Topic for Today: Testosterone & Breast Cancer 

Comment: We often hear our clients tell us that their family physician, endocrinologist, etc. told them to stop their bioidentical hormones. They are told “they are bad for you.” Of course, they have no experience with bioidentical hormones and no studies to support what they say. At the same time, these same physicians often prescribe statin drugs to block cholesterol, synthetic hormones like Premarin, Prempro, Progestin, and Birth Control Pills (which contain synthetic estrogens and synthetic progestins) to treat a variety of female symptoms, anti-depressants, sleep drugs, blood pressure drugs, migraine medications, pain medications, etc. They frequently recommend hysterectomies (600,000 per year), breast removal, gastric by-pass and lap-band surgery (hundreds of thousands each year), liposuction, etc.

The truth is that it’s easier to treat symptoms with a drug recommended by a drug company than to actually determine and treat the real causes of a person’s distress or condition. +For example, in our 13 years of experience, migraines in women can be reduced significantly by increasing their progesterone levels. Irregular or difficult periods are generally due to progesterone deficiency or imbalances. Men and women who have been told they are depressed generally have hormonal deficiencies or imbalances. Testosterone helps most as does progesterone and thyroid for women. In our experience, most weight gain is due, at least in part, to hormonal issues.The advice generally given is, “Eat less and exercise more.”

Let’s look at some of the SCIENCE that involves Testosterone and Breast Cancer.

Testosterone Decline

“…recent years have seen a substantial, and yet unrecognized, age independent population decrease in testosterone in American men”

“The population-level declines are greater in magnitude than the cross sectional declines in Testosterone typically associated with age.”

Travison TG et al. A population-level decline in serum testosterone levels in American men. J Clin                  Endocrinol Metab 2006, October 24

While viewing our science, please note that Johnson & Johnson was recently fined $1.1 Billion for downplaying the risks of Risperdal, an antipyschotic drug. This drug was FDA approved and introduced in 1994. It provided profits of billions of dollars as it was prescribed by thousands of physicians. This is not a unique case. The Science was provided to physicians by Johnson & Johnson.

Testosterone

“Life force hormone”; primary source of libido, associated with aggression

Produced mainly in testes in men, secondarily in adrenals; produced in both adrenals and ovaries in women

Protects against osteoporosis, helps maintain lean muscle mass, inhibits estrogen-induced proliferation of breast tissue

“Androgynous de-differentiation of the sexes” in old age (relative estrogen decline in women, relative testosterone decline in men) (Hays B 2005)

Progesterone (Bioidentical) vs. Progestin (synthetic) Breast Cancer and Oral Contraceptives

There is a link in most studies between early breast cancer before age 40 with women who used oral contraception for long durations of time.

Women who began use as teenagers, younger than 20 have a 20% statistically significant increased relative risk that continued for 1-4 years. This risk is independent of all other breast cancer risks.

  Speroff L., Glass R. & Kase N. Clinical Gynecologic Endocrinology and Infertility. 7th   Edition. Lippincott Williams and Wilkins. Baltimore, Maryland. 2005. Pg. 896.

How many physicians have prescribed synthetic Premarin and Prempro (even today)? Guess what is in Birth Control Pills?

Breast Cancer Progesterone and synthetic progestins have similar effects on endometrial tissue but there is significant evidence that they have differing effects on breast tissue proliferation

Synthetic progestins have clear association with increased risk for breast cancer

Women’s Health Initiative: MPA significantly increased risk for breast cancer (RR=1.26;Cl:1.00-1.59)

Lyytinen et al: combination estrogen and progestogen increases risk fob rest cancer after 3 years (P<0.05)

Nurses’ Health Study: 58,000 postmenopausal women were followed for 16 years (725,000 women-years)    Unopposed estrogen use increased risk for breast cancer by 23% (Cl:6-42) but addition of synthetic progestin resulted in tripling of risk (67% increased risk; Cl: 18-136)

Rose et al: compared risk for breast cancer in 1897 women on estrogen and synthetic progestin v. 1637 control patients who had never used HRT Synthetic progestin increased risk for breast cancer by 25% for each 5 years of use compared with estrogen alone (RR=1.25;Cl: 1.02-1.18)

Risk of Breast Cancer with Bioidentical Progesterone – *Progesterone shown to decrease risk for breast cancer 

Fourier et al: reported association between various forms of HRT and incidence of breast cancer in 80,000 postmenopausal women followed for > 8 years.

*Estrogen-only had non-significant increase of 1.29 times risk (P=.73) but if synthetic progestin added to combination, risk increases to 1.69 times control (P=0.0001)

*Combination progesterone and estrogen significantly reduced risk compared with synthetic progestin (P=0.001) o Fourier et al: in another study of 50,000 postmenopausal women.

*Risk significantly increased if synthetic progestin used (RR=1.4) but was reduced if progesterone was used (RR=0.9)

*Significant difference in risk for breast cancer between use of estrogens combined with synthetic progestins v. estrogens combined with progesterone (P<0.0001)

Wood et al: post-menopausal primate given placebo, estradiol, estradiol +MPA, estradiol +progesterone for 2 months with 1-month washout period

*Compared with placebo, significantly increased proliferation found with combination of estrogen +MPA in both lobular (P=0.009) and ductal tissues (P=0.006), but was not seen with estrogen + progesterone

*Intramammary gene expression of proliferation markers were also higher after treatment with estrogen +MPA (4.9-fold increase P=0.007; 4.3-fold increase P=0.002), but not with estrogen + progesterone

Why do we recommend PROGESTERONE? Another Reason.

Cardiovascular Risk with Synthetic Progestin Versus Progesterone

WHI study showed addition of MPA to Premarin (CEE) resulted in substantial increase in risk of heart attack and stroke

Synthetic progestins produce negative cardiovascular effects and negate cardioprotective effects of estrogen

*Progesterone has opposite effect by maintaining and augmenting the cardioprotective effects of estrogen and decreasing the risk for heart attack and stroke

*MPA and other synthetic progestins negate positive lipid effects of estrogen and reduce HDL while progesterone either maintains or augments’ estrogen’s positive lipid and HDL effects

Coronary Arterial Effects

*Coronary artery spasm, which increases the risk for heart attack and stroke, is reduced with the use of estrogen and/or progesterone

Addition of MPA to estrogen has the opposite effect, resulting in vasoconstriction and increasing the risk for ischemic heart disease

Minshall et al: studied coronary hyperreativity by infusing a thromboxane A2 mimetic in primates which were administered estradiol along with MPA or progesterone

  • *Estradiol given with progesterone protected coronary arteries against spasm but protective effect was lost when MPA was used instead

Myagawa et al: compared reactivity of coronary arteries in primates pretreated with estradiol combined with either progesterone or MPA

  • *None of the animals treated with bioidentical progesterone experienced vasospasms while all of those treated with MPA showed significant vasospasms

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