Hysterectomy and Bioidentical (Natural) Hormones

From the Hopkins Health Watch Q&As


Q: My question is why do all the M.D.s that I have seen since my total hysterectomy say “No” to progesterone since I do not have a uterus and if I used it, it is a cause of breast cancer? With or without a uterus and ovaries, medically does a woman need to supplement progesterone and even some testosterone?

A: As so frequently happens, the M.D.s you are seeing are confused about the difference between the synthetic progestins such as Provera, and bioidentical (natural) progesterone. They are not the same thing. You’ll find an entire chapter on the subject in What Your Doctor May Not Tell You about Menopause. In short, progestins contribute to breast cancer, strokes, heart attacks, backaches, mood swings, and much more. Progesterone does not. Progesterone is the same as the hormone made by your body, which is why it is called bioidentical.

Progestins were created by scientists in a laboratory. They don’t exist in nature. This is confusing to your body, which causes unwanted side effects. If your doctors insist that progestins and progesterone are the same, ask them why progesterone levels in a blood test don’t increase when you take progestins? Or why progestins aren’t used in fertility treatments? Or why progestins cause birth defects yet progesterone is the major hormone of pregnancy?

As to why your doctor doesn’t understand this, here’s a very short history of HRT in the U.S., starting in the mid 1960s:

  • Estrogen is given to menopausal women as an anti-aging remedy.

  • Thousands of women die of uterine cancer as a result of taking the estrogen.

  • Scientists figure out that estrogen needs to be “opposed” by progesterone. But progesterone is a bioidentical hormone that can’t be patented, so quasi-progesterones called progestins are invented that are very potent and have some, but not all of the effects of progesterone. All of the progestins have negative, even dangerous side effects that progesterone does not have.

  • Clever marketing by drug companies creates thousands of confused doctors who, to this day, do not understand the difference between progestins and progesterone. It’s right there in their medical school texts, but textbooks do not educate our doctors, drug companies educate our doctors.

  • Menopausal women are once again convinced by the pharmaceutical industry and their doctors that new combinations of estrogens and a progestin will protect them from uterine cancer and keep them young forever.

  • So many women complain about the terrible side effects of the progestins and refuse to take it that the medical rule becomes, “If you don’t have a uterus to protect, you can take estrogen alone.”

  • Millions of women have hysterectomies so that they can take estrogen without the progestins.

  • The Women’s Health Initiative Study shows that conventional HRT (estrogen and progestin) increases women’s risk of breast cancer, heart disease, gallbladder disease and strokes.

  • Millions of women go off of their HRT.

  • Now the doctors, still confused as ever, tell women that they don’t need progesterone if they don’t have a uterus, and that the progesterone causes cancer.

Doctors do not like being told that they are confused, but do you understand now just how confused they really are? They need to study their endocrinology textbooks and re-educate themselves about hormones. As long as drug companies are educating our doctors, we will be stuck in a dark age of medicine where profit rules and confusion reigns.

After a hysterectomy women not on HRT have twice the risk of dying from heart disease, brain disease and bone disease. It’s not just a lack of estrogen that creates the increased risk, it’s also lack of progesterone and testosterone. Hormones really do help! However, they help even more if they're natural hormones.

After a hysterectomy women not on conventional HRT have twice the risk of dying from heart disease, brain disease and bone disease. It’s not just a lack of estrogen that creates the increased risk, it’s also lack of progesterone and testosterone. Hormones really do help! However, it helps even more if the hormones are bioidentical.

After a hysterectomy, women on conventional HRT have an increased risk of cancer and strokes, thanks to the progestins and excessively high doses of estrogen.

According to two large European studies (see references below), women with or without a hysterectomy who use bioidentical hormones (e.g. estradiol and progesterone) have no increased risk of any disease.

If you want details on exactly how and why estrogen, progesterone and testosterone can help a woman feel better and live longer, please read What Your Doctor May Not Tell You about Menopause.

Campagnoli C, Abba C, Ambroggio S, Peris C, Pregnancy, progesterone and progestins in relation to breast cancer risk. J Steroid Biochem Mol Biol, 2005 Dec;97(5):441-50.

de Lignières B, de Vathaire F, Fournier S et al, “Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women,” Climacteric. 2002 Dec ;5 (4):332-40.

Fournier A, Berrino F et al, “Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study,” Breast Cancer Res Treat 2007 Feb 27.

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