On June 26, 1995, Time Magazine ran a feature article on estrogen. The illustration on the cover showed a woman's hands cradling a capsule of Premarin, currently America's most prescribed drug. As if to underline the dichotomy that women are facing, one hand is youthful and perfect while the other is aged and wrinkled. The byline of the article states: "America's No. 1 Drug Is An Elixir of Youth, But Women Must Decide If It's Worth The Risk Of Cancer."
For women who need estrogen - and many do - this kind of choice sounds like a nightmare. Fortunately, the estrogen quandary is one bad dream that we can wake up from. Yes, there are better answers. Yes, they are here. And yes, they are available. Safe, natural forms of estrogen can now be obtained - with or without a doctor's prescription.
As menopause approaches, estrogen deficiency makes itself known in the all too familiar symptoms of hot flashes, night sweats, sleep disorders, mood swings, and vaginal dryness. Other symptoms could include loss of libido, fatigue, rapid skin aging, bladder problems, loss of breast tone, or deep depression. The emotional changes that accompany hormonal deficiency can be particularly difficult. Without proper support, we may be talked into taking synthetic hormones or even anti-depressants, drugs whose side effects may not be worth the benefits they bring. Let's look at some better alternatives.
Women who have only mild symptoms may find that a good quality wild yam cream, along with herbal and dietary support, is all they need. Wild yam extract enhances progesterone activity in the body and also increases estrogen levels slightly. These products are very safe. They are used topically on the skin and the active ingredients are absorbed directly into the bloodstream.
Highly effective creams containing 8-10% Mexican wild yam extract are now available from health food stores, although brands vary greatly in strength and potency.
However, a substantial percentage of women feel better when they are using estrogen directly. In estrogen replacement therapy (ERT), this hormone can support health in the following ways.
Benefits of estrogen replacement therapy
Prevents mood swings caused by estrogen deficiency, slows bone loss, restores vaginal lubrication and tone, relieves hot flashes, may help restore libido, alleviates sleep disturbances, improves vitality and energy, maintains tone of breast tissue, prevents vaginal and bladder infections, prevents migraines by dilating blood vessels, protects against heart disease, and increases mental clarity and short term memory.
But what about the well-established link between estrogen and cancer? Betty Kamen, author of Hormone Replacement Therapy, Yes or No? states that "Women on long-term estrogen therapy appear to have about a 30% greater chance of developing breast cancer." A recent study published in the New England Journal of Medicine put the figure at 30 to 40% for women using estrogen for five or more years.
This sounds scary, but it's not the whole story. Let's look more closely at why estrogen can cause cancer. Estrogen is estrogen, right? Well, not quite. There are actually three major forms of this hormone in the female body. They are called estradiol, estrone, and estriol. The commonly prescribed forms of estrogen are made of estradiol, estrone, or combinations of the two.
For example, Premarin is largely estrone. Estrace and Estraderm (two other commonly prescribed estrogens) are estradiol, Ogen is estrone, and so on. Estradiol and estrone are very potent estrogens and they both have a stimulating effect upon the cells of the breast and endometrium (uterine lining). It is this ability of estrogen to make cells grow - even where they're not supposed to - which can eventually lead to cancer.
However, there is a third type of estrogen called estriol, which is often called "the forgotten estrogen" because it has been overlooked in favor of its more dangerous cousins. Estriol is the estrogen which dominates during pregnancy, when huge amounts are produced by the placenta. Estriol has a much less stimulating effect on the breast and uterine lining than estradiol and estrone. In fact, estradiol is 1000 times more stimulating to the breast tissue than is estriol, according to leading authority Dr. John R. Lee of Sebastopol, CA. Estrone is considered even more risky, and is believed to be the estrogen most responsible for breast cancer.
Why has estriol been so ignored? Traditionally, it has been considered a weak or ineffective estrogen. It is true that it needs to be used in larger amounts than the more commonly used forms of ERT. However, in larger amounts estriol is quite effective. Also, it rarely produces the unpleasant side effects associated with Premarin. Estriol has been used in Europe for many years, but was not available in the U.S. until recently.
The most exciting thing about estriol is the fact that not only does it not promote breast cancer, but considerable evidence exists to show that it protects against this disease. In 1978, Alvin H. Follingstead, M.D., wrote an article for the Journal of the American Medical Association calling for the use of estriol instead of estrone and estradiol. In support of his position, he cited a group of postmenopausal women with metastatic breast cancer. When given small doses of estriol, 37% of the women experienced either a remission or a complete arrest of the metastasized lesions! In 1966, H. M. Lemon, M.D. demonstrated that women with breast cancer have lowered estriol levels. Later, he showed that women without breast cancer had naturally higher estriol levels (compared to estrone and estradiol) than those with breast cancer.
Dr. Julian Whitaker, publisher of the Health and Healing newsletter, says that "estriol's anti-cancer effect is thought to be due to its anti-estrone characteristics. It apparently blocks the stimulatory effect of estrone on the breast." Whitaker explains that estriol is "weaker" in that it requires 2 to 4 mg. of estriol to equal the effects of 0.6 to 1.25 mg. of Premarin. "But this is inconsequential", says Whit-aker, "when one considers that the more estriol a woman takes, the less likely she is to get breast cancer, which is exactly the opposite of the dosage relationships of the commonly used estrogens."
Pure estriol will probably be the estrogen of choice for women who have an increased risk of cancer. For those who do not, a blend of the three estrogens seems to be ideal. Dr. Jonathan Wright, from Kent, Washington, has been experimenting with the use of estriol since the early 1980's. He has created a formula called "Tri-Estrogen" which contains 10% estradiol, 10% estrone, and 80% estriol.
This formula has been found by Dr. Wright to rapidly alleviate the symptoms of menopause without amplifying the danger of breast cancer. Women who have tried Tri-Estrogen (also called Tri-Est, or Triple Estrogen) generally find it gentle, effective, and largely free of side effects. Tri-Estrogen is also believed to be more effective against osteoporosis than is pure estriol.
When choosing an estrogen, we should also consider its source. Premarin is made from the urine of pregnant mares and contains "horse estrogens" which are not natural for the human body. And the production of this drug entails substantial cruelty to the mares. In contrast, the pharmaceutical forms of estriol and Tri-Estrogen are made from soybeans and are "guilt-free hormones". These products, as well as further information, are available by prescription from the Women's International Pharmacy, (800) 279-5708.
In a new and exciting development, a company called Nutraceutics has developed a non-prescription form of Tri-Estrogen. This product, called Pro-Estron, is based on Dr. Wright's formula of 80% estriol, 10% estrone, and 10% estradiol.
Pro-Estron is a phyto-estrogen product derived from natural plant extracts including licorice root, soybeans, and Ayurvedic herbs, and also contains wild yam phyto-progesterones. One capsule is said to be approximately as strong as .625 Premarin (an average dose of estrogen), although the phyto-estrogens may not relieve symptoms as rapidly as pure estrogen. Women who have had complete hysterectomies, and need large amounts of estrogen, can take higher doses. This product promises to offer the best of both worlds to women who wish to make their own choice for natural hormone replacement. However, women who have damaged or underfunctioning livers are usually better off using a tri-estrogen cream, which is still available only by prescription.
For maximum safety as well as comfort, women using estrogen should always balance this hormone with adequate progesterone. Progesterone is the second major female hormone, and one of its major tasks in the body is to offset some of estrogen's effects. High percentages of women who take estrogen alone develop a pre-cancerous condition of the uterus (called endometrial hyperplasia). Using a natural form of progesterone, however, will prevent hyperplasia, as well as helping to protect against breast cancer.
Space does not allow a full exploration of progesterone considerations in this article. Suffice it to say that most "progesterones" prescribed by doctors are actually progestogens or progestins. These are synthetic, chemically altered forms of progesterone, and they have a wide range of uncomfortable and even dangerous side effects.
Two forms of "natural" progesterone are available. The pharmaceutical form, Progesterone USP, is available by prescription. Current research indicates that large amounts of Progesterone USP may be counterproductive if used for more than 3-4 months. Progesterone benefits may also be safely obtained by using wild yam products. Wild yam extract contains diosgenin, a phyto-progesterone (a substance which is almost identical to progesterone and acts similarly in the body).
We are all very fortunate that Nature has provided us with a wealth of natural plant hormones-and that dedicated researchers have come forth to offer us products that will work in harmony with our bodies. The latter third of life does not have to be a trade-off between hormonal benefits and risks. It can be a time where we can take responsibility to fine-tune our bodies into health and harmony.
The information in this article is for educational purposes only, and is not intended as medical advice.
Elora Gabriel is a hormonal researcher who specializes in hair analysis for nutritional testing and endocrine function. For further information on Pro-Estron and other non-prescription hormonal products, she can be contacted at:
Tides of Life
91-A Deer Run Road
Black Mountain, NC 28711
Return to the January/February Index page