Life Extension Magazine November 2013
As We See It
Surprise Findings in Estrogen Debate
By William Faloon
Higher Progesterone = Lower Breast Cancer Incidence
A growing body of literature has documented a strong connection between a woman’s progesterone levels and her subsequent risk for breast cancer. A trial reported in the International Journal of Cancer measured blood levels of pro-gesterone in 5,963 premenopausal women. Incredibly, the analysis of the data revealed that those women with the highest blood levels of progesterone who had regular menses experienced an 88% decreased risk of breast cancer.84
These findings corroborate another study in which 1,083 women treated for infertility were followed for upwards of 33 years to determine their subsequent breast cancer risk. Compared to women with normal progesterone levels, progesterone deficient women had a 5.4 times increased risk of premenopausal breast cancer and were 10 times as likely to die from any cancer.85
Similarly, researchers at the University of North Carolina School of Public Health measured progesterone levels in pregnant women, who were then followed for upwards of 32 years. The researchers discovered that those women with the highest blood levels of progesterone during pregnancy had a promising trend toward a lower risk of breast cancer, compared to women with the lowest levels of progesterone during pregnancy. When the researchers analyzed the risk of breast cancer in women under age 51, those with the highest progesterone levels had a staggering 70% decreased risk compared to the group with the lowest progesterone levels.86
Findings from two other investigations revealed that survival rates for breast cancer are strongly correlated with the patient’s progesterone levels at the time of surgery.87,88 One study noted that in cases where cancer had spread to local lymph nodes, 65% of women with a progesterone level of 4.0 ng/mL or more on the day of their surgical treatment of breast cancer were alive 18 years later, while only 35% of women with low progesterone levels on the day of surgery were still living after 18 years.88 The scientists noted that progesterone lowers the expression of vascular endothelial growth factor, which promotes the increase in new blood vessels (angiogenesis) that is essential for tumor growth. These scientists concluded: “This study has confirmed that a raised level of progesterone at the time of tumor excision is associated with an improvement in prognosis for women with operable breast cancer.” 88
Natural Progesterone and Cardiovascular Health
The Women’s Health Initiative, a large randomized clinical trial, demonstrated that the addition of synthetic progestins to estrogen therapy resulted in a substantial increase in the risk of heart attack and stroke.1
Numerous studies, on the other hand, document that natural progesterone has beneficial effects on cardiovascular health.
In one trial published in the Journal of the American College of Cardiology, researchers studied postmenopausal women with a history of heart attack or coronary artery disease. The women were given estrogen in combination with either natural progesterone or synthetic progestin. After 10 days of treatment the women underwent exercise treadmill tests. Compared to the synthetic progestin group, the amount of time it took to produce myocardial ischemia (reduced blood flow to the heart) on the exercise treadmill was substantially improved in the natural progesterone group.91
The risk of a blood clot is a serious concern with the use of estrogen replacement therapy, especially by the oral route. This risk doesn’t occur when natural progesterone is added to the mix.92 One investigation compared the risk of blood clots in postmenopausal women taking natural progesterone to the risk in women taking synthetic progestin. The group of women who used synthetic progestin in combination with estrogen had a startling 290% greater risk of blood clots, compared to the group who never used HRT. The group receiving natural progesterone in combination with estrogen, on the other hand, had a 30% decreased risk of blood clots, compared to women who never used HRT.92
Natural Progesterone Protects Against Atherosclerosis
Atherosclerosis (hardening of the arteries) is a leading cause of heart disease. Several studies have determined that synthetic progestin promotes the formation of atherosclerosis.93-95
The story is quite different for natural progesterone, where multiple animal studies have shown that natural progesterone inhibits the process of atherosclerosis.95-97
To illustrate, scientists fed monkeys with surgically induced menopause a diet known to cause atherosclerosis for a total of 34 months. The scientists then divided the monkeys into groups that received estrogen alone, estrogen plus synthetic progestin, or a control group that did not receive hormones. The control group developed substantial atherosclerotic plaque. The administration of estrogen resulted in a 72% decrease in atherosclerotic plaque, compared to the control group.95
Treatment with synthetic progestin yielded disturbing results. The group of postmenopausal monkeys that received estrogen combined with synthetic progestin had a similar amount of atherosclerotic plaque as the control group. This showed that synthetic progestin completely reversed estrogen’s inhibitory effects on the formation of atherosclerosis.95
In contrast, when the same investigators administered natural progesterone along with estrogen, no such inhibition of estrogen’s cardiovascular benefit was seen.98
Natural Progesterone Increases HDL
High-density lipoprotein (HDL) functions to remove cholesterol from the arterial wall and thus helps protect against the development of atherosclerosis.99 Low HDL is a proven risk factor that contributes to heart disease.99
Synthetic progestin is known to cause reductions in HDL levels.100-102 One mechanism by which natural progesterone enhances cardiovascular health is its ability to maintain or even increase HDL levels in women receiving estrogen replacement therapy.103-105
In one study published in the Journal of the American Medical Association, 875 postmenopausal women were randomized to receive estrogen alone, estrogen combined with synthetic (non-natural) progestin, estrogen combined with natural progesterone, or placebo. The results demonstrated that the group receiving natural progesterone demonstrated much higher HDL levels than the group receiving progestin.106
These results confirm earlier preliminary data provided by researchers who administered estrogen combined with either progestin or natural progesterone to postmenopausal women. The use of progestin resulted in an undesirable 15% decrease in HDL levels, compared to only minor changes to HDL levels in those patients prescribed natural progesterone.100
What Happens During Menopause?
The average age of menopause in the United States is only 51.107
Perimenopause is the time period leading up to menopause, a time when a woman’s hormones may fluctuate quite wildly, producing a variety of uncomfortable effects.108 Although estradiol, a critical estrogen in the body, is significantly reduced in menopause, estrone , another important estrogen found naturally in a woman’s body, does not drop as precipitously, and in some cases, levels of estrone may increase in the perimenopausal period.109
Estrogen dominance is a term that is relatively unrecognized in conventional medicine, yet alternative medical practitioners estimate that this syndrome may affect nearly half the women over age 35 in the United States.110 Caused by an imbalance between estrogen and progesterone, this syndrome may cause many undesirable and dysfunctional issues.110
When the adrenal glands are stressed, they secrete excess cortisol. Cortisol is made from progesterone in the body. Progesterone is depleted as cortisol levels increase because more progesterone is being used to make cortisol.111
As more progesterone is shunted or sequestered to make cortisol, less is available to balance estrogen. Another common reason for low progesterone levels is an anovulatory cycle (a menstrual cycle in which there is no ovulation), often observed in perimenopause.111,112 Without ovulation there is no corpus luteum to make additional progesterone for the cycle. The reduced progesterone level leads to excessive estrogen and relative deficiency of progesterone.
So for a period of time, perimenopausal women in particular may have relatively high estrogen in relation to progesterone. Yet progesterone is required to protect against the adverse effects of a relative increase in estrogen.110 Is it any wonder why incidences of cancer and thrombosis (arterial blood clotting) begin to increase in the perimenopausal time period? Progesterone is needed to balance the normal effects of estrogen, which is especially important when estrogen replacement is initiated.
A blood test can reveal a woman’s own, individualized hormonal needs to include progesterone replacement, as well as estrogen, like estradiol. Tragically, conventional doctors today are blindly prescribing estrogen drugs without testing their female patients to ascertain their individual needs.
The consequences of untreated menopause from a longevity and quality-of-life standpoint are severe. Simply defined, menopause is a deviation from youthful estrogen/progesterone balance. Proven methods exist to rationally restore hormone status, but most maturing women never learn about it. That’s all about to change.
A Vindication for Suzanne Somers
For the past decade, actress and best-selling author Suzanne Somers has passionately advocated natural hormone replacement for maturing women. She endured blistering criticism from mainstream doctors who warned of catastrophic problems if women dared to restore their estrogen/progesterone to youthful ranges.
Suzanne’s fervent position was that individualized dosing of natural estrogens and progesterone markedly improves life quality and extends healthy life span.
Mainstream doctors based their dire warnings on the huge Women’s Health Initiative study whose initial results were released in the 2002-2004 period. This study looked at women taking oral Premarin® or PremPro® and linked these drugs to increased disease risk.1 Subsequent studies and analysis reveal these deadly effects were caused by synthetic progestin and probably the orally administered Premarin®. Suzanne figured this out before mainstream medicine.
Premarin® by itself was linked to increased stroke risk, which is probably related to:
- It being prescribed orally (instead of transdermal),
- The horse estrogens counteracting estrogen’s endothelial benefits, plus
- Doctors failing to prescribe natural progesterone to balance out the effects of estrogen.34
As of 2012 the maker of PremPro® has paid out $896 million to resolve lawsuits alleging that the drug caused cancer in women. Another $330 million has been reserved to pay future claims.113
The FDA has not removed Prempro® from the market. If you type “PremPro” into Google, the drug maker has an attractive website (www.prempro.com) to induce menopausal women to take it.114
So the question begs, who is going to alert the American public to avoid these lethal hormone drugs?
Suzanne Somers is 66 years old. A lot of people retire before this age or are forced to quit working because of health impairments.
Instead, Suzanne is dedicating herself to educating the world about the lethal effects of synthetic progestin and the advantages of natural estrogens and progesterone. She has been a personal beneficiary of natural hormone replacement. Don’t be surprised to see her on major television shows airing this year and next.
A dilemma Suzanne recognized long ago was the difficulty women had in locating physicians knowledgeable about prescribing natural sex hormones to maturing women. She has spent the last decade interacting with doctors to find out where women could go to have their hormones restored to a youthful range based on individual need.
In her new book, Suzanne describes the profound anti-aging effects that occur in response to natural hormone replacement and reveals a new network of physicians (www.ForeverHealth.com) committed to properly prescribing them.
Big Pharma’s Catastrophic Impact on Longevity
In 1994, I wrote Life Extension’s first article warning against synthetic progestins and horse urine-derived estrogens.
An incredible amount of evidence from nearly 20 years ago showed that natural progesterone was safer and more effective than synthetic progestin found in PremPro® and Provera®. Yet the public was kept largely in the dark. The number of female lives that could have been spared had the FDA acted humanely (by removing progestin drugs) is difficult to calculate. Instead, the FDA issued proclamations that made it more challenging for American women to access natural progesterone creams.
Premarin® (horse urine-derived estrogen) was first introduced in 1942.115 It may have had a place in medical history when properly used. Why women today would choose this 71-year old drug, when natural estrogen creams are widely available indicates how progress is impeded when medicine is dominated by FDA regulation in lieu of free market innovation.
This editorial revealed startling new findings showing that estrogen protects against premature death in women who are deficient in it.11 This is confirmed by 27 prior studies showing a 28% reduction in mortality reduction in maturing women who replace their hormones.12
What makes these reductions in premature death so compelling is that most of the women in these studies were not using the natural forms of estrogen and progesterone that have shown superior benefits. The clear message is that restoring youthful hormone balance may be one of the most effective ways to feel better today and live much longer in the future.
In this issue of Life Extension, we feature an exclusive interview with Suzanne Somers and describe ways maturing women can reduce their cancer risks.
It costs $75 a year to belong to the Life Extension Foundation®. If the only benefit a woman received was learning about the lethal effects of synthetic progestin nearly 20 years ago, then membership may have resulted in one of life’s grand bargains.
For longer life,