“Rerun” Study Data* States that Hormone Therapy Worsens Breast Cancer:
What is the truth? And what does this mean for you?
Yet another re-run newsflash has emerged from that old, familiar
Women’s Health Initiative (WHI) study. The same information was
released in 2002, utilizing fear-tactics to scare the *#!!&%! out of
women and doctors.
Based on data from women who took “PremPro™” (an oral hormone mixture
of relatively high-dose oral estrogen and the
dangerous-if-given-long-term synthetic progestogen, Provera™), this
“new” study purports to show that there was an increased death rate
among women who took/take PremPro™ for signficant lengths of time.
It is important for you, dear reader, to understand that all hormones
are not created equal, and to state that “hormone therapy increases the
risk of breast cancer” is flat wrong. Even worse, it is dishonest!
It may be correct to say that long-term consumption (>5 years) of
PremPro™ slightly increases the risk of breast cancer. But the reader
must understand that this same WHI study found that the administration
of Premarin™ alone (the “Prem” in PremPro™), without the dreaded
Provera™, produced no increase in breast cancer in these studies.
In fact, women who took only estrogen, without the synthetic progestin
(Provera™), had LESS breast cancer than the control group! Of course,
this is good news—not the scary stuff that sensationalist journalists
like to pander.
The Real Risk: Oral Hormones, Not Transdermal
It is important to note, Premarin™ is an oral medication. In several
peer-reviewed medical studies, it has been shown that oral hormones are
much more dangerous than hormones given transdermally (through the
skin) via patches gels, creams, or spray. Orally-administered hormones
must be given in tremendously high doses because of their “first-pass”
digestion via the liver. In this digestive process, potentially
dangerous clotting factors are released, increasing the risk of stroke
and blood clots, and “binding” testosterone, which lowers sexual
The blood concentration of estradiol (estrogen) for women taking the
dose of Prem-Pro™ used in the study is 85 picograms (pg)/ml of blood.
Compare that with a level of 30 pg/ml in women utilizing low-dose, but
still effective, transdermal (TD) hormones.
Might it be possible that this almost three times higher level of
hormones in the orally-administered product might have had something to
do with the increased breast cancer death rate, especially considering
it is known that breast risk is tied to dosage? Furthermore, it is
well-known that the progestin used in this study (Provera™) is
dangerous when utilized on an ongoing basis; women who took it with the
oral estrogen had more breast cancer. Women who did not, did not.
Simple as that!
A number of good peer-reviewed studies in medical literature have shown
both that low-dose TD hormones are safer, and also that Provera™ is
dangerous—MUCH more so than the bioidentical progesterone, Prometrium™.
Additionally, the reader must understand that well-powered studies from
the US and Europe have shown unequivocally that there is a “window of
opportunity” in which to start hormone therapy (HT). If started within
five (perhaps even seven or eight) years of onset-menopause and given
long term (more than ten years) there is a protective effect of 30%
less cardiovascular disease and Alzheimer’s, less colon cancer, and far
fewer broken hips from osteoporosis.
Selling Fear—Irresponsible Reporting Catches Attention
Everyone must die of something:
• 51% of women die from cardiovascular disease.
• Many die from the immobilization following hip fracture.
• Many die from colon cancer.
• And the toll that cognitive decline takes on families may be
• Only 7% die from breast cancer.
Long-term use of HT may increase this death rate by ¼ to ½ %, while
decreasing overall mortality from heart disease and the other things
mentioned by greater than 30%. But the breast cancer scare is exciting
and sells newspapers, and ill-informed “talking heads” like to
pontificate in self-importance.
For Drs. Cheblowski and Manson (both of whom I know personally) to say
that hormone therapy increases the breast cancer death rate is, I feel,
irresponsible, as it paints all HT with the same brush. It is much
better and more accurate to say that “treatment with PremPro™ increases
risk,” NOT “hormone therapy increases risk.”
All HT is not created equal! Low-dose TD estrogen, coupled with
low-dose progesterone either continuously (or cyclically if given
long-term), is safe, effective, and even health-preserving for most
The most important message of this blog: Do not take Premarin™ or
PremPro™. It is vital to see a doctor who will individualize your
therapy, and who uses only TD hormones and a safe progestogen.
For more information about menopausal medicine, including safe hormone
therapy, visit www.drmichaelgoodman.com.
**New York Times Oct. 19th; “Good Morning America” Oct 20th