In July of 2002, US Government scientists at the National Institutes of Health abruptly halted the nation’s biggest study on Hormone Replacement Therapy (HRT), saying long-term use of synthetic estrogen and progestin drugs increase a women’s risk of breast cancer by 26%, her risk of a heart attack by 29%, and her risk of stroke by 41% (SOURCE: JAMA. 2002;288:321-333).
However, many women are still getting conflicting information about their alternatives. Dr. Ginger Constantine of Wyeth Pharmaceuticals, the maker of Premarin and PremPro (the estrogen-progestin combination used in the abruptly halted study), contends “There’s still a place for this product.” She noted that lower doses than were used in the government study can bring menopause relief, although there’s no proof they’ll also bring fewer side effects.
The media is downplaying the risks of the harmful side effects from HRT with a numbers game, attempting to make the numbers and the risks sound smaller than they are. A recent AP story states that “For every 10,000 women taking the pills, every year there will be 8 more breast cancers, 7 more heart attacks, 8 more strokes and 8 more life-threatening blood clots in the lungs than if they hadn’t taken the pills. For an individual, those are small risks although with millions of users they add up.”
The truth is that they add up to big numbers that the drug companies would rather not tell you. Last year there were 6 million women using estrogen-progestin pills daily in the US. That means that last year they caused 4800 breast cancer deaths, 4200 heart attacks, 4800 strokes and 4800 life-threatening blood clots in this country.
The news has prompted many women to abandon the drugs. Sales of Wyeth’s estrogen-progestin drug Prempro, the brand used in the study, are down 52 percent and sales of Wyeth’s estrogen only durg Premarin and dwon by 15%.
Apparently, the drug companies, doctors and the media are doing a good job of spinning this story to blame only the estrogen and progestin drugs made by Wyeth Pharmaceuticals. Since the study in July, Wyeth’s competitors – Pfizer (Femhrt), Pharmacia (Ativella) and Novartis (Vivelle) have been selling more of their competing products.
What’s a Woman to do?
Dr. Lorraine Anne Fitzpatrick of the Mayo Clinic says that there are no good alternatives to estrogen for menopause symptoms. She says that the most promising are antidepressants like Prozac (known as SSRIs), but they need more study and pose their own side effects.
Some doctors are now recommending Raloxifene (Evista) by Eli Lilly. Evista is a selective estrogen receptor modulator approved for the prevention and treatment of osteoporosis, but does not affect hot flashes or other postmenopausal symptoms. Although recent research shows that Evista is associated with a 62% reduction in the risk of strokes, the drug is so new that it is not yet known whether it reduces or increases the risk of heart attacks and cancer.
Natural Alternatives for Women
There are safe and effective natural alternatives. In my practice, I recommend natural Hormone Augmentation. For mild symptoms of menopause, I use an herbal hormone balancing formula known as ESPROGEN that includes Agelica sinensis (Dong Quai) (standardized to 0.8% lingustillide), Dioscorea villosa (Wild Yam) (standardized for 10% Diosgenin), Glycyrrhiza glabra (Licorice) DGL, Tunera diffusa (Damiana) (5:1) and Cimicifuga racemosa (Black Cohosh).
For moderate or severe symptoms of menopause, I recommend Hormone Augmentation with a combination of bio-identical Estriol and Progesterone enhancing herbs, known as OstaB3 or PhytoB respectively. The Estriol is extracted from Soybeans and the Progesterone is extracted from the Wild Yam. Osta B3 and PhytoB contain Barbasco (Wild Yam) extract, Dioscorea extrat, Hawthorn extract, Alfalfa extract, Soybean extract, Licorice extract, Sarsaparilla extract, Wild Oats, and Cherry bark extract.
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 Estriadiol. Not only does it NOT promote breast cancer, but considerable evidence indicates that it may protect against and reverses breast cancer.
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.
Testing Your Hormones
It is best to test your hormone levels before beginning any hormone therapy. You want to make sure that you are getting enough, but not too much. Your Estriol level should be 8 times higher than your Estradiol or Estrone levels. Once you know your hormone levels you can get or keep them in balance. For information about these hormone tests, click here.