Confusing Data
Answering questions about HRT

 

Published October 19, 2002 in the North Island Weekender

 

Now more than ever the average peri-menopausal woman is confused. After the prestigious medical journal, The Journal of the American Medical Association (JAMA) published the Women’s Health Initiative study in the July 17 2002 issue, showing the risks of hormone replacement therapy (HRT), women flocked to their MDs seeking counsel. Now these same patients are seeking another opinion from Naturopathic Physicians. This is what I tell them. 16,608 healthy women participated in this trial. The statistics show a 29 percent increased risk for coronary heart disease, 41 percent increased risk for a stroke! a 26 percent increased risk for invasive breast cancer and double the risk for blood clots. Can you imagine the statistics if unhealthy women were used for the trial? The HRT, estrogen, Premarin, and the progestin, Provera, used in this trial are not bio-identical and both have a profound effect on the gene expression of cells affected by these hormones.

Another study in the same issue of JAMA reported on an increased risk for ovarian cancer in women who used estrogen replacement for more than 10 years. According to Dr. Parl MD author of Estrogens, Estrogen Receptors and Breast Cancer, exogenous exposure to HRT or Birth Control Pill (BCP) will increase breast cancer risk two fold. In recognition of Breast Cancer Awareness month this information needs to be shared with women of all ages. I encourage all teenagers to get off BCP’s after five years maximum and try the diaphragm, Cervical Cap (available at our office), IUD and /or condoms with all the above if not in a monogamous relationship. See my article published July 27^th 2002 further to this topic.

The other confusing topic is the use of herbs and foods that are called “phytoestrogens”. Sally, a breast cancer patient, came into my office seeking advice after being told that soy and red clover are phytoestrogens therefore carcinogenic and to be avoided by breast cancer survivors. The term “phytoestrogen”, which means a plant estrogen, is too strong a term. There are no plants on earth that contain estrogens. They contain “estrogen-like” molecules that are 1/400^th the strength of the estrogens found in women and in hormone therapies. They bind very loosely to estrogen receptors on over 200 cell types in the body. When they bind to that cell they will increase the estrogen effect of that cell, but only if the body requires it. These “estrogen-like” herbs and foods are called adaptogens. If the body needs that activity it will increase it, if not it will decrease it. There are many herbs and foods called adaptogens, soy and ginseng are the most commonly known. I explained to Sally that estrogens made in her body or taken in hormone form, such as in the form of Premarin, have much more profound effects on the gene expression of cells than the “estrogen-like” effects created by foods such as soy or herbs such as red clover or wild yam. They do not participate like estrogens at all. For example soy can decrease hot flashes, increase bone density, increase HDL’s (the good cholesterol) without raising the blood or urinary levels of estrogens.

There are many foods that contain these “estrogen- like” molecules such as onions and garlic, so why is your doctor not steering you away from those? The answer is they don’t understand the effects of these adaptogens.

The terminology is confusing as well. What about bio-identical hormones? Again these are not grown in nature but derived from the wild yam, manipulated in the lab but the big difference is they are identical to what is in your body already, so your body knows how to respond to them. It doesn’t know how to respond to synthetic estrogens or “progestins” hence the numerous side effects we see with both. Most MDs don’t use the word bio-identical and speak of provera and progesterone as if they are the same thing and suggest estrogens in a soy base are natural estrogens. This further confuses the patient. I encouraged Sally to read Wisdom of Menopause by Dr. Northrup and What Your Doctor May Not Tell You About Breast Cancer by Dr. Lee to gain further understanding on the subject.

Not only is this discussion relevant for women it is also relevant for men suffering from prostate cancer. With these patients we are trying to decrease the estrogen effect that we consider to be the main cause of prostate cancer. This topic is for another article. Suffice it to say that “estrogen–like” foods and herbs are a safe and effective way for breast cancer survivors to regain their health and prevent reoccurrences. I emphasized to Sally that these foods and herbs be organic and not genetically modified (GM) in any way, as we don’t know the effect GM has on the body in the long run. Sally left with more information with which to make a decision about her health for the long term. After all, the definition of the word doctor is “to teach”.

 

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