYP1A1](https://pmc.ncbi.nlm.nih.gov/articles/PMC9036542/), [CYP1B1](https://pmc.ncbi.nlm.nih.gov/articles/PMC5058821/), and [COMT](https://pmc.ncbi.nlm.nih.gov/articles/PMC3665426/) influence how efficiently estrogen is detoxified.

### Liver Health

The [liver](https://pmc.ncbi.nlm.nih.gov/articles/PMC4505810/) is the main site for the conversion of estrogen into its metabolites.

### Gut Health

A healthy gut microbiome helps eliminate excess estrogen through stool. Consistently imbalanced estrogen metabolites despite reasonable therapies may signal a need for digestive health testing, such as the [GI MAP](/content/lab-tests/diagnostic-solutions-gi-map-zonulin/index.html) stool test or the [GI Effects Comprehensive](/content/lab-tests/genova-gi-effects-comprehensive-profile-1-day/index.html) stool panel

### Diet and Lifestyle Factors

- **Diet:** [cruciferous vegetables](https://pubmed.ncbi.nlm.nih.gov/10952093/) like broccoli and kale support the production of protective metabolites. In contrast, a diet high in [processed foods](https://pmc.ncbi.nlm.nih.gov/articles/PMC6019153/) may exacerbate hormone imbalances.

- **Toxins:** exposure to [endocrine-disrupting chemicals](https://www.niehs.nih.gov/health/topics/agents/endocrine) in plastics, pesticides, and many home and personal care products can [disrupt](https://www.nature.com/articles/s41574-019-0273-8) estrogen metabolism.

- **Stress:** [high cortisol levels](https://pmc.ncbi.nlm.nih.gov/articles/PMC6165882/) from chronic stress may lead to altered hormone levels.

- **Sleep:** [changes in estrogen](https://academic.oup.com/jes/article/7/5/bvad036/7078096) levels, like during menopause or the days before your period, can make it harder to sleep, and poor sleep can also worsen hormone problems, creating a two-way connection.

## Limitations of Estrogen Metabolite Testing

While this test is highly informative, it has some limitations:

- It measures metabolites, not active hormone levels in blood or tissues.

- It provides a snapshot, meaning results might not capture fluctuations over time.

- It is not particularly [useful](/content/lab-tests/dutch-dutch-plus/index.html) in pregnancy, postpartum, breastfeeding, in children or prepubescent adolescents, or in settings where hormone levels are very different than typical adult hormone levels.

- It is [not helpful](/content/lab-tests/dutch-dutch-plus/index.html) in people with liver or kidney disease or those on certain medications.

This test is best used in conjunction with other tests, such as saliva and/or blood hormone panels, for a comprehensive hormone assessment.

## Optimizing Estrogen Metabolism

Improve estrogen metabolism and reduce risks with these strategies:

### Dietary Changes

- Eat [cruciferous vegetables](https://pubmed.ncbi.nlm.nih.gov/10952093/), which promote protective estrogen metabolites.

- Choose [high-fiber foods](https://pmc.ncbi.nlm.nih.gov/articles/PMC7875566/) to support gut-based estrogen elimination.

- Limit [alcohol](https://pmc.ncbi.nlm.nih.gov/articles/PMC4729640/), [processed foods](https://pmc.ncbi.nlm.nih.gov/articles/PMC6019153/), and added sugars which disrupt hormone balance.

### Supplements

- **Diindolylmethane (DIM):** research indicates that DIM may [support](https://aacrjournals.org/cebp/article/26/3/435/71367/Effect-of-Diindolylmethane-on-Estrogen-related) protective estrogen metabolism.

- **Methylated B vitamins:** these [support](https://pubmed.ncbi.nlm.nih.gov/12579301/) healthy methylation and detoxification.

- **Sulforaphane:** [this compound](https://pmc.ncbi.nlm.nih.gov/articles/PMC6275259/), naturally high in broccoli sprouts, supports detox enzymes and healthy estrogen processing.

While some dietary compounds, such as DIM, sulforaphane, and methylated B vitamins, have been studied for their role in estrogen metabolism, always consult a healthcare professional before making changes to supplementation.

### Lifestyle Tips

- **Manage Stress:** chronic stress [may disrupt](https://pmc.ncbi.nlm.nih.gov/articles/PMC6165882/) hormone balance; [practice](/content/post/how-to-reduce-stress-through-mind-body-therapies/index.html) mindfulness or yoga. **‍**
- **Prioritize Sleep:** quality sleep [regulates](https://academic.oup.com/jes/article/7/5/bvad036/7078096) hormone levels. **‍**
- **Exercise Regularly:** [exercise](https://pmc.ncbi.nlm.nih.gov/articles/PMC4950919/) improves circulation and detox pathways and reduces fat tissue-related estrogen production. **‍**
- **Avoid Xenoestrogens:** use glass containers, organic produce, and non-toxic products to reduce exposure to endocrine-disrupting chemicals.

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## Key Takeaways

- **Estrogen metabolism affects overall health**: It plays a role in bone strength, mood, metabolism, and cardiovascular health.
- **Urine estrogen metabolite testing** measures how the body processes estrogen, providing insight into hormone balance and detoxification.
- **Testing may be useful for** evaluating hormone imbalance symptoms, menopause management, metabolic health, and potential risks related to estrogen-sensitive conditions.
- **Key metabolites** include 2-OH (protective), 4-OH (potentially harmful), and 16α-OH (proliferative) estrogens. Ratios between these can offer insights into hormone health.
- **Factors affecting metabolism**: Genetics, liver function, gut health, diet, and lifestyle all influence estrogen processing.
- **Limitations**: This test provides a snapshot of estrogen breakdown but does not measure active hormone levels or replace other hormone testing.
- **Ways to support healthy estrogen metabolism**: Eat cruciferous vegetables, get enough fiber, limit processed foods, reduce toxin exposure, manage stress, and consider targeted supplements like **DIM, sulforaphane, and methylated B vitamins** (under medical guidance).

_The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website._

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### References

_2-Hydroxyestradiol \|_ Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/2-hydroxyestradiol](/content/biomarkers/2-hydroxyestradiol/index.html)

_4-Hydroxyestrone \|_ Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/2-hydroxyestrone](/content/biomarkers/2-hydroxyestrone/index.html)

_4-Hydroxyestradiol_ \| Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/4-hydroxyestradiol](/content/biomarkers/4-hydroxyestradiol/index.html)

‍ _4-Hydroxyestrone_ \| Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/4-hydroxyestrone](/content/biomarkers/4-hydroxyestrone/index.html)

‍ _2-Methoxyestradiol_ \| Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/2-methoxyestradiol](/content/biomarkers/2-methoxyestradiol/index.html)

_2-Methoxyestrone_ \| Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/2-methoxyestrone](/content/biomarkers/2-methoxyestrone/index.html)

_16-Hydroxyestrone_ \| Rupa Health. (2020). Rupa Health. [https://www.rupahealth.com/biomarkers/16-hydroxyestrone](/content/biomarkers/16-hydroxyestrone/index.html)

Amabebe, E., & Anumba, D. O. C. (2018). Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health. _Frontiers in endocrinology,_ 9, 568. https://doi.org/10.3389/fendo.2018.00568

Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen-gut microbiome axis: Physiological and clinical implications. _Maturitas, 103_(103), 45–53. https://doi.org/10.1016/j.maturitas.2017.06.025

Bradlow, H. L., Davis, D. L., Lin, G., Sepkovic, D., & Tiwari, R. (1995). Effects of pesticides on the ratio of 16 alpha/2-hydroxyestrone: a biologic marker of breast cancer risk. _Environmental health perspectives,_ 103 Suppl 7(Suppl 7), 147–150. https://doi.org/10.1289/ehp.95103s7147

Breehl L, Caban O. Physiology, Puberty. \[Updated 2023 Mar 27\]. In: StatPearls \[Internet\]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534827/

Brown, L. M., & Clegg, D. J. (2010). Central effects of estradiol in the regulation of food intake, body weight, and adiposity. _The Journal of steroid biochemistry and molecular biology, 122_(1-3), 65–73. https://doi.org/10.1016/j.jsbmb.2009.12.005

Bryant, A. (2024, September 2). _How to Have a Good Night Sleep: Top Proven Strategies for Better Rest._ Rupa Health. [https://www.rupahealth.com/post/how-to-have-a-good-night-sleep-top-proven-strategies-for-better-rest](/content/post/how-to-have-a-good-night-sleep-top-proven-strategies-for-better-rest/index.html)

Bukato, K., Kostrzewa, T., Gammazza, A. M., Gorska-Ponikowska, M., & Sawicki, S. (2024). Endogenous estrogen metabolites as oxidative stress mediators and endometrial cancer biomarkers. _Cell Communication and Signaling :_ CCS, 22, 205. https://doi.org/10.1186/s12964-024-01583-0

Caldon C. E. (2014). Estrogen signaling and the DNA damage response in hormone dependent breast cancers. _Frontiers in oncology,_ 4, 106. https://doi.org/10.3389/fonc.2014.00106

Chakrabarti, S., Lekontseva, O., & Davidge, S. T. (2008). Estrogen is a modulator of vascular inflammation. _IUBMB Life, 60_(6), 376–382. https://doi.org/10.1002/iub.48

Chantalat, E., Valera, M. C., Vaysse, C., Noirrit, E., Rusidze, M., Weyl, A., Vergriete, K., Buscail, E., Lluel, P., Fontaine, C., Arnal, J. F., & Lenfant, F. (2020). Estrogen Receptors and Endometriosis. _International journal of molecular sciences, 21_(8), 2815. https://doi.org/10.3390/ijms21082815

Cloyd, J. _A Functional Medicine Approach to Addressing Hair Loss in Women._ (2023, September 8). Rupa Health. [https://www.rupahealth.com/post/a-functional-medicine-approach-to-addressing-hair-loss-in-women](/content/post/a-functional-medicine-approach-to-addressing-hair-loss-in-women/index.html)

Cloyd, J. _High Cholesterol: Causes, Implications, and Effective Management Strategies._(2024, June 28). Rupa Health. [https://www.rupahealth.com/post/high-cholesterol-causes-implication](/content/post/high-cholesterol-causes-implication/index.html)

Conner, V. (2022, September 13). _Fibromyalgia: Causes, Symptoms, & Alternative Treatments._ Rupa Health. [https://www.rupahealth.com/post/fibromyalgia-causes-symptoms-treatments](/content/post/fibromyalgia-causes-symptoms-treatments/index.html)

Conner, V. (2022, October 11). _6 Complementary and Alternative Therapies for Chronic Fatigue Syndrome._ Rupa Health. [https://www.rupahealth.com/post/6-natural-therapies-that-can-help-with-chronic-fatigue-symptoms](/content/post/6-natural-therapies-that-can-help-with-chronic-fatigue-symptoms/index.html)

Creedon, K. (2022, March 18). _8 Ways To Prevent Osteoporosis As You Age._ Rupa Health. [https://www.rupahealth.com/post/a-functional-medicine-approach-to-osteoporosis](/content/post/a-functional-medicine-approach-to-osteoporosis/index.html)

Cutolo, M., Capellino, S., Sulli, A., Serioli, B., Secchi, M. E., Villaggio, B., & Straub, R. H. (2006). Estrogens and autoimmune diseases. _Annals of the New York Academy of Sciences_, 1089, 538–547. https://doi.org/10.1196/annals.1386.043

DeCesaris, L. (2023, January 25). _How to Support a Healthy Menstrual Cycle._ Rupa Health. [https://www.rupahealth.com/post/how-to-support-a-healthy-menstrual-cycle](/content/post/how-to-support-a-healthy-menstrual-cycle/index.html)

DeCesaris, L. (2023, August 16). _How To Test For Female Hormones: A Comprehensive Guide._ Rupa Health. [https://www.rupahealth.com/post/how-to-test-for-female-hormones-a-comprehensive-guide](/content/post/how-to-test-for-female-hormones-a-comprehensive-guide/index.html)

Delgado BJ, Lopez-Ojeda W. Estrogen. \[Updated 2023 Jun 26\]. In: StatPearls \[Internet\]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/

_DUTCH Plus by Precision Analytical (DUTCH)._(n.d.). Rupa Health. [https://www.rupahealth.com/lab-tests/dutch-dutch-plus](/content/lab-tests/dutch-dutch-plus/index.html)

Emond, J. P., Caron, P., Pušić, M., Turcotte, V., Simonyan, D., Vogler, A., Osredkar, J., Rižner, T. L., & Guillemette, C. (2023). Circulating estradiol and its biologically active metabolites in endometriosis and in relation to pain symptoms. _Frontiers in endocrinology,_ 13, 1034614. https://doi.org/10.3389/fendo.2022.1034614

Eliassen, A. H., Missmer, S. A., Tworoger, S. S., & Hankinson, S. E. (2008). Circulating 2-Hydroxy- and 16 -Hydroxy Estrone Levels and Risk of Breast Cancer among Postmenopausal Women. _Cancer Epidemiology Biomarkers & Prevention, 17_(8), 2029–2035. https://doi.org/10.1158/1055-9965.epi-08-0262

Emmanuelle, N. E., Marie-Cécile, V., Florence, T., Jean-François, A., Françoise, L., Coralie, F., & Alexia, V. (2021). Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications. _International journal of molecular sciences, 22_(4), 1568. https://doi.org/10.3390/ijms22041568

Falk, R. T., Brinton, L. A., Dorgan, J. F., Fuhrman, B. J., Veenstra, T. D., Xu, X., & Gierach, G. L. (2013). Relationship of serum estrogens and estrogen metabolites to postmenopausal breast cancer risk: a nested case-control study. _Breast Cancer Research, 15_(2). https://doi.org/10.1186/bcr3416

Farkas, S., Szabó, A., Hegyi, A. E., Török, B., Fazekas, C. L., Ernszt, D., Kovács, T., & Zelena, D. (2022). Estradiol and Estrogen-like Alternative Therapies in Use: The Importance of the Selective and Non-Classical Actions. _Biomedicines, 10_(4), 861. https://doi.org/10.3390/biomedicines10040861

Fowke, J. H., Longcope, C., & Hebert, J. R. (2000). Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. _Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 9_(8), 773–779.

Fussell, K. C., Udasin, R. G., Smith, P. J., Gallo, M. A., & Laskin, J. D. (2011). Catechol metabolites of endogenous estrogens induce redox cycling and generate reactive oxygen species in breast epithelial cells. _Carcinogenesis, 32_(8), 1285–1293. https://doi.org/10.1093/carcin/bgr109

Gava, G., Orsili, I., Alvisi, S., Mancini, I., Seracchioli, R., & Meriggiola, M. C. (2019). Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. _Medicina (Kaunas, Lithuania), 55_(10), 668. https://doi.org/10.3390/medicina55100668

_GI Effects® Comprehensive Profile - 1 day by Genova Diagnostics._ (n.d.). Rupa Health. [https://www.rupahealth.com/lab-tests/genova-gi-effects-comprehensive-profile-1-day](/content/lab-tests/genova-gi-effects-comprehensive-profile-1-day/index.html)

_GI-MAP + Zonulin by Diagnostic Solutions._ (n.d.). Rupa Health. [https://www.rupahealth.com/lab-tests/diagnostic-solutions-gi-map-zonulin](/content/lab-tests/diagnostic-solutions-gi-map-zonulin/index.html)

Gu, C. Y., Qin, X. J., Qu, Y. Y., Zhu, Y., Wan, F. N., Zhang, G. M., Sun, L. J., Zhu, Y., & Ye, D. W. (2016). Genetic variants of the CYP1B1 gene as predictors of biochemical recurrence after radical prostatectomy in localized prostate cancer patients. _Medicine, 95_(27), e4066. https://doi.org/10.1097/MD.0000000000004066

Guinter, M. A., McLain, A. C., Merchant, A. T., Sandler, D. P., & Steck, S. E. (2018). A dietary pattern based on estrogen metabolism is associated with breast cancer risk in a prospective cohort of postmenopausal women. _International journal of cancer, 143_(3), 580–590. https://doi.org/10.1002/ijc.31387

Hara, Y., Waters, E. M., McEwen, B. S., & Morrison, J. H. (2015). Estrogen Effects on Cognitive and Synaptic Health Over the Lifecourse. _Physiological reviews, 95_(3), 785–807. https://doi.org/10.1152/physrev.00036.2014

Hartman, T. J., Sisti, J. S., Hankinson, S. E., Xu, X., Eliassen, A. H., & Ziegler, R. (2016). Alcohol Consumption and Urinary Estrogens and Estrogen Metabolites in Premenopausal Women. _Hormones & cancer, 7_(1), 65–74. https://doi.org/10.1007/s12672-015-0249-7

Haufe, A., & Leeners, B. (2023). Sleep disturbances across a woman’s lifespan: What is the role of reproductive hormones? _Journal of the Endocrine Society, 7_(5). https://doi.org/10.1210/jendso/bvad036

Huang, Z., Guengerich, F. P., & Kaminsky, L. S. (1998). 16Alpha-hydroxylation of estrone by human cytochrome P4503A4/5. _Carcinogenesis, 19_(5), 867–872. https://doi.org/10.1093/carcin/19.5.867

Khakham, C. (2023, May 23). _An integrative medicine approach to alzheimer’s disease: Testing, nutrition, and supplements._ Rupa Health. [https://www.rupahealth.com/post/to-functional-medicine-labs-that-help-individualize-treatment-for-alzheimers-disease](/content/post/to-functional-medicine-labs-that-help-individualize-treatment-for-alzheimers-disease/index.html)

Khakham, C. (2023, April 6). _Understanding Your Risk of Cardiovascular Disease With Functional Medicine Labs._ Rupa Health. [https://www.rupahealth.com/post/understanding-your-risk-of-cardiovascular-disease-with-functional-medicine-labs](/content/post/understanding-your-risk-of-cardiovascular-disease-with-functional-medicine-labs/index.html)

Knowlton, A. A., & Lee, A. R. (2012). Estrogen and the cardiovascular system. _Pharmacology & therapeutics, 135_(1), 54–70. https://doi.org/10.1016/j.pharmthera.2012.03.007

Kwa, M., Plottel, C. S., Blaser, M. J., & Adams, S. (2016). The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer. Journal of the National Cancer Institute, 108(8), djw029. https://doi.org/10.1093/jnci/djw029

La Merrill, M. A., Vandenberg, L. N., Smith, M. T., Goodson, W., Browne, P., Patisaul, H. B., Guyton, K. Z., Kortenkamp, A., Cogliano, V. J., Woodruff, T. J., Rieswijk, L., Sone, H., Korach, K. S., Gore, A. C., Zeise, L., & Zoeller, R. T. (2019). Consensus on the key characteristics of endocrine-disrupting chemicals as a basis for hazard identification. _Nature Reviews Endocrinology, 16_(1), 45–57. https://doi.org/10.1038/s41574-019-0273-8

Lee, A. J., Cai, M. X., Thomas, P. E., Conney, A. H., & Zhu, B. T. (2003). Characterization of the Oxidative Metabolites of 17β-Estradiol and Estrone Formed by 15 Selectively Expressed Human Cytochrome P450 Isoforms. _Endocrinology, 144_(8), 3382–3398. https://doi.org/10.1210/en.2003-0192

Lizcano, F., & Guzmán, G. (2014). Estrogen Deficiency and the Origin of Obesity during Menopause. _BioMed research international,_ 2014, 757461. https://doi.org/10.1155/2014/757461

Maholy, N. (2023, April 14). _How to reduce stress through mind-body therapies._ Rupa Health. [https://www.rupahealth.com/post/how-to-reduce-stress-through-mind-body-therapies](/content/post/how-to-reduce-stress-through-mind-body-therapies/index.html)

Maskarinec, G., Heak, S., Morimoto, Y., Custer, L., & Franke, A. A. (2012). The relation of urinary estrogen metabolites with mammographic densities in premenopausal women. Cancer Epidemiology, 36(5), e310–e316. https://doi.org/10.1016/j.canep.2012.03.014

Mauras, N., Santen, R. J., Colón-Otero, G., Hossain, J., Wang, Q., Mesaros, C., & Blair, I. A. (2015). Estrogens and Their Genotoxic Metabolites Are Increased in Obese Prepubertal Girls. _The Journal of clinical endocrinology and metabolism, 100_(6), 2322–2328. https://doi.org/10.1210/jc.2015-1495

Mayo Clinic. (2019) _. Menopause weight gain: Stop the middle age spread._ Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058

Miao, S., Yang, F., Wang, Y., Shao, C., Zava, D. T., Ding, Q., & Shi, Y. E. (2019). 4-Hydroxy estrogen metabolite, causing genomic instability by attenuating the function of spindle-assembly checkpoint, can serve as a biomarker for breast cancer. _American journal of translational research, 11_(8), 4992–5007.

Napoli, N., Villareal, D. T., Mumm, S., Halstead, L., Sheikh, S., Cagaanan, M., Rini, G. B., & Armamento-Villareal, R. (2005). Effect of CYP1A1 gene polymorphisms on estrogen metabolism and bone density. _Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 20_(2), 232–239. https://doi.org/10.1359/JBMR.041110

Napoli, N., Faccio, R., Shrestha, V., Bucchieri, S., Rini, G. B., & Armamento-Villareal, R. (2007). Estrogen metabolism modulates bone density in men. _Calcified tissue international, 80_(4), 227–232. https://doi.org/10.1007/s00223-007-9014-4

National Institute of Environmental Health Sciences. (2024, July 22). Endocrine Disruptors. National Institute of Environmental Health Sciences. https://www.niehs.nih.gov/health/topics/agents/endocrine

Nerattini, M., Jett, S., Andy, C., Carlton, C., Zarate, C., Boneu, C., Battista, M. T., Silky Pahlajani, Loeb‐Zeitlin, S., Havryulik, Y., Williams, S., Christos, P. J., Fink, M. E., Roberta Dı́az Brinton, & Mosconi, L. (2023). Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer’s disease and dementia. _Frontiers in Aging Neuroscience,_ 15\. https://doi.org/10.3389/fnagi.2023.1260427

Parada-Bustamante, A., Valencia, C., Reuquen, P., Diaz, P., Rincion-Rodriguez, R., & Orihuela, P. (2015). Role of 2-methoxyestradiol, an Endogenous Estrogen Metabolite, in Health and Disease. _Mini-Reviews in Medicinal Chemistry, 15_(5), 427–438. https://doi.org/10.2174/1389557515666150226121052

Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. \[Updated 2018 Aug 5\]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext \[Internet\]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/

Samavat, H., & Kurzer, M. S. (2015). Estrogen metabolism and breast cancer. _Cancer letters, 356_(2 Pt A), 231–243. https://doi.org/10.1016/j.canlet.2014.04.018

Santoro N. (2016). Perimenopause: From Research to Practice. _Journal of women's health_ (2002), 25(4), 332–339. https://doi.org/10.1089/jwh.2015.5556

Sepkovic, D. W., & Bradlow, H. L. (2009). Estrogen hydroxylation--the good and the bad. _Annals of the New York Academy of Sciences,_ 1155, 57–67. https://doi.org/10.1111/j.1749-6632.2008.03675.x

Stevenson, S., & Thornton, J. (2007). Effect of estrogens on skin aging and the potential role of SERMs. _Clinical interventions in aging, 2_(3), 283–297. https://doi.org/10.2147/cia.s798

Straub, R. H. (2007). The Complex Role of Estrogens in Inflammation. _Endocrine Reviews, 28_(5), 521–574. https://doi.org/10.1210/er.2007-0001

Swaneck, G. E., & Fishman, J. (1988). Covalent binding of the endogenous estrogen 16 alpha-hydroxyestrone to estradiol receptor in human breast cancer cells: characterization and intranuclear localization. _Proceedings of the National Academy of Sciences of the United States of America, 85_(21), 7831–7835. https://doi.org/10.1073/pnas.85.21.7831

Sweetnich, J. (2023, April 25). _Complementary and Integrative Medicine Approaches to Type 2 Diabetes Management_. Rupa Health. [https://www.rupahealth.com/post/complementary-and-integrative-medicine-approaches-to-type-2-diabetes-management](/content/post/complementary-and-integrative-medicine-approaches-to-type-2-diabetes-management/index.html)

Sweetnich, J. _Functional Medicine Labs That Help Monitor Bioidentical Hormone Replacement Therapy._ (2023, February 24). Rupa Health. [https://www.rupahealth.com/post/functional-medicine-labs-that-help-monitor-bioidentical-hormone-replacement-therapy](/content/post/functional-medicine-labs-that-help-monitor-bioidentical-hormone-replacement-therapy/index.html)

Sweetnich, J. (2023, February 15). _How to Support Optimal Liver Estrogen Detoxification._ Rupa Health. [https://www.rupahealth.com/post/how-the-liver-affects-female-hormones](/content/post/how-the-liver-affects-female-hormones/index.html)

Sweetnich, J. (2023, January 19). _Integrative Medicine Treatments for Migraines Sufferers._ Rupa Health. [https://www.rupahealth.com/post/integrative-medicine-treatments-for-migraines](/content/post/integrative-medicine-treatments-for-migraines/index.html)

Thomson, C., Chow, S., Roe, D., Wertheim, B., Chalasani, P., Altbach, M., Thompson, P., Stopek, A., & Maskaranic, G. (2017). Effect of Diindolylmethane on Estrogen-related Hormones, Metabolites and Tamoxifen Metabolism: Results of a Randomized, Placebo-controlled Trial. _Cancer Epidemiology Biomarkers & Prevention, 26_(3), 435.1-435. https://doi.org/10.1158/1055-9965.epi-17-0027

Tsuchiya, Y., Nakajima, M., Kyo, S., Kanaya, T., Inoue, M., & Yokoi, T. (2004). Human CYP1B1 is regulated by estradiol via estrogen receptor. _Cancer research, 64_(9), 3119–3125. https://doi.org/10.1158/0008-5472.can-04-0166

Vigil, P., Meléndez, J., Petkovic, G., & Del Río, J. P. (2022). The importance of estradiol for body weight regulation in women. _Frontiers in endocrinology, 13,_ 951186\. https://doi.org/10.3389/fendo.2022.951186

Wang, X., Ha, D., Yoshitake, R., Chan, Y. S., Sadava, D., & Chen, S. (2021). Exploring the Biological Activity and Mechanism of Xenoestrogens and Phytoestrogens in Cancers: Emerging Methods and Concepts. _International journal of molecular sciences, 22_(16), 8798. https://doi.org/10.3390/ijms22168798

Weinberg, J. (2022, March 31). _How to tell if you have an estrogen imbalance._ Www.rupahealth.com. [https://www.rupahealth.com/post/a-functional-medicine-approach-to-estrogen-imbalance](/content/post/a-functional-medicine-approach-to-estrogen-imbalance/index.html)

Wong, J. Y., Gold, E. B., Johnson, W. O., & Lee, J. S. (2016). Circulating Sex Hormones and Risk of Uterine Fibroids: Study of Women's Health Across the Nation (SWAN). _The Journal of clinical endocrinology and metabolism, 101_(1), 123–130. https://doi.org/10.1210/jc.2015-2935

World Health Organization. (2024, October 16). Menopause. _World Health Organisation._ https://www.who.int/news-room/fact-sheets/detail/menopause

Xu, S., Sun, J., Zhang, Y., Ji, J., & Sun, X. (2021). Opposite estrogen effects of estrone and 2-hydroxyestrone on MCF-7 sensitivity to the cytotoxic action of cell growth, oxidative stress and inflammation activity. _Ecotoxicology and Environmental Safety,_ 209, 111754. https://doi.org/10.1016/j.ecoenv.2020.111754

Xu, X. L., Deng, S. L., Lian, Z. X., & Yu, K. (2021). Estrogen Receptors in Polycystic Ovary Syndrome. _Cells, 10_(2), 459. https://doi.org/10.3390/cells10020459

Yager J. D. (2012). Catechol-O-methyltransferase: characteristics, polymorphisms and role in breast cancer. Drug discovery today. _Disease mechanisms, 9_(1-2), e41–e46. https://doi.org/10.1016/j.ddmec.2012.10.002

Yoshimura, H. (2023, October 10). _A Root Cause Medicine Approach to Chronic Inflammation._ Rupa Health. [https://www.rupahealth.com/post/a-root-cause-medicine-approach-to-chronic-inflammation](/content/post/a-root-cause-medicine-approach-to-chronic-inflammation/index.html)

Yue, W., et al. Genotoxic metabolites of estradiol in breast: potential mechanism of estradiol induced carcinogenesis. (2003). _The Journal of Steroid Biochemistry and Molecular Biology, 86_(3-5), 477–486. https://doi.org/10.1016/S0960-0760(03)00377-7

Zengul, A. G., Demark-Wahnefried, W., Barnes, S., Morrow, C. D., Bertrand, B., Berryhill, T. F., & Frugé, A. D. (2021). Associations between Dietary Fiber, the Fecal Microbiota and Estrogen Metabolism in Postmenopausal Women with Breast Cancer. _Nutrition and cancer, 73(_ 7), 1108–1117. https://doi.org/10.1080/01635581.2020.1784444

Zhu B. T. (2003). Medical hypothesis: hyperhomocysteinemia is a risk factor for estrogen-induced hormonal cancer. International journal of oncology, 22(3), 499–508.

Ziegler, R. G., Fuhrman, B. J., Moore, S. C., & Matthews, C. E. (2015). Epidemiologic studies of estrogen metabolism and breast cancer. _Steroids, 99_(Pt A), 67–75. https://doi.org/10.1016/j.steroids.2015.02.015

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