The WHI study researched the effects of Premarin and Provera on cardiovascular disease in menopausal women and closed down because they erroneously determined that using hormone replacement therapy over five years increased the risk of cardiovascular disease and breast cancer. Why is this an erroneous assumption? Because lumping all HRT including bio-identical estrogen and progesterone with Premarin and Provera use is like saying that to eating fruit causes cavities because it has “sugar” in it!

Most of what we know about hormones is based on the oldest pharmaceutical—Premarin.
Which is in fact equine estrones—the bio-waste of pregnant mare estrogen metabolism and humans convert Premarin primarily into 4OH estrone, one of the most toxic forms of estrogen.

I will illustrate estrogen types and their metabolism in detail, but first let’s examine the “progesterone” used in the WHI study. They used Provera a synthetically derived progestin. Yes, its chemical name is medroxyprogesterone named by its inventor—not natural, but man-made. What’s the problem with Provera? Well, progesterone is a 21 carbon molecule, one of the largest steroid hormones. Don’t let the word steroid alarm you. All hormones that are made up by sterols (cholesterol) are called steroids. That includes naturally occurring 21 carbon pregnenelone, 19 carbon DHEA and testosterone, and 17 carbon estrogen and cortisol.

19 carbon medroxyprogesterone is more closely related to testosterone than 21 carbon progesterone. In fact the side effects of medroxyprogesterone (Provera) are androgen related (male hormone)….elevated cholesterol and mid-line weight gain. Yes, Provera reverses estrogenic effects on the uterine lining proven to prevent hyperplasia or uterine cancer, but guess what? So does natural progesterone!

What man-made Provera cannot do, that progesterone was created by nature to do, is protect against estrogen fed cancers. Think of estrogen as fertilizer feeding both the roses and the weeds. If estrogen fertilizes or promotes cell growth, than progesterone is like the gardener which picks the weeds and leaves the flowers. Progesterone turns on a very handy gene called P53 which is the cell death gene. It tells the cells when they have out lived their welcome, like breast cells or uterine cells that grow in preparation for a potential pregnancy. At the end of a menstrual cycle if the woman is not pregnant those cells under the influence of progesterone deteriorate (in the breast) or slough off (menstruation).

You see mother nature has it all figured out.

Now let’s go back to Premarin. Why would our bodies convert equine estrones into the most dangerous kind of estrogen? Because Premarin is the waste product of horse estrogen metabolism and our human livers can do nothing else with it. Garbage in, garbage out.

Now estrogens are not all created equally. The human ovary produces estradiol (known as E2 because it was discovered after estrone or E1). Estradiol is a powerful growth promoting hormone. It nourishes blood vessels, nerves, skin, hair, nails, lining of the gut as well as promotes female secondary sexual characteristics like breast development and wider hips than men, and enriches the uterine lining for potential pregnancy. Studies have shown that estradiol stimulates the thymus to promote proper immune programming so that reproductive women produce sufficient antibodies to pass on to their offspring.

Since estradiol is short-lived, the body has a back up system of enzymes in the fat cells that can convert estradiol to long acting estrone. Now there are three main types of estrone named by which carbon molecule carries a hydroxyl molecule.
• 2OH estrone is the safest form made in great quantities in young women of healthy body weight. The enzyme that promotes 2OH estrone conversion uses the micronutrients found in flax, soy, fatty fish, and cruciferous vegetables (broccoli, cauliflower, cabbage, brussel sprouts).
• 16OH estrone is inflammatory and has been associated with breast and gynecological cancers. Overweight women, sedentary women, women who drink too much alcohol or who have been exposed to xenoestrogens (man-made estrogenic toxins like DDT) and certain drugs like cimetidine make too much of this dangerous estrogen. 16Oh estrone can be converted to estriol.
• 4OH estrone is the most volatile of the three associated with the most aggressive forms of breast and ovarian cancer. All the factors that influence 16OH conversion affect 4OH as well as age.

Estriol—the pregnancy hormone is the third estrogen and seems to be the least inflammatory and the most nourishing to vaginal and urethral tissues. Estriol is my favorite bio-identical used topically to make an atrophic dry vagina lush.

Unfortunately, getting older increases poor estrogen metabolism, which is why I do not agree with high dose hormone replacement. The levels of hormones produced by young women are safe for them because they have the means to safely metabolize the hormones. Most older women do not have the means to metabolism the hormones safely. Although they can take lots of Dim or IC3 indoles (the active ingredient in cruciferous vegetables) and lots of EPA (fish oils), keep their weight down and drink alcohol in moderation, but I believe reversing age related metabolic enzyme activity takes a multi-pronged approach.

A holistic approach to hormone replacement therapy includes complete neuro-immune-endocrine and metabolic evaluation. Functional medicine testing is available to assess genetic and metabolic capabilities of an individual. There is no one size fit all prescription for hormone replacement or anti-aging therapies.

After stopping her bio-identical hormone therapy a few years back and now on the verge of menopausal crisis, a former patient returned to my care. Why did she stop her HRT? Because of the Women’s Health Initiative (WHI) study which reported an increase risk of cancer in those subjects using “progesterone” with “estrogen”.

First of all let’s make it very clear, comparing the hormones used in the WHI study with botanically-derived bio-identical hormones is like comparing apples to oranges.

The WHI used Premarin derived from pregnant mare’s urine as the “estrogen” and Provera, synthetic medroxyprogesterone, as the “progesterone”.

Years ago when WHI first began to study HRT’s effectiveness in preventing heart disease, I was asked to by the American Heart Association to be part of a panel of local experts to answer women’s questions on the hormones. As a nurse practitioner who had been treating menopausal women for years with natural hormones, I was honored to be part of the medical panel which included cardiologists and endocrinologists, but the WHI researcher was not too thrilled when I began questioning her terminology. I argued that WHI was not using “progesterone” but a synthetic derivative and that the study would show an increase in cardiovascular disease for two reasons:
1. the hormones were oral which would create havoc in the liver’s production of clotting factors (just as oral contraceptives increase the incidence of blood clots)
2. and not using real progesterone would put the subjects at risk for breast cancer.

Now what I had to say was not well received, but the cardiologist covertly asked about what I knew. Although I explained, the doctors, too fearful to break away from protocol, continued following the pharmaceutical sponsored protocols until…the study was stopped. Why? Because the subjects had significant increases in…
1. blood clots leading to stroke and heart attack
2. and breast cancer especially in the subjects that were given Provera

Guess what? The endocrinologist on that panel is now using natural hormones.
How many women must suffer before health care providers make the switch to alternative therapies?

Needless to say, my former patient gladly went back on bio-identical hormones. I also recommended Genesis Gold® to help metabolize the hormones as safely as possible and to balance adrenal, thyroid, and hypothalamic function as well as glucose metabolism. Finally I counseled her on nutritional and lifestyle changes to encourage healthier body composition and promote safer estrogen metabolism.

Tomorrow, I’ll go into detail about hormone metabolism.

Did Suzanne Somers stir the pot? Absolutely! Unfortunately the AMA will get the FDA involved and that could potentially be disastrous to the use of bio-identical hormones. Why? Because natural hormones cannot be patented, so there is no big pharmaceutical company that will stand behind the research. Rather the big drug companies will be supporting stringent FDA regulation of natural compounds on the erroneous basis that bio-identical hormones can increase cancer risk.

Susan Somer’s interview on Larry King inflamed an already hot topic.
Natural bio-identical hormones have been around for over three decades. They are not new, used by many European physicians to treat menopause for years and in this country by those health care providers willing to think outside of the box. Traditional medicine has been boxed in by the politics of greed, run by the forces of two big industries—the pharmaceutical industry and the insurance industry. Providers fear to try anything new even when patients ask for other options. I applaud my colleagues who have braved the storm and dove into natural therapies including using bio-identical hormones. The FDA is NOT the best watch dog for patient safety for they are skewed by big industry that can afford to support their testing protocols. Following FDA protocol costs a fortune to bring a drug to the market and how many drugs are pulled off the shelf each year for side effects that show up after the testing is completed.

Shouldn’t thirty years of clinical evidence justify continued unhampered use of bio-identical hormones?

There is not a one size fits all protocol for every woman!
Each needs an individualized regime to fit her needs.

If providers would use their scientific training to make justifiable treatment decisions rather than acting like sheep and treating every patient the same, hiding within the flock of doctors who fear to stray from protocol, then there would not be a hormone issue.

Years ago I worked with a physician who complained that I gave the patients too much information! He was afraid that they wouldn’t need us any more. I laughed and told him that there were so many ill patients to be tended, we would be busy for the rest of our lives!

I educate my patients sometimes to ad nauseum. Poor things come so hormonally challenged that they cannot possibly absorb all I have to teach them. Yet there are no stupid questions only reluctant providers who will not take the time to find the answers and instead hide behind what all their colleagues are doing.

If I had a dime for every time a patient said “How come no one else could figure out my problem?” I would be able to retire. I figure out the roots to their dis-ease because I listen to them. I am willing to go where other providers fear to venture. I investigate alternatives and am willing to try new things with my patients. I’ve always pushed the envelope and have found that I am five to seven years ahead of current thinking, current procedure, current practice.

Seven years ago, I too investigated high dose cyclical hormone replacement therapy with patients, actually researchers who desired to be clinically treated with this innovative anti-aging model. I did not find that high dose cyclical therapies worked. Like all new treatments, the patients initially found great relief, but few could follow the demanding protocol which involved heavy duty nutraceuticals to balance the potentially inflammatory hormone metabolism.

I just had a patient come in today reporting that three of her friends have been on the high dose regime for the past three years and seem “addicted” to their hormones. I explained that in our youth, our bodies can tolerate high level of hormone production because we have efficient metabolic pathways to rid ourselves of the dangerous waste. But like any chemical that stimulates cellular receptors, even natural hormones can cause physiological dependency as the patient needs more and more to get the same effect, eventually becoming desensitized or resistant to the hormone. By the way this lovely lady, like most of my patients, is doing very well on moderate dosing of bio-identical hormones. And the best of all, her regime is easy to follow.

While working with the researchers promoting high dose hormone replacement, I began to do some private investigation. They did not believe that the body once through midlife could make its own hormones at a healthy milieu, but I believed otherwise. It didn’t make sense to me to continue to create dependency in patients while promoting natural therapies. There must be a way to activate the body’s potential. After months of investigation, I developed a nutraceutical formula that enhanced and balanced one’s natural hormone production. In the three years since Genesis Gold® has been available, many of my patients have been able to reduce their hormonal dependency, some completely off replacement therapy and showing signs of making their own hormones.

Yesterday one of my patients asked my opinion about the Suzanne Somers’ hormone protocol. While I do not agree with the high dosages recommended in Somer’s books, I do think she has served women by stirring up the pot of bio-identical hormone replacement. Doctors are upset at her touting her own high dose protocol, even her original medical advisors are pulling their support out from under her. Her personal prescription many not be right for every individual woman, but her courage will serve us all. Why? Because the world of medicine needs to be shaken up.

If interested in a truly natural alternative, check out www.genesisgold.net

I must apologize for my absence. I’ve spent the past week focusing my attentions on editing by first book due out this spring. Check it out at www.lovedancebooks.com.

This week, I had a patient come in looking for a miracle. I smiled and explained that there are no magic cures, but she insisted that I would get to the root of her ailment. Well, during the two hour consult, we dove deeply into her life, the history of her problem, the hormonal symptoms that others had attempted to treat. I took her hand and heart to heart, we emerged from the darkness of her despair and into the light of understanding.

I am blessed with a new wave of patients that are open to receive me. The healing begins when they acknowledge their ailments as symbolic representations of their beliefs. Yes, I support them biochemically with natural hormones and nutraceutical supplementation. Yes, I help them see how their lifestyle choices are affecting their health. But I do more, much, much more.

All dis-ease has energetic roots tied to a patient’s belief about herself. If she believes in her vulnerability, she will be susceptible to infectious agents. If she feels unworthy, she will attract toxic relationships and be abused by others. Each dis-ease has its own vibration, its own energy, often cloaked by the disharmonious energies of an imbalanced system. Harmonizing the hormones and balancing the biochemistry is only part of a holistic treatment plan. If the healer does not attend to the patient’s belief system, there will not be enough remedies to prescribe to relieve the patient’s suffering. Perhaps physical symptoms may diminish but the imbalance will rear its ugly head somewhere else in the system. This time of year promises challenging patients who shall present unique opportunities for me.
I anticipate a rich harvest!