More Serious Risks Documented For Hormone Replacement Therapy

This article is based on the principle “First do no harm”.

“First do no harm” is a statement attributed to Hippocrates. Historically medical doctors took the Hippocratic oath as a commitment to ethical standards in the practice of medicine.. Today’s medicine seems to have forgotten Hippocrates. Instead of “first do no harm” the efficacy of treatment protocols and drugs are measured in terms of the risk to reward ratio. The premise is that if a treatment or drug doesn’t harm or kill too many people while helping a bunch, then it’s okay. The corporate entities who are making money from HRT and who have been caught red handed in their attempts to hide the ill effects of HRT definitely don’t care much about Hippocrates. Their motivation is clearly the money that they are raking in. Enough ranting, let’s look at the issue of hormone replacement therapy.

What is hormone replacement therapy (HRT)?

Hormone replacement therapy as the term is now being used in the media and by the medical community refers to the use of equine sources of estrogen and / or synthetic progesterone (called progestin) to “replace” human estrogen and progesterone. We are not talking replacing apples with apples. The estrogen found in the most commonly used HRT prescriptions (Premarin and Prempro) is from horses. It’s inhuman. Wyeth, the pharmaceutical company that has manufactured Premarin since 1942, cannot even say all of the chemicals that are in this extract of pregnant mare’s urine. With regard to progesterone, the progesterone being used in these drugs is not really progesterone. It is a lab synthesized molecule that has a somewhat similar structure to progesterone, but different. And in the microscopic world of our cells, this difference is critical.

HRT also refers to using the above mentioned hormones to relieve the symptoms and health deterioration associated with menopause. A deteriorating condition would be something like osteoporosis which is not entirely a product of menopause, but which can accelerate and become a real problem as a woman gets older.

What not just use bio-identical hormones?

Bio-identical hormones are exactly what nature makes in the human body. They can be synthesized in a laboratory to be exactly what nature made. This is what we call bio-identical. The $64,000,000 question then, is why don’t the major pharmaceutical companies make and distribute bio-identical hormones for doctors to give to their patients? The answer is that there is no money in it. Pharmaceutical companies cannot patent what nature has made. And without a patent they cannot have the exclusive right to it, and therefore cannot mark it up. (The mark up on drugs like Premarin and Prempro is very high, with mark up on many drugs upwards of 10,000%. Premarin is available in Europe for $8.95/100, in Canada for $22.46/100 in the United States for $55.42. Price variations for Prempro are $5.75/28 in Europe, $14.33/28 in Canada and $31.09/28 in the United States). These price variations begin to reveal the profit margins pharmaceutical companies have with these drugs. They are really a cash cow for these companies.

The types of hormone replacement therapy (HRT)

HRT is a catchall term used to describe several combinations of hormone replacement. There are two general subcategories. There are drugs that contain horse estrogens and progestin (synthetic non-bio-identical progesterone) and those that contain just horse estrogens. The risks of these two different subcategories as reflected in many research studies, is different.

The types of risks associated with hormone replacement therapy (HRT)

Numerous risks have been shown to be associated with HRT. The risks include an increased risk for blood clotting, an increased risk for cancers of the breast, ovaries, lung and skin (malignant melanoma), increased risk for uterine bleeding, and increased risk of heart attack and stroke.

In 2002 a major study called the Women’s Health Initiative clarified the increased risk of breast, uterine and ovarian cancer for menopause age women taking HRT. Remember that I spoke of two subcategories of HRT, estrogen and progestin versus estrogen alone. The risks for breast, uterine and ovarian cancers differed depending on whether a woman was taking estrogen with progestin, or estrogen alone.

Less lethal risks include increased risk of breast tenderness and an increased density of breast tissue. This increased density of breast density makes mammograms less reliable and leads to a higher rate of breast biopsy in women (to rule out breast cancer). There is also an increased risk for gall bladder problems, and finally an increased risk of insulin resistance.

An increased risk of insulin resistance is interesting in light of the fact that weight gain is a common complaint of menopause. Increased insulin resistance refers to a body wide cellular decrease in cells to the action of insulin. This is not hard to understand. Insulin causes cells to absorb fuel, particularly sugar in the blood. It especially causes fat cells to absorb blood sugar and turn it into fat. When our body secretes higher amounts of insulin, more of the carbohydrates that we eat are stored as fat, and we get fatter. Insulin also tells the cells to not let go of the fat. So we have a harder time losing weight. When cells become resistant to insulin (which is a greater risk with HRT) the pancreas responds by secreting more and more insulin. So when we are insulin resistant we generally have higher levels of insulin, which causes us to store more fat.

The latest research reveals an even greater risk for breast cancer associated with HRT than previously thought.

The October 20, 2010 edition of the Journal of the American Medical Association published a study entitled “Estrogen Plus Progestin and Breast Cancer Incidence and Mortality in Postmenopausal Women” by Rowan T. Chlebowski, MD, PhD; Garnet L. Anderson, PhD; Margery Gass, MD, et al.

This study continued to follow the health of women in the initial Women’s Health Initiative study which completed in 2005. The initial Women’s Health Initiative study assessed the health of 16,608 women who received different combinations of HRT or placebo’s (sugar pills). In this more recent study, researchers followed 12,788 women in the original study through August, 2009. The current study has given researchers a longer term view of the health risks associated with HRT. What they found was that women who received HRT were more likely to get breast cancer, more likely to get a more aggressive form of breast cancer, and more likely to die of the breast cancer.

HRT raises the risk of kidney stones.

Another research paper that did not receive as much attention in the media as the one above shows that HRT increases the risk of kidney pain due to kidney stones. This study was done at the University of Texas. In the study 21,000 women were followed after their menopause. The incidence of kidney stones in those who took HRT was compared with those who took a placebo. The HRT group had a 21 percent higher risk for developing kidney stones.

Natural menopause remedies increasing in popularity.

In the same way that humans and horses make estrogen, so do plants. These are called phytoestrogens (plant-estrogens). The most effective phytoestrogen found to date for relief of hot flashes and sweats associated with menopause is Siberian rhubarb root extract. Learn more about Siberian rhubarb root extract here.

Phytoestrogens have a very mild estrogenic effect in the human body, about 1/1000 that of the human estrogens. Phytoestrogens have been shown to relieve many of the symptoms of menopause. Depending on the plant source of the phytoestrogen these benefits can vary. Some of the popular sources of phytoestrogens are soy, flax seed and red clover. Black cohosh is a popular menopausal remedy, but researchers now question whether its effects are attributable to phytoestrogens. A promising source of phytoestrogens that has been used primarily in Europe is Siberian rhubarb root extract. Several research studies published in major medical journals have shown it to be both effective and safe in relieving hot flashes and sweats in particular.