Estrogen Matters New Book Says HRT is Safe and Beneficial

Book Review by Jeffrey Dach MD

It is always refreshing when a new book comes out saying all the things I have been writing about for many years. “Estrogen Matters” by Avrum Bluming and Carol Tavris is one of those books.

Number one, estrogen does not cause breast cancer, and withholding estrogen/progesterone HRT from post-menopausal women is not only associated with serious health risks, but also increased mortality.  Number two, estrogen / progesterone HRT (hormone replacement therapy) prevent heart disease in women. Number three, Breast cancer survivors can safely take estrogen/progesterone hormone replacement without increasing risk for cancer recurrence. The two co-authors make a good team.  Dr Avrum Bluming, an oncologist , reviews the supportive medical literature, and his colleague Carol Tavris, adds the women’s perspective on things. Above left image courtesy of  Estrogen Matters: by Avrum Bluming and Carol Tavris. (Note HRT= Hormone Replacement Therapy)

However the book is not without its errors.  In Chapter 2, in my opinion, the authors make a number of errors, perhaps based on a desire for “political correctness”.  In Chapter 2, the authors disparage the term “bioidentical hormone”, saying it is a marketing term. In a later chapter 8, Dr Bluming corrects this error saying the term “bioidentical” refers to  “prescription hormones having the same molecular structure as those produced naturally by the human body.”

Chapter 2, perhaps written by Carol Tavris, attempts to disparage the 2009 New York Times Op-Ed “The Truth About Hormone Therapy“ by David Brownstein MD, Erika Schwartz MD and Kent Holtorf MD.  This is an excellent piece which is still valid today.  The authors also make the error of disparaging compounded hormone preparations, used successfully by millions of women and prescribed by thousands of fully licensed physicians in the US.  The authors also make the error of suggesting that horse estrogen is somehow superior to human estrogen.  I would say horse estrogen is good for horses, not humans.

Chapter 3 deals with Estrogen and the Heart:  I agree with their very clear message: Women should throw their statin drugs into the garbage can, and instead take estrogen/progesterone HRT for prevention of heart disease.  Yes, Estrogen prevents heart disease in women.   My new book comes to the same conclusion: Heart Book by Jeffrey Dach MD available on Amazon, if I am allowed to indulge in a short commercial for myself.

Chapter Four discusses estrogen HRT as preventive for osteoporosis and subsequent osteoporotic fractures.  Rather than subscribe to the Big Pharma construct of DEXA scans and bisphosphonate drugs, the authors advocate hormone replacement conferring “stronger and more resilient bones”.  In my office, we have actually stopped doing routine DEXA scans, as we have found bone density routinely goes up in our post-menopausal patient population on bio-identical hormone replacement.

Chapter 5 makes the case for estrogen HRT as beneficial for mental functioning, cognition ability, and preventive for onset of dementia in post-menopausal women.

Chapter 6 makes the case for estrogen hormone replacement for breast cancer survivors.  I was pleasantly surprised to learn that Dr Bluming had done his own study on this topic published in 2008 in the Journal of Clin Oncology (p.20693), finding that estrogen HRT did not increase recurrence rate for breast cancer in women who had been treated and were cancer free.  To his credit, Dr Bluming even recommended post-menopausal Estrogen HRT for his daughter who was a breast cancer survivor.   I have been writing about this for years and found Dr Bluming used many of the same references found in my 2011 book,  Bioidentical Hormones 101.

Chapter 7 discusses Progesterone and Progestins.  The authors inform the reader of the important difference between bioidentical progesterone and synthetic versions of progesterone called progestins.  Progesterone is naturally made by the female ovary, progestins are not. Progestins have been chemically modified to obtain a patent. The chemical structure bears a similarity to progesterone, but has additional side groups added on to make it chemically different.  Progestins do not occur in nature or in the human body.

The 2002 Women’s Health Initiative study used a progestin called medroxyprogesterone (MPA) revealing this progestin to be in fact, a monster hormone which causes breast cancer and heart disease. MPA (medroxyprogesterone) induces breast cancer in laboratory animals with such efficiency, it has become a popular research model for studying breast cancer.  It is astounding our misguided medical system is still prescribing MPA to post menopausal women as hormone replacement.  This is a practice which should be halted.  Dr Bluming’s views on MPA are more forgiving, and declines to warn the reader that MPA is a “monster hormone” which causes cancer and heart disease.

Chapter 7 discussed synthetic forms of estrogen in birth control pills concluding that birth control pills are safe and effective.  I would disagree with this statement, having seen young women with paralyzed limbs after suffering a stroke from blood clots induced by birth control pills.  As an interventional radiologist in the hospital, my job was to do their angiograms.  Young women on birth control pills arrive in my office with a variety of medical complaints induced by the pills.  Their lab reports show low serum B12, high CRP, high cortisol and other derangements.  They are much better after switching to the non-hormonal copper T- IUD, now approved for women of all ages. This is discussed further in my previous article on Adverse Effects of Birth Control Pills.

In chapter 8, the authors discuss the term “bioidentical hormone”, explaining the difference between estradiol (made by the human ovary) and premarin, made by the horse ovary.  I would disagree with the authors’ opposition to compounded bioidentical hormone preparations.  They instead recommend  “manufactured” FDA approved bioidentical hormone preparations.  I think this is a political statement rather than a scientific one.  The reality is that millions of women are routinely using compounded hormone preparations prescribed by thousands of physicians around the nation.  I am one of these physicians. I find the compounded formulations are superior in many ways to the manufactured products.

Although there is much to laud in the book, I would quibble by mentioning the book omits a discussion of testosterone in women.  Testosterone preparations are available and routinely used by millions of women in as part of their hormone replacement cocktail adding considerable health benefits.

Overall, I liked the book, and I applaud the authors for taking controversial positions in a few areas in opposition to mainstream conventional medicine.  I would however disagree with with their opposition to bioidential compounded formulations, their advocacy of synthetic hormones in medroxyprogesterone (MPA) and in birth control pills, and their advocacy of horse estrogen as superior to human.  In these areas, the authors are quite wrong and lapse into politics rather than science.

Jeffrey Dach MD
7450 Griffin Road Suite 190
Davie, Florida 33314
954-792-4663

Articles with Related Interest:

Bioidentical Hormones Prevent Heart Disease

Bioidentical Hormones for Breast Cancer Survivors

Bioidentical Hormones Prevent Arthritis

Links and References

1)  Estrogen Matters: Why Taking Hormones in Menopause Can Improve Women’s Well-Being and Lengthen Their Lives — Without Raising the Risk of Breast Cancer 1st Edition
by Avrum Bluming (Author), Carol Tavris .  Little, Brown Spark; 1 edition (September 4, 2018)  Avrum Bluming, MD, is a hematologist and medical oncologist

Carol Tavris, PhD, is a social psychologist who has written widely about psychological science.

2)  What is the truth on hormone replacement therapy? Millions of menopausal women shunned it after study claimed it could cause cancer …but now a new book suggests that report was wrong.  A U.S. study claimed HRT carried a significant risk of breast cancer
Before the news made headlines, around one in four British women was taking it
Now a new book claims to have the definitive answer: HRT is safe. By John Naish for the Daily Mail.  Published: 3 September 2018

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