Open Letter From Dr. NBH Re: Estrogen and Breast Cancer

I read the article in the New York Times about the decreased risk in breast cancer for the 10,739 women in the WHI study who had a hysterectomy. This was a very important finding. I was Associate Clinical Professor at Baylor College of Medicine until 2000 when I moved to Austin. Texas. I later became the medical director of NBH Lifetime Health. I treat patients for both weight loss and bio identical hormone therapy. I remember when the study was stopped in 2003, because of the increased incidence of cancer of the breast, stroke and heart disease.

Physicians and patients were reluctant to utilize EHT or HRT. The WHI study now brings to light the fact that it wasn’t the estrogen that increased the incidence of breast cancer. I am convinced and this study and almost all other studies to date have shown that it was the Medroxyprogesterone (progestin) that caused the increase. I have attached a few article in the literature that should back up this statement.

Hopefully, providers and patient will begin to feel more comfortable to take estrogen replacement with natural progesterone as hundreds and thousands of women have been miserable for years, at risk for heart disease, stroke and Alzheimer’s. Unfortunately, the study also didn’t take into consideration an ideal start time to start HRT which should have been age 50. *As we all know, estrogen will not treat arteriosclerosis but helps to prevent it if started at age 50 or when menopause occurs.

I hope that further evaluation in the future will acknowledge the Medroxyprogesterone as the culprit and not natural progesterone. *Natural Bio Health has been prescribing estradiol and natural progesterone for 12 years. In all of those 12 years, not a single woman has reported an incident of breast cancer or heart disease taking these natural hormones. Although it is possible that a client developed breast cancer or heart disease and did not report it to the clinic, this seems unlikely or of low incidence.

For reference purposes:

For some, estrogen lowers heart, cancer risks
By Tara Parker-Pope – The New York Times

*In a finding that challenges conventional wisdom about the risks of some hormones used in menopause, a major government study has found that years after using estrogen-only therapy, certain women had a markedly reduced risk of breast cancer and heart attack.

The research, part of the landmark Women’s Health Initiative study, will likely surprise women and their providers, who for years have heard frightening news about the risks of hormone therapy. But most of those fears are related to the use of combination of two hormones, estrogen and progestin, which are prescribed to relieve hot flashes and other symptoms of menopause, and have been shown to increase a woman’s risk of breast cancer.

The new findings, reported Tuesday in the Journal of the American Medical Association, come from 10,739 women in the Women’s Health Initiative study who had previously had a hysterectomy. The most surprising new finding relates to breast cancer. *The women with hysterectomies who used estrogen alone had a 23 percent lower risk for breast cancer compared with those who had taken a placebo. This is in stark contrast to the higher risk of breast cancer shown in the estrogen-progestin part of the trial.

“The decreased risk of breast cancer in this group is something we totally didn’t expect when we started the WHI hormone therapy trials,” said Andrea LaCroix, the study’s lead author and a professor of epidemiology. “This study differentiates estrogen alone from estrogen and progestin in a very big way. I hope it gets across to women, because we are not reversing ourselves.”

Indeed, the investigators emphasized that the results don’t change recommendations concerning combination hormone therapy for the two-thirds of menopausal women who still have a uterus. The Women’s Health Initiative data have consistently shown that the combination of estrogen and progestin raises breast cancer risk and that the treatment should be used only to relieve severe menopause symptoms, using the lowest dose for the shortest possible time.

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