.svg)
Let's just get right to this elephant in the room of a question, does estradiol (estrogen) cause breast cancer?
Well, it's complicated, much of what we know about this topic came from the 1990's reach study, the Women's Health Initiative. In this study, the hormones that were used were conjugated equine estrogen, brand name, Premarin (yes, that is the equine estrogen or estrogens obtained from pregnant mares), and they added Provera, a synthetic progestin. When it came to breast cancer specifically, they found that estradiol alone given to postmenopausal women actually lowered a woman's risk for breast cancer! Yes you read that right, LOWERED the risk for breast cancer. Where is the PSA on that? However, when they combined Premarin with Provera, coined "Prem-Pro", this is where they found an increased risk of a woman's risk for breast cancer, but not by much! One in about 1000 more women will develop breast cancer who start MHT (menopause replacement therapy); this is considered in research a fairly low risk but still statistically significant. This was hugely misrepresented and changed the course of HRT for decades, implanting fear in the minds of prescribers and women alike. This "increased" risk for breast cancer, to put it in perspective, is much lower than being overweight or drinking two alcoholic drinks a day. So you can see, modifiable lifestyle factors can counter and lower a woman's risk for breast cancer.
Premarin and Provera are sometimes used today, however, most integrative and functional providers use bioidentical hormone replacement therapy (BHRT) which is typically given as a transdermal, or through the skin; this is thought to be a bit safer in several aspects. More current research has shown that bioidentical estradiol (oral or topical) paired with micronized bioidentical progesterone does not carry this same risk. Said in another way, BHRT does not increase a woman's risk for breast cancer. It has a neutral effect on a woman's risk of breast cancer neither lowering it nor increasing it. Bioidentical simply means, as biologically similar to your own hormones as possible. Bioidentical hormones are typically sourced from plant based sources i.e. soy and yams.
At Liv, we are passionate about providing safe, effective and preventative care for our patients. Our Hippocratic oath, do not harm, is top of mind. We carefully analyze the latest research and put it to practice to provide the best care we possibly can with the information we have. We carefully weigh the risks of HRT with the health benefits; acknowledging that if we deny a woman HRT, we most certainly could be doing her harm. We will make sure you are a good candidate for therapy, guide what treatments are appropriate for you, and determine what routes are best to use based on your personal history. Nothing about women's health is a one size fits all, and we will do everything we possibly can to make sure you get all the benefits of HRT you can give your personal story.
In wellness,
Liv
