Mrs. D is a 38 year old lady who came to see me with a constellation of symptoms. She was concerned about being overweight and was especially upset about the fat deposits in her thighs and hips. “I crave a lot of sugar and sweets and I have a lot of premenstrual mood swings and depression.” On further questioning, Mrs. D admitted to experiencing water retention, breast swelling, heavy periods, and a loss of sex drive. Mrs. D's family history was that of a mother and also an older sister having had breast cancer. On physical exam her breast exam revealed fibrocystic changes.
Mrs. D. was suffering from estrogen dominance, a condition where there is an imbalance between the two hormones estrogen and progesterone. In a healthy woman, estrogen and progesterone tend to balance each other out. When a woman's body makes either too much estrogen or too little progesterone, a condition where there is a hormonal imbalance with excessive estrogen may occur. Estrogen dominance is a risk factor for developing breast cancer. As a women goes through menopause, her ovaries stop producing the balance of hormones, and progesterone is usually very low. Is it coincidental that the majority of all breast cancers occur after menopause? Estrogen dominance can also occur if a woman is taking artificial or natural estrogens in too high amounts. Mrs. D had previously called her obstetrician's office and was advised to go on birth control pills “to balance her hormones.”
A Brief History of Artificial Hormone Replacement and It's Complications
Over half a century ago physicians began treating women who had entered menopause with an artificial (for humans) estrogen derived from horse urine known as Premarin. Although this drug controlled their hot flushes, mood swings, and other symptoms, women taking this drug began developing uterine cancer at a rate up to 8 times that of women not taking the drug. It was not known at that time that a condition called estrogen dominance was being created by this drug. This increased cancer development was due to a high dose of estrogen continuously stimulating the lining of the uterus. When another drug called Provera (a progestin) was later added, the increased uterine cancer development was reversed. This combination of drugs was prescribed for decades by physicians and gynecologists. Then, in 2002, the results of a revolutionary study called the Women's Health Initiative (WHI) involving over 161,000 post menopausal women were published. Some of the participants had been given the combination of Premarin and Provera. This group was found to be at greater risk for breast cancer, heart disease and stroke. In fact, the stroke risk was so alarming that the study was terminated early. Other participants were randomly assigned Premarin or placebos. This part of the study found no increased risk of breast cancer in women who had taken Premarin for less than 7 years (the Premarin group did have an increased risk of stroke). Although there were numerous articles that followed in newspapers and medical journals touting the safety of “estrogen” and that it didn't cause breast cancer, the sales of Prempro, Premarin and Provera plumeted because of the serious side effects.
Another study which involved 127,000 nurses, called the Nurse's Health Study, found women who took artificial hormones for at least 15 years had a markedly higher risk of developing breast cancer. This study also showed women who had naturally high levels of estrogen (estrogen dominance) were at greater risk for developing breast cancer.
There are also environmental sources of xenoestrogens (foreign estrogens) that humans are exposed to everyday. Some of these sources are pesticides or pesticide residues on non-organic vegetables, chemicals from plastics, and hormones that are given to cattle and poultry that end up in our bodies after consuming meat, milk, or dairy products.
Natural vs. Artificial Hormones
I want our readers to understand that Premarin, birth control pills and other artificial hormones are not identical to the hormones the human body produces. They are, in fact, totally different chemical structures and I use the word “artificial” in this article to make this point. Premarin contains absolutely no estriol, the major natural estrogen that makes up 80% of human estrogen. It does contain 10% estrone, which humans make. The other 90% of Premarin is composed of horse estrogens that are totally foreign to human beings but not horses. Unfortunately, the term “estrogen” and “Premarin” are used interchangeably by doctors, the lay press, and medical journals. Even more unfortunate is the fact that bio-identical hormones are lumped into this group when they are the only hormones identical in chemical structure to what the human body produces.
Are natural or bio-identical hormones safer than artificial hormones? We don't know for certain because there have been no large clinical studies to determine this. Intuitively, physicians who prescribe bio-identical hormones feel they are safer when prescribed in proper, balanced amounts because they are not foreign to the human body and because the human body has the metabolic pathways in place to metabolize our natural hormones.
Is There a Hormone Imbalance in Your Breasts?
Mrs. D was made aware that estrogen dominance was a risk factor for developing breast cancer. Further evaluation included measuring the blood levels of hormones in the 3rd week of her menstrual cycle which showed low progesterone and high estrogen levels. But was this affecting her breasts? I advised Mrs. D to obtain a thermogram of her breasts. If discovered, certain thermographic risk markers can warn a woman that she needs to work with her doctor to improve breast health. Breast thermography is the only non-invasive method that visualizes whether there is an estrogen dominant effect on the breasts. Mammography does not, and is not recommended for women below the age of 40. Mrs. D's thermographic scan subsequently did show a thermal pattern consistent with her estrogen dominance. If you suspect you have estrogen dominance, or would simply like more information on Breast Thermography, go to our website www.prevent-doc.com and click on the link to Thermography. Or call Gainesville Thermography at 352-332-7212.
CAM Therapies to the Rescue
Mrs. D was advised against using birth control pills. Current studies show birth control pills do increase the risk of developing breast cancer, although this risk is not as great as with estrogen replacement therapy. Instead, natural micronized progesterone cream was prescribed to correct her low progesterone levels. She was instructed to apply the progesterone cream to her breasts,
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