Northeast Wisconsin
  • Northeast Wisconsin
  • October 2017
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Breast cancer and hormone replacement therapy

Much has been written about the connection between breast cancer and hormone replacement therapy (HRT). HRT is not new; it’s been around for many years. The first known experiments with hormone replacement therapy date back to the 1700s when scientists ground up the ovaries and testicles of animals and added them to potions in an attempt to cure the prevailing ills for the women of the time. Hormone therapy went through a series of transformations involving ingredients such as amniotic fluid from pregnant cows and urine from pregnant women, with little success. It wasn’t until 1949, when Premarin was introduced, that women had much hope of relief from hot flashes, mood swings, night sweats and low libido caused by menopause. Premarin soon became the standard treatment for combating the uncomfortable symptoms of menopause. 

In 1975, clinical trials discovered a link between Premarin and uterine cancer. Hormone replacement therapy began to be closely scrutinized by the scientific and medical communities. Then in 1993, one of the most publicized studies, called the Women’s Health Initiative (WHI), began studying the effects of estrogen and progesterone on the long-term health of menopausal women. The study involved 16,608 women and was to run until 2005. However, the study was stopped in 2002 because researchers were discovering an alarming increase in heart attacks, strokes, blood clots and breast cancer. When the results of this study were published, it justifiably set off alarms for women, and HRT became classified as dangerous in the minds of many. But this is not the whole picture of hormone replacement therapy.

As more and more research was completed and the medical and scientific world gained greater insight into the world of hormones and HRT, a clearer picture emerged on what is considered “responsible” hormone management and replacement therapy. This includes the use of bioidentical hormones and customized doses created by compounding pharmacies. Bioidentical hormones are plant-based hormones with the same molecular structure as the hormones naturally occurring in women’s bodies. Customized dosing means the hormone is dosed specifically for the individual. Compounding pharmacies are those with the ability and expertise to create customized-dosed medications in a variety of delivery applications, such as oral, topical, vaginal and sublingual (under the tongue). Traditional synthetic hormones, such as Premarin, are massed produced in pre-determined dosing with raw materials that do not mirror the molecular structure of our human hormones.

In 2005 new data began to emerge as the first results of the E3N French Women Prospective study were published. Part of the study followed 54,548 postmenopausal women for 6 years. These women had an average age of 53 and had not been on any kind of HRT for at least a year before entering the study. The study concluded that women using synthetic HRT had an increased risk of breast cancer, while women using bioidentical hormones had the same breast cancer risk as women who did not take hormones at all. 

Customized-dosing is another critical part of the equation for responsible HRT. In breast cancer survivors or women who are at a higher genetic risk for breast cancer, it is important to prescribe the lowest amount of estrogen necessary to achieve a positive physiological result. In other words, just enough to alleviate her symptoms. It is also important to obtain a proper estrogen to progesterone ratio. This is accomplished most easily by using customized-dosed hormones created by a compounding pharmacy. 

The route of delivery is also an important factor in responsible HRT. Topical estrogen and progesterone is one of the preferred methods of delivery because it is absorbed through the skin and directly into the blood stream for circulation and use in the body. Taking an oral estrogen means the estrogen must pass through the GI tract and is metabolized in the liver and kidneys. This can lead to metabolites, which have been associated with higher risks in some studies. 

The bottom line is that hormone replacement therapy can provide much needed relief from women who are suffering from things like hot flashes, night sweats, mood swings, low libido, painful sex and so much more, but it must be done right to provide the ideal physiological dose without causing harm to the patient. 

Randi Mann, NP and owner of Wise Woman Wellness, works with top breast cancer researchers and top laboratory hormone specialists to develop protocols for women who have survived breast cancer or who are genetically predisposed for breast cancer. There is relief for the unpleasant symptoms of menopause. To find out more information, please visit us on the web at www.WiseWomanWellness.com

 

Randi Mann, NP

Randi Mann, WHNP-BC, NCMP, is a board certified Women’s Health Nurse Practitioner, NAMS Certified Menopause Practitioner and is the owner of Wise Woman Wellness, LLC, an innovative, wellness and hormone center in De Pere. She is an integrative, functional medicine provider offering natural treatments and prescription medications for thyroid and hormonal imbalances including customized dosed, bioidentical hormones.

She combines the best of conventional, functional and integrative medicine to help women. Attend the introductory “End Hormone Havoc — Stay Sane, Slim and Sexy” seminar — offered monthly. Call 920-339-5252 to register. Visit www.wisewomanwellness.com for details.

Website: www.wisewomanwellness.com
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