Estrogen Does NOT Cause Breast Cancer: Debunking Common Myths About The Hormone
It is very popular to vilify estrogen these days. The most obvious reason is the result of several sensationalized interpretations of the famous WHI (Women's Health Initiative) "Prempro" data first out in 2002. While the attempt to objectify the effects of post-menopausal hormone replacement therapy is highly admirable, confusion and inappropriate interpretations have resulted in unprecedented fear of "all things estrogen." This has created huge challenges for those of us who are interested in the wellness and education of women.
MYTH: "Estrogen causes breast cancer."
REALITY: The best data indicates that not only does estrogen not cause breast cancer; estrogen supplementation after menopause might have a slight protective effect.
Estrogen induces breast development in our species, so of course there is a strong relationship with breast disease and the hormone that regulates breast growth-- but balance is the key. Persistently high levels of estrogen, such as in the obese woman (or even in pregnancy) can promote growth of abnormal cells that might otherwise have been plucked out by the immune system. This is not causation, but facilitation after the fact. Stating that estrogen causes breast cancer is like saying fertilizer causes weeds. In a garden even weeds need some soil nutrients, and if these are completely removed, the weeds can't grow...but neither can the desired plants. The fact is the positive metabolic effects of ideal amounts of estrogen may help the body defend itself from breast cancer before it starts.
MYTH: "If you are deficient in estrogen, taking bioidentical estrogen is safe."
REALITY: Bioidentical or not, estrogen does have risks.
Estrogen is Nature's gift to incite feminine differentiation. It is also loaded with a few bells and whistles to help protect some feminine liabilities. Women have a very unique reproductive cycle that results in more blood loss than any species on Earth. Menstruation is not unique to humans, but the amount of blood loss is. Surgery residents are known to gasp at the amount of blood lost during a routine C-section (when they are invited to observe), yet the pregnant woman clots like no other...an advantage, and a risk. This tendency to lose enormous amounts of blood with reproduction probably explains why estrogen receptors in the human have evolved to increase clotting in the presence of the hormone. In other words: bioidentical or not, estrogen increases blood clot formation, and that may increase the risk of deep clots, pulmonary embolism (blood clots in the lung), and stroke. The good news: lifestyle factors and careful dosing can significantly modify these risks.
MYTH: "Estrogen makes you gain weight."
REALITY: Estrogen makes carbohydrate metabolism more efficient, helping to create the attractive waistline so closely associated with the fertile woman.
How many chubby-tummy little girls suddenly develop a carved out waistline by about age 15? Ask any menopausal woman if she feels skinnier without her estrogen? The truth is that estrogen has a very positive effect on metabolism, increasing the body's sensitivity to insulin, helping promote a smaller waist-to-hip ratio. It's easy to understand that features we humans see as "attractive" usually reflect fertility. In fact the best current data about metabolism and hormone replacement therapy in menopause demonstrates a positive effect for women taking HRT. The confusing factor is the association of estrogen with progesterone. Progesterone, the "other" female hormone, has its name because it it "pro-gestation." In other words, progesterone's job is to protect the assumed pregnancy, and that means pushing up blood sugar (hence the susceptibility to gestational diabetes), and weight gain with birth control high in progestins (synthetic progesterone). Progesterone also protects the uterine lining. Many of the effects associated with progesterone are mistakenly assumed to be due to estrogen. Most women feel their best when progesterone is not in the picture, during what I call the "Venus Week", the week after a woman's period.
MYTH: "Estrogen makes you stupid."
REALITY: Estrogen enhances verbal memory.
The scary part about the "stupid" myth is that everyone knows it's not true, but the converse is often only whispered about. My patients are horrified by the loss of verbal memory that often accompanies declining estrogen levels in menopause. I must admit it scares me to death, as my livelihood is deeply dependent on verbal skills. Many neurologists are now giving serious consideration to encouraging hormone replacement therapy for menopausal women who have a strong family history of Alzheimer's disease. Parkinson's disease (another potential cause of dementia) is far less common in women who take HRT, and while stroke risk complicates the risk/benefit profile, some women are very willing to take that risk to reduce their chances of verbal decline. To borrow a concept from Harvard gynecologist Dr. Alan Altman, it appears that estrogen is not a "repairer" per se, of verbal memory, but perhaps a preserver.
MYTH: "Men do fine without estrogen, so women don't really need it."
REALITY: Men actually do have estrogen, and have health consequences without it.
Men do not have ovaries, but they do have estrogen-- and the best evidence is that for the rare man that cannot convert testosterone to estrogen there are serious health consequences. A rare enzyme deficiency known as aromatase deficiency prevents a few men in the world from having any significant estrogen. These men not only have abnormal bone development, a high percentage suffer from what is known as metabolic syndrome, a deadly combination of high triglycerides, abdominal fat and elevated blood pressure. Cognitive effects are not well researched, but there is concern that even drugs that prevent the conversion of testosterone to estrogen (such as some used to prevent breast cancer recurrence in women) may have negative effects on the aging brain.
Ultimately we all must accept that nature endows us with estrogen as one way to promote reproductive vitality, it can't be all-bad. This gift has benefits and risks. Remaining "vital" is highly desirable, perhaps even negotiable, but fair negotiation is not possible if the stakes are not understood. There is still much unknown, but investigators are working hard as many are baby boomers on the brink of gonadal retirement themselves, whether they are men or women. One thing about baby boomers, we like being vital, so stay informed and stay posted.
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My cousin's wife wants to go off premarin. If her doctor tells her to just stop taking it, any danger? She suffers from chronic inflammation and wanted to see if going off premarin would make a difference. Doctor doesn't seem to know much about possibly problems with her stop taking other than she could get back menopausal symptoms. She's been taking over a decade and said she doesn't even know if she needs it any longer. She knows I research various health topics a lot online and asked if I read anything about dangers of abruptly stopping premarin. If her symptoms come back, she's looking at other alternatives and I've shared ones I found here, but I didn't know anything about problem with quitting "cold turkey"..
Here's an article from the Virginia Hopkins Health Watch that might help your cousin's wife --
Getting Off HRT
http://www.virginiahopkinstestkits.com/getoffhrt.html
Estrogen after middle age is the number one producer of breast cancer. . How women because of a little sweat will jepordize their lifes, I will never understand. I jogged during my menopause in 89 degree heat and never experienced what sweats were from menopause or simple exercise. Swimming , hiking, jogging, tennis, work out, during menopause will keep you agile, and healthty without hormones.
Not all women experience the same symptoms in menopause, Dora. I worked with a woman who looked like she had just come in out of the rain because of symptoms. It's great you didn't suffer greatly, but many women do, to the point of it greatly decreasing their quality of life. I believe supplements, exercise and diet play important roles, but aren't always enough. If your symptoms HAD not been manageable, would you not have at least explored some other options?
When my aunt asked about being put on a bioidentical, she was told insurance wouldn't cover. She's in her late sixties and on a fixed income. Her choices seem to be premarin or a generic version. There are other women in my family who have various types of menopause-related problems. One chose bioidenticals (because she isn't on a fixed budget), another won't consider anything even though she's suffering and my older aunt was told insurance wouldn't cover any a partial payment for patches or a bioidentical. Yet my uncle has his Viagra covered......?
A wonderful article about estrogen, but let's be balanced when we talk about hormones!
The excess breast cancer found in the good epidemiological studies about conventional HRT has to do with, 1) the progestins (synthetic progesterone), and 2) excess estrogen.
Estrogen is a stimulating hormone, an upper akin to an amphetamine drug, as it hits dopamine receptors in the brain. In a culture that highly values excitement, it’s understandable that women who feel mentally sharp, excitable and talkative identify themselves as feeling their best. These qualities are also valuable in much of the working world. Yes, estrogen is a fabulous hormone!
Progesterone is more akin to a barbiturate drug, as it hits the GABA receptors in the brain, is a calming, relaxing hormone. These qualities are valuable for mothers, but not much valued in our culture, and particularly not in the workplace, where speed and production are paramount.
As you say on your website, estrogen helps women be more interested in making connections with others, but I would like to point out that progesterone helps them be more interested in maintaining those connections, and nurturing them.
This balance applies in breast cancer. Estrogen stimulates cell growth, progesterone differentiates those cells. (The hallmark of cancer cells is that they are undifferentiated.) It’s a beautiful hormonal dance. Estrogen and progesterone work together to maintain hormone balance. One without the other creates hormone imbalance.
Virginia Hopkins
Editor, Virginia Hopkins Health Watch
www.virginiahopkinstestkits.com
I am 74 and have been on HRT since menopause. I realize there are risks, but for me the benefits outweigh them. Recently I have been reading more about the effects on verbal memory, and I feel fortunate to have an educated physician who stays up to date on the research indicating a preserving effect of estrogen.
Thank you, thank you and thank you again for writing a common sense article about estrogen.
The logic applied to the "dangers" of estrogen replacement have never made any sense. It protects us and gives us the positive effects when we are young, but bingo as soon as we turn a menopausal age it becomes dangerous, despite our levels being less even with estrogen replacement.
Before I started ERT (not the horse urine kind), I felt stiff in the morning and could barely drag myself out of bet, I felt an overall general malaise, I felt depressed, I lost incentive to exercise. After I went on ERT, I felt much, much better, completed a half marathon, started taking ballet classes again, didn't have to worry about unsightly, dripping sweat, started exercising regularly, regained interest in healthy food, etc. An amazing difference.
I get particularly angry when male doctors try to tell me how dangerous it is. For me, personally, I choose to be on ERT for the rest of my life.
Neva, thank you for your post. May I ask if you use regular hrt, patches or bioidentical hormones? I have a relative who refuses to even consider any hrt at all, even though she seems to be suffering without it.
Hi Timezone,
I use I mg. Estrace/Estradiol and 100 mg. Prometrium/Progesterone.
'Reality The best data indicates that not only does estrogen not cause breast cancer; estrogen supplementation after menopause might have a slight protective effect.'
Complete falsehood. Taking estrogen synthesized from pregnant mare's urine will absolutely put one at risk for cancer. You are playing God with the human species & there will be unintended consequences.
The problem is disease mongering by the pharmaceutical industry. Menopause is a naturally occuring phenomenon, not a disease. Plant based neutraceuticals have far fewer side effects, none of them deadly.
No one is advocating pregnant mare's urine. The writer mentioned bioidentical hormones.
Firstly, "god" never had anything to do with the human species.
All diseases are naturally occuring phenomena. Do we take it from your comment that you don't intervene: don't bother going to the doctor, don't take any supplements, won't intervene if you develop cancer, heart disease, etc.
Having said that, I do wish you the best of health always.
Neva
The writer made a claim that estrogen does not cause breast cancer. Why then did
breast cancer rates go down after HRT(Premarin-synthetic estrogen) was stopped? What are we to conclude? The research alluded to was based on pharmaceutical drugs, not bio-identical hormones.The analogy made was not accurate.
While in agreement with the author on the following..."bioidentical or not, estrogen does have risks', I can't tell you how many patients come to my clinic suffering from the side effects of bio-identical hormones. Hint topical application of bioidentical hormones is ill-advised. Why? There is no way to control the dosage. Subsequent tests show up to 20 times the recommended amount of estrogen in tested patients. Tablets are recommended so that the dosage can be controlled.
If 'god' or the Univeral Intelligence has nothing to do with the human species, how did we come to be?
Diseases are not naturally occuring phenomena. They occur when we are out of balance. It's not normal to be sick. Haven't had the flu in 30 years even though I treat
dozens of flu patients with natural remedies.
You are reading too much into my comment. Practicing a healthy lifestyle , moderate exercise & use of natural herbs/supplements on a frequent basis is important. Prevention might be 90% of the cure.
No, thanks. At age 68, I'm aging gracefully and vanity-wise, look 15 yrs younger. I let my body do what it needs to do by eating healthy foods and taking vitamin supplements to keep my immune system up, and getting out of the way of younger people. It's their turn to shine--let them have at it.
Excellent comment, excellent advice, congratulations on realizing nature is going to take it's course, the only thing we can do is try to maintain our health, eat well, get the rest we need, and let mother nature do the rest. Thanks for your comment. 0 ;-)
Their turn to shine? Keeping out of the way of younger people?
How sad. Sounds to me as if you have given up.
See Nelson Montana's Profile
Exactly. Some people aren't ready to roll over and die. There are many options to slow down the aging process and remain youthful longer. Ignoring them is as foolish as not caring for your teeth because it's natural to let them decay.
Why did the numbers of breast cancer cases drop so dramatically after the breast cancer HRT study was published. A US scientific study of this drop in breast cancer cases shows the change is due to women stopping HRT.
"If you stop hormones, the risk of breast cancer [associated with hormone use] rapidly declines," said Dr. Rowan Chlebowski, a medical oncologist at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.
Dr. Rowan Chlebowski -- a man?
An Oncologist!
More interesting reading:
http://www.caring4cancer.com/go/cancer/nutrition/questions/soy-and-hormone-related-cancers.htm
Thanks Dr. Booth for the enlightened report. I'm 61 and out of nowhere when I turned 60 I started getting acne. It was unresponsive to antibiotics and very stressful. It's bad enough to get old, but to get acne for the first time is adding insult to injury! Fortunately, I have a very wise Nurse Practitioner at OHSU. Sept 1 she prescribed estrogen to my delight and relief. I'd always done well with it earlier in my life, but doctors wouldn't prescribe it after I turned 50.
My skin is returning to normal and people have commented in how much better I'm looking. I still have weight to lose and hope to do so, but I'm feeling more like me again! Women need to know they have this option and I am grateful to read your support. BTW I said I wouldn't take Premarin because of the cruelty to horses in gathering it, so she prescribed estradiol and that is plant based, I believe.
It is plant based.
I developed acne as well, but in my case I redeveloped it. Real bummer. It is of course because of the imbalance between estrogen and testosterone, as the estorgen declines.
I am all for estrogen replacement. It makes a huge difference to one's health.
I once spoke to a naive, twenty something year old pipsqueak of a male doctor about bio-identical hormones. He had the nerve and stupidity to tell me he only practiced western medicine! There are incompetent people in all professions. Why would we expect the medical profession to be any different.
Thanks for your response, Neva. Did your acne return while you were on estrogen? That's horrible if it did. Such a drag getting old!
This is a trained doctor and possibly has done research on this..but I would not go to her. She has her mind made up and there are other research studies out there to the contrary. The voice of experience tells me...NEVER take one doc's research paper without checking with others.
I'm with you Springsm.
Since that study was released in 2002, MANY woman made the decision not to take the hormone replacement therapies for the last 6 years, and the rate of breast cancer DRAMATICALLY WENT DOWN.
It was highly irresponsible for the HP to post this story (especially with that headline).
Shame.
Thank you HP for posting an article on a much-needed topic.
Anyone who watched Oprah's show on the subject -- repeated by popular demand -- and listened to the doctors who have been prescribing bio-identical hormone replacement for years and the women whose lives have been changed for the better after taking them, knows it is long past due to expose the herd-like conventional wisdom of trashing estrogen replacement.
Hmmm. My mother got estrogen-receptor positive breast cancer (a young-woman's cancer) at age 65 from taking Premarin for 30 years.
ER positive cancer is an OLD woman's cancer. It's ER neg cancer that's a young woman cancer.
Wrong. Illogical, too. OLD women don't have much estrogen. Look it up.
That's ridiculous!
Maybe no, but Cancer causes bankruptcy.
yeah and neither do endocrine disruptors in chemicals. Hormones and cancer intersect and artificial estrogen and testosterone do lead to imbalances.
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