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f.a.q.'s > Other Information > Does Cancer obscure benefits of biologically identical hormones?

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The international cancer research agency concluded that estrogen and progestin therapy slightly increases the risk of breast and cervical cancer and that a common type of birth control pill increases the risk of more types of cancer than previously thought. This latest announcement fuels the fire started in 2002, when the Women’s Health Initiative (WHI) study reported that combined use of synthetic estrogen and progesterone increased the risk of breast cancer, heart attacks, stroke, and blood clots.

Menopausal women who are frightened by these results should consult their healthcare providers about other options, including plant-based BHRT (also called human identical HRT), the chemical composition of which exactly matches the hormones made naturally by the human body.  “Studies on BHRT have not demonstrated the side effects occurring with synthetic hormones and, in fact, suggest benefits in terms of reduced heart disease, stroke, osteoporosis, cancer, and Alzheimer’s disease as well as quality of life.”

Authors of the WHI study noted that “the results of this study do not necessarily apply to other formulations of oral estrogens and progestins (natural progesterone)” and that “it remains possible that estradiol and progesterone, which more closely mimic the normal physiology and metabolism of endogenous sex hormones, may provide a different risk-benefit profile.”

The differences between synthetic and biologically identical hormones are in their chemical structure and function. Premarin®, for example, the mostly commonly prescribed form of synthetic estrogen, is derived from the urine of pregnant mares and is thus foreign to the human female. Biologically identical hormones are chemical and functional twins of those produced by human reproductive organs and adrenal glands.

Among the advantages of BHRT, in addition to matching the hormones produced by the human body, is that prescriptions can be customized to suit each woman’s individual needs. Various dosages forms also are available, including transdermal gels, sublingual tablets, and subdermal pellets, which provide more consistent and natural means of delivery.

The WHI study linked some of the detrimental effects of synthetic hormones to their oral administration (swallowing capsules). The hormones travel directly to the stomach and liver and are broken down, minimizing the benefits by more than half and subjecting patients to an increased risk of such conditions as breast cancer. Oral estrogens may increase body fat mass and reduce lean body mass, thus raising risk factors for cardiovascular disease, diabetes, and other cancers. Studies indicate that Premarin® increases C-reactive protein, a marker of inflammation in the blood associated with a higher risk of heart disease, but transdermal delivery of estrogen does not appear to have the same effect (Vehkavaara et al., 2001; Vongpatanasin et al., 2003).

Women considering the risks and benefits of HRT should make an informed decision, based on their symptoms, current health, and medical history, in conjunction with their healthcare provider and consulting pharmacist. For more information on HRT and other women’s health issues, visit www.collegepharmacy.com and request more information via one of the online forms.

References
Vehkavaara S, Silveira A, Hakala-Ala-Pietila T, Virkamaki A, Hovatta O, Hamsten A, Taskinen MR, Yki-Jarvinen H. Effects of oral and transdermal estrogen replacement therapy on markers of coagulation, fibrinolysis, inflammation and serum lipids and lipoproteins in postmenopausal women. Thromb Haemost. 2001 Apr;85(4):619-25.

Vongpatanasin, Wanpen, MD, FACC et al. Differential Effects of Oral versus Transdermal Estrogen Replacement Therapy on C-Reactive Protein in Postmenopausal Women. Dallas, Texas and Sacramento, California. JACC Vol. 41, No. 8, 2003. “Estrogen and Inflammatory Markers.” April 16, 2003:1358-63.

Last updated on November 12, 2007 by Dr Wayne Johnson