Estrogen? Opposing Studies? Take a Peek. Drive Cancer? Protect Against?
Drs. Brownstein, Rosensweet, Berkson, DeRosa, Peterson!
Medicine evolves with trends.
One study says one thing, and another study contradicts it.
Over time the “science” often, not always, rises to the top.
All the while debate and controversy reign.
This is medicine.
If you ask several cardiologists what are the best ways to put in stents, there will be various opinions. It can get heated.
Aspirin is like this. It had been used for heart protection. Now it has mostly fallen out of favor. Studies used to say it helped. Protected. Now many say the risks are not worth the benefits. In most of us. Not all of us.
So how are docs and patients to decide what to do?
This is especially true with estrogen replacement.
Here is one review study that says hey, the more estrogen replacement, the greater the risk of breast cancer.
This collaborative British group looked at studies from Jan 1, 1992, to Jan 1, 2018 of risk of breast cancer in women on estrogen replacement (ER) and breast cancer. These women were on hormones and in almost all these studies, were 60 years or older.
These researchers found that for every menopause hormone therapy type (MHT) , except vaginal oestrogens, this upped the risk of breast cancer, which increased steadily with duration of use.
Risk of breast cancers were consistently greater for preparations that contained synthetic progestins.
After ceasing MHT, some excess risk persisted for more than 10 years.
This was bad news for estrogen.
But, there are MORE studies that show the exact opposite.
Here is a systematic review and meta-analysis that shows the exact other side.
Objective: To investigate the association between estradiol therapy and incidence of breast cancer, taking into consideration of different types of combined progestogen, the duration of exposure and the type of regimen.
Method: A systematic review and meta-analysis.
Result: A total of 14 studies were included in our study. In estradiol-only therapy did not increase the risk of breast cancer. It was only when synthetic progestins were added to the estrogen therapy.
Conclusions: Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen. Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and (natural) progesterone carries no risk.
The re-analysis of the Women’s Health Initiative showed that women on estrogen replacement for an average of at least 5 years, had 23% less breast cancer. And 44% less death if they did get it.
In other words, women on estrogen replacement had better breast and life protection if they had ever been on estrogen therapy. These benefits continued for 20 years even if you went off after 5 years of estrogen therapy.
Estrogen replacement has many clinical (life) benefits.
Estrogen signals have many benefits that slow down aging.
Estrogen improves sleep, energy, cognition, skin, renal and heart function, blood sugar control and much more.
But you can see that the “science” goes back and forth.
Though more in the favor and protection of estrogen, than not.
Also, more studies point accusing fingers at synthetic progestins (why do we still even use these? But that’s a rhetorical question, as these are patented meds that make more money for share holders than compounded natural progesterone that has never been shown to boost risk of breast cancer but mostly be protective against it).
But docs and patients alike are naturally confused. Scared, even.
Yet functional doctors that prescribe hormones, and who do so with a tapestry including many other protective components such as adding estriol (the anti-cancer estrogen), iodine (which has almost 10 ways it protects against breast cancer), testosterone (a major anti-proliferative and breast cancer protective hormone: maleness protects femaleness) and more, rarely see breast cancer in their patients.
In the few they see, these cancers mostly show up as better players, less aggressive, more ER+, PR+ and these women commonly thrive through their anti-cancer treatments.
This Thursday evening, we are going to be talking about all this controversy: Let’s Talk Estrogen.
It’s FREE. And these are seasoned hormone docs.
With our 150 combined years of hormone replacement therapy experience among the doctors present, we will DIVE head-first into explaining, with simplicity, grace and experience, the best side of estrogen. And vindicate her.
We are almost sold out of space for ‘sign-ups’.
Sign-up to get into the talk, or to get the archived recording sent to you. Without signing up you will not be able to get either benefit.
Here is the link and the time is NOW to sign up.
https://drlindseyberkson.com/lets-talk-estrogen-landing/
Knowledge is power.
Dr. B.
References:
Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019 Sep 28;394(10204):1159-1168
Estradiol therapy and breast cancer risk in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Gynecol Endocrinol. 2017 Feb;33(2):87-92
The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85
Hormone replacement therapy in the geriatric patient: current state of the evidence and questions for the future. Estrogen, progesterone, testosterone, and thyroid hormone augmentation in geriatric clinical practice: part 1. Clin Geriatr Med. 2011 Nov;27(4):541-59
Hormone replacement therapy in the geriatric patient: current state of the evidence and questions for the future--estrogen, progesterone, testosterone, and thyroid hormone augmentation in geriatric clinical practice: part 2. Clin Geriatr Med. 2011 Nov;27(4):561-75
https://drkentholtorf.com/medical-literature/the-bioidentical-hormone-debate