Recently, a new analysis of the women involved in the Women’s Health Initiative (WHI) was published in October 20th issue of the Journal of the American Medical Association (JAMA). In the new report, researchers have found that hormone replacement therapy not only increased the risk of breast cancer in women, but also the likelihood that she would die from the disease. While these findings may seem alarming at first, it’s important that you don’t let the media scare you into believing that all hormones are bad for you.
Most importantly, this is not new data. The hormones they are referring to in this study, which are the same hormones they studied in the WHI trials of 2002, are once again, synthetic hormones, not bioidentical hormones. The deception in what is being reported now is the data appears to include “all hormone replacement therapy.” When in fact, these hormones are completely different from the “proven safe” bioidentical estradiol and bioidentical progesterone I prescribe.
In the study, researchers followed women using a combination of Premarin and Provera – known as Prempro. Premarin is known as conjugated equine estrogens and is horse estrogen, having some similarities to human estrogen but is not the same. Provera is a progestin and is very different in function from natural progesterone.
The study stated that there is an increased in risk of death from breast cancer when you are taking this combination of estrogen and progestin (Prempro). These hormones are synthetic, NON-bioidentical hormones. That is EXACTLY why I don’t use these hormones in my practice!
Bioidentical hormones have the exact same structure in your body and hormones that your body would naturally make. This is very important because the structure of all the different chemicals and molecules in your body is critical to how those molecules react with the receptors on your cells. Additionally, studies show that bioidentical hormones actually reduces the likelihood of abnormal breast cell proliferation.
We have learned a lot since the WHI trials. In the years since the WHI studies were halted prematurely, several studies have shown that estrogens administered orally as opposed to those taken transdermally (medication delivered through the skin) increased the risk of stroke and cardiovascular disease. Taking estrogens through the skin has been shown to decrease the risk of heart disease. A huge French study of almost 100,000 women known as the E3N/EPIC cohort study has shown very clearly that progesterone and progestin are not the same. Contrary to the statement made by some in the press that there is “no evidence to support natural hormones being safer” than their synthetic counterpart, the E3N cohort study shows very clearly that the risks are not at all the same. In groups with many 1000’s of women the women taking the estrogen, estradiol, that is naturally found in women along with progesterone decreased women’s risk of breast cancer, whereas women taking estradiol or any other estrogens along with progestins had a much higher risk of breast cancer and heart disease and stroke as well.
There is an overwhelming body of evidence that supports the safety and efficacy of bioidentical estradiol and bioidentical progesterone.
At the end of the day, balancing hormones under the supervision of a highly trained physician is not only safe, but can be life changing. When the body is in balance, not only are symptoms like hot flashes, night sweats, sleep issues, mood changes, weight gain, low libido and many more significantly reduced, but we also reduce the risks for many serious diseases like diabetes, cardiovascular disease and Alzheimer’s. Ultimately, the decision to use hormone replacement therapy is one to be made between the patient and their physician, not the media.