^^^^^^ Setting the record straight Prempro vs. natural
HRT -- for more ^^^^^^^ Bad Press: Prempro,
one of the first HRTs, has
been marketed since 1942 by Wyeth Laboratory (bought out by Pfizer in
2009). It has been and still is
best-selling HRT. A supposedly definitive study of HRT was done by the FDA’s drug
research branch, National Institute of Health (NIH) (with
undoubtedly a nod from pharma). The Women’s
Health Initiative (WHI)
knowingly selected the worst formulation
of HRT, Prempro. NIH had the results of the Hormone Estrogen Replacement Study (HERS)
completed in 1998 which used Prempro; moreover, earlier studies singled out its
progestin (medroxyprogesterone) MPA as the cause for the increased risk of breast cancer (Goodman
& Gilman 2006, 1552). Prempro consists of an estrogen cocktail
derived from pregnant mare’s urine
which is added the synthetic progestin MPA. (The cruel treatment
of mares and subsequent
slaughter was broadcast
by Frontline.) “Pregnant
estrogens are the weak estrone
(>50%), and the two mare estrogens, equilin (15-25%)
and equilenin…. Mare (equine) estrogens such as equilin, that
are foreign to the human body, have been shown, when compared to other studies,
to have effects that are significantly worse than the natural estradiol.” MPA, the synthetic progestin used in
Prempro, blocks most of the beneficial
effects of estrogen--the natural progesterone doesn’t. Using Prempro, the WHI found that compared to a
placebo there was increased incidents:
heart attacks 29%, breast cancer 26%, pulmonary embolism 113%, strokes
41%, total deaths 15%, all cancers 3%; reduced incidents: hip fractures
34% and colon cancer 37%.” “MPA antagonizes this athero-protective
effect [on coronary arteries]” at 1997. Though “all
causes of mortality were not effected”, the press highlighted risks for HRT
(undoubtedly with a nod from their biggest advertiser), &
HRT sales plummeted. The equine
estrogen only arm of WHI had better results; more proof that
adding MPA causes the harm. Pfizer
in 2010 settled a suit over breast
cancer for $330 million or $150,000 per person.
Yet Prempro is still on the market (thank you FDA & pharma) and
still first in sales. Based on the
WHI, NIH issued this
warning on all HRTs: “…increased risk of myocardial infraction, stroke,
invasive breast cancer, pulmonary emboli, and deep vein thrombosis in
postmenopausal women… Estrogens with or
without progestins should be prescribed at the lowest effective doses and for
the shortest duration consistent with treatment goals…”
The warning is placed on all packages of HRT, and it is accepted
as correct by most doctors. My doubts
confirmed when attending a lecture on the WHI
given in 2002 at UCSD by Professor Dr. Robert Langer. He explained to a large medical audience that
the WHI results cannot be validly applied to other HRT formulas. Over 50 years of research was not overturned;
rather physicians and the public were tragically misled by the press, pharma, guidelines,
and the NIH. Tobacco ethics guides pharma.
Up to Fail
was published in the
highly acclaimed science journal, Nature, 09/09/2010: “Is Nature
ignorant of the vital fact that Prempro contains no progesterone, but instead the artificial
Provera [MPA]. The
other component is Premarin (conjugated estrogen), which is a very uncertain,
patent mixture of substances from the urine of pregnant mares…. [MPA] has
crucially different effects. Prempro is totally unrepresentative of
any other product used for HRT purposes…. . Much of it was
before the NIH chose to use Prempro in its intended landmark study.
Using a study of the effects of Prempro to attack the entire use
of HRT has, through needless fear, caused
millions of women to forgo considerable benefits of HRT using better
products. This point has been repeatedly
made by endocrinologists”.
Why does Nature not know it?--END OF
"I think that it borders on a tragedy that Premarin and Provera
[the 2 compounds in Prempro] were chosen as the only HRT treatments [for the
WHI Study]”. Another researcher
that Provera [MPA]--and no other progestin--blocks the mechanisms that allow
estrogen to fight the brain's immune response to Alzheimer's….
Bruce S. McEwen Neuroendocrinologist
Rockefeller University is unequivocally critical of the study: "I think
that it borders on a tragedy that Premarin and Provera were chosen as the only
HRT treatments." “With Medroxyprogesterone [MPA] in Provera you are
activating two receptors involved with cell division in the breast," she says,
"and that's the culprit, not estrogen [for breast cancer].”
Recent research shows that Provera
interferes with estrogen's ability to prevent memory loss
and dementia. “Estrogen is able to protect neurons
against toxic assaults that are associated with Alzheimer's disease,"
notes Roberta Diaz Brinton, a neuroscientist at the University of Southern
California…. she found “that Provera--and no other progestin--blocks
the mechanisms that allow estrogen to fight the brain's immune response to
Alzheimer's”. This immune response wears away at brain cells and
causes them to leak neurotransmitters such as glutamate, which overloads and
kills neurons.” Hormone Hysteria, Scientific American Sept. 2003.
OF HRT ---
Cardiovascular disease (CVD) & MI: “estrogen lowered … 37%
LDL …, extends life 2.1 years,”
Braunwald, Heart Disease 5th Ed, 97, p 1708. “HRT decreases CAD morbidity and
mortality … was 0.56 compared
not taking estrogen” Braunwald 1142; another 50%, 16 vs 33, reduction in CHD. Estradiol blocks
oxidation of LDL to prevent atherosclerosis. “Estradiol completely
reverses the effects induced by OX-LDL on the DDAH/ADMA/NO pathway,” Avoid MPA and LNG (levonorgestrel). Another
study found 26 MI deaths for estradiol vs. 56 for placebo (115%). A meta-study found and
Coronary Heart Disease.
Lowers hypertension risk.
Two AHA studies explain
mechanisms of cardio arteries protection and Wiki, also, Angina
pain is associated with low
breast cancer 73% less for estradiol: “in breast cancer 10 in treated group v 17 in control
group.” HRT after & also during breast cancer
ratio 0.28--results would be better with
progesterone. “MPA (in Prempro)
increases the risk of
breast cancer” some progestins increase risk.
Contrary to pharma, estradiol progesterone doesn’t increase
risk, and when given following breast cancer
fewer deaths at 15 years HRT, and also,
cancer. HRT also prevent skin cancer.
Colon cancer: “the
reduction among current users RR = 0.55… users of 11 years or more RR of
0.54 [46% lower, also].” Estrogen
and progesterone have beneficial
effects for “esophagus, stomach, gallbladder, and intestines.”
Breast cancer survival: “Cancers
in women who use HRT are often less
advanced, and lower mortality has been reported in those who use HRT than in
nonusers… The association of HRT with
lower proliferation rate and smaller tumor size was exclusively caused by
ER-positive tumors” at. After
diagnosis 72% higher survival: “The risk of
death was lower among the HRT survivors; odds ratio 0.28…” at, Also, breast cancer
mortality rate of 5 per
1000 person years in HRT users compared to 15 in nonusers, at. For negative results, pharma used the progestin
MPA (WHI study); other progestins could be similar; however, “progesterone
combined with estradiol induces apoptosis [cancer cell death]” at.
Alzheimer’s disease with past long-term
HRT, 7 vs 30 control. Estrogen is neuro-protective by inhibiting oxidative damage.
Progesterone is also neuro-protective:
used in large doses following trauma “to limit central nervous system damage.” Again MPA in WHI study increased risk of
dementia, 40 cases of dementia versus 21 in the placebo group, at.
loss of estrogen resulted in decrease neuron
density in the substantia nigra (structure of brain damaged by Parkinson’s
disease), and restoration of estrogen in increased density” at, and. Again MPA exacerbates
condition & risk, at. Pharma of course
does junk science to show
that HRT does not affect the course of the disease.
Venus Thrombosis: an 8% reduction in risk of with esterfied estrogen while those on
Prempro had a 65% elevated risk JAMA
04, and; a 23% reduction exogenous
estrogen (5.1% of cases versus 6.3% control cohort).
Breast density maintained for women on HRT. The difference has been repeatedly noted on mammograms.
Healthier skin American Journal of Clinical
more hair, hair, hair.
postmenopausal women indicate that estrogen
associated with dryness, atrophy, fine
wrinkling, poor healing, epidermal thinning, declining dermal collagen content,
diminished skin moisture.
The decrease was preventable by the use of HRT.” “The mean collagen content in the skin
was … found
to be 48% greater”, slows
skin aging, also, and less skin
are plausible biological
mechanisms by which estrogen might lead to improved cognition.”
“Esterified estrogens produced significant
in bone mineral density (lumbar spine, hip). 54.2%
greater spinal mineral. “1 of 4 white
women over the age of 60 had spinal compression fractures associated with
woman of 5 will fracture a hip by the age of 90” Bone gain from long-term
role. Numerous journal articles hold that progesterone work with estradiol
to increase remodeling of bone, at, and, and.
Rheumatoid Arthritis (RA): “HRT was well tolerated, increased
well-being, reduced articular index and increased lumbar spine bone density
over a one year period in postmenopausal women with RA” also,
& lowers RA CVD deaths.
Osteoarthritis (OA): When both incident and progressive
radiographic knee OA
cases combined, “current ERT [estrogen only replacement therapy] use had a 60% decreased risk compared with never use”. Progesterone most important.
degeneration, and hearing: HRT resulted in a 36% reduction and other eye pathologies. Hearing
Infections Recurrent (UTI), also urinary urgency, urogenital & vaginal
atrophy are associated
with low estrogen in post-menopausal women.
of 8 quality studies found the placebo group 2.5 times more likely to have
a subsequent UTI. Topical
administration most effective; however for vaginal
atrophy estradiol tablets.
Diabetes: the drop of
estradiol increases LPL which
regulates weight, distribution of fat,
and activity. Gary Taubes, Good
Calories, Bad Calories, 398, Taubes Why we Get Fat, 90-91,
and Wade at,
In Obese estrone +40% at. Weight
related issues (metabolic syndrome,
insulin resistance, & diabetes) are associated with drop in estradiol, at.
Satisfaction: prevents vaginal
atrophy, “HRT improves sexual function” better,
Mood elevation and depression: “Numerous molecular and clinical studies have implicated estrogen in
modulating brain function including that related to mood,” treatment of mood disorders and
additional weight gain.
10 Reasons for HRT: Menopause Int. & Oncology: Both list the above benefits, and the latter
advises HRT for survivors of breast cancer because of “a 70% reduction in
the risk of death” during the 15 years, also.
age related loss of skeletal muscle mass with age is associated with low level
of estrogen & testosterone in 22.6%
in older postmenopausal women not receiving estrogen or TTT. TTT
prevents and reverses
natural HRT (NHRT) at dose comparable to the Danish
study (Trisekvens sequential
2 mg estradiol with
NHRT is part of
nature’s clock. NHRT sets the body’s clock to premenopausal and thereby reduces the
rise for age-related chronic conditions.
Their lack causes the precipitous
decline after menopause. Life
extension with long-term NHRT is
over 4 years. True to profits-first corporate
tobacco ethics, pharma offers 1) HRT in too
low a dose; 2) synthetic estrogens, horse estrogen, and synthetic progesterone
(progestins) of questionable value and safety; 3) human estrogens estrone (E1),
Estriol (E3), estetrol (E4) which are less bioactive and thus block the action
of estradiol, the best estrogen; 4) progestins they could be like MPA
and block some of the benefits of estradiol.
hot flashes, NIH guidelines include a
major tranquilizer (SSRI) or an estrogen blocker such as Tamoxifen.
I recommended 50 mg progesterone micronized
in oil capsule
with 2 mg estradiol prepared by a compounding pharmacy. Alternate is topical lotion of 8 mg of
estradiol + 100 mg progesterone (absorption is 10%). If concerned about muscle strength, add 10 mg of testosterone
to reverse sarcopenia,
deficiency, & to improve libido without reduction in
estradiol. For lotion, apply as widely as possible over the torso and
face; with water and rub it in. Tell your physician you are aware
of risks and are convinced of benefits of NHRT
and give him a copy 2010 journal article.
Tell him you observed the benefits
friend & a relative and want the same.
Most doctors will comply. Beware
of hormone balancing; the doctor is milking the treatment. The evidence for sequential HRT is weak and
it has a lower compliance because of vaginal bleeding—at 1997. For
more on Why Natural HRT. Avoid “bio-identical” plant
estrogens, and progesterones—they aren’t identical to human sex hormones. These hormones occupy receptors with uncertain action and possible
benefits like MPA, and have low
lack of quality clinical trials on them. The youthful
free-serum estradiol level is > 300 pmol/L, or > 80 pg/mL.
Low estrogen entails gain in unhealthy visceral
fat. Reset you bio-clock with NHRT,
fix your diet, learn about
the corruption caused by pharma
(on YouTube), and why doctors
are their pharma’s pawns. For
testimonials and more on osteoporosis, link.
First was DES
(diethylstilbestrol) a non-steroidal estrogen developed in 1938. Like Fleming
with penicillin, DES was not
patented because Dodds felt that scientists were working for the pubic, and it
was too important to deny cheap
by patenting. Animal studies had in the
1930’s exposed DES serious side effects; but the industry relied upon human
trials, and the FDA on Sept. 19, 1942 approved DES though aware of the more
reliable animal studies. DES was
marketed under 200 brand names. Numerous
claims were made such as producing
healthier babies and preventing miscarriages. In 1971 DES was found to
cause a 40 fold
increase in cervical & vaginal cancers.
Later studies found several internal genital abnormalities in the
daughters and sons of mothers given DES. 26
years later In 1997 Eli Lilly stopped making and
marketing DES. DES was also the standard treatment for advance
prostate cancer for over 40 years. The
other early blockbuster HRT Prempro with
the progestin MPA has been shown to increase
the rate of growth of breast cancer.
So too does nonrethisterone and dienogest, but progesterone induces
 Equilin blocks E1 and E2
receptors and thus would reduce the effectiveness of natural estrogens. Though
Prempro and Premarin (just equine
estrogen) are still the world’s leading HRT and ERT, no follow-up research was
done because the financial incentive is to hide side effects.
on HRT is driven by their profits for
chronic conditions arising from osteoporosis, depression, arthritis, Alzheimer’s
disease and the assorted
illnesses and conditions related to atherosclerosis especially heart attacks,
strokes, and hypertension; an example of tobacco ethics.
Prometrium is marketed in dose of either 100 or 200 mg of progesterone
micronized in oil.
is no evidence that the human body
can convert its active ingredient. For
example diosgenin, the plant steroid, is chemically converted to produce several steroid
and sold as natural, see Wiki, and
for more on progesterone, Dr. Lee.
^^^^^^^^^^^^^^^^^^ Non-technical summation ^^^^^^^^^^^^^^^
Natural Estrogen (Estradiol) with
progesterone NHRT: What
every woman should be taking because of the numerous, major health benefits,
benefits that would slash pharma’s profits.
Of the 4 natural estrogens only estradiol (E2) has major health
benefits. Two--estriol (E3)
(E4)--are found in pregnant women and block estradiol. Big pharma being against hormone replacement
therapy (HRT) markets ineffective products including those containing estriol
and estetrol, and estradiol at too low a dose & with inferior progestins
such as in the best-selling Prempro.
Prempro, a combination of estrogen derived from pregnant mare’s urine
and the progestin MPA. The biological
effects of mare’s estrogens are different than human estrogen and MPA blocks most of the positive effects of
estrogen. Thus the results of
WHI study funded by the FDA apply only for Prempro. Nevertheless he FDA warns that HRT has only
one valid medical use, to manage hot flashes, and should be used at the lowest
dose for the shortest time. Thus
has used marketing science & guidelines to overturn 4 decades of positive results
for HRT: Alzheimer’s 83%, Heart
attacks 51%, Coronary Heart Disease 50%,
Colorectal Cancer 46%, Breast Cancer 73%, Thrombosis 8%, Macular Degeneration 65%,
osteoporosis fractures 90%, & prevents arthritic join destruction, firmer
breasts, healthier skin (less wrinkles, thicker, 48% more
collagen), reduces hair loss, improved cognitive function, less
depression and mental illness, and a general feeling of well-being with
libido. These results occur
because estrogen & progesterone receptors set the body to “premenopausal”
maintenance. Through their many
functions, these hormones are part of nature’s clock for death in the 7th
decade. The lack of estradiol & progesterone is the reason for the
precipitous decline in health of women after menopause. Life extension with long-term NHRT is over 4 years, and twice
that with a natural diet. Progesterone (P4),
the major natural
occurring progestogen, is similar to estrogen and works together. It has
numerous benefits, while some of the artificial progestins are clearly harmful
(such as stimulating the growth of breast cancer), and none have been adequately
researched as to side effects. Like
testosterone, a very similar hormone, at higher dose, more benefits.
A sufficient dose is available only from a compounding pharmacy (2 mg
of estradiol plus 100 mg of micronized progesterone) in a capsule; or you can
use a lotion obtained in a dose of 8 mgs estradiol plus 100 mg of progesterone
per application (there is a 15% absorption rate with
topical hormones). Apply widely as possible over the torso,
back, shoulders, underarms, and face using water and rubbing it in to promote
better absorption. Ideal free-serum estradiol
level is 200-500
sources for HRT are not natural and are metabolized by the liver on first pass
from the digestive system. These
mimics fail to perform well and have adverse consequences (see MPA above).
Mimic can occupy sites that estradiol would
go to and block their action, one of which is the control of appetite. Doctors who follow the Wiley Protocol are
other methods of hormone balancing for post menopause women are milking the
insurance and patient, and it lacks convincing scientific evidence. In Europe excellent results have been obtained with sequential Trisekvens; Novo Nordisk, Denmark, though with greater side effects
(nausea, break-through bleed), thus low compliance. Since ovulation is not
possible sequential NHRT lacks
benefits (see Natural
HRT, below). Keep it
simple, and send the message to your cells that you are premenopausal.
Why Natural HRT, which estrogens, higher dose, and non-sequential
There are 4 superior choices
for natural hormone replacement
therapy (NHRT). 1) that of
estradiol and progesterone; 2) a
sequential uses of those hormone to mimic the women’s premenopausal cycle; 3)
to take all 3 natural estrogens plus
progesterone, and 4)
to take them sequentially. What is the
evidence to support these choices?
Unfortunately, dispositive quality evidence is lacking: no long-term
clinical trials; nor are there
short-term clinical trials. The reason
is simple, the profit margin in insufficient on off patent drugs to justify
such trials. Products natural to the
body cannot be patented (with a few exceptions). Contributing factor: in the golden age of medicine, when there was
still significant amount of university ran and clinical trials with just mere
funding by pharma, progesterone was available only as a topical cream (not
orally active). Today that has changed,
and like CoQ10 it is available in an oil based capsule micronized. For these
reasons the evidence for NHRT is mainly anecdotal. The second source for evidence is population
studies (epidemiological), but nearly all of them have a major flaw, they
gather the evidence from all women on HRT, independent of formulation. A few
epidemiological studies separate women
according to type of products, & a few clinical trials are for one product. These provide evidence suggestive that 1 of
the 4 choices could be better.
So why do I favor # 1), non-sequential progesterone
First, estradiol has been used in a number of preparations with
excellent results. In the French
epidemiological study (EN3) estrogen showed no increase in breast cancer; &
Prempro the greatest increase (due to the progestin MPA). E3N
study supports the use with estrogen with progesterone and not a
progestin. Second progesterone and
estradiol work together in the body, thus to use a synthetic form, called a
progestin, has consistently resulted in lower benefits—see MPA example above.
Third, for those using a better progestins,
their results were superior to using only estradiol, ethinyl estradiol,
and esterified estrogen,
this favors the combination NHRT. Fourth
those who used estradiol and testosterone (common in Europe in the 1980-90s)
instead of synthetic progestin had very good results; this also supports the
use of progesterone. Fifth, there is no
clinical evidence supporting comparable benefits from the other forms of
estrogen comparable to those from estradiol; this supports the use of estradiol. Sixth,
the laboratory work testing with
estradiol indicates that it is the most important of the 4 estrogens. Seventh
in the Danish study of the sequential
high-dose (tri-cyclic) Trisekvens
(a product only available in Europe), the results were excellent. Eight, compliance
issue because of mild side
effects of nausea and break-through bleeding like those of a menstrual
period. Ninth, the paucity of evidence
supporting for postmenopausal women a need for having cyclic hormones. Tenth, cyclic NHRT would
cost more and is less convenient to take. Eleventh, if I in recommended sequential,
some woman would find a doctor who charges many times more for monitoring blood
hormone levels and providing a custom balanced hormone cocktail based on her
blood work. This lacks sound
science. Conclusion: Thus recommend
#1, NHRT of estradiol with progesterone from a compounding pharmacy, 2
mg estradiol and 100 mg of micronized progesterone in oil as a capsule.
Why the higher
dose of estradiol? This is comparable to that used in Trisekvens
which had excellent results. In the
1960s through the 1980s the higher dose of estradiol was the norm, and during
that period the numerous benefits were uncovered in epidemiological studies;
thus higher dose is better. Second, in
men higher dose testosterone
has significantly greater health benefits, more evidence for a higher dose of
estradiol. Third, pharma in their
opposition to these healthful hormones recommends the lowest dose, still more
evidence that the higher is better.
The goals is to restore youthful benefits and avoid age related
conditions, thus to restore hormones to youthful levels. Natural products have
evolved to work in the
body through receptors and complex feedback systems; thus synthetic chemicals don’t
function as well. Natural hormones have
lower risk of side effect (for which the reporting system is broken). Of the over 100 synthetic hormones, there is
no evidence that they work better, and only one has very good results in a
clinical trial—unfortunately the Danish product is not licensed in the US.
Why not branded drugs
for HRT? With the support of the NIH, pharma
opposes HRT since 1990s, thus current products have various issues: 1) dose
is too low for most of the healthful
benefits; viz. not equivalent to 2 mg of estradiol. Fernhrt has only .25 mcg
of ethinyl estradiol
(1/8th the recommended 2 mg).
Estragyn (estrone) is a 0.1 gm vaginal cream; but estrone is far less
bioactive than estradiol, and the absorption rate is under 25%. 2) A
number of products are not estrogen, but estrogen antagonists (they occupy
estrogen receptors on the cells and thus block estradiol’s action). Tamoxifen
is one of several estrogen
antagonists marketed as HRT. 3) Estrogens
with harmful progestins: Femhrt has the progestin norethindrone acetate, and
Prempro has the progestin MPA. 4) Use
less bioactive estrogens such as estrone, estriol, derivatives of the
estrogens, and mare’s estrogen in Premarin.
5) For hot flashes several tranquilizers of the SSRI and dopamine
agonist types have been approved, and many more are used off-label.
finding a doctor who will prescribe HRT as recommended. Be prepared with
an answer when
your doctor suggests that you try something else first. You can refer to books, such as Natural
Hormone Replacement (the Amazon reviews has good material). Ask him to
read an article in Menopause Internal Journal which I have pasted with link. Refer to the experience of friends, or other
articles you have read. And you
simply tell him that the 40 years of positive journal literature was not
overturned by the flaw Women’s Health Initiative Study (WHI) which used
estrogen from mare’s urine along with MPA as a progestin, which has been known
to block some of the benefits of estrogen and increase risk for breast cancer.
doctors have fallen for the anti-HRT myths:
promotes breast cancer, and benefits aren’t worth the risks. As argued at HRT, this is false for NHRT
and most formulations of HRT. Thus
get HRT or NHRT long-term (not just
for hot flashes) requires a physician who is willing to do what once was the
norm before 2002. The earlier studies
HRT were not wrong. I about 3/4th
of doctors will write a prescription for NHRT
for their regular patient after lecturing on the risks and a referral for a
He is protecting himself from possible
litigation. Copy this 2010 journal article Ten
Reasons to be Happy About Hormone Replacement Therapy: A Guide for Patients to
MS word and print it. Read it before
seeing him, and give him a copy. These hormones
are part of nature’s clock for us to die in the 7th decade. The
estradiol & progesterone is the reason for the precipitous decline in
health of women after menopause. Sending
a message to your body that you are premenstrual; it is worth the effort to jump through a
few of pharma’s hoops.
of uncertain effects: The use of progestins, in particular medroxyprogesterone
post-menopausal symptoms have been associated with increased risk of blood
clots and breast
cancer in a study carried out by the Women's
study did not involve dydrogesterone, it is possible, but not certain, that it
too increases these risks. [The blood clots a key risk factor for MI,
explains why with Prempro used in the WHI) there was no reduction in MI—while
with other formulas of HRT the reduction is 35% or greater. The WHI has a second
flaw in that of 55%
equine estrogen, which is of uncertain consequences, thus the estrogen alone
arm of the study is applies only to Premarin —jk.] https://en.wikipedia.org/wiki/Dydrogesterone
Our in vitro results indicate that not all progestogens act
equally on breast cancer cells. Some progestogens (medroxyprogesterone acetate
norethisterone acetate (NETA) and dienogest) alone or
combined with estradiol (E2) stimulate proliferation of breast cancer cells,
while others (dihydrodydrogesterone (DHD), the active metabolite of
dydrogesterone, tibolone and progesterone (Prog)) alone or combined with
estradiol induce apoptosis [prevents cancer]. Further pharmacological and clinical
should be initiated to evaluate these findings in vivo.
women in the treated group with an intact uterus started treatment with 2 mg
synthetic 17-β-estradiol for 12 days, 2 mg 17-β-estradiol plus 1 mg
norethisterone acetate for 10 days, and 1 mg 17-β-estradiol for six days (Trisekvens;
Novo Nordisk, Denmark). http://www.bmj.com/content/345/bmj.e6409?etoc=
. “Because of break-through bleeding
with sequential Trisekvens, non-sequential
combined HRT form of Trisekvens was better received.” At.
Prempro has been the leading selling HRT since the mid 40s in the US,
and it still is. The issues with
mare’s urine estrogens has been known for decades by scientist including those
in the FDA as inferior of the other HRT & natural HRT. Because of birth control pills, HRT, and the
possibility that an estrogen would protect men—as it does women—from
cardiovascular disease, there has been thousands of published articles on the
estrogen and progesterone family of hormones.
Unfortunately the FDA acts
products for pharma while minimally regulating in the public’s interest—see
Consumer Report’s article,
Dr. Jonathan V. Wright in Natural
Hormone Replacement (1997) recommends
all 3 hormones.
Note, the large
trials government funded trials (HERS
and WHI) are designed to show HRT as
dangerous, since pharma opposes for business reason HRT.
Esterified estrogen and ethinyl estradiol are commonly used instead of
estradiol because of longer half-life--still available. They are
derivatives of estradiol, of which for
esterified estrogen there are over 30--a way for pharma to obtain patents of exclusivity. I consider these 2 equivalent to estradiol,
though some of these forms must be inferior.
 The women in the treated group with
an intact uterus started treatment with 2 mg synthetic 17-β-estradiol for 12
days, 2 mg 17-β-estradiol plus 1 mg norethisterone acetate for 10 days, and 1
mg 17-β-estradiol for six days (Trisekvens;
Novo Nordisk, Denmark).
. “Because of break-through
with sequential Trisekvens, non-sequential
combined HRT form of Trisekvens was better received.” At.
Over 95% of HRT products are not sequential and the literature does not
indicate an associated problems. Nor
the benefits exceptional favorable from sequential Nordisc compared to the best
of epidemiological studies.
 Testosterone is structurally
the same as
estradiol but for one group on the molecule.
In the body women convert some of their estradiol to testosterone so
that there level is about 1/10 that of a man’s.
Men convert some of their testosterone to estradiol.
 Progestins are of uncertain effects:
The use of progestins, in particular medroxyprogesterone
acetate, in treating post-menopausal
symptoms have been associated with increased risk of blood clots and breast cancer in a study
carried out by the Women's
Health Initiative. While the study
did not involve dydrogesterone, it is possible, but not certain, that it too
increases these risks. [The blood clots a key risk
factor for MI,
explains why with Prempro used in the WHI) there was no reduction in MI—while
with other formulas of HRT the reduction is 35% or greater. The WHI has a second flaw in that of 55% equine
estrogen, which is of uncertain value, thus the estrogen alone arm of the study
is applies only to Premarin —jk.] https://en.wikipedia.org/wiki/Dydrogesterone
 Men have a similar
problem in obtaining a
testosterone of sufficient dose, which entails using a compounding
Estrogen (Estradiol) with progesterone HRT: What every woman should be taking
the numerous, major health benefits, benefits that would slash pharma’s
profits. Of the 4 natural estrogens only
estradiol has major benefits. Two--estriol (E3) and estetrol
(E4)--are found in pregnant women. These 2 inhibit the functions
estradiol. Big pharma being against
hormone replacement therapy (HRT) markets ineffective products including those
containing estriol and estetrol, estradiol at too low a dose, and Prempro. Based
on marketing science, including a major
study by the FDA which used Prempro, a combination of estrogen derived from
pregnant mare’s urine and the progestin MPA.
The biological effects of mare’s estrogens are different than human
estrogen and MPA blocks the some of the positive effects of estrogen. Nevertheless,
the FDA warns that HRT (hormone
replacement therapy) has only one valid medical use, to manage hot flashes, and
it should be used at the lowest dose for the shortest time. But the finding
cannot be validly generalized to the
natural estradiol and progesterone—though pharma and the FDA do. Thus
marketing science overturned 4 decades
of positive results that show significant health benefits for HRT: Alzheimer’s
attacks 32%, Coronary Heart Disease 50%, Colorectal Cancer 46%, Breast Cancer
73%, Thrombosis 8%, Osteoporosis Fractures 90%, Macular Degeneration 65%,
reduces & prevents arthritic join destruction, firmer breasts, healthier
skin (less wrinkles, thicker, 48% more collagen), reduces hair loss, improved
cognitive function, less depression and mental illness, and a general feeling
of well-being with increased libido. Estradiol is the only effective treatment to
prevent osteoporosis, and its methods of cardiovascular protection are well
documented. The lack of estradiol is
the reason for the precipitous decline in
health of women. Life extension with
long-term HRT should be at least 4 years—though clinical trials do not address
this. Because of a modest increase in
uterine cancer a progestin (synthetic hormone with some progesterone properties
that is orally active) is added to hormone replacement therapy rather than the
natural progesterone which isn’t orally active.
Progesterone--the major natural occurring progestogen--has numerous
benefits, while some of the artificial progestins are clearly harmful, and none
have been adequately researched as to side effects. Thus like with testosterone
orally active, the best method of application is a lotion obtained from a
compounding pharmacy in a dose of 4 mgs estradiol plus 100 mg of progesterone
per application. Apply widely as possible
over the torso,
back, shoulders, underarms, and face using water and rubbing it in to promote
better absorption. Recently progesterone has been
micronized in oil and available as a pill.
Ideal free-serum estradiol level is 7-9
compounding pharmacy can prepare a pill consisting of 2 mg of estradiol with 50
mg of progesterone (there is a 15% absorption rate with topical hormones,
except for the patch). The lotion form
is better for the skin. Plant sources of
estrogen are not very effective. Doctors
who follow the Wiley Protocol are other methods of hormone balancing for post
menopause women are milking the insurance and patient, and it lacks sound
scientific evidence. Keep it
Maturitas, the European Menopause Journal. Vol 53, Issue 1
pgs 11-18, 10 January 2006
percutanous testosterone gel in postmenopausal women with decreased libido –
effects on sexuality and psychological general well-being
To elucidate if percutanous treatment with 10mg
testosterone per day could enhance sexuality and psychological
well-being in postmenopausal women presenting problems with low libido.
Secondary to study the influence on blood lipids, hemoglobin and erythropoietin
Fifty-three postmenopausal women participated. As a complement
already on-going HRT, 10mg
of a testosterone gel (Testogel, Besins–Iscovesco) or placebo was administered.
Treatment continued for three plus three months in a double blind, randomized,
The scores concerning “frequency
of sexual activity,
orgasm and intercourse”, “sexual arousal, fantasies and enjoyment”,
“satisfaction with orgasms”, and “interest in sex” were all significally
improved for testosterone addition as compared to placebo both before
and after crossover. Testosterone
levels increased more than 10-fold during
treatment while DHT-levels were more than doubled. Estrogen levels were not
affected during the addition of testosterone. Liver enzymes, total cholesterol, triglycerides, HDL and LDL revealed
no significant differences between any of the periods or groups.
Endometrial thickness did not change significantly during treatment. Hemoglobin
and erythropoietin remained unchanged. No significant differences in the number
of experienced side effects were found.
Testosterone gel of 10mg
had positive effects on several aspects of sexual life such as frequency of
sexual activity, orgasm, arousal, fantasies and sexual interest in
postmenopausal women on HRT. Several psychological variables were positively
influenced. The given dose resulted in too high serum levels. Even if no
negative effects were observed, monitoring of serum levels and a decreased dose
should be considered in future studies.
Health Initiative investigated
the use of MPA and conjugated
equine estrogens compared
to placebo. The study was prematurely terminated when previously unexpected
risks were discovered, specifically the finding that though the all-cause
mortality was not affected by the hormone therapy, the benefits of the hormone
replacement therapy (reduced risk of hip
fracture, colorectal and endometrial
cancer and all other
causes of death) were offset by
increased risk of coronary
heart disease, breast
cancer, strokes and pulmonary
embolism. MPA increases the risk of
breast cancer, dementia and thrombus when used in combination with conjugated
equine estrogens to treat the
symptoms of menopause.
MPA is associated with an
increase in depression. MPA may
suppression and interfere
with carbohydrate metabolism but
does not cause diabetes.
MPA can cause weight gain, worsen diabetes
mellitus and edema (particularly
of the face). MPA may cause reduced bone
Mathew Allison, UCTV
lecture: Nurse’s Study 1985,
Walnut Creek 1987, L.R.C 1988, Leisure World, 1988. All higher dose (2-4x
current), & mostly unopposed (no progestin), reduction in CVD was RR of .3,
.5, .3, & .4 respectively. However,
later studies Uppsala, 1992, and Nurse’s 2000 using opposed estrogen and lower
dose .8 & .75. From RD Langer.
legend meets reality, estrogen plus
progestin and coronary heart disease in the Women’s Health Initiative,
Menopausal Medicine 2003; 10(4): 5-7.
Mathew made no mention of difference of Prempro, and of MPA as to their
points out that
the trial was stopped early because of harm caused, and he also shows that the
RR for death was .98. He never commented
how this result doesn’t justify stopping the trial early.
estrogen only group has a marked drop in coronary events in years 7-9, 20 vs
What Can We Learn
Design Faults in the Women's Health Initiative Randomized Clinical Trial?
Points out that by including in
the study a large number of women, up to age 74, that it was an atypical
population and thus deluded the benefit of women free of CVD, those most likely
to take HRT and would show the greatest CVD benefit.
: legend meets reality, estrogen plus progestin and coronary heart disease in
the Women’s Health Initiative, Menopausal Medicine 2003; 10(4): 5-7—NOT
AVAILABLE THROUGH GOOGLE SCHOLAR