Estrogen and Cancer: Flaws of the Women’s Health Initiative. Everybody knows estrogen causes breast cancer. The media reports that emerged after the Women’s Health Initiative (WHI) have been abundantly clear about it. The ultimate message to physicians and patients is estrogen causes breast cancer so stay away from it. Do we really know that, or have we just been told that? What’s the true agenda? The frequent negative media reports on breast cancer, as well as black-box warnings preclude women from feeling safe.
The fear of breast cancer coupled with the general condemnation of the use of hormone replacement therapy by physicians poses an insurmountable obstacle against millions of women gaining access to the treatments they need. Following the release of the unsettling results of the Women’s Health Initiative (WHI), millions of women abruptly stopped taking their hormone replacement therapies upon the advice of their physicians, and on their own. The indictment pertains to all formulations of hormone replacement therapy, without discrimination or any real clarification.
Physicians perplexed by the unexpected results of the Women’s Health Initiative (WHI) were forced to reevaluate the study. As a result, many questions about the validity of the findings and soundness of the study were raised. Numerous physicians and research scientists disagree with the conclusions promoted by the Women’s Health Initiative (WHI), but unfortunately these conclusions remain the standard from which medical society position papers, black-box warnings, and therapeutic recommendations are currently derived. The broad interpretation and publicity as a result of the Women’s Health Initiative (WHI) resulted in a general condemnation of all hormone replacement therapy in postmenopausal women. Numerous flaws in its design are apparent and data resulting from the Women’s Health Initiative (WHI) and other such studies should be interpreted only within the narrow context of their study design. Extrapolation from the Women’s Health Initiative (WHI) to other forms of hormone replacement therapy is inappropriate and any conclusions invalid.
Design flaws of the Women’s Health Initiative (WHI)
1. Hormones used in the study were Premarin and Prempro. The authors of the Women’s Health Initiative (WHI) couldn’t have picked worse hormones to evaluate the impact of hormone replacement therapy on women’s health. Premarin (equine conjugated estrogen) is composed of hormones and multiple hormone metabolites extracted from pregnant-mare-urine. Prempro, in addition to having Premarin, it also contains medroxyprogesterone acetate, a synthetic progestin that is known to cause birth defects. These agents are drugs with hormone-like properties and are completely unnatural to the human body. What is natural to female biology is estradiol, the principal estrogen in women, that interacts through its receptors with thousands of distinct target genes in the nucleus of cells, with the ability to precisely discriminate function across different cell types. Substitution of a synthetically modified estrogen or the estrogen from another species such as Premarin will not replicate the desired results throughout the female body and will throw a woman’s physiology out of balance.
2. Static low-dose continuous therapy. It is ironic that the Women’s Health Initiative (WHI) made no attempt to respect the complexities of the female biology. Estradiol plays a central role in facilitating all biologic functions in the female body. It enables all, and its importance must not continue to be underestimated. The specific message estradiol communicates varies with precise changes in timing of delivery and the amount of estrogen found in the blood. In the young healthy reproductive female, estradiol is delivered into the blood from the ovaries in a wave-like rhythmic pattern over her 28-day cycle interacting with her brain, uterus, and all other tissues of her body. A woman’s physiology cannot be replicated by taking a pill or a patch, much less the hormones from a horse.
In reproductive females, day one of their menstrual cycle begins with estrogen low, quiet like a distant drumroll, that builds and grows until the crescendo rise in estrogen heralds the advent of a ripe egg that aches for a purpose that is timeless.
New life is the timeless theme of estrogen, while at the same time assuring preservation of existing life. Depending on the specific cellular message and response of the target tissues, estrogen regulates all growth, healing, and repair functions throughout the female body, assuring her health.
3. Oral route of estrogen administration. Rule number one of hormone replacement therapy; never take an estrogen by mouth. Low-dose static oral estrogen therapy doesn’t approximate normal female biology and will not promote apoptosis, an important function required for normal development and tissue homeostasis. The loss of apoptotic regulation is fundamental to the development of diseases such as cancer, stroke, heart disease, neurodegenerative disorders, and autoimmune disorders. It turns out that high-dose estradiol inhibits proliferation and induces apoptosis. According to several new studies it is high doses of estradiol that can induce regression of hormone dependent breast cancer in postmenopausal women. Estradiol needs to be cycled, with relatively high doses of estradiol followed by phases of relative estradiol deprivation balanced with adequate natural progesterone in order to preserve human mammary gland health and homeostasis.
4. Physiologic consequences to taking estrogen by mouth:
- Rise in clotting factors, increasing the risk for blood clots, DVT’s, pulmonary emboli, and stroke
- Rise in hormone binding proteins such as sex hormone binding globulin, thyroid-binding globulin, cortisol binding globulin, triggering a cascade of negative physiologic consequences
- Increase in pro-inflammatory cytokines, C-reactive protein, and other mediators of inflammation
- Increasing risk of hypertension
- Weight gain
- Inhibition and reduction of human growth hormone; a very critical problem of oral estrogen therapy (HRT vs. OBC)
- Increase in carbohydrate cravings
- Alteration in serotonin metabolism
5. Statistical flaws in the WHI. . . . http://goo.gl/q6qik