The following article is a summary of my 2 year
research on hormone replacement therapy and was written in 1997, updated in
1999. In 2001, the HERS study, co-funded by the NIH and
Wyeth-Ayrest (manufacturer of Premarin), a double blind study on hormone
replacement therapy (HRT) using what was considered the safest type - low dose
combinations of synthetic estrogen and synthetic progestin, was halted midway,
at the two year point. This is because those in the HRT group was observed
to have an extremely high incidence of breast cancer, as well as heart
attack, stroke and thrombosis. The study was originally initiated
because epidemiological studies (which are known to be flawed) had "proven" that
HRT was safe.
In fact, warnings against heart attack,
thrombosis and stroke in women taking HRT and birth control had been given in
the Merck Manual since the mid 1980's or before (40 percent greater risk, half
again that in smokers). And as the article below will show, studies which
are not epidemiological studies have shown a strong link between synthetic
(pharmaceutical) estrogen and cancer since 1930!
In 2002,
synthetic estrogen was placed on the FDA list of known carcinogenic (cancer
causing) chemicals.
Today, there are still millions of women on
HRT despite this very 'in your face' finding by the NIH and the inclusion of
pharmaceutical estrogen on the FDA list of cancer causing chemicals.
A good
substitute is Natural Progesterone Cream which can be bought in any health foods
store. This natural and safe product not only alleviates symptoms of
menopause but has enabled many women to avoid hysterectomies (Stephen Goldstein,
MD head of gyno at NYU med school and author of, COULD IT BE ... PERIMENOPAUSE,
estimated that 85 percent of hysterectomies could be avoided with proper
hormonal supplementation.)
The following article presents the evidence I found showing the link between breast cancer and HRT even in 1997 when the community in general was saying it was safe:
An article appearing in Scientific American in 1997, postulated that
the risk of breast cancer being induced by Hormone Replacement Therapy
(HRT) could be as high as 43 percent in women over the age of 60. [1]
Actually, I discovered that the medical community knew about the risks
involved with pharmaceutical hormones for quite some time when I stumbled
upon a statement of the 'estrogen-breast cancer link' in a nursing journal
I was reading. Surprised because in the popular media, this risk
has not been openly admitted, I began to research more and the following
article is a result of my research. (last update:
07/19/2003)
This nurses study has had some problems in other areas. For example, at the 10 year point, a link between obesity and death seemed to be clearly shown but at the twenty year point, no such link could be established. [2]
The risks of Hormone Replacement Therapy seem more clearly proven. There have been two studies that I can find which seem to evidence that it is quite easy to induce breast cancer in rats by giving them shots of estrogen. The first study occurred in 1932 and I have not been able to chase that study down electronically. (Due to the date of the study, I suspect I would have to dig through [ugh] printed matter in some dusty library.) I did find another study which seemed to repeat the results of the 1932 study. This study took place in Canada in 1966 and was reported in the Canadian Cancer Journal. [3] Additionally, a recent issue of Tufts University Health Newsletter called estrogen "a KNOWN CULPRIT in breast cancer development." [4]
Given the inconclusive results on the benefits of HRT in the few studies done on humans, and the characteristic of estrogen which like other hormones, promotes the growth of new tissue (including cancerous tissue), and given the significant rise in the incidence of breast cancer which coincides with the prescribing of HRT, we can assume that the risk of cancer from this therapy in post menopausal women whose cells are more susceptible to neoplasm due to environmental DNA damage, is rather significant.
In considering the greatly increased risk of cancer, the medics have come to a conclusion about HRT. The magic number of ten years is suggested as an ideal time frame for taking estrogen and it is suggested to begin the therapy after the 60th birthday. This is according to the theory that the greatly increased risk of breast cancer between 60 and 70 is due to the fact that women in this age group have typically been on HRT for over ten years, and not due to other factors. This theory is totally unproven, of course but it doesn't rule out hormone therapy which will surely please the drug companies who stand to lose millions if the drug is discarded.
Since HRT is definitely a high risk treatment, it is worthwhile to examine the so-called benefits and see if these could be achieved in less risky treatments.
First, HRT is said to reduce the chance of heart disease. Since estrogen has been proven to INCREASE heart attacks in women taking it as birth control [5], we must dig deeply to find just how it reduces the danger of heart disease in post menopausal women. The only thing I could find in all my studies is that there is some evidence that foods rich in estrogen (such as soybean protein foods) are thought to have a favorable effect on reducing cholesterol and a reduction in cholesterol is an important factor in reducing the risk of heart failure due to veins and arteries plugged up with plaque. It is possible that scientists have generalized that since eating foods rich in estrogen can have this effect, then, estrogen derived from horses urine have the same effect. [6]
There are some problems with this generalization though. Natural plant estrogens bind well to our estrogen receptors and are suspected to protect against breast cancer rather than cause it! Thus, when we consume natural estrogens, what we consume [7] is in a more useable form than when we pop a pill containing estrogen from horse's urine.
Finally, it has been proved without a doubt that the best way to reduce cholesterol is to exercise and eat a low fat diet. (Ornish, Bailey, Pritikin, Everson et al)
The second supposed benefit of estrogen therapy is to preserve bone density, thus reducing the amount of osteoporosis in middle age and elderly adults. The way this might work is that in an atmosphere of little to no calcium consumed in the daily diet, the bones lose calcium rapidly, thus becoming porous and easily broken. The reason this happens less in younger people, so continues this theory, is the presence of estrogen which slows down the calcium loss. The theory was more proven by the fact that young athletes who have stopped menstruating due to a bodyfat level too low to produce a sufficient amount of estrogen have evidenced bone density similar to that of a seventy year old woman with osteoporosis.
It is clear that estrogen therapy WILL NOT increase bone density. This was proven when this therapy was given to the young athletes with osteoporosis. Although the disintegration of the bone density was halted, doctors were unable to increase bone density through estrogen therapy.
HOWEVER, in a study of women and men in nursing homes, it was proven that light resistance exercise (20 minutes, 3 times a week) WILL increase bone density and this increase is seen in as little as a period of six weeks! It would thus seem, a much sounder treatment of this condition, to do at least 20 minutes of weight training, 3 times a week, than to take the dangerous estrogen replacement therapy. Even exercise haters can stomach that small amount of exercise!
Additionally, it has been proven that increasing calcium intake can stop the loss of bone density. Drinking as few as three glasses of milk a day will provide a woman with the calcium needed. [8] It should be noted that much larger quantities of the other so-called calcium rich foods must be eaten to provide the same amount that 3 glasses of milk will provide. [9]
The bottom line is, while drinking milk and doing a small amount of resistance exercise has been PROVEN to increase and preserve bone density with NO ILL SIDE EFFECTS, estrogen therapy has been observed to only slow down bone density loss (2-15 percent) rather than stop it, with devastating and DEADLY side effects.
The third benefit which has been recently attributed to estrogen therapy is that there is perhaps a lower incidence of Alzheimer's disease in women on HRT. The evidence here is the weakest of all. One real problem in Alzheimer's studies is the fact that we lack the tools to definitively diagnose this syndrome in a living person (a definitive diagnosis can be made in dissecting the brain in autopsy) and there are many types of senility which could present as Alzheimer's which are simply caused by poor diet, lack of exercise and lack of mental stimulation. Recently there have been several studies on populations seemingly lower in Alzheimer's incidence among which were arthritics and some Catholic sister orders. But since we know so little about Alzheimer's and since the studies sometimes conflict (a recent study showed a GREATER incidence of Alzheimer's in aspirin takers which directly conflicts with other studies), this so called `benefit' of HRT is not worth considering exposing yourself to a greatly increased risk of breast cancer!
And finally, Hormone Replacement Therapy is supposed to alleviate some of the symptoms of menopause like headaches and hot flashes and mood swings. These symptoms can be better alleviated with the use of natural plant estrogens such as are obtained by eating TOFU (TOFU is credited for the fact that women in Japan have far less difficulty with menopause than do American women). Also products which come in pill form such as 'Black Cohosh' (obtainable in Health Foods stores) will do well to alleviate symptoms (although can cause uterine contractions in some women). With synthetic (pharmaceutical) estrogen, a 60 percent lessening of menopausal symptoms is expected however, in my case I have seen a 99 percent lessening of symptoms using the natural products. Natural progesterone cream seems by far the best remedy for menopause and peri menopause. This cream is made from sweet potatos and is available in Health Foods stores. Use the progesterone for 26 days a month and take 3-4 days rest each month. This is so your progesterone receptors still sensitive to the cream.
My conclusion in my research is that the dangers of HRT (pharmaceutical hormones) have been proven - the benefits are largely theoretical at this point. Look at it this way - would you travel on a plane which has been proven unsafe even if your ticket were given for free? (And HRT is definitely NOT free!). With those odds, all women should think long and hard and explore their other options before undertaking this dangerous and risky therapy.
JoAnn Manson, one of the researchers on the Nurses Study points out that heart disease can be better prevented by exercise, dietary changes, quitting smoking and controlling blood pressure. Dr Francine Grodstein, another researcher from Brigham and Women's Hospital agrees. She states that such life style changes have ONLY benefits (no dangers or risks) and she adds, "(Pharmaceutical) Estrogen is one of many options and women are recognizing that they have OTHER options." [10]
By Sue Widemark
UPDATE NOTE: A recent study found that estrogen actually CAUSED more heart attacks in women who were high risk!
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