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dr. phuli's blog

Thanks Oprah for Speading Some Light on Hormones!

Monday, January 26th, 2009

I recently saw Oprah’s first show on hormones (1/23/09). It is great that  some much needed light is being spread on this topic. Hormone use doesn’t have to be confusing. Myths and fear prevent women from taking charge of their health and feeling better. Here is what I would add to Oprah’s last discussion:

  1. Most women avoid using hormones because they fear developing breast cancer. These women are missing out on the short and long term benefits of hormone support.
  2. Women continue to make estrogen as they age. Avoiding estrogen does not lower a woman’s breast cancer risk (avoiding Progestins, synthetic progesterone, does).
  3. Estrogen is not a single hormone, it is a family of hormones, some good and some dangerous. As women age they tend to make more dangerous forms, that is why breast cancer rates increase as women grow older.
  4. The WHI study did not show any increase in breast cancer from synthetic estrogen. Only women using estrogen with Progestin had an increase in breast cancer. Thousands of studies have shown that Progestins are linked to breast cancer and should never be used to treat menopause.
  5. Diet, life style, and genetics determine what types of estrogen a woman makes.  Women can alter their breast cancer risk with foods and certain supplements.
  6. Hundreds of studies have proven that estrogen prevents heart disease, bone fractures, depression, memory loss, sexual dysfunction, and even wrinkles.
  7. The WHI study showed that women using estrogen alone, (not with Progestins), in the first 10 years of menopause, had less hardening of the arteries in the heart.
  8. Studies show that increases in blood clots with the use of estrogen occur only when women take estrogen orally. Women should not eat estrogen. They should apply it to their skin with a lotion or patch.
  9. Most women do not need to measure their estrogen and progesterone levels before starting therapy. These hormones should be measured while on therapy to make sure these hormones are being absorbed and breaking down safely.
  10. We are living older than ever before and we must do everything we can to ensure that we reach these bonus years with a strong mind, bones, heart, and spirit. Smart hormone support helps to ensure this will happen.

0 Comments  |  Permalink  |  Posted in Menopause, Natural Hormones, WHI Study, Estrogen, Heart Disease, Hormones, Uncategorized

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Breast Lumps and the WHI Study:
Guess What, We Are Not Horses!

Friday, April 11th, 2008

Okay another week of misleading headlines. The confusion stems from a study that is about to be published in the Journal of the National Cancer Institute (JNCI)2 (View PDF). The alarming headline, “Estrogen Linked To Breast Lumps”, would lead you to believe that this is a new finding and that the researchers studied natural bioidentical estrogen and not synthetic horse estrogen, right? Wrong. They examined data from the World Health Institute (WHI) study published in 2002, which involved a group of women who used only Premarin, derived from horse estrogen, and keep in mind that this group had had hysterectomies, so we already know from the get-go that their hormone balance was not great.

The WHI gave this group of women horse estrogen (yes estrogen designed for 1200 lb mares and known to be much more potent than a woman’s own natural estrogen). And, guess what? These women had an increase in breast lumps. Go figure. They really should have titled the article, “Horse Estrogen Use Causes Breast Lumps” or “Estrogen not Properly Balanced with Progesterone Increases Breast Lumps”.

As I discuss in my book The Natural Hormone Makeover, breast lumps will occur if estrogen is in excess of progesterone. The women in this study did not have any progesterone to oppose the extra strong stimulating effects of Premarin, horse estrogen. Progesterone is naturally produced by women to counteract estrogen’s stimulating effects on the breast.

I have posted a great article on my website from Climacteric1 (View PDF) which shows that using transdermal natural estradiol with natural progesterone does not increase breast cancer or breast disease. Show this to your doctor. Other nations have been using natural hormones for years. When are more US physicians going to start? Ladies, when you begin to demand natural hormones. In order to stop being treated like horses we may need to act more like cougars!

1Lignieres, B. de, et al., “Combined Hormone Replacement Therapy and the Risk of Breast Cancer in a French Cohort Study of 3175 Women”, Climacteric 5, no. 4 (2002): 332-340. View PDF

2Rohan, TE, et al., “Conjugated Equine Estrogen and Risk of Benign Proliferative Breast Disease: A Randomized Controlled Trial”, Journal of the National Cancer Institute 100, no. 8 (2008): 563-571. View PDF

0 Comments  |  Permalink  |  Posted in Breast Disease, Breast Lumps, Natural Hormones, Progesterone, Breast Cancer, Estrogen, WHI Study, Hormones

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Vitamin D: More Than Bone Heath

Monday, December 10th, 2007

Recent studies have established the importance of vitamin D for cancer prevention. It is now clear that all women should have their vitamin D levels monitored for bone health and for cancer prevention. This is especially important for premenopausal women to prevent breast cancer. Here is why:A study of 1180 women (older than 55 years) showed that calcium and 1100 IU/day of vitamin D resulted in higher vitamin D levels and half as many cancers over a 4 year period, compared with women who used placebo (pills without any vitamin D or calcium). (Am J Clin Nut 2007. 85:1586-1591)

A second study was published from data derived from the Women’s Health Initiative. This study showed that vitamin D and calcium supplementation lowered the incidence of breast cancer in premenopausal women. No change was found for the 20,000 postmenopausal women; however, the vitamin D dose was small, only 400 U/day, and these older women were likely deficient at the start of the study. Unfortunately, vitamin D levels were not followed (as they were in the earlier mentioned study) so there is no way to determine if vitamin D deficiency was improved in both groups. (Arch Intern Med, 2007. 167: 1050-1059).

Less than ten years ago vitamin D used to be considered a potentially dangerous vitamin supplement, and recommendations were to use no more than 400 U/day. Research has since shown that an estimated 60% of all women in the United States, regardless of where they live, are deficient in vitamin D, and it can be supplemented safely in 1000- 2000 U/day (many doctors are using much higher doses). Vitamin D is vital to build strong bones and is also important for immune function and cancer prevention.

Ask your doctor for a blood test of your 25 OH D level, and aim for a level of 50 nmol/L. How much vitamin D you take depends on how low your level is. Taking 1,000 U/day will raise your level by 15-25 nmol/L. The best form to take is cholecalciferol, D3 (preferred to ergocalciferol D2). Always take vitamin D with food to improve absorption. If you are taking it and your level is not improving consider taking a pancreatic enzyme (that contains lipase) with your meals. Also remember vitamin D is made from sunlight on our skin- so get 20 to 30 minutes of outdoor sunlight every day if possible.

2 Comments  |  Permalink  |  Posted in Bone Loss, Breast Cancer, Menopause, Osteopenia, WHI Study, Osteoporosis, Estrogen

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