Researchers now report that women who take estrogen-only hormone replacement therapy (HRT) for a long period of time have a higher-than-average risk of developing ovarian cancer.
Typically, only women who have had their uterus removed take estrogen alone because the hormone is known to increase the risk of cancer of the uterine lining. Women who have a uterus take estrogen in combination with progestin, which cuts the cancer risk.
These results only suggest a link between ovarian cancer and estrogen replacement therapy and do not prove that ovarian cancer is a direct result of the estrogen.
Women who took estrogen for longer periods of time had a higher risk of the disease, and the researchers noted a 7% increase in risk associated with every extra year of estrogen use.
Those who took estrogen for at least 10 years were twice as likely to develop ovarian cancer and those who used the drugs for 20 or more years were three times as likely to develop ovarian cancer as those who did not take the hormone, the report indicates.
JAMA July 17, 2002;288:334-341, 368-369
Any physician who still believes estrogen reduces a woman's risk for heart disease should have his license suspended. Evidence to the contrary has been published in some of the most widely circulated, peer-reviewed journals for the last four years.
In addition to the study that received widespread media attention in the same issue of JAMA, this little gem escaped national attention. This is most likely because ovarian cancer is not as common as breast cancer or heart disease.
It is interesting that the association with breast cancer was only true for unopposed estrogen. If you were taking the progestin therapy there was not an increase in ovarian cancer. However, as we know from the other study published in JAMA, if you take the combination pill you will increase your risk of breast cancer and heart disease.
The obvious conclusion is that most women need to avoid HRT.
I can understand how a physician, and certainly the consumer, would be confused about estrogen. Twenty years ago, I was too.
In 1984 I was completing my residency and eventually did an additional year of postgraduate training were I compiled a preventive medicine review which focused on osteoporosis prevention and treatment. Since I was fresh out of medical school, and freshly brain-washed with the drug model, I was convinced that estrogen was one of the best things since sliced bread. I developed a lecture series about how beneficial estrogen was for preventing disease. I became a speaker for Wyeth in the mid 80s, and they actually paid me to fly around the country lecturing to physician groups about the benefits of estrogen for osteoporosis and heart disease.
Since then, a large number of studies demonstrating how dangerous estrogen is have been done. However, the drug companies knew this for many years. There was a clear deception foisted upon us by the drug companies so they could sell their hormone replacements. They were quite successful. Premarin has become almost synonymous with hormone replacement therapy (HRT).
Premarin was introduced in 1942, long before synthetic alternatives existed. It was the most prescribed drug in America each year from 1992 through 1999 -- perhaps the most prescribed drug ever. It generated more than $2 billion in sales for Wyeth last year alone.
Wyeth tried to preserve its market share. I was one of the physicians who received the "Dear Doctor" letters from Wyeth. The letter urged physicians to consider talking to patients about the "critical role" that one of its products, Prempro, has in relieving the symptoms of menopause.
However, the letter couldn't hide the facts. Estrogen increases your risk of breast cancer and heart disease. It makes no sense for any woman not suffering from menopausal hot flashes to be on it. Even with hot flashes, estrogen should only be used as last resort, and even then the lowest dose human forms of estrogen would be far preferred to Premarin.
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