Many women (and physicians) were caught off guard in 2002 when a governmental study was released on the effects of hormone therapy on women and breast cancer. It is for this reason that when discussing hormone therapy for women in menopause, one must first discuss and understand the Women’s Health Initiative. The study was first published in 2002 and raised serious concern for women everywhere about the risk of using hormones.

Dr. Rohde does not support the use of synthetic hormones and instead offers a natural alternative through bioidentical hormones. Unlike synthetic hormones, bioidentical hormones or natural hormones are replicas of the body’s own natural hormones. They are made from soy, yams and other plant extracts and are then changed in a lab to be biologically identical to the hormones your body makes. For optimal safety and results, Dr. Rohde supplements hormones at the lowest doses to achieve and maintain hormonal balance. We then evaluate your symptoms and retest hormone levels regularly until optimal balance is achieved.

When our hormones are in balance, when we eat right and exercise, we are the healthiest, the most vital, and suffer the lowest amount of disease.

The Women’s Health Initiative

The Women’s Health Initiative (WHI) was designed to define the risks and benefits of using synthetic hormone therapy to potentially prevent heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women.

It is important to note that the women in this study were all postmenopausal and had an average age of sixty-eight. This fact is significant as most of these women had 15 years since the loss of their hormones to develop diseases that appropriately balanced levels of estrogen, progesterone, and testosterone might have prevented.

The fact that the study used synthetic hormones and not the natural bioidentical hormones should not be overlooked as well. Synthetic hormones are not natural to the human body. The action of synthetic hormones is different than those of natural human hormones, as the synthetic hormones bind to the cell receptors more tightly, causing prolonged stimulation. The synthetic hormones are difficult to get out of your system. Finally, these synthetic hormones act as toxins in the body because they are not metabolized the same way human “bioidentical” hormones are metabolized. There is a great deal of scientific and biochemical research which shows how differently synthetic hormones act in the body as compared to natural bioidentical hormones.

Finally, women who had symptoms of menopause (such as hot flashes and night sweats) were dissuaded from entering the study. These are the women most likely in the greatest need and those likely to receive the greatest benefit from hormone therapy.

INCREASED RISK OF HEART DISEASE

There was a significant increase in heart attacks in the first year of the study in women using either Premarin or Prempro (Premarin plus Provera) yet a smaller non-significant increase in heart attacks in the following years. Heart disease actually increased in the placebo group by year 6, as compared to the group treated with hormone therapy, leading to the apparent protective effect of hormone therapy.

INCREASED RISK OF BREAST CANCER

The study was divided into three groups: One receiving nothing (placebo), one group receiving Premarin (horse estrogen), and the last group receiving Prempro (Premarin plus Provera, the synthetic progestin). When comparing the women who received no hormone therapy to the women receiving Premarin (horse estrogen) alone, there was actually a decrease (although not significant) in breast cancer. It is only when adding the synthetic progestin Provera that we saw an increase in breast cancers when compared to those women who received no hormone therapy. Studies have revealed that natural progesterone, unlike synthetic progestin, protects the breasts against cancer.

INCREASED RISK OF STROKE AND BLOOD CLOTS

It is known that when giving estrogens orally, the effect on the liver is to increase the proteins that clot your blood, thereby increasing your risk for blood clots and strokes. However, this effect is not seen with natural estrogens given in the cream form through the skin. This may be due to the fact that estrogen given as a cream does not have to pass through the liver to get into your system.

DECREASED RISK OF OSTEOPOROSIS

The WHI showed that women taking synthetic estrogens had a decreased risk of hip fractures. There are studies as well showing the positive effect of natural estrogens on the prevention of hip fractures and the treatment of osteoporosis.

Nurses Health Study

Finds Higher Breast Cancer Risk

Contrary to much current medical thinking, long-term use of hormone replacement therapy may significantly increase the risk of breast cancer in postmenopausal women, even when progestins are added to estrogen, according to this study. Although estrogen alone has long been associated with an elevated risk of breast cancer, most women taking the therapy use a combination of estrogen and progestin, which has been thought to be safer. However, this study in the New England Journal of Medicine found that even women taking a combination of the hormones had a significantly higher risk of breast cancer if they consumed the hormones for more than five years.

Women 60 and older were at the highest risk when undergoing long-term use of hormone therapy. The study showed that short-term use of hormones was not associated with an increased risk of breast cancer. But unfortunately prior to this study many doctors kept women on hormones for many years, even life, because of estrogen’s purported ability to ward off heart trouble and bone fractures. This latest research suggests such lengthy use many do more harm than good for most women.
“It clearly raises the need to reconsider the risk and benefit if a woman is going to use hormones for more than five years”, said Dr. Graham A. Colditz of Brigham and Women’s Hospital in Boston, the study’s principal author.

Some earlier studies have also found links between synthetic estrogen and breast cancer, others have not, and the issue has been heavily debated. But this latest report is the largest to examine the question. The study says the increased chance of breast cancer may make hormone supplements a significant gamble. The study found that women who took either synthetic estrogen alone or synthetic estrogen plus progestin for more than five years had a 46% higher risk of breast cancer than did those who never used the therapy. The risk varies depending on the woman’s age. The researchers calculated that a 60 year old woman who has used synthetic estrogen for at least five years has a 3% chance of developing breast cancer over the next five years if she keeps taking the treatment. If she had never used hormones after menopause, her risk over the same period would be 1.8% . The study also found that long-term user’s increased risk of breast cancer drops back to normal within two years of stopping hormone therapy.

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