Women's Health BHRT for Women What are the risks?
What are the risks?
You may be reluctant to start bioidentical HRT - many women are, even when they are aware of all the benefits—because they worry both about the side-effects and the reported risk of breast cancer. This is yet another reason that Optigenics chose to use bioidentical HRT.
We can manage side effects because we don’t use traditional HRT programs. Instead, our approach helps you maintain physiological levels of estradiol and progesterone by administering them transdermally (through our skin cream) while we continually and closely monitor your blood levels.
Remember that two basic principles of our hormone replacement program are: 1) We only put into your body the same hormones it naturally produces and at levels it has previously known (your physiological levels); and 2) We monitor your levels and results meticulously. Blood tests are affected by several factors. Commercially available blood tests cannot accurately measure a human’s blood levels when the hormones (as are often used in traditional HRT treatment) are extracted from horse urine. Recent studies by Dr. Elizabeth Ginsberg show us that when estrogens are taken orally and a woman consumes even a small amount of alcohol, her estrogen blood levels can be increased by 300% - substantially higher than even the peak levels a normal young woman might experience during her menstrual cycle. That very increase may be the cause of excessive vaginal bleeding and breast tenderness that many women experience when taking the standard dose of an oral ERT (estrogen replacement therapy).
Extensive and large-scale clinical trials of transdermal bioidentical HRT (BHRT) have not yet been completed. However, we can say that, having treated more than 1,800 patients since 1997, the side effects experienced by our patients were minimal, manageable, and reversible. For our clients having estrogen replacement (ERT), the most commonly reported side effects are breast tenderness and vaginal bleeding. Both are often eliminated or eased by reducing the dosages. Testosterone replacement therapy can worsen hair growth and acne problems in women who have a tendency to grow hair in unwanted areas or had teenage acne. Extended use of high levels of testosterone may cause the clitoris to become enlarged or the voice to deepen, but both symptoms decrease when we reduce testosterone levels. In short, when hormone levels are restored back to physiological (youthful) levels and are not allowed to reach supraphysiological (overly high) levels, side effects are easily managed.
The main obstacle for most women considering long-term HRT is the fear of breast cancer. We want to be quite clear that our position is: the non-medical media has overstated the breast cancer risk. The percentage, often stated by lay reporters, is that “one in eight women” on HRT will get breast cancer. That seems to say to women on HRT that they have more than a twelve percent chance of getting breast cancer regardless of their age. Do you want the truth? That 1 in 8 figure is only true after women reach the age of 85. For a 65 year old woman on ERT for 10 years, the risk of breast cancer increases from approximately 4.5 percent to 5.6 percent. The increase is quite small when compared to the benefits, but even it may be avoidable by taking bioidentical ERT, as prescribed in the transdermal form we use.
Remember the ERT and breast cancer risk research cited above that demonstrated how women’s estradiol levels tripled when they drank small amounts of alcohol daily while taking oral ERT? That research may explain this intriguing finding by Dr. Susan Gapstur and her colleagues: On analysis of the Iowa Women’s Health Initiative data, she discovered that the greatest increase in breast cancer risk was in the group of women taking oral estrogen and drinking the daily equivalent of at least a glass of wine. This, in all likelihood, results from those higher than normal levels of estrogen found in the Ginsberg study of the effect of alcohol intake on blood levels of estradiol in women using oral ERT. Still, this does not mean that women on HRT must completely abstain from alcohol. Because we use bioidentical transdermal estradiol, the increase in blood levels due to alcohol consumption is only about 30 percent. We can even mitigate that small increase because we make our transdermal creams to order for individual women using an infinite number of custom dosages.
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