The single largest barrier to women taking ET/HT and allowing themselves to feel better after menopause is the fear of breast cancer. Informed physicians can’t just sit by and allow the media to get this important story wrong.
The study just released regarding hormone replacement therapy (HRT) and breast cancer released October 20th (from WHI group Chlebowski et al) has been met with fearful reactions by the news media, but what can we learn from this new study? For one thing, the absolute risk is exactly what we knew from before. There is a .008% increase risk for a breast cancer diagnosis with an increase risk of death from breast cancer of a .012%. These are very tiny individual risks.
The new information is in the details of breast cancer cell types associated with Medroxyprogesterone Acetate (MPA, the progestin found in Prempro), and the incidence of higher death rates. The problem remains with MPA. The estrogen alone trial of the WHI study showed a 23% decreased risk if being diagnosed with breast cancer.
As of today we even have very reassuring data about estradiol and natural progesterone not statistically increasing risk for breast cancer and also showing much better survival if one does get a breast cancer diagnosis if the woman is on estradiol at the time of diagnosis. The detail of which hormones a woman takes is very important. We must help make women aware of news about different products that does not relate to their risk status, unless they choose to be on Prempro for 11+ years.
I have never given any age of a woman a Premarin or PremPro prescription for a new start of hormone replacement therapy for the management of menopausal symptoms. There are many better options and that is the bottom line for this article as well. Simply look at transdermal estrogens, all biologically identical to that which we naturally make in our bodies and for which nature selected over millions of “randomized blinded trial years” (the process of natural selection at its finest in my opinion). In all sorts of research, at cellular levels, as well as gene regulation and gene suppressions/expression studies, estradiol is very positive in its effects on cell differentiation; in essence, keeping healthy breast cells healthy. That is the goal of ideal hormone support for every tissue we study: the enhancement of balanced regulated cell growth and positive anti-oxidant effects of estradiol.