Why Consider Bioidentical Hormone Replacement Therapy
Over the years I have seen a pattern emerge again and again: estrogen dominance and not enough natural progesterone to balance this out. Estrogen dominance can lead to issues like Poly Cystic Ovaries Syndrome, Endometriosis, and potentially Breast Cancer. It can also lead to pre-mature aging. There is a solution, however. You can use plant-based Bioidentical Hormone Replacement Therapy as part of your Healthy Breast Journey.
Do You Know the Risks of Synthetic Hormone Replacement Therapy?
Pharmaceutical Hormone Replacement, or HRT, mimics estrogen and progesterone. They continue to be the go-to for millions of menopausal women. This is a very sad state of affairs. Long-term studies since the 1990s have shown evidence of their link to Breast Cancer as well as heart disease.
The biggest study was the Womens Health Initiative clinical trial . The WHI was designed to assess the major health benefits and risks of the most commonly used combined hormone preparations in the United States. It was supposed to go for nine years. After 5 years, the researchers abandoned the study because the rates of heart disease and Breast Cancer among the women were so high.
A review of the WHI data was published in 2013 by the National Institutes of Health. The report stated that ates of overall illnessesand death were 12 percent higher in women taking estrogen plus progestin than in women taking placebo pills during the trial.
Hormones And Breast Canceraddendum
The Womens Health Initiative, a large study sponsored by the National Institutes of Health, came out with surprising results several years ago. Previously it had been believed that hormone replacement in post-menopausal women prevented osteoporosis, heart disease and dementia, and had no adverse effects. Doctors and women were disabused of that belief by statistics indicating an increased incidence of breast cancer, blood clots, heart attacks and strokes.
The medical professions response was immediate, and overwhelmingly in the direction of discontinuing estrogen and progesterone replacement therapy. Women were left to their own resources, to suffer again the hormonal deprivation they had known before hormones were introduced. Another alternative was to start them on antidepressant medications or sedatives, as if they were mentally ill. These drugs reduced some symptoms but not others, and worsened sexual difficulties.
The conclusions drawn, that all hormones were dangerous and should not be used except in extreme circumstances, were erroneous. Yet they are still held to this day by many physicians, who deny their female patients the benefits of hormones.
The hormone studies used only oral formulations, now known to increase blood clotting factors and elevate the risk of phlebitis, heart attacks and strokes. Non-oral formulations do not have this effect.
Our Top Estrogen Modulating & Cancer
Gut dysbiosis is an imbalance of the gut bacteria in the gastrointestinal tract, which is very common. Poor gut health can cause inactivated estrogen metabolites to become reabsorbed back into the blood, leading to an increase in estrogen levels and in turn influencing breast cancer risk. Our top tips include:
- Eat clean and organic where possible.
- High fibre foods and wholegrains which promote gut motility and encourage elimination of estrogen via the bowel.
- Opt for a low GI diet with lots of phytonutrients which are important for detoxification of estrogen in the liver.
- Avoid dairy which can contain traces of estrogens.
- Steer clear of alcohol which affects the detox pathways in the liver.
- Get a good range of nutrients in your diet including: Omega 3, magnesium, zinc, selenium, and the whole range of B vitamins.
- Eat plenty of cruciferous vegetables as they stimulate enzymes that help to lower estrogen and help form the good metabolites.
- DIM is a supplement that can push the good estrogen pathways.
- Calcium d glucarate can decrease the reabsorption of estrogen in the gut.
- Incorporate ginger, garlic and curcumin into your diet for their inflammation reducing properties.
- Green tea contains catechins which are polyphenols important in detoxification.
You can read more about how the gut influences hormone balance here.
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Reproductive Risk Factors Oestrogen And Breast Cancer
Oestrogens have an essential role, together with other hormones, in the development of the female sex organs and secondary sex characteristics, the regulation of the menstrual cycle and reproduction. Thus, it has been proposed that the effects of many established reproductive risk factors for breast cancer are mediated by hormonal mechanisms, for the most part involving oestrogens .
Although risk for breast cancer increases with age, there is a marked decline in the rate of increase in risk with age following the loss of ovarian function, either as a result of a bilateral oophorectomy or due to the menopause , showing that hormone production by the ovaries is a crucial risk factor for breast cancer in humans. The duration of exposure to ovarian hormones seems to be closely related to breast cancer risk: a 1-year delay in the onset of menarche is associated with a 5% reduction in risk for developing breast cancer in later life , and each 1-year delay in the onset of menopause is associated with a 3% increase in risk .
Breast feeding is associated with a modest decrease in risk for breast cancer, above and beyond that associated with multiple pregnancies . This effect might be due to the suppression of ovulation, reducing exposure to ovarian hormones.
Hormone Balance And Breast Cancer Prevention
At Women in Balance Institute, we believe the cure for breast cancer is prevention. Our goal is to help women reduce breast cancer risk through lifestyle, natural hormone balance and bioidentical hormone treatments. Hormone health experts believe this active awareness can ultimately reduce breast cancer diagnosis, breast cancer treatment and breast cancer recurrence.
We hope to empower women to change the dialogue:
- from breast cancer treatment to breast cancer prevention
- from HRT , to BHRT and bioidentical hormone replacement therapy
- from one-size-fits-all, to individualized hormone testing and natural hormone treatments that restore natural hormone balance
The Women in Balance Institutes aim is to raise awareness about the role of hormone imbalance in breast cancer risk and the huge potential of natural hormone balance to reduce breast cancer risk and prevent breast disease. Shifting levels of estrogen, progesterone, DHEA, testosterone, cortisol and other hormones change a womans hormone balance throughout her life, most notably during perimenopause and menopause. This is the time for women to take action and partner with a bioidentical-friendly health care provider who routinely uses saliva hormone testing to detect and correct hidden hormone imbalances for menopause symptom relief and to reduce breast cancer risks.
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What This Means For You
If you are a transgender woman taking hormones, this study suggests that your risk of breast cancer is higher than a cisgender man, but lower than a cisgender woman. The researchers recommend that you have screening mammograms every other year starting at age 50. Its a good idea to talk to your doctor about your personal risk of breast cancer and develop a screening plan that is best for your unique situation.
If you are a transgender man taking hormones, this study suggests that your risk of breast cancer is lower than a cisgender woman. If you have not had a double mastectomy, the researchers recommend that you have screening mammograms every other year starting at age 50. Its also a good idea to talk to your doctor about your personal risk of breast cancer and develop a screening plan that is best for your unique situation. If you have legally changed your sex, you may not receive automatic breast cancer screening invitations, so it makes sense to work with your doctor to develop a plan.
For more information on mammograms, including where to get one, visit the Breastcancer.org Mammograms pages.
Summary Of Key Terminologies
cBHRT: Compounded Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones which are produced by specialist pharmacies and do not follow the same MHRA regulatory pathway as conventional rBHRT
rBHRT: Regulated Bioidentical Hormone Replacement Therapy: Precise duplicates of human hormones developed in a conventional way by the pharmaceutical industry and authorised by the regulators such as the MHRA in the UK
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What Is It About Hrt That Increases Risk Of Breast Cancer
Women are often concerned that hormone replacement therapy itself is the cause of breast cancer but this is not the case. Its how the estrogen is metabolised in the body, and an accumulation of estrogen that increases ones risk.
To put it simply, every individual metabolises estrogen in the body by detoxification processes in the liver and then excretion via the urine and stool. How each individual metabolises estrogen can vary due to genetic and lifestyle factors. When estrogen is broken down, it gets turned into metabolites. Some of these are considered to be good or protective and others bad or toxic . This is because research shows that women with more of the bad metabolites have a higher risk of breast cancer than women with more of the good metabolites. 4-hydroxyestrone can bind to and damage DNA if overproduced or not adequately detoxed in the liver.
Its essential that the body excretes the estrogen metabolites effectively to prevent an accumulation of estrogen in the body. If the body doesnt excrete the estrogen metabolites efficiently, they are absorbed back into the bloodstream, resulting in a build-up of estrogen , which can increase breast cancer risk and can have a negative impact on health. Genetic variations can cause some women to produce higher levels of estrogen and its metabolites and this can also cause estrogen dominance.
What Are The Side Effects Of Hormone Therapy
The side effects of hormone therapy depend largely on the specific drug or the type of treatment . The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy .
Hot flashes, night sweats, and vaginal dryness are common side effects of all hormone therapies. Hormone therapy also may disrupt the menstrual cycle in premenopausal women.
Less common but serious side effects of hormone therapy drugs are listed below.
- Breathing problems, including painful breathing, shortness of breath, and cough
- Loss of appetite
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Synthetic Hormones Cause Breast Cancer
Thanks to Phyllis J. Bronson, Ph.D. who alerted me via email about a report that synthetic chemically altered hormones cause breast cancer published March 29, 2013 in the Journal of the National Cancer Institute. This report is really about an old NIH study, the Womens Health Initiative, which was terminated early because Prempro, caused breast cancer and heart disease. Prempro is a synthetic hormone known to cause breast cancer.
This information was published originally in 2002 and again in 2011 in JAMA by the same authors. See my previous article which discussed this.
Above image: breast cancer in specimen radiograph courtesy of jeffrey dach md.
How The Study Was Done
The study included 2,260 transgender women and 1,229 transgender men who were taking hormones and being seen at a specialty clinic in Amsterdam between 1972 and 2016.
On average, transgender women were 31 years old when they started hormone treatment and transgender men were 23 years old.
Transgender women took hormones for an average of 13 years, and transgender men took hormones for an average of 8 years.
During the study, 15 cases of invasive breast cancer were diagnosed in the transgender women at an average age of 50 and after an average of 18 years of hormone treatment.
This rate was higher than the rate of breast cancer in the general cisgender male population, but lower than the rate of breast cancer in the general cisgender female population.
Four cases of invasive breast cancer were diagnosed in the transgender men at an average age of 47 and after an average of 15 years of hormone treatment.
This rate was lower than the rate of breast cancer in the general cisgender female population.
This study found an increased risk of breast cancer in trans women in the Netherlands compared with Dutch cisgender men, the researchers wrote. In both trans women and trans men, the risk of breast cancer was lower than in Dutch cisgender women. This suggests that hormone treatment alters the risk of breast cancer in transgender people compared with initial risk based on their birth assigned sex.
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Morning Rounds With Dr Steven Economou At Rush Hospital Breast Cancer Surgeon
Thirty Five years ago, surgeon Steven Economou MD asked me, Does Estrogen cause breast cancer, and does hormone replacement increase cancer recurrence in breast cancer survivors? Back then, I did not know the answer, and neither did he. Thirty Five years later, we now have the answer.
Above left image: Steven Economou MD, Surgeon Rush Medical Center Chicago, courtesy of the NIH and Raphael E Pollock MD , Annals of Surgical Oncology March 2008.
Not An Elixir Of Youth
Hormone therapy is not a magic bullet or an elixir of youth, and it shouldnt be used willy-nilly, Manson says.
But women who are suffering with menopause symptoms should not be denied hormone therapy, she says, unless they are at increased risk of cardiovascular disease, breast cancer or other estrogen-sensitive cancers.
The pendulum has swung widely from the perception that hormone therapy is good for all women to the perception that its all bad for all women, to now a more appropriate place in between where hormone therapy is perceived to be good for some but not all women, Manson says. Were recommending that hormone therapy be used for the duration that its needed to address symptoms at the lowest effective dose and with ongoing reassessment of the balance of risks and benefits.
The time to start therapy is as soon as the symptoms start. Intervening earlier, rather than later, actually seems to carry less risk, Santoro says.
Once symptoms start, they are unlikely to get better soon. On average, the menopause transition lasts about four years, Santoro says. Some women have symptoms that persist even longer, however. Although there are exceptions, most women wont go through menopause before 45, Santoro says.
If youre 45 or older and starting to have hot flashes, night sweats or mood or sleep changes, it could be your hormones and it might be time to start some active management, she says.
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Are There Any Scientifically Proven Advantages For Rbhrt Over Conventional Hrt
Progestogens may not be alike with regard to potential adverse metabolic effects or associated breast cancer risk when combined with long-term estrogen therapy. Micronised progesterone and some progestogens have specific beneficial effects that could justify their use besides their expected actions on the endometrium. Synthetic analogues of progesterone bind to the glucocorticoid, mineralocorticoid and androgen receptors. This can lead to unwanted side effects such as fluid retention, acne and weight gain. Progestogens and progesterone can lower mood through stimulation of the neurotransmitter gamma amino butyric acid whilst progesterone has sedative effects through its intermediate metabolites, progestogens can cause PMS-type side effects including anxiety and irritability.
It is well recognised that unlike oral estrogen, transdermal estrogen does not appear to increase the risk of VTE. Observational and case control data suggest that the use of certain progestogens e.g. dydrogesterone and micronised progesterone may reduce the increased risk of VTE conferred by oral estrogen, compared to that noted with other synthetic progestogens.
With Alzheimers Research At A Crossroads Ai Might Point The Way Forward
For years, research has suggested a potential link between MHT and an increased risk of breast cancer. In 2002 and 2004, the Womens Health Initiative released reports that showed women who used combination MHT were more likely to develop breast cancer. MHT use fell after the reports received widespread coverage. That was followed by a decline in breast cancer rates.
But there wasnt much information on whether that risk persisted, or how it differed based on the type of MHT a woman took. So an international group of researchers pulled together data from dozens of studies published and unpublished to examine the issue more closely. They took a womans age at first use of MHT, how long she used the medication, and the time elapsed since she last used it into account. The mean age of women starting menopause was 50, which was also the mean age at which women started using MHT.
The researchers found that compared with women who never used MHT, women who did had a significantly higher risk of developing invasive breast cancer. They estimated that 6.3% of women who never used MHT developed breast cancer, compared to 8.3% of women who used the combination drug continually for five years. Thats roughly one extra cancer diagnosis for every 50 users.
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What Are The Side Effects Of Bioidentical Hormones
When the FDA approves a drug, the drug company must report on any side effects they are told about, including prominently noting it in the paperwork when picked up at the pharmacy. Pharmacies that compound hormones do not have to report drug side effects to the FDA, or provide such paperwork. This contributes to the myth that compounded hormones are safer, when in fact doctors dont know all of the possible side effects of these hormones.
Side effects can occur when a dose is first given. The body is not used to the new level of hormones. The dose may need to be changed. Some side effects can be linked to a certain hormone in the mixture. Many side effects get better as the body adjusts to the new level of hormones. Some common side effects include:
- Weight gain