A lot of clear, up-to-date information is now available regarding hormone therapy.
Below are several “pearls” of information that are based on FACT, not HYPE:
1) The estrogen most responsible for breast cancer is estrone (E1), not estradiol (E2). Estrone is the type of estrogen most secreted by the postmenopausal ovary, and is the metabolic byproduct of most oral forms of estrogen replacement.
2) An increased risk of breast cancer has been noted in women taking “standard” doses of oral hormone replacement combined with a progestin (synthetic progesterone—for example, “Provera™”). Because they are metabolized by the liver, oral hormones are given in much higher doses than transdermal (passing through the skin—e.g. patches, sprays, gels) estrogen. These higher doses also increase the risk of BrCa.
3) During the liver metabolic process that all orally-delivered estrogens go through, certain adverse by-products are liberated:
a) Sex Hormone Binding Globulin: binds to testosterone, lowering your levels of this vital hormone.
b) Thyroid Binding Globulin: binds to thyroid, slightly lowering your thyroid hormone and metabolic rate.
c) Cortisol Binding Globulin: binds to cortisol, which may slightly lower your metabolism and energy.
d) Clotting factors, increasing your risk of blood clot and stroke.
e) Pro-inflammatory proteins such as C-reactive protein and MMP-9, increasing risk of cardiovascular disease in high-risk individuals.
f) Other proteins increasing the risk of metabolic syndrome, especially in obese women, and increasing the risk of weight gain. (Transdermal estradiol bypasses the liver and does not cause these changes.)
With ease of use, and the present availability of five different type delivery systems of transdermal and transvaginal FDA-approved bioidentical estrogen products (and also compounded bioidenticals), there would appear to be little rationale, in this day and age, for prescribing oral estrogen therapy. If your practitioner is giving you oral estrogens, speak with her or him about the diminished safety and efficacy of these products, or find another provider to prescribe!