The new study from the Women’s Health Initiative WHI -Ness 2009 : Influence of Estrogen Plus Testosterone Supplementation on Breast Cancer misreports/ conceals the truth: contrary to it’s title, and claim that “we found a modest, albeit non-significant, elevation in breast cancer risk associated with Estrogen + TESTOSTERONE use”, it did not study the human hormones estrogen and testosterone at all. CEE is what it says- a mixture of sexhormones common to most mammals plus the xenohormone equilins that are not found in humans.
The risky “convenience factor” of oral hormones aside, has it ever been shown that the combination of human and equine estrogens is as good or safe as the endogenous balanced human estrogens? Was it purely “convenience” for women that changed pioneer gynecologist and sexologist William Masters (who died just 8years ago) from being an ardent advocate of balanced parenteral testosterone-estradiol replacement in the first RCT of HRT (Masters & Grody 1953) to a marketeer (apparently without any trials to back up his conversion) of Wyeth’s convenience premarin pill by 1957?
Why are so many doctors unable to state scientific fact, acknowledge – especially in the title and abstract- that WHI, and Ness’s paper, actually studied xenohormones, not physiological doses of human hormones? Xenohormone is quite simply a hormone that is foreign (xeno-) to humans. Ness ea actually found that only full-strength oral Estratest -methyltestosterone MTT 1.25mg + conjugated equine estrogens- CEE 0.625mg/d) (not half-strength, nor any other types of T+E) was significantly associated with (almost double) breast cancer , and then only in the first year. And it does not report the influence in those women of CEE+MTT (compared to no HRT, or CEE alone) on breast cancer mortality or all-cause mortality; nor the influence on all other major chronic degenerative diseases.
The statement in their abstract is misleading that ” women using E+T have a significantly increased risk of invasive breast cancer.” They found this increase ONLY with CEE 0.625mg/d plus MTT 1.25mg/d in the first year in those elderly women, not with any other type or route of appropriate E+T.
As with other early reports from the WHI, it is misleading to generalize their results (when Estratest was always an inappropriate combination of xenohormones -by an inappropriate route) to other populations, other types and doses and routes of HRT). But of course they dare not say so, that would be lambasting the FDA for negligently allowing ongoing use of MTT – this toxic anabolic xenosteroid has long been declared obsolete for obvious reasons, banned in eg Germany since 1988 and South Africa more recently.
MTT methyltestosterone – ie xenotestosterone- is no more “testosterone” than, say, ethinylestradiol – xenoestradiol- is estradiol, or medroxyprogesterone – xenoprogesterone- is human progesterone, or GABApentin is human GABA. Except for patent protection, there is no evidence that the synthetic designer ie xenoderivative (which is not metabolized safely to the natural respective human hormone) of the natural estradiol, progesterone, testosterone or GABA is either as good or as safe as the original. Drug companies studiously avoid any comparative trials that could test this. This disadvantage does not apply to esters like depot injection testosterone cypionate/ undecanoate or estradiol valerate, which are gradually broken down at a predictable rate to deliver the natural testosterone or estradiol, which- at physiological blood levels and balance- have all the advantages of the endogenous human hormones in youth.
An editorial from Norway in the August 2008 Lancet similarly wrongly blames breast cancer on “hormone replacement therapy”, claiming that the fall in breast cancer incidence is likely due to decreased HT use since publication of the WHI, and thus proclaiming that any HRT should be used only for menopausal symptoms for the shortest time possible. This is again negligently false, since the WHI showed that when used appropriately in young postmenopausal women PMW, estrogen – CEE even at a massive dose equivalent to 2mg estradiol a day- alone lowered the incidence of new breast cancer, and all other major common diseases and deaths, by a third. And even the lowdose combination of estrogen + progestin for up to 9 years eliminated all major chronic diseases in such women (the Oulu study Heikkinen 2006). The use of such potent non-human hormones in elderly women in the WHI was most inappropriate since such hormones have been known for decades to have significant risks compared to physiological parenteral human hormones- eg Women & the Crisis in Sex Hormones, Harvester Press UK Seaman 1978.
The findings in the WHI validate appropriate oral HT, but it has been abundantly clear since the design paper of the WHI in 1998 that these results with xenohormones cannot be extrapolated to other women, other types of hormones given by other routes.
The above journal reports also casually ignore the numerous proven long term benefits (which far exceed trivial dose-adjustable risks) of appropriate parenteral human HRT, whatever the appropriate physiological combination of estrogen, progesterone and testosterone that we have used for the past >50 years (eg Masters and Grody 1953; Greenblatt, Gambrell; Gelfand; Studd; Davis & Burger et al) let alone insulin, thyroid, cortisol etc . These benefits of parenteral human sex HRT (as opposed to oral xenoHT) – including reduction in the mortality from breast cancer and total mortality even on HRT after breast cancer- are set out in detail in a major 2008 review “Could transdermal estradiol + progesterone be a safer postmenopausal HRT” by a leading International Menopause Society team under Professor Andreas Genazzani.
As they sum up, the answer ( from 60 years of modern use, 2600 years of therapeutic use and a million years of successful evolution of homo sapiens on these balanced human hormones ) is: yes.
And the major benefits- reduction in all chronic degenerative aging diseases -including breast cancer- with appropriate parenteral human HRT including testosterone replacement has been shown in numerous appropriate studies (not studies with xenohormones) for over 50 years in both men and women, as set out in numerous reviews hereunder.