|June 24, 2004|
|Life Extension Update Exclusive |
Estrogen replacement therapy fails to protect against dementia, may lower cognitive function
The studies analyzed data from the Women’s Health Initiative Memory Study (WHIMS), an ancillary study to the Women’s Health Initiative which examined the role of hormone replacement therapy on approximately 27,000 women aged 65 to 79. Both the estrogen combined with medroxyprogesterone acetate (MPA) and estrogen alone arms of the trial were terminated early because of increased adverse health risks experienced by both groups who received the hormones.
In the first study, Sally A. Shumaker, PhD, of the Wake Forest University School of Medicine and colleagues sought to find out whether conjugated estrogens alone lowered the risk of dementia and mild cognitive impairment in women who received them compared to those who received placebos. They found that the hormones increased the combined risk of dementia and mild cognitive impairment and recommended against using hormone therapy in to prevent either condition.
In the second study, Mark A. Espeland, PhD, also of Wake Forest University School of Medicine, and colleagues from the WHIMS investigated cognitive function in the conjugated equine estrogens alone group and in the combined estrogen alone and estrogen plus progestin groups. They concluded, "Our results suggest that neither CEE nor CEE plus MPA should be initiated in older women for the purpose of protecting cognitive function. Furthermore, at least 1 subgroup of women was at particularly high risk for the adverse effects of hormone therapy on cognition--women with relatively low baseline cognitive function."
In an accompanying editorial, Lon S. Schneider, MD of the University of Southern California, Los Angeles, asks whether short-term estrogen use in early post menopause could be effective to reduce dementia two to three decades later. He concludes that, "The WHIMS results do not prove that estrogen therapy has no effect on AD or dementia, but they do clearly indicate that women older than 65 years should not be treated with CEE with or without MPA to attempt to prevent dementia or enhance cognition.”
Female Hormone Replacement Therapy
Progressive alternative physicians recognize that an imbalance occurs between the types of estrogens as well. As estradiol levels decline, estrone levels decline much more slowly, resulting in more estrone than estradiol. Although both hormones are strong enough to cause concern about the development of breast cancer, the ratio of the hydroxyestrones becomes a more significant factor during this phase of life. Some hydroxyestrones (4- and 16-hydroxy-estrone) may promote cancer, while 2-hydroxyestrone seems to prevent it.
Progesterone declines more rapidly than these estrogens, resulting in a phenomenon called estrogen dominance. During the reproductive years, there is a balance that fluctuates in a cyclical manner between the estrogens and progesterone, according to the menstrual cycle. This shift in dominance of estrogen over progesterone that occurs with age causes a decrease in fertility and the ability to carry a pregnancy to term. Estrogen dominance causes fatigue, depression, thyroid malfunction, fluid retention, and fat storage, resulting in weight gain. The phenomenon of estrogen dominance is exacerbated by environmental exposure to pesticides and obesity.
It is therefore not always lack of estrogen that is the problem. Often there is too much estrogen relative to progesterone and an imbalance not only of estrogen and progesterone, but also an imbalance of the three types of estrogens (estriol, estrone, and estradiol). Testosterone and DHEA may also decline and may need to be replaced to ensure the best outcome.
The issue of synthetic versus natural hormones is as important with progesterone as it is with estrogen. Just as the pharmaceutical industry created the dangerous estrogen drug Premarin, it has also produced a pseudo-progesterone named Provera. As with Premarin, the warning label on Provera contains many dangers, including the possibility of birth defects, breast cancer, blood clots, fluid retention, acne, rashes, weight gain, and depression. Drugs such as Provera are classified as "progestins," not as progesterones. The side effects of Premarin and Provera may be the main reason that women stop taking their replacement hormones. Side effects are definitely the reason that hormone replacement therapy (HRT) has such a questionable reputation.
An alternative to artificial progestins is the option of using natural progesterone products. Products that can be purchased over the counter (such as ProFem) use progesterone derived from soybeans. Not only are such soy-based natural progesterones far safer than synthetic drugs, they are as easily utilized as the real progesterone manufactured within the human body.
In an attempt to provide aging women with the multiple health effects of estrogen without side effects, scientists have developed plant extracts with estrogenic activity (phytoestrogens).
Natural Estrogen is one answer to concerns about the risks of synthetic estrogen replacement.
One of the most frustrating aspects of aging is memory loss. Whether as benign as forgetting where you left the car keys or as debilitating as Alzheimer’s disease, this reduction in mental function challenges us and makes us long for the mental vigor of our youth.
Traditionally, scientists have thought that little could be done about deteriorating brain function. New research has shown, however, that this kind of mental decline is not inevitable. Scientists have found that a naturally occurring hormone called pregnenolone not only improves memory and concentration, but also fights fatigue, relieves arthritis, speeds injury recovery, and enhances mood.
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