Wednesday, February 6, 2013

Hormone Replacement Therapy HRT Does NOT Cause Breast Cancer, New Study

Hormone Replacement Therapy HRT Does NOT Cause Breast Cancer, New Study by Jeffrey Dach MD This month, a shocking new study concluded Hormone Replacement (HRT) is safe and DOES NOT cause breast cancer. This new Lancet Oncology reports on long term follow up for the Women's Heath Initiative Study which was originally published in JAMA in 2004. (1-4) The Original 2004 WHI Report - 6.8 years of Follow Up The original WHI study (second arm) enrolled about 10,000 women after hysterectomy. Half were given placebo, and the other half were given a horse estrogen called Premarin (see above left image courtesy of wikmedia commons). Premarin is also called CEE for Conjugated Equine Estrogen. This is estrogen from pregnant horses. 23% Less Breast Cancer The original report in JAMA 2004 included 6.8 years of follow up showing 23% Less Invasive Breast Cancer in the Premarin Hormone (CEE) group than in the placebo group . There were 94 breast cancer cases in the hormone (CEE) group and 124 cases of breast cancer in the placebo group. This comparison narrowly missed statistical significance. In addition, there was 9% less heart disease, and 39% less hip fracture in the hormone treated group. The Premarin pill caused increased clotting (hypercoagulable state) resulting in increased stroke and pulmonary embolus in the Premarin Pill users, which caused early termination of the study. This is one reason why topical estrogen is preferable to pill form estrogen. Topical delivery of estradiol (bioidentical estrogen) does not cause increased coagulability, does not increase risk for CVA or stroke, is safer and the preferred delivery route. 11.8 years of Follow Up on the WHI Women- Still 23% Reduction The original WHI group of women were followed for an additional 6 years, for a total of 11.8 years of follow up, and this data was reported in Lancet Oncology by Garnet L Anderson PhD, and Rowan T Chlebowski (3,4). Here is what they found. After 11.8 years of follow up, the Premarin (horse estrogen) had 151 cases of invasive breast cancer and the placebo group had 199 cases. This represents a 23% reduction in breast cancer in the hormone treated group. This was statistically significant. (P=.02) 63% Reduction in Mortality From Breast Cancer In addition, in the hormone treated group, there was a 63% per cent reduction in death from breast cancer. 16 women died from invasive breast cancer in the placebo group, compared to only 6 in the hormone treated group. Editorial by Howell and Cuzick In an editorial in the same issue of Lancet Oncology, the Drs Anthony Howell and Jack Cuzick review the findings and conclude that the benefits of estrogen HRT include: 1) reduced risk of coronary artery disease and reduced risk of heart attacks 2) Reduced Risk of All Cause Mortality with improved survival numbers in the hormone treated group. 3) They advise women to avoid PremPro (the combined HRT pill ) which adds in a synthetic progestin, as the synthetic progestin IS associated with increased breast cancer. Here is the quote: "Young women (50—59 years) taking oestrogen were significantly less likely to have coronary heart disease, myocardial infarction, and death from all causes, not only with respect to older women but also placebo controls of the same age. Observational and WHI studies agree on the increased risk of breast cancer with combined hormone replacement therapy (including a progestin). " "The WHI investigators should be congratulated for providing insight into the value of conjugated equine oestrogens and young women can be reassured of the low risks and potentially striking benefits," Chemical structure of Premarin (left) compared to Human Bioidentical Estrogen (rught)courtesy of wikimedia commons: Above Left Image: Equilin -Premarin (Horse) Above Right Image:Human Estradiol The NIH Should Study Human Bioidentical Estradiol and Progesterone The WHI study showing the Estrogen reduces risk of breast cancer, reduces heart disease, reduces risk of hip fracture, and other and health benefits was done with Premarin, a horse estrogen. You might ask the obvious question, "Why Did The Study Not Use Estradiol", which is a human hormone (a bioidentical hormone)? Why use estrogen from a horse when human estradiol in available? The answer is obvious. The NIH is a branch of the government and the government is controlled by the Pharmaceutical industry which makes Premarin. We need the NIH to do studies for the benefit of the people, not the drug industry. We need to repeat the WHI study using estradiol and progesterone, and never again victimize women with the carcinogenic PremPro pill ( Premarin and Provera) which was shown to cause breast cancer and heart disease. Bioidentical Hormones Are Safe and Do Not increase Risk of Breast Cancer In retrospect, the Lancet Oncology findings have been known for decades. Bioidentical Hormone users are healthier and live longer than non-hormone users. Bioidentical Hormones do not cause increased breast cancer risk, and are associated with all the health benefits shown in the Women's Health Initiative (second arm) for women using estrogen alone. Premarin is not human, but it is natural. A much more better HRT program is the combination of human bioidentical estrogen available as a patch or transdermal cream, with the addition of Progesterone a human bioidentical hormone. Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Birth Control and Pregnancy

Long-acting Reversible Birth Control Methods More Effective Than Pills, Patch, and Ring Print This Post Print This Post A study just published in the New England Journal of Medicine[1] to evaluate birth control methods has found dramatic differences in their effectiveness. Women who used birth control pills, the patch, or vaginal ring were 20 times more likely to have an unintended pregnancy than those who used longer-acting forms such as an intrauterine device (IUD) or implant. Birth control pills are the most commonly used reversible contraceptive in the United States, but their effectiveness hinges on women remembering to take a pill every day and having easy access to refills. The hormonal IUD (Mirena) is approved for five years, and the copper IUD (Paragard) can be used for as long as 10 years. Hormonal implants are inserted under the skin of the upper arm and are effective for three years. Many women, however, cannot afford or decline to pay the up-front costs of these methods, which can be more than $500. The study involved over 7,500 women enrolled in the Contraceptive CHOICE project. Participants were between the ages of 14 and 45 and at high risk of unintended pregnancy. The women were either not currently using contraception or wanted to switch birth control methods, and none wished to become pregnant within the next 12 months. The women were counseled about the contraceptive methods, including their effectiveness, side effects, risks, and benefits, and all methods were provided free of charge. Participants chose among the following birth-control methods: IUD or implant (n=5781), birth control pills, patch, or ring (n=1527), and contraceptive injection (n=176). Overall, there were 334 unintended pregnancies. Of these, 156 were due to contraceptive failure. Overall, 133 (4.55%) women using pills, the patch, or ring had contraceptive failure, compared with 21 (0.27%) women using IUDs and implants. In age-adjusted analyses, pregnancy risk was significantly higher among women using birth control pills, the patch, or the ring than among those using IUDs or implants (hazard ratio, 21.8). Participants younger than 21 years who used short-acting contraceptives had nearly twice the pregnancy risk as older participants using the same methods, while risk did not differ between age groups for long-acting contraceptives. Although IUDs are very effective and have been proven safe in women and adolescents, they are chosen by only 5.5% of U.S. women who use contraception.[2] According to the authors, this study may represent a shift in how patients should be counseled about birth control, which could greatly affect unintended pregnancy rates—and can have negative effects on women’s health and education and the health of newborns. The authors also note that when IUDs and implants were provided at no cost, about 75% of the women chose these methods for birth control. Unintended pregnancy is a major problem in the United States. About 3 million pregnancies per year—50% of all pregnancies—are unplanned.[3] The rate of unintended pregnancy in the United States is much higher than in other developed nations, and past studies have shown that about half of these pregnancies result from contraceptive failure. My only comment on the above study is if you are going to chose an IUD, non hormonal option is a better option, however, you will need to ask for the Paragard or most doctors will automatically give you the Mirena which has medroxyprogesterone in it and is not healthy for you. Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol