^^^^^^ Setting the record straight Prempro vs. natural HRT -- for more ^^^^^^^
Bad Press: Prempro, one of the first HRTs, has been marketed since 1942 by Wyeth Laboratory (bought out by Pfizer in 2009). It has been and still is the best-selling HRT. A supposedly definitive study of HRT was done by the FDA’s drug research branch, National Institute of Health
(NIH) (with undoubtedly a nod from pharma). The Women’s Health Initiative
(WHI) knowingly selected the worst formulation
of HRT, Prempro. NIH had the
results of the Hormone Estrogen Replacement Study (HERS) UK completed in 1998 which used Prempro; moreover, earlier studies singled out (medroxyprogesterone) MPA as the cause for the increased risk of breast cancer (Goodman & Gilman 2006, 1552).
Prempro consists of an estrogen cocktail derived from pregnant mare’s
urine to which is added the synthetic progestin MPA. (The cruel treatment of mares and subsequent slaughter was broadcast by Frontline.) “Pregnant mare’s estrogens are the weak estrone (>50%), and the two mare estrogens, equilin (15-25%) and equilenin…. Mare (equine) estrogens such as equilin, that
are foreign to the human body, have been shown, when compared to other studies, to have effects that are significantly worse
than the natural estradiol.” MPA, the synthetic progestin used in Prempro,
blocks most of the beneficial effects of estrogen--the natural progesterone doesn’t. Using Prempro, the WHI found that compared to a placebo there was increased incidents:
heart attacks 29%, breast cancer 26%, pulmonary embolism 113%, strokes 41%, total deaths 15%, all cancers 3%; reduced
incidents: hip fractures 34% and colon cancer 37%.” “MPA antagonizes this athero-protective effect [on coronary arteries]” at 1997. Though “all causes of mortality were not effected”, the press highlighted risks for HRT (undoubtedly
with a nod from their biggest advertiser), & HRT sales plummeted. The equine estrogen only arm of WHI had better results; more proof that adding MPA causes the harm. Pfizer in 2010 settled a suit over breast cancer for $330 million or $150,000 per person.
Yet Prempro is still on the market (thank you FDA & pharma) and still first in sales. Based on the WHI, NIH issued this warning on all HRTs: “…increased risk of myocardial infraction, stroke, invasive breast
cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women… Estrogens
with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with
treatment goals…” The warning is placed on all packages of HRT, and it is accepted as correct by most doctors. My
doubts were confirmed when attending a lecture on the WHI given in 2002 at UCSD
by Professor Dr. Robert Langer. He explained to a large medical audience that
the WHI Prempro results cannot be validly applied to other HRT formulas. Over 50 years of research was not overturned; rather physicians and the public were
tragically misled by the press, pharma, guidelines, and the NIH. This is another example of regulatory capture. Tobacco ethics
CONFIRMATION: Set Up to Fail
was published in the highly acclaimed science journal, Nature, 09/09/2010: “Is Nature ignorant of
the vital fact that Prempro contains no progesterone, but instead the artificial progestogen Provera
[MPA]. The other component is Premarin (conjugated
estrogen), which is a very uncertain, patent mixture of substances from the urine of pregnant mares…. [equine estrogens]
have crucially different effects. Prempro is totally unrepresentative of any other product used for HRT purposes…. . Much of it was known before the NIH chose to use Prempro
in its intended landmark study. Using a study of the effects of Prempro to attack the entire use
of HRT has, through needless fear, caused millions of women to forgo considerable
benefits of HRT using better products. This point has been repeatedly made
by endocrinologists. Why does Nature not know it?--END
that it borders on a tragedy that Premarin and Provera [the 2 compounds in Prempro] were chosen as the only HRT treatments
[for the WHI Study]”. Another researcher finds that Provera [MPA]--and
no other progestin--blocks the mechanisms that allow estrogen to fight the brain's immune response to Alzheimer's…. Bruce S. McEwen Neuroendocrinologist of the Rockefeller
University is unequivocally critical of the study: "I think that it borders on a tragedy that Premarin and Provera were
chosen as the only HRT treatments." “With Medroxyprogesterone [MPA] in Provera you are activating two receptors involved with cell division in the breast,"
she says, "and that's the culprit, not estrogen [for breast cancer].” Recent
research shows that Provera interferes with estrogen's ability to prevent memory loss
and dementia. “Estrogen is able to protect neurons against toxic assaults that are associated with Alzheimer's disease," notes
Roberta Diaz Brinton, a neuroscientist at the University of Southern California…. she found “that Provera--and no other progestin--blocks the mechanisms that allow
estrogen to fight the brain's immune response to Alzheimer's”. This immune response wears away at brain cells
and causes them to leak neurotransmitters such as glutamate, which overloads and kills neurons.” Hormone Hysteria, Scientific
---- BENEFITS OF
Cardiovascular disease (CVD) & MI: “estrogen
lowered … 37% LDL …, extends life 2.1 years,” Braunwald, Heart Disease
5th Ed, 97, p 1708. “HRT decreases CAD morbidity and CAD
mortality … was 0.56 compared to subjects not taking estrogen” Braunwald
1142; another 50%, 16 vs 33, reduction in CHD. Estradiol blocks oxidation of LDL to prevent atherosclerosis. “Estradiol completely reverses the effects induced by OX-LDL on the DDAH/ADMA/NO pathway,” Avoid MPA and LNG (levonorgestrel). Another study found 26 MI deaths for estradiol vs. 56 for placebo (115%). A
meta-study found and a 50% reduction of Coronary Heart Disease. Lowers hypertension risk. Two AHA studies explain mechanisms of cardio arteries protection and Wiki, also, Angina pain is associated with low estrogen, treated. Calcification of arteries is strongly associated with MI. HRT lower calcification of coronary arteries—at, using Prempro.
Cholesterol effects, percentage of reduction
in LDL with E 37%, with E +PA 46% (E is equine estrogen and PA is medroxyprogesterone Braunwald, Table 51-2). Estrogen is held to significantly protect LDL from oxidation at . “E2
at a concentration of 1 μmol/L inhibited LDL oxidation by 37% to 62% at the various concentrations of copper” at. Oxidized LDL in the tunica media of the artery is held to by pharma to be the major cause for atherosclerosis and
Breast cancer risk decreased: 73% less for estradiol: “in breast cancer 10 in treated
group v 17 in control group.” HRT after & also
during breast cancer greatly increases survival, also ratio 0.28--results would be better with progesterone. “MPA (in Prempro) increases the risk of breast cancer” some progestins increase risk. Contrary to pharma, estradiol progesterone doesn’t
increase risk, and when given following
breast cancer over 2/3rd fewer deaths at 15 years HRT, and also, also, same for uterine cancer. HRT also prevent skin cancer.
Colon cancer: “the reduction among current users RR = 0.55… users of 11 years or more RR of 0.54 [46% lower, also].” Estrogen and progesterone have beneficial effects for “esophagus, stomach, gallbladder, and intestines.”
Breast cancer survival: “Cancers in women who use HRT are often less advanced, and lower mortality has been reported
in those who use HRT than in nonusers… The association of HRT with lower proliferation
rate and smaller tumor size was exclusively caused by ER-positive tumors” at. After diagnosis 72% higher survival: “The risk of death was lower among the HRT survivors; odds
ratio 0.28…” at, Also, breast cancer mortality rate of 5 per 1000 person years in HRT users
compared to 15 in nonusers, at. For negative results, pharma used the progestin MPA (WHI study); other
progestins could be similar; however, “progesterone combined with estradiol induces apoptosis [cancer cell death]”
Alzheimer’s disease with past long-term HRT,
7 vs 30 control. Estrogen is neuro-protective by inhibiting
oxidative damage. Progesterone is also neuro-protective: used
in large doses following trauma “to limit central nervous system damage.” Again MPA in WHI study increased risk of dementia, 40 cases of dementia versus 21 in the placebo group,
Parkinson’s disease,” loss of estrogen resulted in decrease
neuron density in the substantia nigra (structure of brain damaged by Parkinson’s disease), and restoration of estrogen
in increased density” at, and. Again MPA exacerbates condition & risk, at. Pharma of course does junk science to show that HRT does not affect the course
of the disease.
Cognitive Function: “There
are plausible biological mechanisms by which estrogen might lead to improved cognition.”
Longevity: Telomere numbers of units on the end of DNA are essential for cell longevity
and functionality—see Wiki.
It has been shown both in animal and human studies that treatment with estradiol lengthens through action on telomerase
the number of telomere units, see careful matched study of HT therapy, and, and, and, for animals. This
action on telomerase in part explains the many benefits from estradiol.
Programed death through menopause is to remove
elderly women from the community, thus the precipitous decline in health of women after menopause. To slow this process requires
the taking of natural HRT.
Macular degeneration, and hearing: HRT resulted in a 36% reduction and other eye pathologies.
NAFLD: “Non-alcoholic fatty liver disease is also more common among men than women in
all age groups until age 60, where the prevalence between sexes equalize. This is due to the protective nature of estrogen,”
Wiki.— for diet's role.
Obesity & Diabetes: the drop of estradiol increases LPL which regulates weight, distribution of fat,
and activity. Gary Taubes, Good Calories, Bad Calories, 398, Taubes Why we Get Fat, 90-91, and Wade at, In Obese estrone +40% at. Weight related issues (metabolic syndrome, insulin resistance,
& diabetes) are associated with drop in estradiol, at.
Osteoporosis: “Bone loss increases after menopause due to lower levels of estrogen.,. [causes removal of ovaries” Wiki “Esterified
estrogens produced significant increases in bone mineral density (lumbar spine, hip).
54.2% greater spinal mineral. “1 of 4 white
women over the age of 60 had spinal compression fractures associated with osteoporosis. One woman of 5 will fracture a hip by the age of 90” Bone gain from long-term HRT, also; estradiol's role. Numerous journal articles hold that progesterone work with estradiol to increase remodeling of
bone, at, and, and.
Rheumatoid Arthritis (RA): “HRT
was well tolerated, increased well-being, reduced articular index and increased lumbar spine bone density over a one year
period in postmenopausal women with RA” also, & lowers RA CVD deaths.
Osteoarthritis (OA): When both incident and progressive radiographic knee OA cases combined, “current ERT [estrogen only replacement therapy] use had a 60% decreased risk compared with never use”. Progesterone most important.
age related loss of skeletal muscle mass with age is associated with low level of estrogen & testosterone in 22.6% in older postmenopausal women not receiving estrogen or TTT. TTT prevents and reverses sarcopenia, and.
Skin healthier American Journal of Clinical Dermatology & more hair, hair, hair. “Studies of postmenopausal women indicate that estrogen deprivation is associated with dryness,
atrophy, fine wrinkling, poor healing, epidermal thinning, declining dermal collagen content, diminished skin
moisture. The decrease was preventable by the use of HRT.” “The mean collagen content in the skin was … found to be 48% greater”, slows
skin aging, also, and less skin cancer, 2008.
Urinary Tract Infections Recurrent (UTI), also urinary urgency,
urogenital & vaginal atrophy are associated with low estrogen in post-menopausal women. A meta-analysis of 8 quality studies found the placebo group 2.5 times more likely to have a subsequent UTI. Topical administration most effective; however for vaginal atrophy estradiol tablets.
Venus Thrombosis: an 8% reduction in risk of with esterfied
estrogen while those on Prempro had a 65% elevated risk JAMA 04, and; a 23% reduction exogenous estrogen (5.1% of cases versus 6.3% control cohort).
Sexual Satisfaction: prevents vaginal atrophy, “HRT improves sexual function” better, estradiol & testosterone, &.
and depression: “Numerous molecular and clinical studies have implicated estrogen in modulating brain
function including that related to mood,” treatment of mood disorders and depression no additional weight gain.
10 Reasons for HRT: Menopause Int. & Oncology:
Both list the above benefits, and the latter advises HRT for survivors of breast cancer because of “a 70% reduction in the risk of death” during the 15 years, also.
Breast density maintained for women on HRT.
The difference has been repeatedly noted on mammograms.
natural HRT (NHRT) at dose comparable to the Danish study (Trisekvens sequential 2 mg estradiol with a progestin). NHRT is part of nature’s clock. NHRT sets the body’s clock to premenopausal and thereby
reduces the rise for age-related chronic conditions. Their lack causes the precipitous decline after menopause. Life extension
with long-term NHRT is over 4 years. True to profits-first, corporate tobacco ethics, pharma offers 1) HRT in too low
a dose; 2) synthetic estrogens, horse estrogen, and synthetic progesterone (progestins) of questionable value and safety;
3) human estrogens estrone (E1), Estriol (E3), estetrol (E4) which are less bioactive and they block some of the action of
estradiol, the best estrogen; 4) the other progestins could be like MPA and block some of the benefits of estradiol. For hot flashes,
NIH guidelines include a major tranquilizer (SSRI) or an estrogen blocker such as Tamoxifen.
My wife takes 50 mg progesterone micronized in oil capsule with 2 mg estradiol prepared by a compounding pharmacy. Alternate, which she once took, is topical lotion of 8 mg of estradiol + 100 mg progesterone (absorption
is 10%). The use of sequential treatment with progesterone
used for the last 10 days is probably as good or better, but unfortunately the evidence is thin. Some doctors favor the sequential treatment because it duplicates the body’s natural cycle. If concerned about muscle strength, add 10 mg of testosterone in
lotion to reverse
sarcopenia, androgen deficiency, & to improve libido without reduction in estradiol. For lotion, moisten skin then apply as widely as possible over the torso and face and rub it in. Tell
your physician you are aware of risks and are convinced of benefits of NHRT outweigh
risk, then give him a copy 2010 journal article. Tell him you observed the benefits in a friend & a relative and
want the same. Most doctors will comply. Beware of hormone balancing; some
doctors are milking the insurance. The evidence for sequential HRT is weak and
it has a lower compliance because of vaginal bleeding—at 1997. For more on Why Natural HRT. Avoid
“bio-identical” plant estrogens and progesterones—they aren’t identical to human sex hormones. These hormones occupy receptors with uncertain action and possible block benefits
like MPA, and have low bio-availability. There is a lack of quality clinical
trials on them. The youthful free-serum estradiol level is > 300 pmol/L, or > 80 pg/mL. Estrogen is involved in both weight regulation and fat distribution. Low estrogen entails for most a gain in unhealthy visceral (adnominal) fat.
Reset you bio-clock with NHRT, fix your diet, learn about the corruption caused by pharma (on YouTube), and why doctors are their pharma’s pawns. For testimonials and more on osteoporosis, link.
^^^^^^^^^^^^^^^^^^ Non-technical summation ^^^^^^^^^^^^^^^
Natural Estrogen (Estradiol) with progesterone NHRT: What every woman
should be taking because of the numerous, major health benefits, benefits that would slash pharma’s profits. Of the 4 natural estrogens only estradiol (E2) has
major health benefits. Two--estriol (E3)
and estetrol (E4)--are
found in pregnant women and
block estradiol. Big pharma being against
hormone replacement therapy (HRT) markets ineffective products including those containing estriol and estetrol, and estradiol
at too low a dose & with inferior progestins such as in the best-selling Prempro. Prempro, a combination of estrogen derived from pregnant mare’s urine and the
progestin MPA. The biological effects
of mare’s estrogens are different than human estrogen and MPA
blocks most of the positive effects of estrogen. Thus the results of the major WHI study funded by the FDA apply only for Prempro. Nevertheless he FDA warns that HRT has only one valid medical use, to
manage hot flashes, and should be used at the lowest dose for the shortest time. Thus pharma has used marketing science & guidelines to overturn 4 decades of
positive results for HRT: Alzheimer’s 83%, Heart attacks
51%, Coronary Heart Disease 50%, Colorectal Cancer 46%, Breast Cancer 73%, Thrombosis 8%, Macular Degeneration 65%, osteoporosis fractures
90%, & prevents arthritic join destruction, firmer breasts, healthier skin (less wrinkles, thicker, 48%
more collagen), reduces hair loss, improved cognitive function, less depression
and mental illness, and a general feeling of well-being with increased libido. These results occur because estrogen
& progesterone receptors set the body to “premenopausal” maintenance. Through their many functions, these hormones are part of nature’s clock for
death in the 7th decade.
The lack of estradiol & progesterone is the reason
for the precipitous decline in health of women after menopause.
Life extension with long-term NHRT is over 4 years, and twice that
with a natural diet. Progesterone (P4), the
major natural occurring progestogen, is similar to estrogen and works
has numerous benefits, while some of the artificial progestins are clearly harmful (such as stimulating the growth of breast
cancer), and none have been adequately researched as to side effects.
Like testosterone, a very similar hormone, at higher dose, more benefits. A sufficient dose is available only from a compounding pharmacy (2 mg of estradiol plus 100 mg of micronized
progesterone) in a capsule; or you can use a lotion obtained in a dose of 8 mgs estradiol plus 100 mg of progesterone per
application (there is a 15% absorption rate with topical hormones).
Apply widely as possible over the torso, back, shoulders,
underarms, and face using water and rubbing it in to promote better absorption. Ideal free-serum estradiol level is 200-500 pmol/L.
Plant sources for HRT are not natural and are metabolized by the liver on first pass from the digestive system. These hormone mimics fail to perform well and have
adverse consequences (see MPA above). Mimic
can occupy sites that estradiol would go to and block their action, one of which is the control of appetite. Doctors who follow the Wiley Protocol are other methods
of hormone balancing for post menopause women are milking the insurance and patient, and it lacks convincing scientific evidence.
In Europe excellent results have been obtained with sequential Trisekvens; Novo Nordisk, Denmark, though with greater side effects (nausea, break-through bleed), thus low compliance. Since
ovulation is not possible sequential NHRT
lacks benefits (see Natural
HRT, below). Keep it simple, and send
the message to your cells that you are premenopausal.
Why Natural HRT, which estrogens, higher dose, and non-sequential
There are 4 superior choices for natural hormone replacement
therapy (NHRT). 1) that of
estradiol and progesterone; 2) a sequential uses of those hormone to mimic the women’s premenopausal cycle; 3) to take all 3 natural estrogens plus progesterone, and 4) to take them sequentially. What is the evidence to support these choices? Unfortunately, dispositive quality evidence is lacking: no long-term clinical trials; nor are there short-term clinical trials.
The reason is simple, the profit margin in insufficient on off patent drugs to justify such trials. Products natural to the body cannot be patented (with a few exceptions).
Contributing factor: in the golden age of medicine, when there was still
significant amount of university ran and clinical trials with just mere funding by pharma, progesterone was available only
as a topical cream (not orally active). Today that has changed, and like CoQ10
it is available in an oil based capsule micronized. For these reasons the evidence
for NHRT is mainly anecdotal. The
second source for evidence is population studies (epidemiological), but nearly all of them have a major flaw, they gather
the evidence from all women on HRT, independent of formulation. A few epidemiological
studies separate women according to type of products, & a few clinical trials are for one product. These provide evidence suggestive that 1 of the 4 choices could be better.
So why do I favor
# 1), non-sequential progesterone with estradiol? First, estradiol has been used in a number of preparations with excellent
results. In the French epidemiological study (EN3) estrogen showed no increase
in breast cancer; & Prempro the greatest increase (due to the progestin MPA). E3N study supports the use with estrogen with progesterone and not a progestin. Second
progesterone and estradiol work together in the body, thus to use a synthetic form, called a progestin, has consistently resulted
in lower benefits—see MPA example above. Third, for those using a better
progestins, their results were superior to using only estradiol, ethinyl estradiol, and esterified estrogen, this favors the combination NHRT. Fourth those who used estradiol and testosterone
(common in Europe in the 1980-90s) instead of synthetic progestin had very good results; this also supports the use of progesterone. Fifth, there is no clinical evidence supporting comparable benefits from the
other forms of estrogen comparable to those from estradiol; this supports the use of estradiol. Sixth, the laboratory work testing with estradiol indicates that it is the most important of the 4 estrogens. Seventh in the Danish study of the sequential high-dose (tri-cyclic) Trisekvens (a product only available in Europe), the results were excellent. Eight, compliance
issue because of mild side effects of nausea and break-through bleeding like those of a menstrual period. Ninth, the paucity of evidence supporting for postmenopausal women a need for having cyclic hormones. Tenth, cyclic NHRT would
cost more and is less convenient to take. Eleventh, if I in recommended sequential,
some woman would find a doctor who charges many times more for monitoring blood hormone levels and providing a custom balanced
hormone cocktail based on her blood work. This lacks sound science. Conclusion: Thus recommend #1, NHRT of estradiol with progesterone from a compounding pharmacy, 2 mg estradiol and 100 mg of micronized progesterone
in oil as a capsule.
higher dose of estradiol? This is comparable to that
used in Trisekvens which had excellent results. In the 1960s through the 1980s
the higher dose of estradiol was the norm, and during that period the numerous benefits were uncovered in epidemiological
studies; thus higher dose is better. Second, in men higher dose testosterone has significantly greater health benefits, more evidence for a higher dose of estradiol.
Third, pharma in their opposition to these healthful hormones recommends the lowest dose, still more evidence that
the higher is better.
Why natural? The goals is to restore youthful benefits and avoid age related conditions,
thus to restore hormones to youthful levels. Natural products have evolved to
work in the body through receptors and complex feedback systems; thus synthetic chemicals don’t function as well. Natural hormones have lower risk of side effect (for which the reporting system is broken). Of the over 100 synthetic hormones, there is no evidence that they work better,
and only one has very good results in a clinical trial—unfortunately the Danish product is not licensed in the US.
branded drugs for HRT? With the support of the NIH,
pharma opposes HRT since 1990s, thus current products have various issues: 1)
dose is too low for most of the healthful benefits; viz. not equivalent to 2 mg of estradiol.
Fernhrt has only .25 mcg of ethinyl estradiol (1/8th the recommended 2 mg).
Estragyn (estrone) is a 0.1 gm vaginal cream; but estrone is far less bioactive than estradiol, and the absorption
rate is under 25%. 2) A number of
products are not estrogen, but estrogen antagonists (they occupy estrogen receptors on the cells and thus block estradiol’s
action). Tamoxifen is one of several estrogen antagonists marketed as HRT. 3) Estrogens with harmful progestins: Femhrt has the progestin norethindrone acetate,
and Prempro has the progestin MPA. 4) Use less bioactive estrogens such as estrone,
estriol, derivatives of the estrogens, and mare’s estrogen in Premarin. 5)
For hot flashes several tranquilizers of the SSRI and dopamine agonist types have been approved, and many more are used off-label.
of finding a doctor who will prescribe HRT as recommended. Be prepared with
an answer when your doctor suggests that you try something else first.
You can refer to books, such as Natural Hormone Replacement (the Amazon reviews has good material). Ask him
to read an article in Menopause Internal Journal which I have pasted with link. Refer to the experience of friends, or other articles you have read.
And you can simply tell him that the 40 years of positive journal literature was not overturned
by the flaw Women’s Health Initiative Study (WHI) which used estrogen from mare’s urine along with MPA as a progestin,
which has been known to block some of the benefits of estrogen and increase risk for breast cancer.
Nearly all doctors have fallen for the anti-HRT myths: promotes breast cancer, and benefits aren’t
worth the risks. As argued at HRT, this is false for NHRT and most
formulations of HRT. Thus to get HRT
or NHRT long-term (not just for hot flashes)
requires a physician who is willing to do what once was the norm before 2002. The earlier studies on HRT were not wrong. I about 3/4th of doctors will
write a prescription for NHRT for their
regular patient after lecturing on the risks and a referral for a mammogram. He is
protecting himself from possible litigation. Copy this 2010 journal article Ten Reasons to be Happy About Hormone Replacement Therapy: A Guide for Patients to MS word
and print it. Read it before seeing him,
and give him a copy. These hormones are part of nature’s
clock for us to die in the 7th decade. The low estradiol & progesterone
is the reason for the precipitous decline in health of women after menopause. Sending a message to your body that you are premenstrual;
it is worth the effort to jump through a few of pharma’s
Progestins are of uncertain effects: The use of progestins, in particular medroxyprogesterone
in treating post-menopausal symptoms have been associated with increased risk of blood
clots and breast
cancer in a study carried out by the Women's
While the study did not involve dydrogesterone, it is possible, but not certain, that it too increases these risks. [The blood clots a key risk factor for MI, explains why with Prempro used
in the WHI) there was no reduction in MI—while with other formulas of HRT the reduction is 35% or greater. The WHI has a second flaw in that of 55% equine estrogen, which is of uncertain consequences, thus the
estrogen alone arm of the study is applies only to Premarin —jk.] https://en.wikipedia.org/wiki/Dydrogesterone
Our in vitro results indicate that not all progestogens act equally on breast cancer cells. Some progestogens
(medroxyprogesterone acetate (MPA), norethisterone acetate (NETA) and dienogest) alone or combined with estradiol
(E2) stimulate proliferation of breast cancer cells, while others (dihydrodydrogesterone (DHD), the active metabolite of dydrogesterone,
tibolone and progesterone (Prog)) alone or combined with estradiol induce apoptosis [prevents cancer]. Further pharmacological and clinical studies should be initiated to evaluate these findings in vivo.
The women in the treated group with an intact uterus started treatment
with 2 mg synthetic 17-β-estradiol for 12 days, 2 mg 17-β-estradiol plus 1 mg norethisterone acetate for 10 days,
and 1 mg 17-β-estradiol for six days (Trisekvens; Novo Nordisk, Denmark). http://www.bmj.com/content/345/bmj.e6409?etoc= . “Because of break-through bleeding with sequential Trisekvens, non-sequential combined HRT form of Trisekvens was better received.” At.
 Prempro has been the leading selling HRT since the mid 40s in the US, and it still is. The issues with MPA and mare’s urine estrogens has been known for
decades by scientist including those in the FDA as inferior of the other HRT & natural HRT. Because of birth control pills, HRT, and the possibility that an estrogen
would protect men—as it does women—from cardiovascular disease, there has been thousands of published articles
on the estrogen and progesterone family of hormones. Unfortunately the FDA acts to promote products for
pharma while minimally regulating in the public’s interest—see Consumer Report’s article, and also.
 Dr. Jonathan V. Wright in Natural
Hormone Replacement (1997) recommends all 3 hormones.
 Note, the large trials government funded trials (HERS and WHI) are designed
to show HRT as dangerous, since pharma opposes for business reason HRT.
 Esterified estrogen and ethinyl estradiol are commonly used instead of estradiol because
of longer half-life--still available. They are derivatives of estradiol, of which for esterified estrogen there are over 30--a way for pharma to obtain patents of
exclusivity. I consider these 2 equivalent
to estradiol, though some of these forms must be inferior.
 The women in the treated group with an intact uterus started
treatment with 2 mg synthetic 17-β-estradiol for 12 days, 2 mg 17-β-estradiol plus 1 mg norethisterone acetate for
10 days, and 1 mg 17-β-estradiol for six days (Trisekvens; Novo Nordisk, Denmark). http://www.bmj.com/content/345/bmj.e6409?etoc= . “Because of break-through
bleeding with sequential Trisekvens, non-sequential combined HRT
form of Trisekvens was better received.” At.
 Over 95% of HRT products are not sequential and the literature does not indicate an associated
problems. Nor are the benefits exceptional
favorable from sequential Nordisc compared to the best of epidemiological studies.
 Testosterone is structurally
the same as estradiol but for one group on the molecule. In the body women convert some of their estradiol to testosterone so that there level is about 1/10 that of a man’s. Men convert some of their testosterone to estradiol.
 Progestins are of uncertain effects: The use of progestins, in particular medroxyprogesterone acetate, in treating post-menopausal symptoms have been associated with increased risk
of blood clots and breast cancer in a study carried
out by the Women's Health Initiative. While the study did not involve dydrogesterone, it is possible, but not certain,
that it too increases these risks. [The blood clots a key risk factor
for MI, explains why with Prempro used in the WHI) there was no reduction in MI—while with other formulas of HRT the
reduction is 35% or greater. The WHI
has a second flaw in that of 55% equine estrogen, which is of uncertain value, thus the estrogen alone arm of the study is
applies only to Premarin —jk.] https://en.wikipedia.org/wiki/Dydrogesterone
 Men have a similar problem
in obtaining a testosterone of sufficient dose, which entails using a compounding pharmacy.
Estrogen (Estradiol) with progesterone HRT: What every woman should be taking
the numerous, major health benefits, benefits that would slash pharma’s
profits. Of the 4 natural estrogens only
estradiol has major benefits. Two--estriol (E3) and estetrol
(E4)--are found in pregnant women. These 2 inhibit the functions
estradiol. Big pharma being against
hormone replacement therapy (HRT) markets ineffective products including those
containing estriol and estetrol, estradiol at too low a dose, and Prempro. Based
on marketing science, including a major
study by the FDA which used Prempro, a combination of estrogen derived from
pregnant mare’s urine and the progestin MPA.
The biological effects of mare’s estrogens are different than human
estrogen and MPA blocks the some of the positive effects of estrogen. Nevertheless,
the FDA warns that HRT (hormone
replacement therapy) has only one valid medical use, to manage hot flashes, and
it should be used at the lowest dose for the shortest time. But the finding
cannot be validly generalized to the
natural estradiol and progesterone—though pharma and the FDA do. Thus
marketing science overturned 4 decades
of positive results that show significant health benefits for HRT: Alzheimer’s
attacks 32%, Coronary Heart Disease 50%, Colorectal Cancer 46%, Breast Cancer
73%, Thrombosis 8%, Osteoporosis Fractures 90%, Macular Degeneration 65%,
reduces & prevents arthritic join destruction, firmer breasts, healthier
skin (less wrinkles, thicker, 48% more collagen), reduces hair loss, improved
cognitive function, less depression and mental illness, and a general feeling
of well-being with increased libido. Estradiol is the only effective treatment to
prevent osteoporosis, and its methods of cardiovascular protection are well
documented. The lack of estradiol is
the reason for the precipitous decline in
health of women. Life extension with
long-term HRT should be at least 4 years—though clinical trials do not address
this. Because of a modest increase in
uterine cancer a progestin (synthetic hormone with some progesterone properties
that is orally active) is added to hormone replacement therapy rather than the
natural progesterone which isn’t orally active.
Progesterone--the major natural occurring progestogen--has numerous
benefits, while some of the artificial progestins are clearly harmful, and none
have been adequately researched as to side effects. Thus like with testosterone
orally active, the best method of application is a lotion obtained from a
compounding pharmacy in a dose of 4 mgs estradiol plus 100 mg of progesterone
per application. Apply widely as possible
over the torso,
back, shoulders, underarms, and face using water and rubbing it in to promote
better absorption. Recently progesterone has been
micronized in oil and available as a pill.
Ideal free-serum estradiol level is 7-9
compounding pharmacy can prepare a pill consisting of 2 mg of estradiol with 50
mg of progesterone (there is a 15% absorption rate with topical hormones,
except for the patch). The lotion form
is better for the skin. Plant sources of
estrogen are not very effective. Doctors
who follow the Wiley Protocol are other methods of hormone balancing for post
menopause women are milking the insurance and patient, and it lacks sound
scientific evidence. Keep it
Maturitas, the European Menopause Journal. Vol 53, Issue 1
pgs 11-18, 10 January 2006
percutanous testosterone gel in postmenopausal women with decreased libido –
effects on sexuality and psychological general well-being
To elucidate if percutanous treatment with 10mg
testosterone per day could enhance sexuality and psychological
well-being in postmenopausal women presenting problems with low libido.
Secondary to study the influence on blood lipids, hemoglobin and erythropoietin
Fifty-three postmenopausal women participated. As a complement
already on-going HRT, 10mg
of a testosterone gel (Testogel, Besins–Iscovesco) or placebo was administered.
Treatment continued for three plus three months in a double blind, randomized,
The scores concerning “frequency
of sexual activity,
orgasm and intercourse”, “sexual arousal, fantasies and enjoyment”,
“satisfaction with orgasms”, and “interest in sex” were all significally
improved for testosterone addition as compared to placebo both before
and after crossover. Testosterone
levels increased more than 10-fold during
treatment while DHT-levels were more than doubled. Estrogen levels were not
affected during the addition of testosterone. Liver enzymes, total cholesterol, triglycerides, HDL and LDL revealed
no significant differences between any of the periods or groups.
Endometrial thickness did not change significantly during treatment. Hemoglobin
and erythropoietin remained unchanged. No significant differences in the number
of experienced side effects were found.
Testosterone gel of 10mg
had positive effects on several aspects of sexual life such as frequency of
sexual activity, orgasm, arousal, fantasies and sexual interest in
postmenopausal women on HRT. Several psychological variables were positively
influenced. The given dose resulted in too high serum levels. Even if no
negative effects were observed, monitoring of serum levels and a decreased dose
should be considered in future studies.
Health Initiative investigated
the use of MPA and conjugated
equine estrogens compared
to placebo. The study was prematurely terminated when previously unexpected
risks were discovered, specifically the finding that though the all-cause
mortality was not affected by the hormone therapy, the benefits of the hormone
replacement therapy (reduced risk of hip
fracture, colorectal and endometrial
cancer and all other
causes of death) were offset by
increased risk of coronary
heart disease, breast
cancer, strokes and pulmonary
embolism. MPA increases the risk of
breast cancer, dementia and thrombus when used in combination with conjugated
equine estrogens to treat the
symptoms of menopause.
MPA is associated with an
increase in depression. MPA may
suppression and interfere
with carbohydrate metabolism but
does not cause diabetes.
MPA can cause weight gain, worsen diabetes
mellitus and edema (particularly
of the face). MPA may cause reduced bone
Mathew Allison, UCTV
lecture: Nurse’s Study 1985,
Walnut Creek 1987, L.R.C 1988, Leisure World, 1988. All higher dose (2-4x
current), & mostly unopposed (no progestin), reduction in CVD was RR of .3,
.5, .3, & .4 respectively. However,
later studies Uppsala, 1992, and Nurse’s 2000 using opposed estrogen and lower
dose .8 & .75. From RD Langer.
legend meets reality, estrogen plus
progestin and coronary heart disease in the Women’s Health Initiative,
Menopausal Medicine 2003; 10(4): 5-7.
Mathew made no mention of difference of Prempro, and of MPA as to their
points out that
the trial was stopped early because of harm caused, and he also shows that the
RR for death was .98. He never commented
how this result doesn’t justify stopping the trial early.
estrogen only group has a marked drop in coronary events in years 7-9, 20 vs
What Can We Learn
Design Faults in the Women's Health Initiative Randomized Clinical Trial?
Points out that by including in
the study a large number of women, up to age 74, that it was an atypical
population and thus deluded the benefit of women free of CVD, those most likely
to take HRT and would show the greatest CVD benefit.
: legend meets reality, estrogen plus progestin and coronary heart disease in
the Women’s Health Initiative, Menopausal Medicine 2003; 10(4): 5-7—NOT
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