Hormone Replacement Therapy: American Study Provides Proof of Serious Health Risks
The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Seaway News newspaper in Cornwall, Ontario, Canada. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.
Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine
So did you hear the 'news' on July 9, 2002? You would have had to avoid all television, radio and most print media to miss the 'new' findings regarding the use of hormone replacement therapy (H.R.T.). It turns out that the second most commonly prescribed medication in North America (second only to the cholesterol lowering drugs such as Lipitor) does not protect you from heart disease as women have been led to believe for decades. In fact, the National Institute for Health in the U.S. has concluded after 5 years of study on 16,000 women that "long term use of estrogen and progestin increases a woman's risk of a stroke by 41 %, of a heart attack by 29 % and of breast cancer by 24 %". These findings were published in the July 9, 2002 issue of the Journal of the American Medical Association. Consider the findings that HRT may double your risk of lobular breast cancer (Cancer, June 14, 2000) and you may determine the true picture of this treatment.
Well, these 'new' findings are of a great relief to practitioners such as myself. The reason is that ample concern has existed for some time surrounding the use of H.R.T. but those who voiced concern were always sentenced as 'quacks' by established medical 'authorities' and many family practitioners. In fact, the C.B.C.'s coverage of this story quoted a medical doctor who still encouraged continued use of H.R.T. despite these findings stating that 'only H.R.T. will reduce the symptoms of menopause'. Allow me to publicly say that this statement is not only wrong, but illustrative of how 'evidence based ' medicine often ignores the real evidence.
To better appreciate this concept, consider the statement expressed by Dr. Salim Yusuf of McMaster University in response to these new findings. He said that "we never had good data that HRT prevented heart attacks or strokes, but people extrapolated based on some mechanisms". This doctor is on the monitoring board which recommended that the clinical trial on these 16, 000 be stopped (it was planned for 3 more years, but the doctors stopped the study due to the significant danger).
To underscore Dr. Yusuf's point, lets review the real evidence. In 1983 a clinical study reported that "the effects of estrogen-progestin balance…may underlie the increased incidence of stroke and myocardial infarction (heart attack)" (N Engl J Med 1983 Apr 14;308(15):862-7). In 1985 a study revealed that "women reporting postmenopausal estrogen use at one or more examinations had over a 50 % elevated risk of cardiovascular morbidity " (N Engl J Med 1985 Oct 24;313(17):1038-43). In 1987 it was stated that " in North America, estrogen/progestorne oral contraception has been associated with an increase in venous thromboemolism (clots in veins), myocardial infarction (heart attack) and stroke" (Am J Obstet Gynecol 1987 Oct;157:1042-8). Well, I think you get the point.
Why then have women been led to believe that long term HRT has no possible health risks? Why have women been led to believe that an 80 year old should have estrogen levels in their body similar to that of a 20 year old ? Its not enough to say its unnatural, it greatly questions medical logic. With U.S. sales of Premarin alone being worth $1 billion in the year 2000 (according to the Kaiser Family Foundation), it also illustrates the political power to keep prescriptions being written. This lobby has worked, as more than 12.5 million prescriptions were written for estrogen and progestin products in Canada alone in 2001. Someone is getting wealthy, but we can now say that women have been subjected to significant health risks.
With this new revelation, what do you or those you love do ? First, I would encourage you to purchase the book 'Women's Bodies, Women's Wisdom' by Dr. Christiane Northrup M.D. While being a medical doctor, this lady describes the numerous, clinically studied alternative treatments available for treating menopausal symptoms. Second, if you are well past your menopausal years, evaluate why exactly you are still taking the medication! Third, if your starting menopause, consider having an actual hormone profile conducted. Women have been routinely prescribed the same dosage of medication as every other women, without knowing if they have high or low estrogen, high or low progesterone, abnormal testosterone, abnormal DHEA and so on. While you can test this with blood, new science has taught us that only salivary testing is relevant. Consult a clinic such as Millennium Health Centre which actually uses this advanced testing.
In all, you have many options to treat menopausal symptoms. Diet is absolutely critical, botanical medicines work at the same level as synthetic hormones without the clear health risks, acupuncture provides tremendous support and some key nutritional supplements have extensive clinical research to endorse their use ( for instance, a product called Hesperidin has demonstrated a 53% improvement in hot flushes as stated in the medical journal Circulation 91:1182-88, 1995).
As for use of HRT to prevent osteoporosis, I'll defer details to another article. A summary is that HRT does not encourage new bone growth, it merely slows the loss of existing bone. Obviously, it does so with significant consequences. Prevention of bone loss and actual new bone growth can be achieved through other safe means.
As with antibiotics and new drug-resistant bacteria, HRT and the new study reveal a very old reality. We can not beat mother nature. How quickly medicine dismisses this reality. How quickly too does medicine change its opinions surrounding treatments after people have been exposed to the risks. Good luck.