By now you have probably seen or read the latest study regarding hormone therapy and the risk of breast cancer. I want to highlight some of the specifics of the report published in the Journal of the American Medical Association and explore any implications it may have in regards to bio-identical hormones.
It's important to note the recent JAMA article is a follow-up to the Women's Health Initiative (WHI) study reported in 2002. That study covered women, mostly in their 60's ( substantially after menopause) who had been taking synthetic (non-bio-identical) hormones orally (not the route we recommend) over several years. The WHI women used progestin, a synthetic hormone, not progesterone, a hormone naturally produced by our bodies with the same molecular structure as bio-identical hormones.
The 2002 study found a significant increase in the incidence of breast cancer, enough so that the study was actually discontinued. They also found increased incidence of strokes, blood clots, and heart attacks. However, it also found a decreased risk of hip fractures, total fractures, and colorectal cancer. Unfortunately, thousands of women were abruptly taken off their synthetic hormones without any mention of bio-identical hormone replacement as a viable option. Many were simply offered anti-depressants instead.
As we look more carefully at the WHI findings, and the JAMA report, there are clear reasons for the differences in results between these studies compared to multiple studies on bio-identical hormones. The WHI studies used synthetic hormones, including progestins, which are derived from pregnant mares' urine. The molecular structure of progestin (or any synthetic hormone) is different from that of the hormones produced by our own bodies, and these synthetic molecules do not fit precisely into human cell receptors designed for our natural hormones, causing these undesirable effects.
In addition, the progestins used in each of these studies as a substitute for natural progesterone are known to cause imbalances of the other sex hormones such as estrogens and testosterone. This imbalance diminishes or totally prevents their beneficial influences, such as estrogen's positive effects on the heart.
Progestins do not balance estrogen like progesterone does; this is an essential element for long term hormonal health. In fact, progestins actually decrease the body's ability to make progesterone and they plug up hormone receptor sites in the body, preventing the body from working appropriately. In fact, progestins have been shown to actually stop the positive effects estrogen has on the heart.
Since the follow-up study followed the same methods and looked at the same variables as the original study, it is not surprising we see similar outcomes.
It is interesting to note that another researcher at the National Institutes of Health, Dr. Andrew Kaunitz, who was not involved with the recent study, reviewed the report and posed some pertinent questions. He pondered how the outcome would be different if researchers had used natural progesterone, studied women right at menopausal age with a focus on health benefits as opposed to focusing exclusively on risks. Hopefully, future studies will look at these and other important differences.
For now, we don't see any solid facts from any of the reports we've reviewed to challenge the conclusions of multiple research studies with bio-identical hormones.
We always need to evaluate research findings, scrutinizing what was studied and compare that to what we already know. Breast health is an important issue for all of us, but let's not let headlines or even research study titles fuel the fear that all hormones increase breast cancer risks.
Here's to staying in balance!
Be well! 
Jane Kennedy
Nurse Practitioner
Gordon Medical Associates
Please send your comments or questions to me at:
jane@gordonmedical.com 
