Despite the overwhelming clinical and marketing success of Premarin® and other forms of synthetic "estrogen," there has been, almost from the start, a disturbing undercurrent of doubt about the safety of conventional "estrogen" replacement therapy. That doubt can be summed up in one word: cancer.

The first cancer associated with "estrogen" replacement therapy was cancer of the endometrium (the lining the uterus). If we look up Premarin®'s legally required labeling2, the first thing striking the eye is a large boxed-in area strategically placed to make sure it's the first thing we see when we read this document. The actual wording of the Premarin® cancer warning is shown below. A variation of this warning appears on the labels of all "estrogens" not occurring naturally in humans, as well as the popular estrogen "patch".

Official Premarin® Warning Label
Premarin® is a registered trademark of Wyeth-Ayerst Laboratories

Estrogens Have Been Reported To

Increase the Risk of Endometrial Carcinoma

Three independent, case-controlled studies have reported an increased risk of endometrial cancer in Post-menopausal women exposed to exogenous estrogens for more than one year. This risk was independent of the other known risk factors for endometrial cancer. These studies are further supported by the finding that incidence rates of endometrial cancer have increased sharply since 1969 in eight different areas of the United States with population-based cancer-reporting systems, an increase which may be related to the rapidly expanding use of estrogens during the last decade.

The three case-controlled studies reported that the risk of endometrial cancer in estrogen users was about 4.5 to 13.9 times greater that in nonusers. The risk appears to depend on both duration of treatments and on estrogen dose. In view of these findings, when estrogens are used for the treatment of menopausal symptoms, the lowest dose that will control symptoms should be utilized and medication should be discontinued as soon as possible. When prolonged treatment is medically indicated, the patient should be reassessed, on at least a semi-annual basis, to determine the need for continued therapy. Although the evidence must be considered preliminary, one study suggests that cyclic administration of low doses of estrogen may carry less risk that continuous administration. It therefore appears prudent to utilize such a regimen.

Close clinical surveillance of all women taking estrogens is important. In all cases of undiagnosed persistent or recurring abnormal vaginal bleeding, adequate diagnostic measures should be undertaken to rule out malignancy.

There is no evidence at present that "natural" estrogens are more or less hazardous than "synthetic" estrogens at equal-estrogenic doses.

There are Two Key Points in This Warning:

First, taking Premarin® for more than a year increases the risk of cancer of the endometrium by as much as 14%. Well-controlled studies have shown that the risk of endometrial cancer is cumulative, rising at a rate of four to five cases per 1,000 Premarin® users with each year of use. By the fifth year of Premarin® use, a woman might be facing a 2% risk, and by her tenth year, her risk might be as high as 4% or 5%. Second, other forms of "synthetic" estrogen carry about the same risk.

After many years of prescribing "unopposed estrogen" ("estrogen" with no other accompanying hormones), and probably causing tens of thousands of women to develop cancer as a result, physicians finally discovered that the risk of developing endometrial cancer due to estrogen replacement can be reduced by also replacing missing progesterone. Progesterone can block or "oppose" estrogen's cancer causing tendencies.

Nature and Creation have known this all along! (Sometimes, we in medical practice are a bit slow). As long as there have been human bodies, and very likely longer, estrogen and progesterone have participated in the intricate dance of the menstrual cycle. The rise and fall of each is intimately linked to the rise and fall of the other. They're like two sides of a coin. To replace one without the other is an invitation to trouble which was too long ignored by nearly all medical doctors.

The "progestogen" (NOT progesterone, but more about that later also) physicians most often prescribe now is also a synthetic one called medroxyprogesterone, which goes by the brand name Provera®. The combination of synthetic "estrogen" and Provera® called "hormone" replacement therapy, or HRT, is standard practice among most doctors today.

While the addition of Provera® may minimize the risk of endometrial cancer due to patentable "estrogen," it does nothing to lessen another serious risk of estrogen" replacement: breast cancer. Women on a regimen of standard HRT using synthetic "hormones" like Premarin (Reg.) and Provera® may increase their risk of breast cancer by as much as 30%, according to some estimates. In. real numbers, this means that for every 1,000 women using one of these drugs, 30 will eventually develop breast cancer from the HRT itself.

Not good odds, but many doctors observe that without "estrogen," the risks of heart disease and osteoporosis, and their complications, are far greater."

The authors go on to discuss the use of progestins on the last page of their book, Natural Hormone Replacement as follows:

"Provera and Heart Disease:

Worse Than No Treatment at All

Heart disease is responsible for at least three-fourths of the deaths in postmenopausal women. Although much evidence suggests that estrogen replacement helps reduce the risks associated with heart disease, new data confirms that the common practice of taking the synthetic progestin Provera® along with "estrogen" to minimize the risk of endometrial cancer may be increasing women's risk of suffering a heart attack to an unacceptable level. Natural progesterone, however provides cancer protection but carries no such risk.

This conclusion comes from a new study carried out in rhesus monkeys at the Oregon Regional Primate Research Center. Eighteen monkeys had their ovaries removed to simulate menopause. They were then put on a hormone replacement regimen that included estradiol plus either Provera® or natural progesterone. After 4 weeks, the researchers injected a substance that causes coronary arteries (which supply the heart with blood) to constrict, cutting off the flow of blood to the heart muscle.

The researchers reported that the animals receiving Provera® would have died within minutes had they not received a protective drug treatment. The same thing happened in those animals that received no hormone replacement. By contrast, those monkeys that received natural progesterone quickly recovered from their simulated heart attack with no protective drug treatment.

"The big surprise," noted the primary author of the paper in an interview in Science News, is that Provera® poses such a "huge risk." "This is a really dangerous drug."

The results of a British study in women show that this conclusion is not limited to monkeys. Sixteen postmenopausal women with coronary artery disease also received "hormone" replacement that included an "estrogen" plus either Provera® or natural progesterone. Those who received natural progesterone were able to exercise significantly longer on a treadmill test before developing symptoms indicating reduced blood flow to their hearts. Noted one researcher, in terms of heart disease protection, Provera is 'worse than no treatment at all.' "

Again, every women should read this book!
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Foot Note:

You can find a drug's labeling on a small sheet of paper that comes packaged with every drug. If your pharmacist does not automatically give you a package insert, or Pi, when you fill a prescription you should ask him/her for it. The PI, which usually comes folded like a miniature road map and is printed in annoyingly tiny type, contains lots of interesting information about a drug. For example, it includes everything the drug company would like doctors to know about their drug that the FDA will allow them to say. It may also contain a few things they would rather not say that the FDA insists that they do. You can find PIs for most drugs in a book called the Physicians' Desk Reference, or PDR, which you can purchase or find in any library.

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Book review on Natural Hormone Replacement

Midwest Book Review :
Natural Hormone Replacement For Women Over 45 shows how natural hormone replacement offers a safe and effective alternative for the treatment of menopause. Conventional hormone replacement treatment as prescribed by most medical doctors in the United States, relies on unnatural versions of the hormones progesterone and estrogen that are dangerous and completely foreign to a woman's body. Risky and unpleasant, conventional hormone replacement treatment has long been women's only choice because of the influence of the drug companies. Natural Hormone Replacement For Women Over 45 provides compelling evidence that natural hormone replacement provides all the benefits of conventional treatment, but with drastically reduced risks of unwanted side effects and cancer. Readers of Natural Hormone Replacement For Women Over 45 will learn how to end hot flashes and other discomforts of menopause; cut the risk of osteoporosis, heart disease, and cancer; extend their youthful years; invigorate their sex life; decrease the risk of Alzheimer's disease and senility; locate a pharmacy that prepares natural hormones; and find a physician who prescribes them. Natural Hormone Replacement For Women Over 45 is must reading for all women facing menopause and the infirmities of the aging process.

Table of Contents

Prologue

Welcome to the Age of Natural Hormone Replacement

Hormones of the Menstrual Cycle

Hormones: Patentable, Natural, or Natural for Horses?

Relieving Common Menopausal Symptoms

Preventing & Reversing Osteoporosis

Preventing Heart Disease

Testosterone & Other Androgens: Not Just for Men

Hormone Replacement & Cancer

Estrogen & Senility

Using Natural Hormones

Natural Hormones from Foods & Herbs

Resources

Afterword

Index

Appendix

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Book Report on: What Your Doctor May Not Tell You About Menopause

mbaldwin@sover.net , 04/29/97, rating=10:
The most important book on women's health I've ever read.
The author, a medical doctor with 30 years of private practice experience, decided that he wasn't being very effective in helping his women patients deal with unpleasant premenopausal and menopausal symptoms. He began to research the research on hormone balance, HRT (hormone replacement therapy), and the way the medical and pharmaceutical industries deal with the "disease" of menopause and "female problems." What he discovered was that treating menopause as an "estrogen deficiency disease" was exactly wrong. In fact he argues that premenopausal and menopausal women are much more likely to be in a state of "estrogen excess" relative to levels of progesterone, which are often close to zero. Estrogen excess leads to weight gain, mood disorders, endometriosis, low sex drive, fybrocystic breasts, heart disease, and osteoporosis. Yet what the most doctors and drug companies offer to do is to increase estrogen levels with synthetic hormones made with pregnant mare's urine and synthetic progestins. While this may temporarily relieve certain symptoms like vaginal dryness and hot flashes, this HRT regime ultimately leads to worse side effects, including increased breast cancer risk, increased bone loss, increased overall cancer risk, and increased heart disease risk. Yet we are told that HRT is the only way to prevent osteoporosis and heart disease! John Lee explodes these myths and many more, including that any woman needs anhysterectomy unless she has cancer (yet over 600,000 are done in the US each year, meaning 600,000 potential new consumers of HRT!!)Over the years he has helped thousands of women restore their hormone balance and their lives with diet, exercise, and the use of natural progesterone (usually applied topically in a cream). He convincingly demonstrates that this regimen can increase bone density (even in women in their 70's and 80's!), reduce fibrocystic breast problems and the risk of breast and other cancers, reduce the risk of heart disease, increase feelings of well-being, sex drive and energy levels, reduce PMS, migraine headaches and unpleasant menopausal symptoms. He also systematically reveals the role of "xenoestrogens," the thousands of synthetic chemicals in the environment and our food supply which mimic our bodies' hormones and which increasingly create havoc with our systems.But don't just take my word for it. Please go out and read this book, then pass it along to other women you care about, including your teenage daughters and your mothers.

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