|ESTROGEN DEFICIENCY DISEASE:
April 8, 1997
in this forum:
Could severe reactions to birth control pills contraindicate Hormone Replacement Therapy later in life? How effective are "natural" hormones as an alternative to traditional medicines? Should women with a history of breast cancer avoid estrogen therapy? Are there studies looking at the relationship between menopause and lost time at work? Could women in their 80s and 90s risk overdosing their systems with by taking estrogen? Additional Comments
March 27, 1997:
Reversing a recent panel of medical experts, The American Cancer Society advises women in their 40's to receive annual mammograms.
January 24, 1997:
National medical experts meeting in Washington, D.C. say women in their 40's should decide for themselves whether to have annual mammograms.
A position paper on the pro's and con's of taking estrogen at the onset of menopause.
An extensive reading list on menopause.
Barbara Posen of Jamaica, NY asks:
My friend has been investigating different kinds of estrogen. From consultation with holistic and alternative medicine doctors, she has learned that there are more natural forms of estrogen and estrogen programs that may not carry the same risks as the synthetic Permarin-like drugs.
Do these alternative estrogens avoid the increased risks such as breast and uterine cancer? What are our options, and what research is being done to look into them?
Dr. Susan Love responds:
Unfortunately there is little to no research on the "natural estrogens." Usually alternative doctors say that estradiol will prevent breast cancer. In fact there was only one study in 12 mice on this and it was not definitive. It is a less potent estrogen and therefore not as good against osteoporosis. It is important to realize that we are not supposed to have high levels of estrogen our whole lives.
Menopause is a natural rebalancing of our hormones to a lower level once our reproductive duties are over. Any "replacement" is actually an addition of drugs which are not normally present or at least at that level. The first decision a woman has to make is whether she wants to take hormones or drugs for menopause and then the second decision is what flavor i.e. natural or synthetic. (By the way Premarin is natural since it comes from the urine of pregnant horses.)
Dr. Charles Hammond responds:
There are different types of estrogens. Estradiol 17-B is the primary, secretory product of the ovary during cycling years, and it is now available in both oral and transdermal delivery systems. Other estrogens, such as Premarin, are derived from animal sources. They are a mixture of a number of estrogens. On one hand, the bulk of the research to date has been with the Premarin like drugs, which were introduced in the 1940's. The 17-B estradiol products yield serum concentrations of estradiol that are quite similar and, to date, observations regarding their benefit and risks seem quite similar to those of the Premarin like drugs. I do not believe that there is a strong indication of preference of one versus the other, other than particular tolerance and preference.
There is considerable information being written in the lay press regarding the phytoor plant estrogens. It is, in my opinion, based on very scanty human experimental data. To date, no studies have addressed whether the amounts taken provide protection for the cardiovascular system, bone, and possibly brain or what their risks are in regard to uterine malignancy or other side effects. Initial research studies are beginning, but to date have not been completed. To use them is, in my opinion, an uncontrolled experiment for you.