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//-->Special ReportHow To Find Your Way Outof the Hormone TrapWhat are women to do now that hormone replacement therapy has noproven health benefits and slightly increases risks for disease?By Bill SardiLondon Times, Wednesday, July 10th, 2002•With millions of dollars spent on research, there isstill no preventive measure for breast cancer, onlytreatment after it has been diagnosed, which consistsof estrogen-blocking tamoxifen after conventionalsurgical, chemo or radiation therapy. But tamoxifenitself promotes endometrial cancer and turns on everywoman and promotes breast cancer so it cannot betaken for more than five years. Has the wonder drugtamoxifen had its day?•New aromatase inhibitor drugs, which stop theproduction of estrogen in fatty tissues, rather thanblock its entry into cells like tamoxifen, are beingwidely studied because they prolong tumor remissionsmore so than tamoxifen. But in the long run aromataseinhibitors only delay the inevitable for women withbreast cancer. They don’t reduce mortality rates andthey may accelerate bone loss and mental depression.“The entire picture of routine postmenopausal estrogentherapy is in a state of complete confusion. We mustproceed with circumspection and caution. We needless passion, fewer hypotheses, and more facts.”-- GS•This pushes American women into the unguided useBerger and WC Fowler Jr, Journal of Reproductiveof phytoestrogens, plant, seeds, beans and herbs thatMedicine, April, 1977have estrogen-like molecules. But are they any saferor effective?Introduction•Hormone replacement therapy, widely prescribed fordecades, is now falling into disfavor. 5000 women eachday join the ranks of the 40 million American womenalready in menopause. Only a small percentage ofwomen continue to take HRT, mostly for symptomsof hot flashes and night sweats and“retaining beauty”rather than any health benefits. What now for thesewomen? How will they avoid bone loss, breast cancer,uterine cancer?•Why does crushed whole flaxseed exhibit unusualhealth benefits for the heart, kidneys, bones, prostateand breast tissues? What is it that whole flaxseedsprovide that other herbal phytoestrogens do not, whichproduces such incredible health benefits? Read thefollowing three-part report.1 | How To Find Your Way Out of the Hormone TrapCopyright Bill Sardi August 2003 www.askbillsardi.comPART I: Hormone ReplacementTherapySo much has been said about hormone replacementtherapy and the state of breast cancer treatment, yetso many questions still remain to be answered. Thislimited report will never be able to answer all theremaining questions American women have aboutsupplemental hormones. But it may provide a clearerpicture of what is really going on. And it may, for thefirst time, give interested readers a valid scenario for So doctors proceeded to prescribe millions of Americanwomen pharmaceutical-grade estrogen, and whilethe prevention of breast cancer altogether.they conceded estrogen replacement increased theFor almost three decades American women have had risk of endometrial cancer, this risk was dismissedestrogen and progesterone, pharmaceutically extracted by prescribing progesterone and advising women onfrom horse mare urine, prescribed for the change of life, hormone replacement to come in for frequent checkups.first to calm the hot flashes and mood issues associated [Postgraduate Medicine 62: 73-79, 1977] All the while,with the change of life, and second to allegedly improve doctors were saying food supplements like flaxseed,bone health, reduce cardiovascular risk and inhibit the black cohosh and red clover were unproven, even“snake oil.”onset of breast cancer.In 1976 Consumer Reports indicated the use ofhormone replacement had almost tripled from 1965 to1976 and the incidence of cancer rose in women over50 were in high-socioeconomic groups, the groups mostlikely to use estrogen therapy. Estrogen therapy wassupposed to be restricted solely to women with vaginalshrinkage or a few other narrow indications. ConsumerReports said:“Earlier reports suggested estrogenmight protect against breast cancer; most recentstudies suggest the opposite.”[Consumer Reports 41:642-45, 1976] Doctors weren’t there to step into thebreech and protect American women. They acquiescedto the pharmaceutical companies because hormonereplacement therapy filled their appointment books andthe greatest yet-to-be-proven medical experiment wasunderway.Phytoestrogens DismissedThe Bomb Drops on HormoneReplacement Therapyfood diets. One of the biases revealed in animal andtest-tube studies is that they may utilize very high,if not unobtainable, levels of plant estrogens whichwould then induce the same side effects as estrogen.In one such study, 300 milligrams of black cohosh perkilogram (2.2 pounds) of body weight was given torodents. That is equivalent to nearly 22,000 milligramsof black cohosh in an adult human, or 1100 blackcohosh pills. [J Medicinal Food 4: 171-78, 2001]For decades doctors continued to prescribe hormonesto postmenopausal women under the assumption theyimproved health for postmenopausal women. Butafter years of customary use it was time for a scientificreview.Did hormone replacement therapy reallyimprove health?The bomb dropped in July of 2002 with reports thathormone replacement slightly increased the risk ofbreast cancer and cardiovascular events like strokes.At the time the news report hit the American public,6 million women were taking these prescribedhormones.With the news that hormone replacement therapy posedhealth risks, doctors were so overwhelmed by phoneIn the meantime, non-prescription, plant-based calls from millions of women that they simply shut offestrogens (called phytoestrogens) were cast aside and their office phones.mis-characterized. A 1978 report said phytoestrogens“can markedly enhance tumor cell proliferation.”Then just 11 months later American women were[Endocrinology 103: 1860-67, 1978] Of course, this hearing news stories about hormone replacementconclusion was drawn from test-tube studies where therapy increasing their risk for being mentallycells were flooded with plant estrogens rather than demented in their later years of life. Among 2229being given in doses commonly found in raw plant- postmenopausal women who took estrogen plusprogesterone replacement pills beginning in 19962 | How To Find Your Way Out of the Hormone TrapCopyright Bill Sardi August 2003 www.askbillsardi.comthru 2002, 40 were diagnosed with probable dementiacompared with just 21 in a group of 2303 women whodid not use hormone pills. The relative risk doubledamong the hormone users. The absolute risk was low,1.8 percent among hormone users, just 0.9 percentamong non-users. Among the 6 million Americanwomen now taking hormone replacement therapy thiscould increase the number of cases of Alzheimer’sdisease by about 13,800 annually. [J Am Med Assoc289: 2651-62, 2003] The increased risk was stillsmall but the point had been made. A small increasedrisk weighed against no potential benefits meant thewidespread use of hormone pills had to be re-evaluated.In March of 2003 the FDA approved a lower dose ofPrempro, the most popular hormone replacement pill,due to concerns over side effects. Imagine trying tobe a sales representative for Wyeth Labs, the producerof Prempro. By May of 2003 postmenopausal womenwere being told still more bad news.Here is what Judy Siegel-Itzkovich of the JerusalemPost had to say about hormone replacement therapy. Itcan’t be said any better than this:“Middle-aged womenshould think twice before taking combined progestin-estrogen pills to alleviate their hot flashes, nightsweats, and other disturbing menopausal symptoms,according to an analysis of data from last year’sUS Woman’s Health Institute study on the effects ofhormone replacement therapy. What pharmaceuticalcompanies have pushed for decades as a ‘preventivefountain of youth’ for menopausal women, now seemsto increase the risk of breast cancer even when takenfor only one year.”[Jerusalem Post June 25, 2003; JAm Med Assoc 289: 3243-53, 3254-63, 2003]because it staved off mental fogginess.”[New YorkTimes July 5, 2003]“Some women said they couldnever give up the pills, not becausethey needed them for severemenopause symptoms but becausethey were convinced that estrogenprevented wrinkles or because itstaved off mental fogginess.”[New York Times July 5, 2003]Women have been conditioned to accept menopauseas a period of life where life-long medication withhormones is normal. Although there have been manywarnings against the use of hormone replacement,“they have either been ignored or trivialized.”[Int JHealth Services 31: 769-92, 2001] Not counting thecost of doctor’s office visits, hormone replacement pillscost nearly $2 billion in the USA annually.Even more bombs dropped on hormone replacementtherapy (HRT) in August of 2003. First the NewEngland Journal of Medicine reported after five yearsthat HRT (estrogin + progestin) ncreased the risk of aheart attack by a relative 81 percent. [New Eng J Med239: 523-34, 2003] In the same week the British medicaljournal The Lancet reported that HRT increased the riskfor breast cancer by 5 per 1000 users which resultedin about 20,000 extra cases of breast cancer in Britainover the past decade. [The Lancet 362: August 9, 2003]Incredibly, a spokesperson for one of the hormone drugcompanies responded to this study by saying:“Therepresentation of these findings may cause unnecessaryWith the negative scientific studies, the use of estrogenalarm and distress to some women taking HRT. Thesetherapy in Canada has dropped an astonishing 32findings do not necessitate any urgent changes to apercent from 2001 to 2002. [J Am Med Assoc 289:woman’s treatment.”[The Guardian, Aug. 8, 2003]3241-42, 2003] But statistically the increased riskfor breast cancer was small, and some women simply What will American women do now as menopausedidn’t want to face a return to all those hot flashes and approaches and they experience all those symptoms ofmood problems. So a few million women keep taking night sweats, hot flashes and mood changes? It’s quitethe pills. And for good reason, at least in the minds of a dilemma since there are about 5000 more Americanthose who take hormone replacement. As a report in women who reach menopause, the permanent end ofNew York Times so aptly said,“Some women said theymenstruation, each day, added to the 40 million who arecould never give up the pills, not because they neededalready in their menopausal years.them for severe menopause symptoms but because theywere convinced that estrogen prevented wrinkles orReactions to menopause appear to be culturallyconditioned in females. Mayan women from Guatemala3 | How To Find Your Way Out of the Hormone TrapCopyright Bill Sardi August 2003 www.askbillsardi.comAnnual Increased Risk from Use of Estrogen/ProgesteroneRisk/benefitChange per yearAnnual increase/decrease amongestimated 4 million users of hormonereplacement+2800 new cases+3200 new cases+3200 new cases+7200 new cases+9200 new cases-2000 fewer cases-2400 fewer casesSource: National Institute on AgingHeart attacksBreast cancerStrokesBlood clotsDementiaHip fracturesColon cancer7 more cases in 10,000 women8 more cases in 10,000 women8 more cases in 10,000 women18 more cases in 10,000 women23 more cases in 10,000 women*5 fewer cases in 10,000 women6 fewer cases in 10,000 women* Over age 65Increased Risk for Uterine Cancer with Use of EstrogenUsing no hormones after 10-19 yearsUsing estrogen alone for 20 years or more+4.4 cases in 10,000 women+14 cases in 10,000 womenplant-food diets is the primary dietary factor involved.This is only partly correct. Estrogen is dumped intothe digestive tract at the end of the monthly cycle andwomen who consume more meat will reabsorb moreof their dumped estrogen and thus exhibit highercirculating levels of estrogen and longer periods. Tothe contrary, women who consume fiber-rich plantfoods excrete 2 to 3 times more estrogen in their fecesBreast Cancerand thus have lower circulating estrogen levels andThe rate of breast cancer varies widely worldwide. shorter monthly cycles. [Cancer Research 41: 3771-Japanese and other Asian women only experience a risk 73, 1981] But while estrogen is a major player in theof breast cancer about a third to half that of American onset of breast cancer, it’s not the only factor. There areCaucasian women. [European J Cancer Prevention 11: other overlooked factors, to be explained in Part III of519-22, 2002] The reduced risk for breast cancer is this report.often attributed to the consumption of phytoestrogens,primarily soy in Asian diets. However, the effect isEstrogen is dumped into thenot consistent. In a telephone survey of women whodigestive tract at the end of thewere diagnosed with breast cancer, the consumptionmonthly cycle and women whoof plant estrogens had little or no effect upon cancerconsume more meat will reabsorbrisk with the average intake of less than one servingmore of their dumped estrogenof tofu per week. [Am J Epidemiology 154: 434-41,and thus exhibit higher circulating2001] Possibly much higher consumption is requiredlevels of estrogen and longerto exhibit a protective effect.look forward to menopause and their newfoundfreedom and consider the symptoms of menopause asevidence of their improved status. [Maturitas 44: 293-97, 2003] Whereas many women in America have beenconditioned to run to the doctor for a pill for their hotflashes and night sweats.periods.The assumption has been, since vegetarian womenhave lower circulating estrogen levels, that this is the A review of scientific data reveals that advancingprimary reason why they exhibit lower rates of breast age, not necessarily a change in sex hormone levels,cancer and that the inclusion of phytoestrogens in is the major factor involved in the onset of breast4 | How To Find Your Way Out of the Hormone TrapCopyright Bill Sardi August 2003 www.askbillsardi.comcancer. More than 80 percent of cases of breast canceroccur after age 50 and only 1.5 percent under age 35.[Clinical Obstetrics Gynecology 25: 387-92, 1982]What many American women have been taught is thatbreast cancer may be inevitable, that is, it’s geneticallyprogrammed. The fact that women who moved to theUS from countries such as Japan with low breast cancerrates approach the higher risk levels of US womenwithin one generation as a result of their adoptionof western lifestyle foods and health practices, isunequivocal proof that breast cancer, for the most part,is not genetic. [Network 10: 1-3, 1989] Very littlebreast cancer is linked to genetic factors. The Councilfor Responsible Genetics says only 5 to 10 percentof breast cancer cases involved inherited mutations.[Breast Cancer Genes, Myths & Facts] All women haveBRCA1 and BRCA2 genes. Mutations in these genesincrease the risk for breast cancer. It is misleadingto say that there is about an 80 percent lifetime riskfor breast cancer if there are mutations in the BRCAgenes. This misstatement is used to sell women on theidea of mastectomy (breast removal). [Journal of theNational Cancer Institute, November 7, 93:1585, 2001]Mutations in the BRCA gene do not necessarily resultin breast cancer. Colin B. Begg of Memorial Sloan-Kettering Cancer Center in New York said this high riskrate cannot be applied to every woman with mutationsof the BRCA genes. The risk is likely much lowerthan that. [Associated Press, August 20, 2002] Butthe 80 percent lifetime risk figure is frequently quoted,particularly by surgeons groups.Breast care centers are just scouting for more treatmentto deliver, not to prevent disease from occurring in thefirst place. Here are the known factors which increasethe risk for breast cancer which can be modified bywomen.•Alcohol consumption (even moderate consumption istroublesome)•Red meat consumption•Lack of whole grains in the diet•Diets containing corn oil (omega-6 oils) rather thanfish oil or flax oil (omega-3 oils)•Over consumption of fatty foods; the consumption ofanimal fat is another risk factor, but true to course, thiswas not shown in a US study of 90,000 nurses. TheJapanese increased their intake of animal fat from 10 to25 percent from 1955 to 1975 without a correspondingincrease in the rate of breast cancer. [Tidsskr NorLaegeforen 30: 1745-48, 1991]•Being overweight (postmenopausal women)•Smoking tobacco•Lack of sunshine (vitamin D)[J Womens Health 12: 183-92, 2003; Nutrition &Cancer 44: 23-34, 2002; Cancer Causes Control 13:883-93, 2002]There is something odd about the statistics providedabout breast cancer. It is widely claimed that thelifetime risk to develop breast cancer is 1 in 8 in theUSA. That would amount to 16 percent of women.Most cases of breast cancer occur among women aftermenopause. There are 40 million women in the USHere is what one internet resource for women had to in the postmenopausal age group, but only 2 millionadvise women about genetic testing and breast cancer: are known to be living with breast cancer and another225,000 or so fresh cases are diagnosed annually.Regardless of the test results,all womenshouldAbout 40,000 of these women die each year. So aboutstill take preventive measures to help reduce5.5 percent of postmenopausal American women suffertheir risk of breast cancer. These preventivewith breast cancer at any given time. The lifetimemeasures include: practicing monthly breastfigure of 1 in 8 is a cumulative figure. This figure hasself-examination, having regular clinical breastbeen criticized and health authorities claim it helps toexams, and having yearly mammograms (at 40get women to come in for exams on a more regularyears of age and older). Though testing frombasis and aids in capturing more funds for research.BRCA mutations may help identify women whoOver $400 million is spent on breast cancer researchare at a higher risk for breast cancer, 80 percentannually, about $200 per active breast cancer patient.of women who develop breast cancer have noHow much of those research funds actually go towardsknown risk factors.true prevention is unknown.But these measures only detect breast cancer at an Inventing a pill that would truly prevent breast cancerearlier stage, they have nothing to do with prevention. would stop a whole industry. Too many jobs rely upon5 | How To Find Your Way Out of the Hormone TrapCopyright Bill Sardi August 2003 www.askbillsardi.com
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