Life's Delicate Balance
Causes and Prevention of Breast Cancer
by Janette D. Sherman, M.D.

Excerpts from Chapter 10
POST-MENOPAUSAL HORMONE REPLACEMENT 
Questions and risks

The view of menopause as an abnormality to be corrected is not new. In 1937, the respected British Medical Journal carried a popular and revealing article:

Practically every menopausal woman becomes aware of a certain mental clumsiness, and inability to cope with the ordinary problems of daily life, and a tendency to "give in". The realization of her shortcomings is worrying and she readily becomes depressed. Emotional instability is well defined, and the patient reacts to trivial situations with rather surprising attacks of laughter or tears. She is subject to rapid and frequent changes of mood: at one moment she will be unbearable irritable, at the next pathetically contrite. There may be marked changes in personality and severe attacks of mental depression, sometimes lasting for days, during which the patient becomes suicidal. A condition of  hypochondriasis, which is particularly distressing to those around her, may develop out of the complicated syndrome, even in the milder cases, and persist for the remainder of the patient's life. (Emphasis Added)

The recommended "treatment" was of course, estrogen therapy, and as recently as 1987, DES was still being promoted for post-menopausal symptoms.
...

Press releases in July and August 1996 proposed estrogen use to lower the risk of Alzheimer's disease.  This of course was a little more than a year after another press release that linked estrogen use to breast cancer. Cynically one wonders if this is a new way to keep the prescriptions flowing.  While the media keep estrogens in the spotlight, the scientific debate continues, proposing yet more study.

The net effect is that it is difficult for both physicians and women to make an informed decision.  I emphasize informed, because media hype is no substitute for data derived from independent studies.

Before women accept the concept of post-menopause "therapy," a number of ideas need consideration.  Do most post-menopausal women  need estrogens at all?  Can post-menopausal heart disease and bone loss be controlled with proper diet, calcium supplements, a cessation of smoking, and increasing one's exercise?  These measures, as opposed to taking a chemical hormone, have not been adequately studied.

The sellers of these products emphasize the role of estrogens as protection against osteoporosis and heart disease, which undeniably are significant problems.  But it is wise to remember that the estrogen industry is in the business of selling products. Is being urged to take a pharmaceutical product for a normal body event motivated by financial gain to the exclusion of safe medical practice?  

ESTROGENS AND BREAST CANCER

In summary, factors linking estrogens and cancer are:

1. The higher the daily dose of estrogen, the less time it takes for the development of cancer.

2. A more constant absorption of estrogen reduces both the time for development of cancer as well as the amount of hormone required.

3. The greater the estrogenic potency, the less time required for the development of breast cancer.

4. Estrogenic chemicals of radically different chemical structures but similar in their hormonal action are similar in their cancer-producing action.

5. Estrogen administration is associated with a variety of breast cancer cell-types: comedo, ductal, fibroadenomatous, all having the ability to metastasize.

6. Long-term, repeated administration of relatively small doses may intensify tissue responses to a hormonal substance.

The conclusions are quite clear: women (and men) have been the experimental objects of some flawed practices.  Corporate and governmental bodies have sanctioned the use of chemicals that have affected our bodies directly and indirectly.  The promotional literature urges we women to confer with our doctors to decide if hormone replacement is for us.  Does that mean that if we have an adverse outcome as a result of our decision (to use hormone replacement or not to use hormone replacement chemicals) that we will be again blamed for the outcome?

"There are maladies we must not seek to cure because they alone protect us from others that are more serious."  
    -- Proust, Remembrance of Things Past