Hormone Replacement Therapy?

In This Chapter:

I think I'm picking up a pattern here. In the chapters on ADD, cancer, and antibiotics we found billion dollar drug industries coupled with growing millions of sick people, and little or no health upside. So, before researching the topic of estrogen, I admit my initial preconceptions about hormone replacement therapy for menopause were less than brightness and trust. The usual pattern seems to be:

- research studies funded by the same companies who propose to sell the drugs
- no conclusive positive results from controlled, randomized clinical trials
- A Drug In Search of a Market
- major side effects from the new drug therapy that are chalked up to the "disease" itself

Guess I'm jaded. So sue me.

You can tell you need prescription drug abuse treatment> when you're taking more than the recommended dosage, or when you go out of your way to get a prescription from anywhere else when your doctor refuses to fill one.

Trying to prove my preconceptions wrong, the research failed me. Anyone can see how the whole thing was set up. Now this chapter is not light reading, even though I tried. But if you are a woman, you need to read the whole thing. After that, you're on your own.

Drug hoax phenomena are not new. The same thing happened in the Boer War (Hadwen), in the Philippines in 1905 (Hume, p 200), and in Desert Storm. Mass administration of drugs that killed many more people than they saved. The difference here is that today the control of information has become much more sophisticated, the focus being trust your doctor, trust your doctor - you really don't have to understand the details. The target is the 30 million menopausal American women, and the game is the $1 billion HRT industry, a vertically integrated boom market.

Here's the basic story. Since the 1930s, American women have been trained and bullied into thinking that a natural normal event in their life - menopause - is a disease condition requiring treatment. Let's stop with that for a minute. If it's a disease, how did all the millions of women throughout history up to the present time muddle through it? How do Third World women or non-HMO lifestyles survive the ordeal? Keep those two questions in mind when you read anything mainstream, either advertising or articles.

The "new" "medical condition" requires drug therapy, which coincidentally has just recently been "discovered": synthetic estrogen - hormone replacement therapy. Does it work? Are women better off now? Does it really prevent osteoporosis? Read on!

What Is Menopause?

Menopause is a period of years in a normal woman's life in which gradual hormonal changes bring about a shift away from the physical powers of childbearing, in favor of a more mature condition of mental development. The unpleasant symptoms we have come to associate with menopause are common only in a small group of women in history: American and Northern European women in the past 75 years. Outside that group, menopause is not so problematic and is taken more in stride as a natural phase in a woman's life, with little fanfare. It seems that the more simple the lifestyle, and the more simple the diet - the more effortless the transition.

Throughout history, simple diet has been a function of low income. The most nutritious foods are the least expensive: whole fruits and vegetables, unprocessed dairy, whole grains. As lifestyle became more complex, and incomes grew, expensive, empty, processed, nutrient-deficient foods were popularized by marketing and advertising - the foods of commerce (Royal Lee). Less need to exercise, more focus on money, greater stress - the basic formula for the rise of the most resistant group of diseases in history : the degenerative diseases. Heart disease, cancer, arthritis, diabetes, osteoporosis - are epidemic in our society, the richest nation in history. Even 100 years ago such diseases were rare.

By now most of us have heard of a Shangri-La place in the Himalayas called Hunza Land, famous for longevity to 120 years old. Two Americans, Dr. Allen Banik and Renee Taylor, visited this isolated mountain civilization, one in 1958 and one in 1962. Both wrote books describing their incredible experiences. Both detail the simple diet as well as the lack of degenerative and infectious diseases. Physically cut off from the world by treacherous mountain passes, the Hunzas developed their own agriculture system of stone terraces, fed by the mineral rich waters of the glaciers. Hunza health is probably unequaled anywhere in the world, or in history. Symptoms of menopause were unheard of in Hunza Land.

In Japan as well as in many other cultures with basic, unrefined diets, there is no word for "hot flashes." As we shall see, the unpleasant symptoms of menopause are directly related to the amount of estrogen a woman has maintained during her adult life, prior to menopause.

Natural phytoestrogens (plant-estrogens) are found in plants like licorice, soybeans, alfalfa, and many others, in very small amounts. Phytoestrogens are weak estrogens and block the stronger forms. A diet abundant in phytoestrogens before menopause will do much to moderate the day-to-day estrogen level so that when menopause arrives, there will not be such big drop.

The Creation Of A Market:
How'd The Whole HRT Thing Get Started In The First Place?

The story really begins in 1938 with the discovery of diethylstilbestrol (DES) by Charles Dobbs. DES was supposed to be the first "synthetic estrogen" - an oxymoron, as we shall see. Dobbs first thought DES would solve the problems of menopause, but the AMA immediately began to make extravagant predictions for "preventing miscarriages" and solving all problems of pregnancy as well (Robbins, p138).

After many years, DES was being prescribed for a "safe pregnancy" and to "prevent miscarriages." By 1960 it was found that between 60 and 90% of DES daughters had abnormal sex organs, leading to high rates of infertility, miscarriages, and cervical cancer (Sellman p28). DES sons commonly had testicular dysfunctional and were often sterile. As for the mothers who had taken DES, their risk of breast cancer had been increased by 40% (Meyers p 143). DES was the first drug ever invented that could cause cancer in the offspring when taken by the mother (Reusch, p 22). But still the drug wasn't taken off the market until 1971! ( Kamen, p99). By that time the industry didn't need DES any more for its bottom line, because ERT was off and running.

Next Contestant

Public attention was then diverted away from the disasters of DES by a 1966 best seller called Feminine Forever, by Robert Wilson, a New York gynecologist. Wilson's thesis was that menopause is an estrogen-deficiency disease. All the unpleasant symptoms which accompany menopause were the simple result of too little estrogen. Insufficient estrogen supposedly caused a woman to lose her youth, beauty, cheerful attitude, and bone density all at once, with the onset of menopause.

Not missing a beat, the drug industry immediately donated $1.3 million to set up the Wilson Foundation for the sole purpose of developing and promoting estrogen drugs. The usual story: limited studies with inconclusive results, skewing results to please the company that was paying for the trials, discontinuing studies that weren't turning out "right" The primary study that was the basis for vaulting synthetic estrogen into the limelight, originally as a contraceptive, was a small, flawed trial done in Puerto Rico, in which 20% of the 132 women suffered serious side effects. Five of them died. Negatives were swept under the carpet as irrelevant - the main thing was that the new wonder drug supposedly canceled the "horrible" symptoms of menopause - hot flashes, vaginal dryness, migraines, etc. FDA approval for synthetic estrogen was given based on this one study! (Marshall) Throughout 1964 and 1965, fueled by the advertising power of the biggest clients, articles appeared in major women's magazines, like Vogue, Cosmopolitan, and Good Housekeeping proclaiming a breakthrough that would finally set women free from the ravages of the dread menopause. (Lee p24) Within a few years, with no real proof that Wilson was right, with superficial clinical trials, synthetic estrogen was being popularly prescribed, and a new industry was off and running. They called it Estrogen Replacement Therapy. Better living through chemistry.

A little snag came up in 1975. The New England Journal of Medicine (Dec 1975 p.1199) published its findings after studying the causes of endometrial cancer. They showed that women who took the new estrogen drugs had just increased their risk of endometrial cancer by a factor of five times. Unless they had been using the drugs longer than seven years. Then it was 14 times the normal incidence.

Sales slowed.

Yankee ingenuity to the rescue: it was found, though not conclusively, that rates of endometrial cancer could be reduced if synthetic progesterone were added to the synthetic estrogen. Synthetic progesterones are called progestins. So they changed the name from Estrogen Replacement Therapy to Hormone Replacement Therapy, and the show went on. Sales climbed back up, and then continued to grow. And grow.

With similar results to the 1975 study, 20 years later the American Cancer Society conducted a huge 13-year study of some 240,000 postmenopausal women to find the relation between HRT and cancer. Their findings: 40% higher incidence of ovarian cancer. After 11 years of HRT, the figure went to 70%! (Rodriguez)

How Could This Be?

As the HRT industry gained strength, the manufacturers began to make additional claims about the benefits of HRT, claims that were again unsupported by solid research:

- HRT could prevent osteoporosis
- HRT could prevent heart disease

The underlying, and unproven, assumption of this new "therapy" - HRT - was that women's lives were being improved now that they were spared the horrors of aging, menopause, osteoporosis, and the loss of femininity. Unfortunately, these promises are rarely kept, and almost never because of a program of synthetic hormones. Worse, the side effects of HRT have proven to be a bigger problem than what they were supposed to cure. It's sort of like the promise of Heaven that missionaries usually gave the natives down through the ages - unreal reward in exchange for real suffering.

To begin to untangle this giant web of double-talk and wrong information, we have to look at some basic endocrinology: Can't tell the hormones without a program. If this gets too complicated for the attention-challenged, just skip to the next section, but at least give it a try.

Hormones

are chemical compounds that are players in the most sophisticated and exquisitely balanced internet in the entire body: the endocrine system. This group of glands, including the adrenals, the pituitary, the ovaries, the testes, the thyroid, and the hypothalamus are interrelated in impossibly complex ways, about which we're just beginning to get glimpses of understanding. It's a swirling universe of chemical elegance and precision, involving millions of refined little molecular firings which wink in and out of existence every second. "Touch one strand and the whole web trembles," is the way endocrinologist Deepak Chopra puts it. The endocrine system controls all other systems of the body by means of chemical messengers, who wait for an answer.

What Is Estrogen?

Estrogen is a hormone, one of the moving parts of that endocrine system. It is a steroid (made from cholesterol) hormone, occurring in both men and women.

Estrogen's functions are primarily the growth and development of sex organs and other tissues related to reproduction (Guyton p1023)

For a basic overview of one little part of the endocrine system, John Lee has a very clear summary, like a recipe, for one group of hormones, those made from cholesterol, the steroid hormones:

[see chart]
- Lee, p15

A break down of the different hormones Lee discusses in the chart will give you a fuller understanding of the ways in which the endocrine system functions as a whole unit.

Prgnenolone - Synthesized from cholesterol by mitochondria of all cells of the body (except red blood cells), this molecule is the precursor to all steroid hormones.

Progesterone - A precursor to most of the steroid hormones, it is responsible for a myriad of important jobs from maintaining pregnancy to regulating menstrual cycles. Made primarily in the ovaries.

17α-OH-progesterone - A variant of progesterone, it leads to cortisol production in the adrenal cortex and to androstenedione from which all other sex hormones are made.

DHEA (dehydroepiandrosterone) - A precursor to the androgens, testosterone, and the estrogens, DHEA is important to protein building and repair. Most likely it has other important jobs as well that are still being discovered. It is made primarily in the adrenal glands. DHEA levels decline dramatically as we age, making it a primary biomarker of aging.

Androstenedione and Androstenediol - Androgenic (masculinizing) hormones, they are precursors to testosterone and the estrogens. Produced in the ovaries and the adrenals from either progesterone or DHEA, they are the source of estrogen production after menopause or loss of one's ovaries.

17-OH-pregnenolone - A modification of pregnenolone created in the adrenal cortex, testes, and ovarian follicles, it is used in the adrenal cortex and testes to create DHEA. In the ovaries it is an alternate step for 17μ-OH-progesterone production.

Testosterone - A male sex hormone that stimulates the growth of male characteristics and the production of sperm, it is also a precursor to the estrogens. It is made primarily in the testes but also in much smaller amounts in the ovaries. 

Estrone, Estradiol, and Estriol - Female sex hormones known as estrogen, they are primarily responsible for the growth of female characteristics  in puberty and regulating the menstrual cycle. They are made primarily in the ovaries but also from androstenedione in fat cells, muscle cells, and skin cells even after menopause. 

Corticosterone, Cortisol - They help regulate numerous bodily functions including glucose and energy balance; they also moderate inflammation and immune responses throughout the body. They are made in the adrenal glands.

Aldosterone - Made in the adrenal glands, it controls sodium and potassium levels in the blood and is important in regulating electrolytes and blood pressure.

Don't worry, there's no quiz. Dr. Lee just wanted to show a little corner of the complex give-and-take between hormones, how a change in any one hormone in this chart can affect many others. Lee and Chopra both speak of the dance of the hormones, the delicately interwoven choreography, about which we have only the most rudimentary knowledge.

We've begun fooling around with this highly tuned endocrine system because we've discovered a few coarse, synthetic, sledgehammer substances that resemble real estrogen, or real thyroid hormone, or real progesterone. But we really have only the vaguest notion what we're doing, because of all the overlapping interrelationships. Our ignorance has given rise to a brand new disease: endometrial cancer (Lee). Plus other big problems.

Back to estrogen. Estrogen is really a general term for three separate hormones:

estriol
estradiol
estrone

From here on out in this chapter, "estrogen" as is produced by the body refers to all three of the above hormones.

Estrogen is produced in three main places in a woman's body:

the ovaries
the adrenal glands
the fat cells

The main purpose of estrogen is to make the uterine lining, the endometrium, ready to implant a fertilized egg in the event fertilization occurs. To aid in this function, estrogen will promote

- water retention
- fat storage
- maturation of the female adolescent

All the above is OK if pregnancy is likely. But excess estrogen throws off the timing. Excess estrogen causes the body to prepare for embryo implantation all the time. This state of over-preparation is the cause of

- sluggish blood circulation
- migraines
- increased clotting
- high stroke risk
- disrupted copper/zinc ratios in brain cells/mood swings
- fibroids
- endometriosis

Every system in the body has a feedback loop to keep balance. Estrogen has a sister hormone called progesterone, whose functions are equally important.

What Is Progesterone, Anyway?

Progesterone is the other primary female hormone. It is produced in the ovaries. It is the precursor for both estrogen and testosterone, as well as all other natural steroid hormones (see chart above).

Progesterone's functions are

- maintains the endometrium in pregnancy
- new bone formation
- regulates blood pressure
- fat conversion
- sugar metabolism
- maintaining myelin (nerve insulation)
- regulates estrogen production

You'll remember that an egg is presented once a month from the ovaries, wrapped in an envelope called a follicle. After the follicle lets go of the egg, the egg journeys down the Fallopian tubes on its way to the uterus, where it awaits possible fertilization. The burst follicle still has an important job to do: it begins to produce progesterone, for the next two weeks. Progesterone's job is to maintain the uterine lining until one of two things happens:

- pregnancy
- no pregnancy.

If pregnancy occurs, progesterone production is taken over by the developing lining itself - the placenta. The burst follicle simply can't make enough progesterone for the demand, since the uterus will expand from the size of a lemon to the size of a basketball during the next nine months.

If no pregnancy occurs, the follicle stops producing progesterone, which triggers the collapse of the blood-rich lining, which is then expelled as the woman's monthly flow.

So the interplay between these two hormones estrogen and progesterone controls the entire infrastructure of reproduction, on a daily basis, after the onset of menarche (first flow) in adolescence. Estrogen creates the lining each month; progesterone maintains it.

Then what's the problem?

Estrogen Dominance

If estrogen levels get too high, progesterone can no longer keep the dynamic balance. This is exactly what happens in American women who live their whole adult lives with pathologically high levels of estrogen. Three main reasons for the high levels:

- over refined diet
- no exercise
- external toxic sources of estrogen : xenoestrogens

Refined carbohydrates, hard fats, empty foods and too much of it all serve to raise estrogen to abnormal levels, as much as twice the normal, which are maintained for the better part of the adult lives of most American women. (See Enzymes chapter)

Second, lack of exercise. Dr. Ellison of Harvard University found that estrogen levels are much lower in women who eat little and perform strenuous physical work, as in locales with non-industrialized lifestyle. The opposite is true for the American woman who eats too much and gets little exercise: abnormally high estrogen levels are the direct result. Dr. Lee points out the obvious corollary: menopause is a much bigger deal in our industrialized countries, because the estrogen decline is so radical - the difference between pre and post estrogen levels is significant. This hormonal rollercoaster dip is very stressful, and is the real cause of the discomforts of menopause.

Third, xenoestrogens. Huh? Xeno- means foreign. So the word xenoestrogen just means estrogens from outside the body. Many external toxins have been found to have estrogenlike effects in the body. Most are petroleum derivatives. Xenoestrogens are found in plastics, computer chips, PVC, pesticides, soap, clothes, DDT and other modern manufactured goods.

There has been extensive zoological research in the area of xenoestrogen effects on animals and the resulting birth defects. In studies of panthers, alligators, birds, turtles, seals, fish, and many other species from diverse parts of the globe, scientists are finding a common theme: feminization of males, decreased sperm counts, low male testosterone, and extremely high levels of estrogen in females, with plummeting numbers of offspring. Though some scientists had known about the problem for several years, public attention was drawn by a series of articles that appeared in three consecutive issues of the LA Times in Oct 1994.

Alligator offspring studied at University of Florida had very high estrogen and low testosterone as a consequence of a large pesticide spill in Lake Apopka near Gainesville. Again, gonad shrinkage was observed in males, leading to a drop in alligator reproduction in the lake estimated at 90% since the spill occurred.

Wild panthers in the Florida Everglades have had their sperm counts reduced by 90%, due to high estrogen levels from years of state dumping of DDT and other toxic pesticides into the swamp waters.

Between 1950 and 1970, some four million pounds of the pesticide DDT, illegal today, was dumped into the ocean in Los Angeles. Examples of eggshell thinning, gonad shrinkage and feminization in males, overdeveloped ovaries in females, and failure to thrive are some of the defects found in seagull studies at UC Davis by Michael Fry. In 1981, Fry published his research in the journal Science. Shrugged off for years by the scientific community, Fry's work is now being corroborated all over the world in dozens of other species.

Males are also affected. Think of the surfing implications for the L.A. spill --- "two girls for every boy"??? Not any more. Declining sperm counts in American males in the past 30 years is well documented. An article in Lancet, May 1993 estimates a drop in sperm count of 50% in the past 30-50 years, and links the decline to environmental estrogen mimickers.

Xenoestrogens, as well as a modern high-fat diet, are lowering the onset of menarche for young girls. In 1900, American girls matured at 14. Today the average age is 12, and for some groups is as early as 8 years old! (Beaton).

The effects of DDT and PCBs are often hidden, and often don't occur until many years later in the offspring of these exposed animals. Birds are born with twisted bills or deformed reproductive organs. Other animals have physical characteristics of both male and female, but can't function normally as either one. The reason DDT and PCBs were outlawed was that they don't break down; they persist unchanged in the environment for years and years, still capable of the same trauma to living cells. These chemicals simply don't degrade.

The effect of hormone-mimicking pollutants, the xenoestrogens, is being kept under wraps, because of its obvious implications for liability by the chemical manufacturers. Chemical contamination is not limited to a few isolated areas. It is a global problem, beyond the scope of this chapter. The reader is directed to Theo Colburn's startling book Our Stolen Future for a better look.

The point is, we are in the same ecosystem, the same food chain, the same biosphere as these animals. Human DNA is 98% identical to that of an ape. Our cells and tissues are susceptible to these same distortions. It is no coincidence that the women of the industrialized nations of northern Europe and the United States have two things in common:

- the highest rates in history of breast cancer, endometrial cancer, and HRT consumption
- high exposure to plastics, chemicals, computer chips, pesticides and other xenoestrogens

John Lee talks about the "sea of estrogen" in which we exist as the result of many factors:

-fat soluble hormones in meat
-PCBs (polychlorinated biphenyls)
-DDT
-foaming agents in soap and detergents
-cosmetics
-condom spermicides
-tons of pesticides, herbicides
-plastic cookware
-birth control pills
-HRT

The pathway of causation is clear: xenoestrogens maintain estrogen levels at double the normal values for the entire adult life of the human female. As the complementary hormone that's supposed to balance the delicate system of sex hormones, progesterone is simply overwhelmed by the dominant estrogens. Natural hormones are subtle and fragile and transient. Xenoestrogens by contrast are harsh and strong and long-lasting. Progesterone just doesn't stand a chance. HRT is just another xenoestrogen, making things worse.

Let's take a look at some of the Consequences of Estrogen Dominance.

Consequences of Estrogen Dominance

As estrogen levels build up to twice the normal level, many systems of the body are adversely affected. Body fat stores increase. Fluids are retained, causing bloating and edema. There are defects in both fat and sugar metabolism, often severe enough to cause diabetes. Risks of endometrial cancer are increased to 5-14 times, as cited in the 1975 NEJM articles above. Promotion of osteoporosis. Slow onset of blood poisoning (toxemia) due to inability of chemical xenoestrogens to be broken down. This in turn obviously contributes to autoimmune disorders like lupus, chronic fatigue, and arthritis, in which the body begins to attack its own cells as they become so toxic that they are unrecognizable as "self." Alteration of zinc and copper uptake in brain cells causes mood swings, a nice euphemism. Incidence of stroke increases 50% with estrogen, according to an extensive project, known as the Boston Nurses Questionnaire Study, of 121,000 nurses (Stampfer).

Normal estrogen stimulates breast and endometrial tissue. Excess estrogen causes excess stimulation of breast and endometrial collagen, resulting in fibroids in both locations (McDougall, p 87).

Another health detriment of estrogen is its destruction of B vitamins. Nutritionist Jean Sumption documents the opposition of estrogen with Vitamins B1, B2, B3, B5, B6 and other B-complex vitamins: Biotin, Choline, Folic Acid, PABA, and Inositol. Most functions of cell metabolism depend on B vitamins. Symptoms of depletion include fatigue, sluggish memory, hair loss, and aging.

This is only a partial list. It should be obvious that effects like these are systemic (everywhere the blood goes) and as such can affect practically any weakened tissue in the body. To say that drugs and chemicals cause a downward spiral of health is not just a metaphor. A growing number of medical researchers (see References) who do not represent the interests of the drug cartels are stepping forward to show that the symptoms of menopause are not caused by too little estrogen, but by too much. To turn popular opinion around 180° from nature and trick American women into thinking that at menopause symptoms and postmenopausal dangers are caused by insufficient estrogen - once again, we are looking at mastery in the control of information. The motivation is simple: $1 billion per year.

Synthetic hormones are not harmless. The side effects of HRT are often the same or worse than the original menopause symptoms they set out to cure.

Side Effects of HRT

-increased risk of breast cancer
-increased risk of endometrial cancer
-osteoporosis
-blood clots
-high blood pressure
-vastly increased rate of heart attack
-skin reactions
-hair loss or gain
-fluid retention, bloating
-vaginal bleeding
-rash, acne
-breast tenderness
-hair loss
-weight gain

and

- Depression (Obstet and Gyn, 1992 80:30)
- Breast cancer (NEJM 19 Jun 97; 336:1821)
- Stroke ( NEJM 1991 vol 325 p 756)
- Lupus (Lee p258)

But wait a minute! I thought everything was supposed to be fine once they added synthetic progesterone to the synthetic estrogen. That's what everybody was supposed to think. But the real stats don't show it.

John Lee, MD, a California endocrine researcher, explains why. Simple: HRT's synthetic progesterone is completely altered after going through the digestive system, when it gets to the liver. The liver changes it into three other metabolites. Any benefits are thus canceled. So the big change in the 70s from ERT to HRT was largely a change in public perception, due to drug advertising, and its second cousin, peer-reviewed medical journal articles.

Dr. Lee's view, and that of other proponents of natural progesterone products is that the problems at menopause are not caused by lack of estrogen, but by lack of progesterone. Remember that estrogen production drops 40% at menopause. Well, progesterone drops to 0%. And look at all the things it's responsible for. The synthetic progesterone in HRT isn't doing any good, since it's being changed into something else in the liver. It's not real progesterone. Therefore the estrogen is still unopposed.

The Anovulatory Cycle

Many American women in their 20s and 30s have monthly cycles in which they don't ovulate. That is, an egg is not released from the ovary. Such a widespread phenomenon is a new twist in human evolution. There are obvious reasons, as well as serious effects which accompany this unnatural process - the inability to reproduce - now taking place in so many adult females.

The reasons for anovulation are simple: severe biochemical imbalance and stress. The xenoestrogens.

We are in the same biosphere, the same food chain as all the animals mentioned above who have experienced reproductive chaos from chemical pollutants. Why should our species be exempt? It isn't. We drink the water of the same planet, eat fish and plants and meat laced with the same immortal PCBs and DDTs - it's a closed system.

Stress obviously promotes biochemical imbalance by overtaxing the adrenals, which then steal progesterone to make more adrenal hormones, which further promotes estrogen dominance. Coffee is a big culprit, as well as soft drinks. A Johns Hopkins study found that women who take in more than 300 mg of caffeine per day (three cups of coffee, or eight sodas) reduce their chance of conception by 26% (Hernandez-Avila).

Effects of a female going through adulthood without being physically able to reproduce? Look around you. See any sexual ambivalence in any areas? I'll spare you my theories on contemporary social phenomena. But the physical effects of anovulation are a very clear result of the disruption of the fragile endocrine balance that has taken eons to evolve. One obvious ill effect of menstruating without ovulating as well as too much estrogen is the over-stimulation of the endometrial lining. After a time, the excessive monthly lining promotes irregular lumps of connective tissue known as fibroids to form.

Too easily and too readily, the buzzword "pre-cancerous" comes up, with the snap prescription for a completely unnecessary hysterectomy. Between 600 thousand and one million hysterectomies are performed on American women each year, 90% of them unnecessary, according to Stanley West, MD. That story is beyond the scope of this chapter except to raise the red flag that estrogen dominance sets the stage for most of the "irregularities" which end up with a prescription for hysterectomy. The reader is referred to Dr. West's book The Hysterectomy Hoax for a dark journey. Also the first half of John Robbins' Reclaiming Our Health.

What's Wrong With What Most Women
Are Told About Menopause?

The standard line is that menopausal women need estrogen therapy to prevent osteoporosis and other menopause symptoms because the body has stopped making its own estrogen. HRT (synthetic estrogen + synthetic progesterone) will take up the slack. HRT is routinely recommended in practically any situation, physical or mental that can be even remotely tied to menopause.

What the drug industry has conveniently ignored is that at menopause, estrogen output drops only about 40% (Sellman, p16). Ovary production of estrogen drops way down below the level necessary for reproductive function. But adrenal and fat cell outputs of estrogen keep on going in order to maintain the other important endocrine functions of estrogen, which are not directly related to reproduction:

-bone building
-electrolyte balance
-insulin balance
-fat and protein metabolism
-cholesterol synthesis

--Guyton, p1024

That 40% figure is only for American and Northern European women, who have the highest estrogen levels in the world. In non-industrialized countries, the drop is much less, primarily because their normal level of estrogen is so much lower. What is commonly ignored is that progesterone levels drop to 0% at menopause, and progesterone is necessary to keep a balance with estrogen.

So do the math: if an American woman has had estrogen levels that are double the normal for most of her adult life, and at menopause, estrogen only drops 40%, that means she is still operating at 120% of "normal," compared with an agrarian-type, non-industrialized woman. But with this estimated 120% of normal estrogen, after menopause, there is NO progesterone to offset it. Estrogen dominance is a new phenomenon in nature, created by modern society, and modern medical politics.

Why Is Fake Estrogen Not The Solution?

Synthetic estrogen dosage is way too much, and too weird, for the body to deal with. Synthetic hormones have molecular forms that do not occur in nature. They are man-made. The dancing of the hormones in the above chart is seriously disrupted by adding hormone-like chemicals than can mimic some of the functions of real hormones, but cannot maintain their role in the ever changing back and forth swirling biochemical dance that is taking place every second in the normal body. These fake hormones are insensitive to the body's requirements for instantaneous alteration into another member of the hormone chart.

Aspirin is made from the bark of the white willow. People have been using white willow bark for centuries as a mild pain reliever. But white willow bark cannot destroy the stomach lining on contact the way aspirin does. In the same way that aspirin is not white willow bark, synthetic estrogen is not estrogen. And synthetic progesterone is not progesterone.

The main problem with synthetic hormones is that they last too long. All the natural hormonal feedback loops, which we do not even completely understand, are disrupted because the synthetics can't act as precursors to the changing hormonal forms in the same way that the natural hormones do. The hormone system becomes fragmented with millions of one-way orders that are supposed to have return messages. As long as synthetics keep coming in, there's no way to de-frag the system. The result is loss of proper interplay between the reproductive, adrenal, and thyroid systems. They all suffer.

American women arguably are among the most stressed people in history, emotionally and nutritionally, as well as environmentally. It is well known that stress depletes the adrenal glands. When this happens, progesterone is converted to adrenal hormones, like cortisol, to take up the slack and try to keep up with adrenal demands. Remember, progesterone is their precursor, in the above chart. The result is further depletion of progesterone, again promoting estrogen dominance.

The above list of side effects of HRT is caused by one simple thing:

Unopposed Estrogen

Too pure and too much. And no progesterone.

So this is why cancer risks with HRT remain much higher than without HRT. The connection between HRT and cancer is really quite logical when you consider the normal functions of estrogen: controlling areas of rapidly dividing cells in preparation for reproduction. Unopposed estrogen, as we've known since the 1970s, upsets the normal endocrine balance. And where does the imbalance appear? Rapidly dividing cells of the reproductive tissues: endometrium, ovaries, breast. Perhaps nature did not intend for these tissues to be going wild at this time of life, when the reproductive system is supposed to be going out of business. Wouldn't a tissue defect like cancer be a natural result of artificially jump-starting tissues which want to start winding down a little? Especially when the hormones are of the imitation, man-made, designer variety?

Dr. Lee underscores one amazing fact: the only known cause of endometrial cancer is unopposed estrogen!

Unopposed estrogen is actually heightened by giving standard HRT because of the increased ratio of estrogen to progesterone. Research has never proven that estrogen deficiency causes cancer, but many studies have shown that progesterone deficiency does. A Johns Hopkins study of 1000 women showed that progesterone deficient women had a tenfold increased chance of dying from cancer compared with women who have normal levels of progesterone (Cowan).

Jerilynn Prior, MD a world authority in endocrinology says that describing menopause as an "estrogen deficiency disease" is the same as describing headache as an "aspirin deficiency disease." She calls this type of thinking 'backwards science.' Illnesses cannot be categorized by which drugs they are missing. That would assume that drugs cure illnesses, which almost never happens. Especially not in the case of HRT. Menopause is not an illness.

So Why Don't Gynecologists Prescribe Progesterone?

Some do. The problem here is that natural sources of progesterone are easy to find and inexpensive to make from many plants sources. As such they cannot be patented. This is a central point to keep in mind, perhaps the most important idea of this chapter. There are inexpensive plant-based phytoestrogens and natural progesterones which can control most estrogen imbalances, especially when incorporated into a detoxifying low-stress diet. Synthetics (drugs) are rarely necessary. But only drugs can be patented. There is no way to make massive profits from a natural plant source, and you have just heard the primary reason for the organized attack on holistic supplements that is under way in the US today. Natural risk-free products are a threat to the drug trade. Drug concerns develop chemical compounds that are almost like the natural hormone. But almost only counts in horse shoes and hand grenades. Maybe the synthetic compound is only different by an atom or two. Perhaps it can mimic some of the activity of the real hormone. After that, it is only necessary to create a market by control of information, by controlling the outcome and publishing of clinical studies, and by controlling regulating agencies, using political and legal tactics. But that one-atom difference in the shape of the molecule is all the difference in the world, in terms of breakdown, toxicity, and side effects. Understanding this paragraph will go far in explaining many of the contradictions of HRT, the unanswered questions, the indirect answers, the arrogance one encounters.

Where Do These
Designer Hormone Replacement Drugs
Come From Anyway?

The most popular synthetic estrogen is a drug called Premarin, made from the urine of pregnant horses! This is no joke. Manufactured by the Philadelphia pharmaceutical giant Wyeth-Ayerth since 1942, an estimated $940 million per year (Sellman p5) worldwide is generated by the sale of this one drug. Most estimates are that at least 75% of HRT drugs contain Premarin. Since 1993, Premarin has been among the top three drugs in the US in gross sales (National Center for Health Statistics).

In 1992, Wyeth-Ayerth spent $9 million just for advertising Premarin! Their ad execs came up with the brilliant phrase "untreated menopause." That same year Premarin was the #1 drug prescribed in the US (Robbins, p 140).

This is marketing mastery.

Before we consider the effectiveness of this drug, let's briefly look at the circumstances involved in its preparation.

Some 700 "horse farms" are set up in remote areas of the United States and Canada. Most of them have extensive security, and with good reason. At any one time, some 80,000 or so horses suffer the slow torture of life as a lab rat. Each mare is strapped into a tiny stall in which there is no room to lie down or even turn around. For seven months of the 11 month pregnancy, the horse is immobilized in the stall, hooked up to a catheter which collects all her urine. She is deprived of sufficient water in order to make the urine more concentrated, thus raising its value to the drug company. Infections frequently occur at the site of the catheter and from the restraining apparatus. Liver and kidney disease are common.

The foals themselves are referred to as "byproducts" by the manufacturing company and are generally sold to the slaughterhouse. The mare is immediately impregnated after she has given birth and soon is imprisoned back in the tiny stall for another run. After about 12 years of this horrible life, the mares are themselves slaughtered and sold for dogmeat.

This has been going on for 56 years! Over one million horses have been cruelly abused in this way.

In Canada, the foaling generally takes place on open prairie. Mother and foal are immediately separated, and most of the foals die. The ones that survive are extremely stressed, and with good reason: they are sold to slaughterhouses and shipped to Europe and Japan where certain cuts are regarded as delicacies.

I think you get the point. For more details follow up at www.allrealgood.com Information like this tends to suggest that agencies like the ASPCA are basically PR fronts focusing on self-promotion and making sure dogs in Jack Nicholson movies get enough overtime.

Even if Premarin were the true answer to all of menopause's annoyances, reviewing the above data should be enough for any sane person to feel some twinge of guilt about contributing to a program of such horrendous cruelty. Menopause can't be that bad, can it? But the reality is that Premarin and other HRT synthetics do not work, do not do what they're supposed to do, and have major side effects. If you have any notion whatsoever of universal harmony or equilibrium, it seems logical that we're not gonna get away with this. And we don't. The first payback is one of the biggies: cancer.

(I have this great role-reversal premise for a novel, which describes an Afterlife in which the animals owned by humans in this life later are reincarnated into the position of Master themselves, with their former owners as pets. Pretty cool, huh?)

Henry Lemon MD of the University of Nebraska College of Medicine feels that an unnatural imbalance is caused by putting horse estrogens into a woman's body. The body does not allow two of the three naturally occurring estrogens, estradiol and estrone, to hang around very long. It converts them into the non-carcinogenic estriol, as soon as possible. Such a helpful conversion cannot happen with Premarin because of the amounts involved. So the propensity for cancer is clearly seen: the carcinogenic forms are allowed to persist.

Premarin was approved by the FDA over 50 years ago, when requirements were much less stringent. There are many unknown ingredients in Premarin which may be normal in a horse, but not a human. It is likely that these are instrumental in the abnormally high rates of uterine and breast cancer following HRT, which rates are anywhere from a 30% to a 600% increase above normal, depending on the study (Lee).

Are women informed? Hardly. Information like the above is very bad for business.

Many phytoestrogens from plants are now available, as well as generic synthetic Premarin substitutes. With clever legal maneuvering however, Wyeth-Ayerth has successfully blocked the generic substitutes from FDA approval by a twist worthy of Johnny Cochran. They have claimed that the generics do not contain one of the unknown elements that Premarin contains, which is true. However it is more likely that the unknown element - 8,9 dehydroestrone sulfate - is toxic, not beneficial! Even the FDA regards 8,9 dehydroestrone sulfate as an "impurity" and yet the FDA will not approve the generics because they don't have it! As all throughout history, today more than ever, politics controls "science."

Osteoporosis

As if cancer risk is not bad enough, let's look at another of women's greatest fears: osteoporosis after menopause. Here is a simple topic about which most women have been completely duped. Standard "common sense" inculcated by media, advertising, and their Ob/Gyn-drug reps warns women that they must take estrogen and calcium or else they will experience bone loss. This false notion is one of the truly great masterpieces of modern disinformation.

First of all, there are no valid, randomized clinical studies which demonstrate increased bone mineralization following HRT.

Bone is not what you see left on your plate after you're done with your medium rare T-bone steak. In the body, bone is living tissue, with rich networks of blood vessels and nerves. Bone is constantly being torn down and replaced by specialized blood cells. Every seven years, your entire skeleton is completely replaced.

Bone has a matrix, or framework, on which calcium is laid down. In America, everyone gets enough calcium. True calcium deficiency results in a disease called kwashiorkor, which is found only in Third World starvation countries, not in America. Osteoporosis is not a disease of calcium deficiency. It's a disease of matrix deficiency: the framework got flimsier. There isn't as much matrix to attach the calcium to. There's plenty of available calcium. Calcium is an inert mineral contained in most foods. The body maintains the blood levels of calcium at a certain level. Anything extra, like in calcium supplements, is spilled out of the body by the kidneys, because it's over the normal blood levels. If there's only so much framework, it really doesn't matter how much calcium is in the blood; the excess is spilled out.

Keep in mind that most calcium supplements don't even make it into the bloodstream, especially if they're tablets. They never even get dissolved in the digestive tract; they pass right out of the body. This you can prove to yourself by placing a calcium tablet in a glass of water and leaving it there all night. Most of them don't dissolve.

Even the calcium supplements that do make it into the bloodstream are mostly spilled out, for the above reasons.

In short, calcium supplementation will not increase bone density in pre-menopausal women, nor prevent it post-menopause (Ettinger, McDougall). Doesn't matter what your latest MLM rep tries to tell you.

American women don't get osteoporosis because they lack calcium, or estrogen. Anybody who does a little research knows this. The countries with the highest rates of osteoporosis on earth are Scandinavia, England, Australia, and the US These are also the places with the highest consumption of dairy products (McDougall, p176). It is pasteurized milk, cheese, and butter which leach calcium from the body, since these enzymeless, artificial, modern foods cannot be easily metabolized. The processes of removal from the blood takes a lot of calcium stores from the teeth and bones (Recker).

The definition of pasteurization is removal of all enzymes via heat. One of the enzymes in milk thus denatured is phosphatase. Its purpose? Calcium absorption. Without phosphatase, calcium absorption doesn't happen.

But wait! What about milk as a source of calcium, building strong bones and good teeth and all that? and you never outgrow your need for it, and all those movie stars with the moustaches? Marketing. Advertising. Promotion.

Who do you think pays for the dietary educational tools used in American schools since the 1950s - you know, the four food groups, and all that? The American Dairy Council and the dairy industry. The whole story is better told in Twogood's book No Milk, available anywhere.

Processed foods are indigestible. The stomach keeps pouring out the gastric juices, in the form of HCl (hydrochloric acid) but it's not enough to break down these weird manmade chemically preserved foods. The food just sits there in the stomach and rots. The abundant HCl may get splashed backward into the esophagus, causing reflux (heartburn). What is the medical solution? Prilosec, which does what? Right. Inhibits production of HCl. Does this aid digestion? No. The undigested food still sits there and rots. Worse news: guess what is required for calcium absorption in the stomach. HCl. Prilosec in this way directly contributes to osteoporosis.

Another reason Americans lose calcium from bones and teeth is acid-forming foods: soft drinks, too much meat, white sugar. All these tend to acidify the blood. If the blood gets too acidic, death will result. For self-preservation, the body must neutralize all this acid, maintain blood pH between 7.3 and 7.45. The process is called buffering, and it requires calcium. When there isn't enough available, the body steals calcium from the bones and teeth. This is why Robert Heaney MD says that eating a high protein diet is like pouring acid rain on your bones. Perhaps a bit overstated, but the point is that a high protein diet is the primary cause of osteoporosis. Not insufficient calcium (McDougall, p171).

It's true that Americans have a high rate of osteoporosis, not just women. But this has nothing to do with estrogen.

Do horses gets osteoporosis? Never. What do they eat? Grass. How about cows? Are they taking Cal-Mag? Do they take Premarin? Calcium is in all foods.

Do menopausal horses get osteoporosis? Negative. Do menopausal third world women get osteoporosis? Negative.

So if HRT is not going to reverse osteoporosis, what will? Reducing pasteurized dairy intake, and other artificial foods, like white sugar and soft drinks.

Not only is there no proof to support the fantasy so many doctors offer their patients - HRT will save you from osteoporosis - there is abundant research that shows that synthetic hormones actually have no effect whatsoever on preventing bone loss. One of the most noted of these is the 14 Oct 1993 study in the NEJM, which conclusively shows that the risk of hip fractures for women over 75 is the same whether or not the woman took synthetic estrogen. Hip fractures are the greatest fear of aging people, as well as a prime indicator of osteoporosis. The article goes on to note that most women believe their physicians when they say that HRT will prevent osteoporosis, yet here is proof that it doesn't. The authors state that estrogen therapy is simply unable to prevent loss of bone density.

Taking synthetic estrogen cannot rebuild bones. It can temporarily slow the rate of bone loss, but when the HRT is stopped, osteoporosis soon catches up like the woman never took HRT at all. Is that temporary benefit worth a 9-14 times greater risk of cancer? Dr. Lee thinks not (Lee, p152).

In addition, many common drugs cause osteoporosis. Millions have been duped into the thyroid scam - told they were overweight because they were 'hypothyroid.' Synthroid to the rescue. What the doctor never tells you is that Synthroid stimulates osteoclasts to resorb bone (Physicians Desk Reference). Remember how bone is built by living tissue? Well, that happens with the simultaneous action of two complementary types of blood cells: osteoclasts for tearing down old bone, and osteoblasts for building new bone. Obviously an imbalance in either one of these will cause a problem.

Turning Bone To Marble

Other non-estrogen drugs which are prescribed to supposedly reduce the chance of osteoporosis, have serious side effects. In his video, Dr. James Lee outlines the dangers of a very popular drug named Fosamax. It's actually quite simple. Again, living healthy bone must go through a constant process of old cells being replaced by new cells, so that every few years we have an entire new skeleton. Osteoclasts are cells that tear down bone; osteoblasts build new cells in those spaces. Got that? OK. The intellects behind Fosamax have decided that if they can stop the osteoclasts from doing their normal job of tearing down bone, this will prevent osteoporosis. How? By the buildup of Fosamax crystals in the bone, which just stay there long after a normal lifespan, which artificially stops the removal system - the osteoclasts. Now there are no spaces in which new bone cells can form. The Fosamax crystals cannot be broken down by the body, and remain in the bone for 15 or 20 years, taking up space, and offering an artificial, plastic-like composition in what should be normal healthy bone. Dr. Lee tells us that modern Fosamax is 1000 times more potent than the original drug.

Even the manufacturers caution against indiscriminate long term use of this drug: on p 1657-8 of the 1998 Physicians Desk Reference we find that:

"bone formation is ultimately reduced Fosamax decreases the rate of bone resorption [tearing down] directly, which leads to an indirect decrease in bone formation."

Decreased bone formation? Does that sound like something that's going to maintain normal bone and prevent osteoporosis in your golden years? Dr. Lee and many others don't think so.

The PDR also tells us that they have no idea what effects Fosamax may have after four years! (p1661)

Here we have a prime example of the philosophical difference between allopathic and holistic medicine: they forgot that Mother Nature Always Bats Last. You can't arbitrarily interfere with one half of a complete life process like bone synthesis and expect no adverse consequences. With Fosamax, we have arrogantly overpowered the body's normal system of bone building which has developed and maintained the skeleton just fine for the person's whole life, by pretending that one phase of that system exists in isolation from the whole rest of the endocrine Internet, and can be omitted with no consequences.

Doctors trick women by telling them that Fosamax will increase "bone mineral density" but what they don't tell them is that the new mineral is not calcium and is no longer part of the living dynamic process which has maintained their bones their entire lives.

This is not yet even mentioning the side effects of Fosamax:

- kidney disease
- ulcers
- heartburn
- joint pain
- headache
- rash

Fosamax is a risky, artificial approach to osteoporosis which pretends like the problem can be divided up into separate, distinct unrelated phases, like with a car. Same old idea, over and over: another drug in search of a market.

Same old story. Osteoporosis is big business. Big business to keep it happening, and big business to treat it. The dairy industry, the meat industry, the soft drink industry all keep it happening. The HRT industry, the nursing home industry, and the hospitals gain from the treatment of osteoporosis. John McDougall explains:

"The diagnosis and treatment of osteoporosis is so profitable because millions of people unwittingly weaken their bones, making them dependent for the rest of their life on diagnostic tests and drug therapy that slows the disorder but never cures it."

- The McDougall Plan - p172

Another area of major disinformation with respect to HRT is

Heart Disease and HRT

Unsupported claims are made actually claiming that HRT will help prevent heart disease. There seems to be no limit to what they'll say. It's pretty hard to reconcile such a recommendation with the fact that cardiovascular disease is stated as a clear contraindication for most estrogen drugs. Contraindication means a situation where the drug can't be prescribed (Br J of Obs and Gyn Feb 1997;104:163 also, PDR. 1998).

We all know that one in two deaths in the US is from heart disease. What is less commonly known is that heart attack in the premenopausal woman is virtually unheard of. Yet 10 years after menopause, and especially if the woman is on HRT, the rates soon come up equal to men's rates. Just a little research uncovers the likely reasons behind such a phenomenon. In his videotape What Your Doctor May Not Tell You About Menopause, John Lee MD notes that HRT is the number one cause of increased rates of heart attacks in postmenopausal women. Why? In a word, vasospasm. The word means tightening of a blood vessel.

The coronary arteries are the ones that supply the heart with blood. They are also the ones that get blocked in heart attacks, and therefore they are the site of bypass operations. They are what is bypassed. The most popular site is the Anterior Descending Coronary Artery.

In males who are screened for bypass, the Anterior Descending may be 80 to 95% blocked, and surgery will be recommended. If death comes first, on autopsy these high rates of blockage are observed.

In postmenopausal women, however, autopsies frequently showed only a 30-50% blockage of the artery, yet death was due to heart attack. Researchers couldn't understand what was happening for the longest time. So they began to do angiogram studies with Rhesus monkeys - animal abuse in the classic Pasteurian tradition. Angiogram, you remember, is where they X-ray the arteries after injecting dye into them. Now monkeys don't go through menopause, so they had to create it for the study. The way they did it was to first remove the ovaries. To induce heart attack they injected Provera, which is a synthetic hormone used for human birth control. The results were "unrelenting" vasospasm of the coronary artery which means that the artery which had as little as a 30% blockage constricted down to complete closure and would not open up again no matter what they tried. Obviously this killed Ms. Monkey in the ensuing heart attack. So the researchers realized that HRT was the missing factor that was responsible for heart attacks in postmenopausal women whose coronary arteries were less than 50% blocked. Did you read that study anywhere in Newsweek or in the Chronicle? Information like this that challenges a billion dollar HRT industry is systematically buried.

If natural progesterone is added to the Provera, the artery does not go into spasm. This data was according to a study done in England at the London Institute of Heart and Lung Research by Peter Collins MD. Again the point here is that natural progesterone is unpatentable. It is not a drug. They can't make a ton of money from it, so it's not promoted. Natural progesterone is not routinely recommended, and most ob/gyn's don't even bother to learn about it because they can't make money from it.

Safe Estrogens - No Thanks

It's the same with estrogen. There are safe, natural sources of estrogen which could be recommended in place of drugs. Many plants have safe, mild estrogen substances called phytoestrogens which are available to the body in minute, physiologic doses, and which can be used to safely supplement a declining estrogen output. Hormones are only needed and used by the body in tiny, very transient amounts. Transient means they only have to be around for a second or two. A physiologic dose would mean a natural hormone like a phytoestrogen or a wild yam-derived progesterone in the same amount as what might be produced by the body for its own needs. Natural hormones can be swiftly broken down after they have performed their function. They don't just continue hour after hour like the synthetics or the xenoestrogens, which are given in sledgehammer amounts called pharmacologic doses. Big difference.

When the reality of this situation begins to sink in, it may sound a little harsh at first. Can it really be that if it comes to a choice between money and their patients' well-being, doctors will choose money most of the time? We can't be too hard on them - they've incurred a lot of debt in medical school. John Lee and Lorraine Day, both medical doctors, well-respected in their fields, excuse their colleagues' ignorance and indifference about the value of natural progesterone by saying that the doctors are too busy with paperwork, hospital duties, and their own lives to have the time to read anything outside the medical library.

Mendelsohn is a little less forgiving.

Since the medical journals in the medical library are very tightly controlled by the pharmaceutical companies, no natural non-drug therapies are allowed to appear, especially one like progesterone which actually does what synthetic estrogen is supposed to do, except with no side effects. So they tell us not to be too hard on doctors, because the doctors just don't know. So shouldn't we be forewarned that doctors are primarily reps for the drug companies, because that's all they have managed to learn?

It's frightening that to make an informed decision about embarking on any course of patentable drug therapy, these are the considerations that must be undertaken. The more you learn about it, the more naive you realize you have been to have thought that things have ever been any other way.

Cancer and HRT

Since the beginning of estrogen drugs in the 1960s, the spectre of cancer has always been there, lurking about in the shadows. That's why progestins (synthetic progesterone) were added in the mid 1970s, changing ERT to HRT. Original studies were shaky, and the majority of modern studies show conclusively that HRT significantly increases the risk of both endometrial and breast cancer. Dr. Lee states flatly that HRT is the only known cause of endometrial cancer! (Lee, p220).

Abstracting ourselves for a moment away from citing 10 medical studies which prove this point, just use your common sense. Let's go back to the beginning of the chapter. What does natural estrogen do? Prepares for reproduction. What tissues does it affect? Those tissues that what? Right. Are rapidly dividing: endometrium, cervix, breast, ovaries. Now, what is cancer? Very simply, cancer begins when a cell has lost its ability to specialize, but not its ability to multiply, or proliferate. Or divide rapidly. A tumor is a group of cells multiplying rapidly out of control, but unable to perform any life function. So therefore, which tissues do you think have the greatest tendency to become cancerous? Right - those which normally will tend to divide rapidly, like endometrial and breast tissue. So estrogen and cancer have a lot in common from the get-go. Is it really that much of a surprise that dozens of controlled medical studies and research reviews have proven practically beyond dissent that HRT, which is estrogen gone wild, can cause cancer? So would it be too impertinent of me to pose the obvious: why is HRT still out there? Let's see, it doesn't do what it's supposed to do - control menopause symptoms, it has no effect on osteoporosis and it's been proven beyond a shadow of a doubt to be a frequent spark for cancer.