By Sarah LoBisco, ND
There are two types of hormonal replacement therapy, bio-identical and synthetic hormone replacement therapy.
Most studies available today on bio-identical hormonal replacement aren’t made generally available to the public domain. However, most integrative practitioners believe hormonal supplementation with hormones that are biochemically similar to our own, are safer.
Furthermore, there are ways to measure these hormonal metabolites (how the body utilizes and excretes them) which can guide dosage, additional supplementation and reduce the risk for resultant downstream inflammatory effects. Using this guidance and individualizing a unique and integrative program for a specific woman’s need are the keys to finding a protocol that is less likely to cause tumor growth.
Synthetic hormonal replacement can be 16x more potent than natural hormones and the most common, Premarin, is formed from horse urine metabolites of estrogens.
There is evidence that synthetic hormonal replacement therapy (HRT) and hormonal contraceptives are linked to a higher risk in some cancers. The National Cancer Institute has a great summary at the links below on the various risks of certain cancers with hormonal replacement.
Probably the most confusing information is hormonal replacement and breast cancer risk studies. There are conflicting results from various studies on breast cancer risk and death with hormone replacement therapy explained below:
The study, published Friday by the Journal of the National Cancer Institute, concludes that the prognosis for cancers related to hormone replacement therapy is just as dire as for other breast cancers. As a result, women who turn to the treatment are more likely to die of breast cancer than their peers who don’t take hormones. . . .
Nearly 70,000 postmenopausal women participated in randomized clinical trials as part of the Women’s Health Initiative project. The study participants who took estrogen plus progestin had higher rates of breast cancer diagnoses and of breast cancer deaths.
At the same time, more than 90,000 additional women took part in a related observational study that tracked details about their health and hormone use over an average of 11 years. Along with many other observational studies, this one found that women who took hormones to treat menopause symptoms and got breast cancer were less likely to die from the illness than women who got breast cancer without taking hormones.
Chlebowski, an oncologist based at the Los Angeles Biomedical Research Institute in Torrance, suspected that the discrepancy could have resulted from key differences between the women in the randomized trial and the women in the observational study.
So he and his team identified a subset of more than 41,000 women from the observational study who more closely matched the women who took part in the randomized trial. In doing so, the researchers set aside data on women who were not using hormones when they participated in a study but had taken them in the past — a factor that had the potential to complicate the findings.
The new results fell more closely in line with the findings from the original randomized trial: Survival after breast cancer was similar for both hormone users and non-users. Tumors that arose in women who took hormones were no less deadly.
They had appeared to be, however, because women who had taken hormones years before might have already developed aggressive cancers and would not have been able to participate in the study in the first place. Because of the study design, they had been selected out, Chlebowski said.
Therefore, I always urge women to try lifestyle and supplemental changes first. These should be individualized and not based on manipulating symptoms with hormones.
More information on specific and general guidelines for hormonal health will be found on my homepage this week (Natural Hormonal Health Updates for Women), as well as the topic of mammograms.
Brown, E. Study Upholds Breast Cancer Mortality For Hormone Replacement. Los Angeles Times (latimes.com). March 30, 2013.
National Cancer Institute. Oral Contraceptives and Cancer Risk. NCI. 4/22/13 accessed. http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives
National Cancer Institute. Hormone Replacement Therapy and Breast Cancer Relapse. NCI.
National Cancer Institute. NCI. Menopausal Hormone Therapy and Cancer. http://www.cancer.gov/cancertopics/factsheet/Risk/menopausal-hormones
Jonathan V. Wright, M.D. with contributions by Christa Hinchcliffe, N.D. and Wendy Ellis, N.D. Taking The Fear Out of Bio-Identical Hormone Replacement Therapy – One Urine Test at a Time. AHHA.org. December 2007. http://ahha.org/BHRT-Article.htm