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Estrogen Bioidentical HRT and Women's Health
Doesn’t Estrogen Cause Cancer?
Estrogen HRT, when using bioidentical forms of estrogen, the forms your body was designed to run on, in physiologic doses, has never been shown to increase the risk of breast cancer.
However, if bioidentical estrogen is not opposed by progesterone (particularly, the natural, bioidentical form of progesterone) then like any form of estrogen it will dramatically increase the risk of endometrial cancer. This is in no way as scary as it may sound. If a woman has no uterus, (and no leftover uterine tissue from a condition such as endometriosis) then there is no risk of uterine cancer. However, in an Anti Aging physician’s practice, this is not an issue for practically any woman, as Anti Aging physicians recognize the value of bioidentical progesterone in almost all women, and monitoring to ensure that optimal levels of progesterone are maintained, so there is very little chance of a woman being on estrogen unopposed.
Furthermore, optimal estrogen levels help reduce the risk of developing colon cancer. (In one study, there was up to a 27% lower risk.)
So, who needs Estrogen HRT?
Almost every woman who is deficient needs to be on estrogen HRT.
What are the symptoms of estrogen deficiency?
Estrogen deficiency has many symptoms. Some of the major ones are:
What are the side effects of estrogen HRT?
Side effects of estrogen therapy are mostly related to estrogen dominance, that is, if there is too much estrogen compared to too little progesterone. These include:
These side effects are eliminated by either reducing the amount of estrogen dose in the HRT, or by adding/increasing the dose of progesterone.
What are the Potential Problems?
Endometrial cancer—Increased risk ONLY if not also on progesterone therapy
Breast Cancer—Low risk IF ANY, from estrogen HRT according to the Women’s Health Initiative study, (WHI), Data is conflicting due to use of synthetic progestin instead of the bioidentical progesterone in the WHI study.
Thrombosis (blood clots)—Increased risk with oral estrogen only was demonstrated in studies using synthetic and horse estrogens, NOT the bioidentical estrogen. However, if a woman is more than 10 years post-menopausal with no prior estrogen HRT, it CAN be initiated in a non-oral form (i.e. transdermal) without this increased risk.
Weight Gain—If estrogen is NOT effectively opposed by progesterone, weight gain from estrogen is usually mostly water retention. However, if progesterone is therapeutic, this is not usually an issue. If it is, this can be eliminated with judicious use of a diuretic. (“water pill”)
Fibroids—Helped or eliminated by opposing the estrogen with progesterone
Headaches— Helped or eliminated by opposing the estrogen with progesterone
Gallstones— Helped or eliminated by opposing the estrogen with progesterone
Heart Attacks—Same as for “Thrombosis” above. Increased risk in specific groups of women is eliminated by using a non-oral form of estrogen HRT.
What about herbal preparations?
Herbal stores do sell estrogen preparations with small amounts of plant-derived phytoestrogens, typically from plants such as Black Cohosh. Unfortunately, these are non-bioidentical for humans, and only provide minimally effective relief from menopausal symptoms. They also do not stimulate the “B2 receptor site” which means that these herbal phytoestrogens do not provide the cardiac and bone protective effects that is desired with estrogen hormone replacement therapy.
What about Breast Cancer Risk in general?
Breast Cancer Risks are INCREASED by:
Breast Cancer Risks are DECREASED by:
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