COMMENT:HORMONAL MAYHEM

The Second Opinion “Estrogen Overkill” by Californian general practitioner Dr John Lee (WDDTY vol 5 no 4) is a disturbing amalgam of fact and fiction. It is wrong to say that “the most common age for breast or uterine cancer is five years before men

In 1988 45-54 year olds had a rate of 163.2 per 100,000 while the rate for 75-84 year olds was 281.4 in the UK, nearly double the rate for premenopausal women, and 400/100,000 in the US where exogenous (outside) female hormones, both “natural” and synthetic, have been prescribed with wanton enthusiasm. Over a lifetime one in nine women is developing breast cancer in the US. The latent period after hormone exposure can be anything from a few weeks to 40 years or longer with most deaths occurring five or 10 years later. Early cervical cancer rates (including abnormal smears) have increased 9,000 per cent in 20-24 year olds with 45-49 year olds increasing by 500 per cent.

In advocating progesterone supplementation, Dr Lee makes three more important mistakes. He seems to confuse sex hormones with essential nutrients such as minerals, vitamins, EFAs and essential amino acids, which we must obtain from our food all our lives. In contrast, ingested hormones are destroyed in the gut.

Animal studies by Dr Gina Schoental have shown that even small amounts of extra progesterone, estrogen or testosterone at key times during pregnancy can interfere profoundly with physical and mental development and sexual orientation.

As a safeguard, we make our own sex hormones from cholesterol as and when needed during reproduction. It is impossible to mimic this delicate system by crudely adding hormones from the outside, whether as pills, cream, pessaries or injections.

Synthetic progesterones (the Pill) are not destroyed when given orally. To achieve the same effect with natural hormones, 1,000 to 5,000 times higher doses are being given. Hence the current fad for rub on progesterone to bypass the gut.

Dr Lee seems to believe that “natural” progesterone is safe, while only synthetic progesterones are dangerous. This is nonsense. For the 30 years natural progesterone has been prescribed, I have personally seen patients who then suffered from irregular bleeding, severe migraine, depression, weight gain, leg cramps and painful breasts.

All the many health risks of the oral contraceptive pill which have been well documented are due to the Pill acting predominantly like progesterone which is what “progestogen” or “progestin” actually means. The estrogen influence in contraceptive pills is relatively small.

The long term effects of exogenous hormones on the pituitary gland including excessive secretion of the milk hormone prolactin are well established. If a woman already has irregular cycles, Pill taking increases her risk of developing a pituitary tumour (prolactinoma) 7.7 fold. In the Oxford/FPA Study, one of the major British studies of the Pill, most woman with post Pill amenorrhoea (no periods) took up to two years to regain their fertility. Some have a premature menopause due to pituitary or ovarian dysfunction.

Much is being made of a new syndrome (luteal deficiency syndrome or LDS), when women have low post ovulation levels of progesterone, longer cycles and more risk of fetal abnormalities and recurrent miscarriages if they conceive.

However, flagging secretions of hormones cannot be boosted by exogenous estrogen or progesterone. Adding progesterone, even as cream, will increase the risk of damage to the mother and baby. The underlying causes of the condition are often deficiencies of essential nutrients, especially zinc.

Exogenous hormones will only make the problem worse by causing further zinc and magnesium deficiencies and eventually deplete copper stores. When zinc is deficient a woman’s own hormone production is impaired. In fact, all exogenous steroid hormones can block the secretion of the body’s pituitary and ovarian hormones.

In general, estrogens stimulate immunity, increasing antibody production, while progesterone and testosterone cause immunosuppression at many points on the immune pathways (J of Immunol 1988; 1491:1-8; Immunol Rev, 1984). In fact, progesterone is a more powerful immunosupressant than the adrenal steroids. Progesterone also can act as a co-carcinogen with viruses and chemicals (Potential Carcinogenic Hazards from Drugs, 1967; 7: 162-71, Springer Verlag, Berlin, NY).

Both female hormones combine to develop and dilate blood vessels spreading infection and cancer (Sexual Chemistry, 1994, Lancet 1994; 343: 926). Progesterone increases melanin formation, another reason for eschewing skin rubbing.

Although Lee now advocates the use of rub on progesterone to treat osteoporosis, progesterone in the form of DMPA has been shown to cause the condition (BMJ 1993; 303:13-6). Researchers have demonstrated that osteoporosis, which can happen to either sex, is due to nutritional deficiencies.

Exogenous steroid sex hormones may dramatically suppress symptoms and deceive the clinically unsophisticated, but long term disaster often results.

A varied, rotating, high protein, low allergy diet plus nutritional supplements is a safer and more effective way of maintaining or restoring a woman’s hormone production.

!ADr Ellen Grant