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HRT, Breast Cancer, And Bioidentical Hormones

The symptoms of menopause are akin to labor pains in that they feel like they will go on forever, yet they herald the birth of new life. In fact, whilst perimenopause lasts a lot longer – from 5 to 10, or up to 13 years, it is not an indicator of how ‘life will be’. Menopause is a time of growth and adaptation, and our bodies are an intimate part of the journey. The symptoms associated with menopause intimately reflect the flux of the body’s hormonal systems.

Menopause can be extremely disruptive, however. Whether it’s sleeplessness, menopause related depression, hot flushes, vaginal dryness, or emotional swings, the good news is that these symptoms can be alleviated. A good menopause treatment will help many seemingly diverse symptoms, as they are all related to the root hormonal flux in the body.

HRT is one choice, popular with doctors, and one that many women have found extremely useful. But what is often not understood, is that there are different types of hormone replacement therapy, even amongst those prescribed by doctors.

Premarin is one of the best well know, and oldest, types of hormone treatment. Premarin is made from the urine of pregnant horses, and is an estrogen only hormonal pill. It was advocated as being beneficial for, amongst other things:

* thickening vaginal tissue
* helping depression
* stopping hot flushes
* preventing heart disease, osteoporosis, and alzheimers

However, research has also found a link between estrogen-only supplementation and breast cancer. The cells in the breasts and the uterus are responsive to estrogen. So to add estrogen in, without the checks and balances intrinsic to our normal hormonal system, can stimulate the growth of this tissue.

What many believed was a mitigating factor in premarin’s favor was the belief that it helped prevent heart disease. This presumption was based on the fact that premarin lowered LDL cholesterol. High levels of LDL cholesterol had earlier been identified as a risk in developing heart disease. However, this belief has been found to be unsupported in several large clinical trials. In one involving women who had heart disease, those taking premarin (in combination with a synthetic form of progesterone which was given with premarin to prevent endometrial cancer), these women actually significantly increased their risk of having another heart attack in the first year of use. This risk leveled off after that, but it didn’t provide any heart protective effects. In a study with healthy women, hormone replacement with premarin, with or without a synthetic progesterone supplement, did not decrease the risk of heart attacks or heart disease.

Another drawback to premarin and other hormone replacement therapies is the way they are often prescribed, in a kind of ‘one size fits all’ way, irrespective of a woman’s size or medical history.

But the news is not all bad with HRT therapies. When premarin was developed, there was not the ability amongst scientists to produce other types of estrogen. Because the estrogen in horses is not natural in women, side effects like bloating, headaches, and sore breasts are common. And because the breakdown products of estrogen from horses are so strong, actually more active in the body than the original horse estrogen, they have a pronounced effect on estrogen sensitive tissues, such as the breast. And given that numerous studies have shown that these metabolic by-products can produce changes in the DNA of cells that are carcinogenic to living tissue, it is no surprise that the incidence of breast cancer increases when women take premarin.

But there are alternatives. Bioidentical hormones are developed from soy beans or yams, and their chemical structure is designed to reflect that which is found in women’s bodies. Further, bioidentical hormones are not usually given in a standardized, ‘one size fits all’ dose, but tailored to a woman’s presenting history. They are generally given at low doses, and because chemically they behave more like regular estrogen, they are not associated with the side effects of premarin, although they have not been used in the large scale studies that premarin has.

References: Dr Christiane Northrup, The Wisdom Of Menopause

Rebecca Prescott presents more information on hormone replacement therapy here. For other menopause information, click here.