Websites that promote bioidentical hormones for treating menopausal symptoms or for maintaining a youthful glow typically claim that their products are safe because they are more “natural” than those made in a regular pharmacy.

I’ve long argued that just because these products are “bioidentical” doesn’t mean you can assume they are safer or even safe at all. And that’s why I want to tell you about a paper published in Cancer Prevention Research by scientists affiliated with the European Prospective Investigation into Cancer and Nutrition (EPIC) study that caught my attention.

EPIC is long-term prospective study looking at the relationships between diet, nutrition, metabolic factors and cancer in 366,521 women and 153,455 men in 10 European countries. In this paper, the investigators looked at whether there was an association between a woman’s own natural hormone levels (estrogen and testosterone) and her risk of developing breast cancer.

The study analyzed blood samples from 554 women taking part in the EPIC study who had developed breast cancer (172 had ER-negative tumors and 382 had ER-positive tumors) and 821 women who had not. The blood samples were taken when the women enrolled in EPIC. At that time, all of the women were about 60 years old, had been postmenopausal for about 10 years, and were not using hormone replacement therapy (HRT). In addition, none had ever had cancer.

Epidemiologic studies have found that risk factors associated with estrogen exposure, such as early age at menarche, late age at menopause, using HRT, and weight gain after menopause, increase a woman’s risk of developing hormone-sensitive breast cancer. The researchers took these factors into account in their analysis so that they could focus specifically on the relationship between hormone levels and breast cancer. They also took into account smoking status, alcohol consumption, physical activity level, and education level, as each has been associated with breast cancer risk.

The study found that the women who had developed breast cancer had hormone levels that were naturally higher than the women who did not develop breast cancer. Even more interesting: this study showed that high hormone levels were associated with an increased risk of developing either a tumor fueled by estrogen (ER+ and/or PR+) or one that was not (ER- and/or PR-).

As the authors note, we are still trying to understand the precise relationship between hormones and breast cancer. It may be that high hormone levels can cause a breast tumor to develop. Or it may be that high hormone levels promote the growth of a tumor that is already established.  Or it could both. There’s much more we need to still learn.

Importantly, this study’s findings give us yet another opportunity to point out that menopause is programmed in for a reason. We need high levels of hormones to reproduce; then, we shift down to lower levels for the second part of life.  There is no reason to “replace” hormones to prolong reproductive levels and there are obvious downsides from trying to do so.

I hope anyone who is considering using bioidentical hormones will think about this: Virtually everyone would agree including those who promote bioidentical hormones that nothing is more “natural” than the hormones a woman produces in her own body. And here we have a study (and it’s not the first) to show that a women’s own hormones can increase her risk of developing breast cancer.

That certainly makes me and I hope it makes you stop and think about how easy it is to assume that anything “natural” is “safe!”

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15 Responses to Replace What?

  1. Steph says:

    Thanks Dr. Love, for keeping us posted on the “controversy” about HRT, staying on top of the issue and staying consistent throughout your career about the risks associated with hormones!

  2. Laurie says:

    Thanks so much for posting this. As soon as I was diagnosed with triple positive breast cancer, my oncologist let me know about this. I wish I had known sooner.

  3. Dawn says:

    Any info on soy products…should I stop drinking my soy latte ? Thanks for the trustworthy information.

  4. Sabina says:

    Many thanks from the bottom of my heart for all you do.

    I have a question and if the data is not readily available I do very much respect your opinion on the matter.
    Can herbs be used safely to help take the edge off menopausal symptoms?

    Thank you. Sabina

  5. Jan Pedersen says:

    This is the first time I’ve heard that triple negative breast cancer is connected with having high hormone levels. Does that mean that HRT treatment for years may have caused my triple negative breast cancer?

  6. Mona Verducci says:

    Regarding this study: Were the elevated hormone levels “naturally” high, or were environmental factors responsible for inducing elevated production of hormones? Were the elevated “endogenous” hormone levels related to exposure to chemical items such as BPA? Did the prolonged use of oral contraceptives in many women (which would lower ovarian production of hormones)result in lower rates of breast cancer?– Just some questions that occur to me.

  7. Sue J. says:

    Thank you so much for all you do and share with us! This is interesting to me because when I became premenopausal and had trouble sleeping (in my 40’s) I used the “natural” progesterone creme (OTC) and Remifenin for years! I was diagnosed with ER+ breast cancer at age 50. I always wonder if the use of these products contributed to my breast cancer. I wish I hadn’t used them.

  8. Robin M says:

    Just wondering how vaginal estriol might fit into these findings. My GYN assures me that the estrogen receptors in the breasts don’t absorb this, nor does it impact the endometrium in the low dose in which I take it.

  9. Jill says:

    This is such valuable information, and so helpful for our decision making process. I’m 47 and just starting to think about menopause, and my 77 year old mom was treated last year for triple nagative breast cancer. So, very timely and useful information. Thank you!!!!

  10. Ann E. says:

    Regarding bioidenticals…My doctor has recommended a low dose for menopausal symptoms and general health. I am post menopausal and post ER+ BC 8 years. The doctor explained that the metabolic pathways for estrogen may follow one of two routes generally, and depending the pathway (one favorable and the other not – to be determined by a 24 hr urine sample) taking HTR is okay, even for breast cancer surviors. Could you explain this in greater detail?

    Thank you so much for all your information!! I used your book to navigate through my diagnosis and treatment back in 2003 and found it extreamly useful.


  11. JWR3281 says:

    The BHRT camp does the exact same disservice to women that Wyeth did. They’ll trump the risks of SYNTHETICS, but then push “natural” hormones as safe, even though they have no long term clinical trials to back them up.

    I, too, have long questioned the idea that even a woman’s own estrogen is all that great for her. Recent studies have now conclusively shown no link between menopause and heart disease and some studies even suggest that high estradiol in older women increases the risks of stroke and dementia. The best evidence we have right now of there being little-to-no adverse effects of “low” estrogen comes from the randomized placebo controlled trials of aromatase inhibitors. These drugs ward off breast cancer recurrences and, so far, have not turned up cardiovascular and cognition risks compared to placebo. Granted women don’t feel good on these drugs due to hot flashes and bone/joint pain, but they don’t appear to jeopardize their health, with the exception of bone loss.

    Unfortunately, I don’t think the push to get women to take SOMETHING

  12. JWR3281 says:

    is going to end anytime soon. Menopausal women make up a HUGE group for marketing campaigns and the hormone shills will continue to try and discredit the conslusive research findings of WHI and other trials. Sadly, I don’t know what it’s going to take to get them to stop with this nonsense and accept that menopause is not a disease or the beginning of the aging process.

  13. JWR3281 says:

    One more thing too about the “natural is better” argument. Apples are natural of course and they are indeed “good” but so is mercury! And I don’t think people are in the habit of, say, wondering through the woods and just indiscriminately picking and eating non-descript berries. Why? Well, some of them may be poisonous.

    Also, there is no such thing a natural hormone product. They are all synthetic. They have to be made in a lab. Yes soybeans and yams are natural and contain the hormone precursors needs to synthesize estradiol and progesterone, but the human body does not have the enzymes necessary to make such a conversion. So at the end of the day, I guess the only “natural” way you could even come close to ingesting ready-made hormones would be to actually take a drink of that mares’ urine! Crude I know, but it’s the best way to convey the point that ALL hormone products are in fact DRUGS. Estradiol and progesterone creams and patches do not grow on trees or shrubs.

  14. Terre M. says:

    Thank you so much for this! I was diagnosed with ER/PR+ Stage 1 IDC 5 years ago, at age 50. When I was 35, I was diagnosed as “pre-menopausal” with “estrogen surges” that were causing some unpleasant symptoms. I’ve always wondered if the “estrogen surges” were linked to my having cancer. I was just taken off of tamoxifin after 5 years cancer free (yea!), but am sorry to say that I am definitely NOT in menopause. So I’m off everything, cold turkey and a bit hormonal to say the least. Kind of like being 13 again. Here’s to hoping that my continued hormones don’t mean I have to go through another round of breast cancer. I’m glad they’re studying this issue because intuitively it feels like there’s a link.

  15. Micki Rathbone says:

    Estrogen is a natural hormone found in both men and women. Keeping estrogen at a healthy level is important for both genders, but women need more estrogen for normal bodily functions, such as conceiving children. During menopause, estrogen levels in women decrease significantly. The methods for how to increase estrogen levels are the same for men and women, although men have a lower capacity for acquiring the hormone.`’-;

    All the best to you <http://www.healthmedicine.covc

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