Hormones and Lung Cancer

Q: I read an article saying there is an increase in lung cancer among women taking hormones. They did not specify if it applies to bioidentical hormones. Do you have any thoughts? Many thanks.

A: The research you refer to was compiled from data from the Women’s Health Initiative (WHI), and presented at a meeting of the American Society of Clinical Oncology. Among women using the HRT PremPro, there were 96 cases of non-small-cell lung cancer, compared to 72 cases in those taking a placebo. That difference wasn’t considered statistically significant, but there were 67 deaths among those who used the HRT, compared with 39 deaths among those who took the placebo—that was significant.

Among smokers, significantly more of those taking HRT died compared with those who didn’t take HRT.

In an editorial in the Journal of Clinical Oncology, lung cancer and estrogen expert Dr. Jill Siegfried of the University of Pittsburgh, theorizes that the estrogen in HRT accelerates the growth of lung cancer tumors. She cites research showing there are receptors for estrogen on lung cancer tumors.

As for bioidentical hormones, in the large French E3N Cohort study, in which the majority of women were using bioidentical hormones, there was no reported increase in the risk of lung cancers. However, it’s likely that it’s excess estrogen, or estrogen dominance, that is increasing the risk of dying in HRT-using women with lung cancer. In that case, it likely wouldn’t make any difference whether it’s synthetic estrogen, pregnant horse urine extract (Premarin), or bioidentical estrogen (estradiol) that a woman is using. This is yet another reason to use hormones in physiologic doses, or what the body would normally make, and to always use progesterone with estrogen.

Most women with measurable estrogen deficiency do just fine with an estrogen patch that delivers 0.025 to 0.05 mg of estrogen daily.

Siegfried JM, “Hormone Replacement Therapy and Decreased Lung Cancer Survival,” Journal of Clinical Oncology, Vol 24, No 1 (January 1), 2006.

 Hysterectomy, Evamist and Fluctuating Hormones

Q: Hello, I’ve just had a complete hysterectomy with a bilateral oopherectomy [removal of both ovaries]. I had the surgery because I was producing too much estrogen and too many androgens and was getting facial hair, acne, etc. I’ve seen homeopathic, TCM doctors and MDs for this and no one could help. I also had severe uterine prolapse, which is why I had the complete hysterectomy.

I’m on the “bioidentical” estradiol spray Evamist, which gives me 1.56 mgs of estradiol a day, and a low dose of estradiol tablet. I seem to continually fluctuate between symptoms of what seems to be estrogen dominance and/or deficiency.

I’m wondering if you could recommend a bioidentical progesterone cream, as I’ve read on your website that I still need progesterone even though I don’t have a uterus. I’m nervous about using a cream that contains testosterone, because I’m still showing signs of testosterone dominance, facial hair and acne when my estrogen level gets low. Thanks for your help and or recommendations.

A: You may want to consider first reading either What Your Doctor May Not Tell You about Menopause (you’re in surgically induced menopause), or Hormone Balance Made Simple. Either of those books will give you a good overview of how your hormones work and which symptoms may be associated with which hormone imbalances.

In short, excess androgens are usually associated with too many sugars and refined carbohydrates in the diet. The chronically high insulin this causes stimulates the ovaries to make androgens. Unless you had the surgery so recently that there’s still excess testosterone in the system, the fact that your ovaries are gone and you’re still having testosterone dominance symptoms may suggest that your adrenals are involved—have you had your adrenal function checked?

Relative to Dr. Lee’s dosage recommendations, the Evamist delivers a huge dose of estradiol—about a hundred times more than Dr. Lee recommended, and you’re right, he certainly strongly recommended against ever taking estrogen without progesterone, with or without a uterus.

Here’s where you can find a list of progesterone creams, all of which contain Dr. Lee’s recommended dose of progesterone. Some of them can be found at your local health food store.

Osteoporosis and Progesterone

Q: I am glad to see you are carrying on Dr. Lee’s work.

I have a mother whom has had osteoporosis and we are using progesterone cream to help with bone building. Is it safe to use the cream for a long period of time? My mother’s doctor indicated to her that she can only be on the cream for a couple of years. Is this true and can the progesterone cause any problems?

Thank you for your assistance in this matter and I look forward to your advice.

A: Your doctor is likely making the classic error of thinking that progesterone is the same as the synthetic progestins, which it is not.

When women used to ask Dr. Lee that question at his talks he would say, “Take it until you’re 90 and then we’ll re-evaluate!”

Be sure that your mother is doing the other important bone-building strategies, such as getting plenty of vitamin D, weight-bearing exercise and so forth—here’s a good article on preventing osteoporosis, and there’s also an extensive chapter on osteoporosis in What Your Dr May Not Tell You about Menopause.

Pregnenolone and Hormone Balance

Q: I feel like I am very close to having my hormones balanced using BHRT [bioidentical hormone replacement therapy] topical creams. I will soon receive my results from my saliva test. However, my chiropractor is recommending starting out with pregnenolone, then adding BHRT topical hormones that are missing. She thinks the body will first create what it needs using the pregnenolone and the missing hormones can be added for balance. What is you opinion of this method?

A: While this sounds like a good theory, the fact is that pregnenolone taken as a supplement will not convert to other hormones in the body. This conversion only occurs when the pregnenolone is made in the body. This has been tested by a number of hormone testing labs.

Too bad, as it would be very convenient to just take one hormone and let the body figure out the rest!