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The Doctor's Corner: Estrogen therapy does not cause breast cancer, experts say

June 07, 2012|By Dr. Jane Bening

Editor's note: This is the first of a three-part update on menopausal hormone care.

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I know, the headline is not what your mother, doctor, TV, women's magazines, and walking buddies tell you. But, it's true. Of tsunami importance, it falls into the category of bad news travels fast, and good news dies away in a flash.

In March, the North American Menopause Society's Advisory Panel on Hormone Therapy issued new, liberalized guidelines for use of estrogen in the menopause. To disclose, I have been a medical speaker for numerous pharmaceutical companies manufacturing bioidentical estrogen.

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One crucial conclusion from the menopause society's experts: The large government – funded and now infamous Women's Health Initiative showed a decrease in breast cancer in the group taking estrogen alone.

These women had undergone hysterectomies. They were given oral conjugated equine estrogen (CEE), brand-named Premarin. This data was available in 2002 – (10 years ago.) when the negative outcomes seen primarily in women taking combined CEE and a synthetic, oral progesterone (Prempro), caused a misleading media blitz that inappropriately condemned all hormone use.

A follow-up study in the Journal of the American Medical Assn. in April 2011 of the women who took only CEE showed a statistically significant reduction in breast cancer over time.

On that fateful morning in 2002 when the bad news hit the air waves, 50 patients called my office asking "Should I stop my hormones?"

This debacle sent many generations and millions of American women reeling into hot-flash hell. Other symptoms include sleeplessness, weight gain, mental fogginess, sexual dysfunction, and thinner bones that fracture.

So, what do the experts say now?

In a recent interview with me, Dr. Holly Thacker, director of Specialized Women's Health at the prestigious Cleveland Clinic, stated that hormone therapy has been shown to decrease overall mortality in women by 30%. Check out Dr. Thacker's newsletters and blog at http://www.speakingofwomenshealth.com.

Dr. Philip Sarrel, professor of gynecology and psychiatry at Yale University for decades, estimates that only 15% of post-menopausal women are using hormone therapy. In addition to the spectrum of contemporaneous symptoms noted above, he is concerned about potentially more serious, long-term effects of low hormones, namely atherosclerosis and heart disease.

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