Hot flashes anyone ?
Published July 27, 2002 in the North Island Weekender
Joan is a 52-year-old Caucasian woman who is taking hormone replacement therapy (HRT) including Premarin (estrogen derived from pregnant horses’ urine) and Provera a synthetic progesterone called progestin. She came in to see me because she had just found out about the Premarin study that was halted after five years due to the increase risk of breast cancer, heart attack, stroke and blood clots and she wanted to find out about alternatives. She experienced hot flushes previous to HRT and her doctor encouraged HRT to protect her against heart disease and osteoporosis so she had been on it for two years.
I told her that certainly there were some very effective herbal remedies that work wonders for hot flushes but I wanted to know her bone density as herbs don’t increase bone density and my treatment program would change if her bone density was not good. I also told her that this so called news breaking information was not new to us. Naturopathic physicians have been discouraging birth control pill (BCP) and hormone replacement therapy for at least the last ten years or so. According to Dr. Parl MD in his book Estrogens, Estrogen Receptors and Breast Cancer a 10-year increase in exposure to exogenous estrogen (BCP and HRT) will increase breast cancer risk two fold! 50 studies including 50,000 women with breast cancer and 100,000 controls show this increase risk of breast cancer with exogenous estrogens.
As all women are exposed to endogenous (internal) estrogen the question is why do some women get breast cancer and others do not? The gene for breast cancer is only found in 5% of all breast cancer cases. The difference appears to be not the estrogen itself but how the body metabolizes estrogen. If estrogens are metabolized into catechol estrogens these are very aggressive compounds that attack anything in sight including DNA causing mutations that lead to cancer. The catechol estrogens can be measured in the serum and urine as 2 hydroxy estrogen and 16 hydroxyestrogen. You want more of the 2’s versus the 16’s. These dangerous pathways can be changed using indole 3 carbinol, diindolymethane (Indolplex), soy, flax, anti-oxidants, green tea, and flavonoids such as quercitin.
I told Joan that some women can’t get by without estrogen replacement therapy (ERT: is Premarin without the Provera) to control their symptoms of menopause and some resistant types of arthritis. In these cases I like to use body identical estrogens rather than synthetic. (See Dr. John Lee’s What Your Doctor May Not Tell You About Breast Cancer and Dr. Christiane Northrup’s The Wisdom of Menopause on this subject). However in these cases I really like to keep track of the 2/16 ratio in terms of the cancer risk and protect these women as much as possible. Other risks of HRT include raising the bad cholesterols (LDL’s), increasing incidence of blood clots and gallbladder disease. Heart disease can be reduced 65% with Vitamin E alone! The trick I said was to have the correct testing to indicate her level of risk.
Her 2/16 ratio was low due to being on HRT for two years. I gave her Indolplex for 6 months along with a good naturopathic program and repeated the test and her ratios normalized. Her bone density was normal but not optimal. I recommended my naturopathic program for rebuilding bones telling her that bone density can improve with proper nutrition! Her HDL cholesterols (good ones) were a little low and the LDL’s (the bad ones) were a little too high which were easily turned around with flax oil one tablespoon per day.
She was very happy to be off the HRT. The herbs I recommended worked just fine for her hot flushes and she felt better than she had on the HRT. The Provera had given her periods every month which has now stopped, she had less fluid retention and irritability.
If you question your hormone replacement therapy please seek out professional help before quitting your medications. Many women have been on estrogens for many years and should not discontinue them without help.
Dr. Pincott has been practicing naturopathic medicine since 1985 and is currently practicing in Campbell River. She can be reached at (250) 286-3655 or www.DrPincott.com