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This is the perfect study to compare synthetic, unnatural hormones with bioidentical hormones.  Premarin was compared with bioidentical estradiol.  Premarin reduced the endothelial NO synthase transcription and activity by 30-50% compared to Estradiol.   Thus, premarin results in a lower NO production and thus greater endothelial dysfunction compared to Estradiol.

This was the WHI review of data as it pertains to dementia and cognitive decline in women.  The take home here is that the data provides little evidence for premarin with or without medroxyprogesterone acetate in > 65 for prevention of dementia.  However, this is in women > 65 and studies show that younger women do indeed receive benefit, especially in those with early ovary removal.  Another point here, MPA (medroxyprogesterone acetate) increases cognitive decline.  Just don't take MPA, it is a bad drug all the way around!

Premarin increases the risk of stroke in postmenopausal women.  The risk of hip fracture was reduced and no change in Coronary Heart disease was found.

Premarin and provera together increase risk of breast cancer development

More evidence of increase breast cancer risk with combined Premarin and Provera; this time post-surgery

Fantastic read on the effects of progesterone metabolism on tumor and cancer growth.  Tumorigenesis is not just about the hormone, hormone balance, but about the metabolism of hormones.  This is why premarin is so carcinogenic: it is primarily metabolized by the 4-OH estrone pathway.

This study found that increasing Testosterone, as determined by serum, is associated with increased CVD, insulin resistance, and metabolic syndrome in postmenopausal women.  I believe that this massive Testosterone doping campaign that we are seeing in men and women is following the same patter seen with premarin and provera. 

Prospective study finds that elevated total and free Estradiol levels in the follicular phase and elevated total and free Testosterone levels in both the follicular and luteal phase are associated with increased breast cancer in women.  The risk is for pre menopause in this study.  This and several other studies point to serious questions about the massive dosing of Testosterone via pellets, injections, and topicals for libido.  We appear to be following the same patter as seen with premarin, provera, now Testosterone in men and this may be the next ball to drop.  Is the Testosterone therapy merely producing an environment that feeds breast cancer?

This study cannot make the conclusion AT ALL.  They claim to say hormones should not be used to prevent chronic disease. Yet, the study they use to support this statement, the WHI, did not look at hormones.  The WHI looked at premarin and medroxyprogesterone acetate, a progestin.  They are not the hormones the body makes. Second, the WHI looked at women that were 6 years postmenopausal, on average, and then they added in bad drugs, disguised as hormone like, and then were dosed high.   If one desires to truly make a statement of prevention, one needs to pre-empt testing and therapy before disease.  Additionally, the study needs to match the hormones needed at the right physiologic level in the right balance.   One must also ensure proper hormone metabolism and know hormone receptor status.  This study does non of the above and the conclusion of this study is irrelevant.  In fact, I think the authors of this study have undergone scientific malpractice in their conclusions.

Estrogen therapy in women recently postmenopausal, found to improve symptoms of depression and anxiety.  The mean age of women in this study was 52.7.  Average age of menopause is 51, so apprx 1 year postmenopausal in this study.  Both premarin and bioidentical estradiol was used in different arms of the study.  Bioidentical progesterone was used in all 3 arms.