| [ The Atlanta Journal-Constitution: 01/27/03]
Look at facts reveals estrogen is getting a bad rap
By GERALD M. REHERT
The attacks on estrogen continue unabated.
On Dec. 12, the National Institute of Environmental Health Sciences, an agency of the U.S. government, declared that all estrogens are "human carcinogens" (cancer causing substances). In other words, they are warning us that within every woman's body are two organs (the ovaries) producing cancer-causing substances (estrogens). Soon I expect these same scientists will be advising all women to have their ovaries removed as soon as they finish childbearing -- if not sooner. And hot flashes will be a badge of courage.
This is all ridiculous.
NIEHS' announcement comes on the heels of the renowned Woman's Health Initiative study that made the news last July. However, anyone familiar with that study knows it only reported a breast cancer increase in women who took estrogen plus a synthetic progestin. Patients who took estrogen alone showed no increased breast cancer risk.
Furthermore, in a separate study published in the prestigious journal of Obstetrics & Gynecology in December, the National Institute of Child Health and Human Development "did not find any additional risk of breast cancer in women who took estrogen alone."
They did, however, find an increase in breast cancer in those women who took estrogen plus a progestin on a daily basis. The obvious conclusion of this recent research, as well as other studies, is that the synthetic progestin is responsible for the increased incidence of breast cancer, and not the estrogen.
I agree with the NIEHS when it says estrogen given alone stimulates uterine cancer. However, this relationship has been known since 1975. Why did it take 27 years to consider this a cause for alarm?
And because of our undeniable knowledge of this association, the medical community has long prohibited prescribing estrogen alone to a woman who has a uterus (i.e. who has not had a hysterectomy). Instead, these women receiveestrogen in combination with a progestin, which, in fact, lowers the uterine cancer risk to less than that of women on no medication -- essentially delivering cancer protection.
The odd contradiction that synthetic progestins increase breast cancer while they reduce uterine cancer poses a dilemma. However the benefits of progestins far outweigh the risks: A daily synthetic progestin (in combination with estrogen) gives practically 100 percent protection against uterine cancer while generating only eight cases of breast cancer per 10,000 women per year. Also the natural progestin, progesterone, is available and has never been shown to cause breast cancer.
So what is this thing called cancer? Cancer is simply uncontrolled cell division, unrestrained human cellular growth, flawed and gone astray. Any substance, natural or otherwise, that promotes human growth will, on rare occasion, through some biochemical error, lead to cancer.
It is no secret that estrogen stimulates the natural growth of human tissue, particularly in the breast and uterus. But estrogen is considered a mitogen (it stimulates normal "mitosis" and cell growth) as opposed to a mutagen (which tends to induce gene mutations, leading to cancer transformation). This was confirmed in 1993, when researchers demonstrated that estrogen does not induce gene mutations. Despite this classification, as mentioned above, any natural growth stimulation, on rare occasion, may be flawed and lead to cancer.
All substances that stimulate growth would be logical suspects for inducing cancer. What about human growth hormone? It promotes growth. Its absence results in dwarfism.
A casual search of the Internet finds associations between HGH and cancer of the colon, breast, prostate and Hodgkin's disease. Yet HGH is conspicuously absent from the latest government carcinogen list, while estrogen, a perfectly natural substance that establishes a woman's femininity, is listed along with the likes of asbestos, chloroform, cigarette smoking radon and mustard gas.
Sometimes we must step back from the science and look at the bigger picture. The anti-estrogenists champion the alternatives to estrogen therapy. These alternatives were invented by pharmaceutical companies over the past 20 years.
Estrogen was created by God more than 15 million years ago and somehow women have managed to survive. I think I'll continue placing my trust in the more natural remedy until the Almighty advises me differently.
Dr. Gerald M. Rehert is an Atlanta gynecologist.
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