A new study published in the February 5, 2009, edition of the New England Journal of Medicine, found that women who take Estrogen-Progestin combination hormone therapy for more than five years suffer a doubling of their risk of getting breast cancer and the risk doubles again every additional twelve months they continue to take the drugs. Women are confused. They have been told for years that these drugs were safe and that they would help prevent thinning of their bones and skin, wrinkles, heart attacks, osteoporosis, and possibly even Alzheimer’s Disease. Then they were told the drugs were bad, then good, then bad and finally that the research was irrelevant.
This latest study, however, is the most dramatic evidence we have seen yet to prove the dangers of these still very popular drugs. “This is very strong evidence that estrogen plus progestin causes breast cancer,” said Marcia Stefanick, co-author of the study. Even women who took estrogen and progestin drugs for as little as a couple of years had a significantly greater breast cancer risk. Collectively, these new findings should end the debate as to whether or not the risks of these drugs are worth the benefits. Women must be given safer alternatives.
Women Getting Conflicting Information that Sounds Like Drug Company Propaganda
Unfortunately, many women are still getting conflicting information about their alternatives. Dr. Ginger Constantine of Wyeth Pharmaceuticals, the maker of the Estrogen-Progestin combination, used in the latest study, has been contending, “There’s still a place for this product.” She noted that lower doses than were used in the government study can bring menopause relief, however, there’s no proof that lower doses would bring fewer side effects.
The president and chief executive officer of the Society for Women’s Health Research, Phyllis Greenberger is another example. She will tell you that she is well aware of the results of the 2002 Women’s Health Initiative, the country’s largest clinical test of hormone therapy, which found that a combination of two of the body’s three estrogens (estrone and estradiol) plus synthetic progesterone, made by Wyeth Pharmaceuticals, increased a women’s risk of breast cancer by 26%, her risk of a heart attack by 29%, her risk of stroke by 41% and her risk of blood clots by 113%. (Source: JAMA. 2002;288:321-333).
But Greenberger has no plans to stop taking the hormone therapy she started more than ten years ago at age 50, although she has reduced the dose. In her case, she said, she doesn’t think the advice is relevant. And she believes the risks of the estrogen-progestin combination have been exaggerated. Why would Ms. Greenberger be so reluctant to give up her hormone therapy? Perhaps its because she knows how bad she felt before taking the hormones; perhaps its because the Society for Women’s health Research, which she heads, receives funding from more than 18 drug companies, including Wyeth, the maker of the Estrogen-Progestin combination that was used in the 2002 and 2009 studies; and maybe its simply because she does not know that there are safe and effective natural hormone alternatives.
What Are Bio-Identical Hormones?
Many women are finding out about natural hormone alternatives. Oprah Winfrey recently had actress and bestselling author Suzanne Somers on her show to discus the positive experiences that they both have had with “bio-identical hormones. Suzanne Somers has been taking them for years. She believes that the supplements keep her young and feeling sexy and are preventing her breast cancer from coming back. Oprah has also recently started taking “bio-identical hormones.” On her website, Oprah writes, “After one day on “bioidentical” estrogen, I felt the veil lift. After three days, the sky was bluer, my brain was no longer fuzzy, my memory was sharper. I was literally singing and had a skip in my step.”
Bio-Identical Hormones are hormones compounded by pharmacists from natural plant extracts. They are virtually identical to the naturally occurring hormones made by the body, including three estrogens: estrone, estradiol and estriol; progesterone and testosterone. Because they are identical to what the body makes they are not associated with the severe list of side-effects associated with the synthetic hormones. Because these natural hormones come from plants they cannot be patented. In essence, God holds the patent.
Synthetic hormones, on the other hand, are copied after the body’s naturally occurring hormones, however, in order to qualify for a patent, the chemical structure of these drugs must be altered slightly to create a unique chemical not found anywhere else on earth. This uniqueness is the distinguishing factor that qualifies them for a patent. This unique chemical structure is similar enough to the original hormone to cause a similar action but it is dissimilar enough to produce a new list of unique and often much more severe side-effects.
Are Bio-Identical Hormones Safe?
There are several good studies on the safety and efficacy of bio-identical hormones, including one large-scale study that compared the risks associated with synthetic and bio-identical hormones. However, even bio-identical hormones can be harmful if they are not combined in the appropriate 8:1:1 ratio as it exists in healthy women, or if given in too high a dose. For this reason I recommend testing before and after dosing to make sure your levels are optimal. Click here for more information on hormone testing.
In 2005 the Fournier Study published in the International Journal of Cancer followed 54,000 women who took bio-identical estrogen and either bio-identical progesterone or progestin. The women taking the bio-identical progesterone had a 10 percent decrease in the risk of breast cancer while the women taking the synthetic progestin had a 40 percent increase in the risk of breast cancer.
A follow-up article published in 2007 in Breast Cancer and Treatment looked at 80,000 women. Women taking bio-identical estrogen and progesterone had no increase in the rate of breast cancer, while those taking an artificial progestin had an increase of 69% in the risk of breast cancer.
The de Lignieres Study published in 2002 in the journal Climacteric concluded that the risk of breast cancer is not increased with bio-identical hormones but is increased with synthetic progestin.
Bio-identical hormones have been used in Europe for almost fifty years. Since bio-identical hormones are available in relatively inexpensive generic forms that can be applied using non-patentable formulations by a compounding pharmacist, American drug companies have no interest in sponsoring studies on the safety and efficacy of bio-identical hormones.
Brief history of hormones
Hormones have been prescribed to treat the symptoms of menopause since the 1930s. By the 1950s a few researchers began to raise warning flags about potential harm of estrogen drugs. Unfortunately, for unknown reasons, the research never got published. Then in the 1960s, the book Feminine Forever claimed that “menopause was completely preventable” and estrogen hormone therapy would keep a woman healthy, happy and beautiful forever. Feminine Forever became a best seller and suddenly everyone either looked the other way or forgot about the health concerns. The book’s author, Robert A. Wilson, traveled the country, extoling the benefits of estrogen therapy and promising women that with it they could remain feminine forever. But soon reporters at The New Republic and The Washington Post disclosed that Dr. Wilson’s lecture tour and work were being supported by a company that manufactured estrogen for hormone treatment.
By this time however, more than half of the 30 million postmenopausal women in the United States were being prescribed estrogen. Then in the mid 1970s two studies linked estrogen drugs to cancer of the uterine lining. This concern was quickly overcome by just published research that showed that adding a synthetic progesterone (progestin) to the estrogen therapy reduced this risk.
In the 1980s, supported by multimillion-dollar advertising campaigns estrogens and progestins soon became the most prescribed drugs in America.
For decades, despite little evidence of their safety and effectiveness, post-menopausal hormones had hormone therapy has been aggressively marketed as one of the best ways for women to turn back the hands of time and reverse the signs of aging. By 2001, more than 60 million women used hormone replacement therapy (HRT) to relieve the major symptoms of menopause, including hot flashes, night sweats, insomnia, fatigue, moodiness, depression and irritability, as for the hope of preventing heart disease, osteoporosis and Alzheimer’s disease.
In 2002, the results of the Women’s Health Initiative, reported that estrone and estradiol plus synthetic progesterone caused an increased risk of breast cancer, heart attacks, stroke and blood clots. Then in 2004, researchers found that estrogen-progestin drugs not only did not prevent Alzheimer’s but actually increased the risk of dementia and mental decline by 47%. Additional studies continued to refute all the previous claims: Estrogen-Progestin drugs do NOT prevent incontinence but may contribute to it; they increase the risk of gallbladder disease, and they can shrink an older woman’s brain. .
The Wisdom of Nature: Estriol is the body’s Natural Anti-Cancer Agent
There are three types of estrogen in a woman’s body that work together to safely produce the desired effects. Estrone and Estradiol stimulate the cell growth necessary for reproduction. However, when found in too high a level they can be carcinogenic. Estriol on the other hand has been found to protect the body from the harmful effects of the Estrone and Estradiol. Estriol has been shown to be anti-carcinogenic. The correct ratio of Estriol to Estrone and Estradiol as found naturally in a healthy woman’s body is 8:1:1. All of the current estrogen drugs used in this country are combinations of synthetic copies of Estrone and Estradiol without Estriol.
The truth is the drug companies that made the first estrogen drugs copied the wrong estrogens. They copied the two most concentrated estrogens Estrone and Estradiol. This made sense from a production standpoint but not from a safety standpoint. Estrone and Estradiol are 1000 times more potent than the third estrogen known as Estriol. Nature puts all three estrogens together for a good reason. Estriol protects the body from developing cancer. The truth is that the pharmaceutical scientists made a mistake by underestimating the wisdom of nature’s hormone synergy and ignored Estriol.
Rather than admit they were wrong and open themselves up to millions of dollars in law suits, doctors and pharmaceutical companies in the U.S. continue to make the synthetic copies of the forms of estrogen that are known to be carcinogenic, although the safe estrogen, Estriol, has been prescribed in Europe for a number of years.
Doctors and pharmaceutical companies in the U.S. are either afraid to learn the truth and therefore don’t investigate it, or they are involved in a horrible cover-up that may be killing thousands of women every year.
In 2008, the FDA issued notice to compounding pharmacists forbidding them from using estriol in their natural hormone formulations because the agency doesn’t have a specified approved use for it. They took this action because Wyeth complained about it. And yet, Wyeth-Pharma sells two types of estriol drugs in Europe, so we know this is not a safety and efficacy issue.
Estriol is the Safe Female Hormone
Estriol is a mild estrogen that’s primarily used in cream form for vaginal dryness and urinary tract problems in menopausal women in Euorpe. It has been used in Europe for 30 years, and its safety and effectiveness are well established. Many doctors in the U.S. who use natural hormones prescribe tri-est and bi-est, estrogen cream formulations made by compounding pharmacies that contain estriol. These formulations appear to be what Wyeth perceives as its competition.
Here’s what the medical literature states about Ovestin, an estriol cream made in Europe: “Ovestin contains the natural hormone estriol, which is a weak estrogen. It treats urogenital symptoms without causing adverse changes to the endometrium (uterine lining), which means that it can be used without a progestogen in women with an intact uterus… The absence of progestogen-induced withdrawal bleeds with Ovestin makes it highly acceptable to women.”
For moderate or severe symptoms of menopause, I recommend Hormone Augmentation with a combination of natural bio-identical Estriol, extracted from soy beans and Progesterone, extracted from wild yams.
Estriol prevents hot flashes, bone loss, thinning of the skin and vaginal membranes yet it is 1000 times less stimulating to the breast tissue than is Estradiol. Not only does it NOT promote breast cancer, but considerable evidence indicates that it may protect against and reverses breast cancer.
According to an unpublished study by Lemon, Foley, and Kessinger, “2.5 to 5 mg and occasionally 15 mg of estriol, equivalent to a little more than 0.65 to 1.25 mg of conjugated estrogens and estradiol) was used, with the informed consent of patients, in postmenopausal women with breast carcinoma and metasiases. Thirty-seven percent receiving this small dosage had remission or arrest of metastatic lesions.”
Natural Progesterone
Taking natural Progesterone helps to prevent uterine cancer and increases Bone Mineral Density by as much as 10-15% within 6 months and 20-25% in 3 years (Clinical Nutrition Review, 1990, 10:384-391). The natural bio-identical hormones are safe and effective alternatives to synthetic drugs, providing all of the benefits and more, without the negatives.
Black Cohosh is an Effective Herbal Remedy for Menopause Symptoms
Extracts from the roots of the herb Black Cohosh (Cimicifuga racemosa) have been shown to be effective in the treatment of menopausal symptoms, including hot flashes, profuse sweating, sleep disturbances and depressive moods. In a review of eight human studies, it was shown to be a safe, effective alternative to estrogen replacement therapy.
U.S. and European Clinical studies documenting the safety and effectiveness of Black cohosh root extracts for the treatment of menopause are impressive. These studies show good therapeutic efficacy and safety profiles for Black Cohosh root. In addition, clinical and experimental investigations indicate that Black Cohosh root does not show hormone-like activity and may possess anti-cancer activity. (SOURCE: Adv Ther 1998 Jan-Feb;15(1):45-53; Planta Med 1991 Oct;57(5):420-4; J Womens Health 1998 Jun;7(5):525-9, University of Bridgeport, Connecticut, USA)
Should You Get Mammograms?
A woman ages about 4 years every time she gets a mammogram. Radiation causes cellular damage associated with aging and DNA mutations that raise the risk of developing cancer. The more mammograms you get the greater the risk of getting Cancer. According to good scientific data that is being mostly ignored in this country, women who start getting annual mammograms at age 40 have a 136% increased risk of dying from breast cancer by the time they turn 50 compared to women who don’t get annual mammograms, according to researcher from the Canadian National Breast Cancer Screening Study.
Mounting evidence now indicates that annual screening mammography for women aged 40-59 does not save lives, but actually increases the incidence of breast cancer, not to mention mammography feels like having your breasts smashed between the garage door and the cement floor.
The truth is there is no reliable evidence that having regular mammograms reduces the risk of dying of breast cancer in women of any age. In fact, there is strong evidence to the contrary. According to the Nordic Cochrane Center, in Copenhagen, a respected international body that assesses medical evidence, an analysis that examined seven completed and eligible trials involving half a million women found that “The currently available reliable evidence does not show a survival benefit of mass screening for breast cancer.”(Lancet 2001 Oct 20;358(9290):1340-2).
For more information about Mammograms, click here.
MRI Screening vs Mammograms
A Dutch study (NEJM 2004; 351: 427-37) found that MRI detected 79.5% of invasive breast cancer, compared to33.3% for mammography and 17.9% for clinical breast exam. Thestudy screened 1909 women, including 358 who carried gene-linemutations.
A Canadian study (JAMA 2004;292[11]:1317-25) concluded thatMRIs were more sensitive and more specific in detecting smallbreast cancers than mammograms, ultrasounds or clinical breastexams.Another factor in recommending MRIs for screening is that mammographymay increase the risk of cancer as well as detecting it, becauseof the exposure to radiation, says Hryniuk. MRIs, on the otherhand, do not expose women to any radiation.
Testingby MRI is the most sensitive and most accurate method of detecting beast cancer. However, it is approximately 7 times more expensive than Mammograms and often produces false positives, by finding small anomalies that look like tumors but are not. These findings often lead to surgery, chemotherapy and/or radiation when it is not truly warranted.
Doctors Beat mammograms at Detecting Breast Lumps
Dr. Gavin T. Royle and colleagues from the Southampton Breast Unit studied diagnostic data for 350 women with suspected breast cancer. Presenting their findings to the 7th Nottingham International Breast Cancer Conference, Royle’s group said that mammography was up to 33% less likely to detect lumps than were physicians. (Eur J Cancer 2001 Sep;37 Suppl 5:1-48)
General practitioners (GPs) successfully identified lumps in 78% of cases, while breast surgeons were found to be slightly better with an 82% success rate. Mammography only proved sensitive in 63% of patients. “Both GP and breast surgeon clinical examination were more sensitive than mammography in determining if a lump was present,” Royle told conference participants. The study also found that ultrasound, which emits no radiation, was the best noninvasive way of determining whether lumps were benign or malignant.
What Does Dr. Hansen Rx Instead of Mammograms?
For Breast Cancer Testing, I recommend that all women over age 35 get an annual breast exam from their family physician. This should be done by the same physician every year. If he finds a suspicious lump the patient should get an Ultrasound. If the lump is hollow in the center it is a cyst and the exam is over. If the lump is solid in the center, then the patient needs an MRI and possibly a biopsy.
Hormone Testing
Estriol is the most important estrogen to measure. You want to make sure that you are getting enough Estriol and not too much Estrone or Estradiol. Your Estriol level should be 8 times higher than your Estradiol or Estrone levels. You should have 100 times more Progesterone should han Estradiol. Once you know your hormone levels you can get or keep them in balance. For information about these hormone tests, please click here.