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I'm a great fan of Dr. John R. Lee, who's been preaching for years about the problems of conventional hormone therapy. Any woman who's ever had negative experiences from hormone therapy, be it hormonal birth control or hormone replacement might enjoy the following two articles. They are both from http://groups.yahoo.com/group/NaturalAlternativesToHRT I had to reprint because you need a password to get in (but anyone can join).
Dr. Lee contends that most hormonal problems experienced by women are due to estrogen dominance, as opposed to estrogen deficiency, even in older women. True estrogen deficiency is rare. Provided a woman has some body fat, her body can generally make enough estrogen. The fact that our modern world is full of environmental estrogens, from food additives, pesticides, plastics, etc. adds to this dominance.
From: "menoqueen" <vickie@m...>
Date: Sun Apr 6, 2003 11:17 pm
Subject: Symptoms Of Estrogen Dominance The Culprit To Most Of Our Symptoms
Doctors have historically recommended, and prescribed, synthetic estrogens and progestins to treat the symptoms of menopause and PMS. This is largely because most of the information that the doctors receive about new treatments are from the pharmaceutical companies. And because a product that can be produced naturally can not be patented the pharmaceutical
companies have to create a synthetic version with a slightly modified molecule in order to patent the product. This however has been shown to be extremely unhealthy for your body. A New England Journal of Medicine article in 1995 involving 121,700 women showed that the chance of developing breast cancer went up to 40 percent in women that used estrogens and
progestins (synthetic progesterone) for more than five years.
Estrogen dominance is a term coined by Dr. Lee. It describes a condition where a woman can have deficient, normal, or excessive estrogen but has little or no progesterone to balance its effects in the body. Even a woman with low estrogen levels can have estrogen-dominance symptoms if she doesn't have
any progesterone.
The symptoms and conditions associated with estrogen dominance are:
Acceleration of the aging process
Allergy symptoms, including asthma, hives, rashes, sinus congestion
Arthritis
Autoimmune disorders such as lupus erythematosis and thyroiditis, and
possible Sjogren's disease
Breast cancer
Breast cysts
Breast tenderness
Candida
Cervical dysplasia
Chronic fatigue
Cold hands and feet as a symptom of thyroid dysfunction
Copper excess
Decreased sex drive
Depression with anxiety or agitation
Dry eyes
Early onset of menstruation
Endometriosis
Endometrial (uterine) cancer
Fat gain, especially around the abdomen, hips, and thigh
Fatigue
Fibrocystic breasts
Foggy thinking
Gallbladder disease
Hair loss
High blood pressure
Headaches
Hot flashes
Hypoglycemia
Increased blood clotting (increasing risk of strokes)
Infertility
Irregular menstrual periods
Irritability
Insomnia
Magnesium deficiency
Memory loss
Mood swings
Osteoporosis
Painful swollen breasts
PMS
Polcystic ovaries
Premenopausal bone loss
Prostate cancer
Sluggish metabolism
Skin: Rosacea, rashes, dermatitis
Thyroid dysfunction mimicking hypothyroidism
Uterine cancer
Uterine fibroids
Water retention, bloating
Yeast infection
Zinc deficiency
The above information was taken from What Your Doctor may not tell you about Premenopause by John R. Lee, M.D.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~'
From: "menoqueen <vickie@m...>" <vickie@m...>
Date: Sat Mar 1, 2003 10:07 am
Subject: Dr. John Lee's Opinion On Estrogens - Must Read
Defining Natural Estrogen can be tricky, as the phrase can be used to refer to one of four substances (3 are endogenous, found within the body; and 1 substance is from plants.):
Endogenous Estrogens – Estrogens found in the body:
1. Estradiol; the principal estrogen before menopause,
2. Estrone, the main estrogen present after menopause, and
3. EstrioI - a weaker and safer estrogen created when estradiol and estrone are metabolized in the body. According to Dr. Jonathan Wright, estriol is the highest concentration in the blood for non-pregnant and pregnant women.
Note: Premarin is one of the most popular forms of estrogen prescribed for menopausal and postmetopausal women, and it is considered a natural - estrogen because it is manufactured from the urine of pregnant mares. We maintain it is only "natural" for horses, not humans.
B. Phyto-Estrogens – Plant estrogens found in many plant sources, primarily soy and wild yam. Phyto-estrogens are not as strong as the other types of estrogens, but studies have been conducted that demonstrate that this a combination of progesterone and plant estrogens may be the safest and most effective form of estrogen for women.
Excerpt from "The John R. Lee, M.D. Medical Letter" October 1999 issue: "Let us agree that women continue to produce estradiol after menopause. Finally, let us agree that estrogen dominance is dangerous and not desirable. It follows that estrogen supplementation should be given only to women in whom saliva tests demonstrate a deficiency in bio-available estradiol that
persists after giving physiological doses of progesterone.
"Q: Who should use estrogen supplements?
A: Estrogen works especially well for hot flashes and vaginal dryness. These symptoms can be taken as a sign of estrogen deficiency. However, because progesterone is a biochemical precursor to estrogen, it alone is often sufficient to restore estrogen levels to normal and eliminate these symptoms. If a three-month trial of progesterone plus proper diet and supplements of magnesium and B6 do not relieve hot flashes or vaginal dryness, then low-dose natural estrogen may be helpful. (Estrogen is not recommended in those women with a history of breast or uterine cancer, obesity, diabetes, or a history of clotting or vascular disorders.) If used for hot flashes, find the lowest
dose of estrogen that works, If vaginal dryness is the problem, I usually recommend vaginal gels or creams containing estriol. Often a small dose applied in the vagina only twice a week, three weeks a month, will do wonders. Otherwise, I'm not sure of any reason to use estrogen.
ESTROGEN: WHICH ONE & HOW MUCH?
(John R Lee, M.D. Medical Letter – November, 1998)
There are many ways to increase estrogen levels in the body. Here are some suggestions, from simple dietary changes to actual estrogen supplementation.
1 Diet modification with less starch and more phytoestrogens (plant-based estrogens) may be all that's needed. Avoid all processed foods and include plenty of fresh organic veggies, seeds, legumes (the bean family) and fish.
2. Stress management may help. Stress can increase cortisol levels that blockade progesterone from its receptors, thus down regulating estrogen receptors as well. Further, stress can alter the production of pituitary hormones and endogenous estrogen.
3. Women who exercise regularly pass through menopause with fewer problems.
4. Use of "natural" (human) estrogens, i.e., estrone, estradiol, and estriol. Each of these hormones differs in certain aspects, but with all of them the goal is to find the smallest dose that relieves symptoms and/or creates the desired blood or saliva level.
Estriol is safer in regard to cancer risk than estradiol or estrone and is the preferred estrogen for vaginal or transdermal use. I have found good results with twice-weekly vaginal dosing for 25 days/month, always along with progesterone. (The progesterone does not need to be used vaginally.) Begin with half the usual prescribed dose. November 1998 THE JOHN R. LEE, M.D. MEDICAL LETTER
THE ESTROGEN QUESTIONS
Excerpt from The John R. Lee, M.D. Medical Letter, (November, 1998 issue) Some guidelines for supplementing safely and effectively
Here's a story that I hear every day: Joan, a pre-menopausal woman in her mid-40s goes to her doctor complaining of hot flashes, poor sleep, and lack of energy. She is still having regular periods. Her doctor tests her estradiol , FSH, LH, and progesterone levels, and finds them all to be normal except for very low progesterone. He then prescribes estradiol supplementation! Within three months Joan gains 25 pounds, is sleeping even less, and feels irritable and anxious, and has headaches.
Another estrogen supplementation scenario that I hear every day is the woman who is prescribed estrogen alone (without progesterone) and within in a year has a pap smear that shows cervical dysplasia, soon followed by a hysterectomy. I consider this medical malpractice, but it happens to hundreds of women every day.
Confusion reigns on the subject of estrogen replacement: What time of life? How much? Which kind? How often? Is it safe? Here are some fairly simple guidelines to help you make your own educated decisions. The two most important guidelines in estrogen supplementation are:
1.Only women who are clearly deficient in estrogen should take it.
2. Estrogen should always be taken with progesterone regardless of your age or whether you have a uterus.
It's that simple, but these guidelines are routinely ignored by conventional medicine. It's almost certain that a woman around the age of 50 who visits her doctor will receive a prescription for estrogen regardless of symptoms, and often without even a blood test.
Conventional medicine also fails to discriminate between different estrogens whether natural or synthetic, phytoestrogens, horse estrogen or human. They fail to consider the interaction between estrogen and diet, or estrogen and progesterone, let alone its interrelationship to testosterone, other androgens, thyroid, or corticosteroids.
Another issue I have with estrogen supplementation in conventional medicine is gross overdosing. For decades I have been suggesting that women who need estrogen take only half or a quarter of the ususal recommended dosages.
A recent study reported in the September 10th issue of the New England Journal of Medicine (NEJM) supports this point of view. In a group of women 65 to 80 years of age who had never used hormone replacement therapy of any kind, blood levels of estradiol (one of the human estrogens) were measured. It was found that two-thirds of these women had blood serum
estradiol levels greater than 5 pg/ml, a level consistent with optimal bone benefit. In the one-third of women who had estradiol levels lower than 5 pg/ml, the estrogen dose necessary to raise it to 5 pg/ml was about one-tenth of that routinely prescribed in conventional medicine.
Postmenopausal Women and Estrogen
Estrogen levels decline at menopause but not to zero. Estradiol falls generally to about 15 percent of pre-menopausal levels, and estrone falls only 40 to 50 percent of pre-menopausal levels. Androstenedione, a hormone made in the ovary long after menopause, is convened in body fat into estrone, which is
partially converted in the gut and liver into estradiol. Therefore, the question becomes: Is this estrogen sufficient for normal bodily functions excluding pregnancy? That is, did Mother Nature intend that women should become estrogen deficient after menopause? I think not! Estrogen deficiency at menopause is a myth created by drug companies to justify selling supplemental estrogen.
It should be obvious that postmenopausal women do not need estrogen levels so high that the endometrim is stimulated as much as it would be in preparing every month for pregnancy (i.e., premenopausal levels), but that is what is currently prescribed.
Use Symptoms as a Guide
Blood or saliva test can measure your estrogen levels, but symptoms alone can be a reliable indicator of estrogen excess or deficiency. The symptoms of estrogen deficiency are persistent vaginal dryness or vaginal mucosal atrophy ( thinning), or persistent hot flashes despite adequate progesterone treatment. Estrogen deficiency can also cause urinary track problems.
Postmenopausal women with these symptoms might benefit from small doses of estrogen as a supplement.
The most common excess estrogen symptoms are weight gain, water retention, breast swelling and lumpiness, headaches, hypertension, insomnia, and anxiety.
Pre-menopausal Women Don't Need Estrogen
Conventional medicine has long held that estrogen production declines during premenopausal years. This is not true. Dr. Jerilyn C. Prior thoroughly reviewed all pertinent references from 1990 to the present and found no evidence that estrogen levels fall before menopause. All evidence indicates that over-all estrogen production remains at normal pre-menopausal levels.
It has also been assumed that pre-menopausal hot flashes are caused by estrogen deficiency. If estrogen levels are normal, what causes the hot flashes? It is fluctuating hormones against a background of progesterone deficiency. Remember, women begin to have non-ovulating menstrual cycles in their mid-thirties. Any month that you don't ovulate you don't make any progesterone (although you will still have a menstrual period). Without progesterone you can't maintain good estrogen receptor sensitivity, so even when there's plenty of estrogen available, your cells can't use it as effectively.
Thus treating the underlying progesterone deficiency first to reduce the overall hormone fluctuations allows you to take advantage of the estrogen you have.
Estrogen for Hot Flashes, Heart Disease and Osteoporosis
Even for women who have reached menopause, progesterone
supplementation alone usually relieves hot flashes, Dr. Helene Leonetti reports in this month's interview, her study of steoporosis treatment in recently menopausal women, the majority experienced excellent relief of hot flashes using progesterone cream alone.
Some argue that estrogen provides protection against coronary heart disease, hut we still don't have one good study proving this, because they have all been done either in combination with progestins (i.e., Provera), or with Premarin, which contains pregnant horse urine that has hundreds of active ingredients besides estrogen, including progesterone and other steroid
hormones.
The most recent study of estrogen, and heart disease reported in August 19th "Journal of the American Medical Association" (JAMA) looked at prevention of coronary heart in postmenopausal women (average age 66.7 years). After an average follow-up of 4 to 5 years, no difference in overall bone disease was observed relative to HRT using Premarin and Provera.
Some women lose bone very rapidly right around menopause. The decline of estrogen combined with low progesterone may be more than the body can keep up with for a few years, even with supplemental progesterone. Most women regain bone density within a few years after menopause, especially if they use progesterone cream. However, a small percentage of women with low estrogen and estrogen deficiency symptoms combined with indications of osteoporosis will benefit from using a small amount of supplemental estrogen with progesterone at this time of their life. These women are often petite, thin (with not enough body fat to make significant estrogen), and have small bones.
Handle with Care. Estrogen is necessary to maintain progesterone receptors; it is necessary to maintain good brain function and healthy bones; and a true estrogen deficiency may compromise the ability of blood vessels to relax and thus help protect against a heart attack. Hut a true estrogen deficiency in
the 1990's is rare because we live in a highly estrogen-ontaminated world (see my book, What Your Doctor May Not Tell You About Menopause). When estrogen levels are too high the risk of cancer increases steeply; its protective value in heart disease is reversed as the risk of blood clots and fluid
imbalances rises; and the brain benefits are lost. Estrogens are indeed the angels of life and the angels of death. They should be used only when needed, with moderation and respect, and with a goal of overall hormone balance.
Dr. Lee contends that most hormonal problems experienced by women are due to estrogen dominance, as opposed to estrogen deficiency, even in older women. True estrogen deficiency is rare. Provided a woman has some body fat, her body can generally make enough estrogen. The fact that our modern world is full of environmental estrogens, from food additives, pesticides, plastics, etc. adds to this dominance.
From: "menoqueen" <vickie@m...>
Date: Sun Apr 6, 2003 11:17 pm
Subject: Symptoms Of Estrogen Dominance The Culprit To Most Of Our Symptoms
Doctors have historically recommended, and prescribed, synthetic estrogens and progestins to treat the symptoms of menopause and PMS. This is largely because most of the information that the doctors receive about new treatments are from the pharmaceutical companies. And because a product that can be produced naturally can not be patented the pharmaceutical
companies have to create a synthetic version with a slightly modified molecule in order to patent the product. This however has been shown to be extremely unhealthy for your body. A New England Journal of Medicine article in 1995 involving 121,700 women showed that the chance of developing breast cancer went up to 40 percent in women that used estrogens and
progestins (synthetic progesterone) for more than five years.
Estrogen dominance is a term coined by Dr. Lee. It describes a condition where a woman can have deficient, normal, or excessive estrogen but has little or no progesterone to balance its effects in the body. Even a woman with low estrogen levels can have estrogen-dominance symptoms if she doesn't have
any progesterone.
The symptoms and conditions associated with estrogen dominance are:
Acceleration of the aging process
Allergy symptoms, including asthma, hives, rashes, sinus congestion
Arthritis
Autoimmune disorders such as lupus erythematosis and thyroiditis, and
possible Sjogren's disease
Breast cancer
Breast cysts
Breast tenderness
Candida
Cervical dysplasia
Chronic fatigue
Cold hands and feet as a symptom of thyroid dysfunction
Copper excess
Decreased sex drive
Depression with anxiety or agitation
Dry eyes
Early onset of menstruation
Endometriosis
Endometrial (uterine) cancer
Fat gain, especially around the abdomen, hips, and thigh
Fatigue
Fibrocystic breasts
Foggy thinking
Gallbladder disease
Hair loss
High blood pressure
Headaches
Hot flashes
Hypoglycemia
Increased blood clotting (increasing risk of strokes)
Infertility
Irregular menstrual periods
Irritability
Insomnia
Magnesium deficiency
Memory loss
Mood swings
Osteoporosis
Painful swollen breasts
PMS
Polcystic ovaries
Premenopausal bone loss
Prostate cancer
Sluggish metabolism
Skin: Rosacea, rashes, dermatitis
Thyroid dysfunction mimicking hypothyroidism
Uterine cancer
Uterine fibroids
Water retention, bloating
Yeast infection
Zinc deficiency
The above information was taken from What Your Doctor may not tell you about Premenopause by John R. Lee, M.D.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~'
From: "menoqueen <vickie@m...>" <vickie@m...>
Date: Sat Mar 1, 2003 10:07 am
Subject: Dr. John Lee's Opinion On Estrogens - Must Read
Defining Natural Estrogen can be tricky, as the phrase can be used to refer to one of four substances (3 are endogenous, found within the body; and 1 substance is from plants.):
Endogenous Estrogens – Estrogens found in the body:
1. Estradiol; the principal estrogen before menopause,
2. Estrone, the main estrogen present after menopause, and
3. EstrioI - a weaker and safer estrogen created when estradiol and estrone are metabolized in the body. According to Dr. Jonathan Wright, estriol is the highest concentration in the blood for non-pregnant and pregnant women.
Note: Premarin is one of the most popular forms of estrogen prescribed for menopausal and postmetopausal women, and it is considered a natural - estrogen because it is manufactured from the urine of pregnant mares. We maintain it is only "natural" for horses, not humans.
B. Phyto-Estrogens – Plant estrogens found in many plant sources, primarily soy and wild yam. Phyto-estrogens are not as strong as the other types of estrogens, but studies have been conducted that demonstrate that this a combination of progesterone and plant estrogens may be the safest and most effective form of estrogen for women.
Excerpt from "The John R. Lee, M.D. Medical Letter" October 1999 issue: "Let us agree that women continue to produce estradiol after menopause. Finally, let us agree that estrogen dominance is dangerous and not desirable. It follows that estrogen supplementation should be given only to women in whom saliva tests demonstrate a deficiency in bio-available estradiol that
persists after giving physiological doses of progesterone.
"Q: Who should use estrogen supplements?
A: Estrogen works especially well for hot flashes and vaginal dryness. These symptoms can be taken as a sign of estrogen deficiency. However, because progesterone is a biochemical precursor to estrogen, it alone is often sufficient to restore estrogen levels to normal and eliminate these symptoms. If a three-month trial of progesterone plus proper diet and supplements of magnesium and B6 do not relieve hot flashes or vaginal dryness, then low-dose natural estrogen may be helpful. (Estrogen is not recommended in those women with a history of breast or uterine cancer, obesity, diabetes, or a history of clotting or vascular disorders.) If used for hot flashes, find the lowest
dose of estrogen that works, If vaginal dryness is the problem, I usually recommend vaginal gels or creams containing estriol. Often a small dose applied in the vagina only twice a week, three weeks a month, will do wonders. Otherwise, I'm not sure of any reason to use estrogen.
ESTROGEN: WHICH ONE & HOW MUCH?
(John R Lee, M.D. Medical Letter – November, 1998)
There are many ways to increase estrogen levels in the body. Here are some suggestions, from simple dietary changes to actual estrogen supplementation.
1 Diet modification with less starch and more phytoestrogens (plant-based estrogens) may be all that's needed. Avoid all processed foods and include plenty of fresh organic veggies, seeds, legumes (the bean family) and fish.
2. Stress management may help. Stress can increase cortisol levels that blockade progesterone from its receptors, thus down regulating estrogen receptors as well. Further, stress can alter the production of pituitary hormones and endogenous estrogen.
3. Women who exercise regularly pass through menopause with fewer problems.
4. Use of "natural" (human) estrogens, i.e., estrone, estradiol, and estriol. Each of these hormones differs in certain aspects, but with all of them the goal is to find the smallest dose that relieves symptoms and/or creates the desired blood or saliva level.
Estriol is safer in regard to cancer risk than estradiol or estrone and is the preferred estrogen for vaginal or transdermal use. I have found good results with twice-weekly vaginal dosing for 25 days/month, always along with progesterone. (The progesterone does not need to be used vaginally.) Begin with half the usual prescribed dose. November 1998 THE JOHN R. LEE, M.D. MEDICAL LETTER
THE ESTROGEN QUESTIONS
Excerpt from The John R. Lee, M.D. Medical Letter, (November, 1998 issue) Some guidelines for supplementing safely and effectively
Here's a story that I hear every day: Joan, a pre-menopausal woman in her mid-40s goes to her doctor complaining of hot flashes, poor sleep, and lack of energy. She is still having regular periods. Her doctor tests her estradiol , FSH, LH, and progesterone levels, and finds them all to be normal except for very low progesterone. He then prescribes estradiol supplementation! Within three months Joan gains 25 pounds, is sleeping even less, and feels irritable and anxious, and has headaches.
Another estrogen supplementation scenario that I hear every day is the woman who is prescribed estrogen alone (without progesterone) and within in a year has a pap smear that shows cervical dysplasia, soon followed by a hysterectomy. I consider this medical malpractice, but it happens to hundreds of women every day.
Confusion reigns on the subject of estrogen replacement: What time of life? How much? Which kind? How often? Is it safe? Here are some fairly simple guidelines to help you make your own educated decisions. The two most important guidelines in estrogen supplementation are:
1.Only women who are clearly deficient in estrogen should take it.
2. Estrogen should always be taken with progesterone regardless of your age or whether you have a uterus.
It's that simple, but these guidelines are routinely ignored by conventional medicine. It's almost certain that a woman around the age of 50 who visits her doctor will receive a prescription for estrogen regardless of symptoms, and often without even a blood test.
Conventional medicine also fails to discriminate between different estrogens whether natural or synthetic, phytoestrogens, horse estrogen or human. They fail to consider the interaction between estrogen and diet, or estrogen and progesterone, let alone its interrelationship to testosterone, other androgens, thyroid, or corticosteroids.
Another issue I have with estrogen supplementation in conventional medicine is gross overdosing. For decades I have been suggesting that women who need estrogen take only half or a quarter of the ususal recommended dosages.
A recent study reported in the September 10th issue of the New England Journal of Medicine (NEJM) supports this point of view. In a group of women 65 to 80 years of age who had never used hormone replacement therapy of any kind, blood levels of estradiol (one of the human estrogens) were measured. It was found that two-thirds of these women had blood serum
estradiol levels greater than 5 pg/ml, a level consistent with optimal bone benefit. In the one-third of women who had estradiol levels lower than 5 pg/ml, the estrogen dose necessary to raise it to 5 pg/ml was about one-tenth of that routinely prescribed in conventional medicine.
Postmenopausal Women and Estrogen
Estrogen levels decline at menopause but not to zero. Estradiol falls generally to about 15 percent of pre-menopausal levels, and estrone falls only 40 to 50 percent of pre-menopausal levels. Androstenedione, a hormone made in the ovary long after menopause, is convened in body fat into estrone, which is
partially converted in the gut and liver into estradiol. Therefore, the question becomes: Is this estrogen sufficient for normal bodily functions excluding pregnancy? That is, did Mother Nature intend that women should become estrogen deficient after menopause? I think not! Estrogen deficiency at menopause is a myth created by drug companies to justify selling supplemental estrogen.
It should be obvious that postmenopausal women do not need estrogen levels so high that the endometrim is stimulated as much as it would be in preparing every month for pregnancy (i.e., premenopausal levels), but that is what is currently prescribed.
Use Symptoms as a Guide
Blood or saliva test can measure your estrogen levels, but symptoms alone can be a reliable indicator of estrogen excess or deficiency. The symptoms of estrogen deficiency are persistent vaginal dryness or vaginal mucosal atrophy ( thinning), or persistent hot flashes despite adequate progesterone treatment. Estrogen deficiency can also cause urinary track problems.
Postmenopausal women with these symptoms might benefit from small doses of estrogen as a supplement.
The most common excess estrogen symptoms are weight gain, water retention, breast swelling and lumpiness, headaches, hypertension, insomnia, and anxiety.
Pre-menopausal Women Don't Need Estrogen
Conventional medicine has long held that estrogen production declines during premenopausal years. This is not true. Dr. Jerilyn C. Prior thoroughly reviewed all pertinent references from 1990 to the present and found no evidence that estrogen levels fall before menopause. All evidence indicates that over-all estrogen production remains at normal pre-menopausal levels.
It has also been assumed that pre-menopausal hot flashes are caused by estrogen deficiency. If estrogen levels are normal, what causes the hot flashes? It is fluctuating hormones against a background of progesterone deficiency. Remember, women begin to have non-ovulating menstrual cycles in their mid-thirties. Any month that you don't ovulate you don't make any progesterone (although you will still have a menstrual period). Without progesterone you can't maintain good estrogen receptor sensitivity, so even when there's plenty of estrogen available, your cells can't use it as effectively.
Thus treating the underlying progesterone deficiency first to reduce the overall hormone fluctuations allows you to take advantage of the estrogen you have.
Estrogen for Hot Flashes, Heart Disease and Osteoporosis
Even for women who have reached menopause, progesterone
supplementation alone usually relieves hot flashes, Dr. Helene Leonetti reports in this month's interview, her study of steoporosis treatment in recently menopausal women, the majority experienced excellent relief of hot flashes using progesterone cream alone.
Some argue that estrogen provides protection against coronary heart disease, hut we still don't have one good study proving this, because they have all been done either in combination with progestins (i.e., Provera), or with Premarin, which contains pregnant horse urine that has hundreds of active ingredients besides estrogen, including progesterone and other steroid
hormones.
The most recent study of estrogen, and heart disease reported in August 19th "Journal of the American Medical Association" (JAMA) looked at prevention of coronary heart in postmenopausal women (average age 66.7 years). After an average follow-up of 4 to 5 years, no difference in overall bone disease was observed relative to HRT using Premarin and Provera.
Some women lose bone very rapidly right around menopause. The decline of estrogen combined with low progesterone may be more than the body can keep up with for a few years, even with supplemental progesterone. Most women regain bone density within a few years after menopause, especially if they use progesterone cream. However, a small percentage of women with low estrogen and estrogen deficiency symptoms combined with indications of osteoporosis will benefit from using a small amount of supplemental estrogen with progesterone at this time of their life. These women are often petite, thin (with not enough body fat to make significant estrogen), and have small bones.
Handle with Care. Estrogen is necessary to maintain progesterone receptors; it is necessary to maintain good brain function and healthy bones; and a true estrogen deficiency may compromise the ability of blood vessels to relax and thus help protect against a heart attack. Hut a true estrogen deficiency in
the 1990's is rare because we live in a highly estrogen-ontaminated world (see my book, What Your Doctor May Not Tell You About Menopause). When estrogen levels are too high the risk of cancer increases steeply; its protective value in heart disease is reversed as the risk of blood clots and fluid
imbalances rises; and the brain benefits are lost. Estrogens are indeed the angels of life and the angels of death. They should be used only when needed, with moderation and respect, and with a goal of overall hormone balance.
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