President's Desk

September 2003 - Part II: Is Conventional Medicine (CM) Evidence-Based

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• Conventional Medicine promotes the notion that there is no proof that estrogen causes breast or other cancers, despite evidence showing that estrogen is involved in these cancers, and that estrogen-progestin replacements are even worse.16-23
  
• Conventional Medicine doesn’t recognize that progesterone protects against breast cancer, or that this benefit can be provided by transdermal application. Conversely, the evidence shows that a deficiency of progesterone leads to a greater than five-fold increase in the incidence of breast cancer. Furthermore, there is good evidence that transdermal progesterone greatly reduces human breast epithelial cell proliferation, the hallmark of impending breast cancer. At least eight different metabolic mechanisms of progesterone are known to be protective against breast cancer. Overall survival of node-positive patients 20 years after breast surgery is 50 percent less in women with low progesterone levels on the day of surgery than in women with normal progesterone levels on the day of surgery.24-29
  
• Conventional Medicine believes that “normal” hormone levels are, in fact, healthy. The truth is that laboratory ranges of hormone levels merely represent statistically common levels found in a certain population. When US ranges of estrogen are compared to world-wide ranges, estrogen levels in the US and industrialized nations are abnormally high prior to menopause. Experts, such as Dr. Peter Ellison, believe that this is a major factor in the higher breast cancer incidence found in industrialized countries.30
  
• Conventional Medicine has long argued that birth control pills are not a significant cause of breast cancer. The evidence is that oral contraceptives prior to 1976 significantly increased the risk of breast cancer among women with a strong family history (sisters and mothers) of breast cancer.31
  
• Conventional Medicine believes that oral contraceptives do not cause cervical dysplasia. The evidence is that they do.33
  
• Conventional Medicine accepts the fact that estrogen is the only known cause of endometrial cancer but doubts that progesterone will prevent endometrial cancer. The evidence is that oral progesterone (200 mg/day) prevents endometrial cell proliferation and atypical hyperplasia in postmenopausal women receiving estrogen therapy. There is good evidence that topically applied progesterone does the same thing.34-36
  
• Conventional Medicine believes that estrogen falls essentially to zero after menopause. The evidence is that at least two-thirds of postmenopausal women continue to produce sufficient estradiol years after menopause. The problem is that, in the absence of sufficient progesterone, sex hormone binding globulin (SHBG) rises and inhibits estrogen function.37
  
• Conventional Medicine believes that serum levels of hormone are accurate measurements of bioavailable hormone. The evidence is that serum levels are irrelevant unless one also knows the concurrent concentration of sex hormone binding protein (SHBG) and can somehow calculate its inhibiting
  effect.37-39
  
• Conventional Medicine believes that low endogenous estrogen after menopause is the cause of osteoporosis. The fact is that bone mass begins to fall at age 36 in US women, a time when estrogen levels remain high. Even after menopause, the evidence is that two-thirds of US women produce sufficient endogenous estrogen for optimal estrogen bone benefit. The problem is that, when progesterone is deficient, SHBG levels rise and inhibit estrogen bioavailability. Among 107 postmenopausal women who are truly estrogen-deficient and given estradiol in doses of 1 mg, 0.5 mg, or 0.25 mg, the 0.25 mg/day dose is optimal for inhibiting bone resorption. Conventional Medicine customarily prescribes 0.5–2 mg doses, which are 2-8 times higher than needed.37,40
  
• Conventional Medicine prescribes estrogen supplements to postmenopausal women in the belief they need it to prevent memory loss and decline in cognitive function. The evidence is that estradiol does help brain function but the optimal concentration, measured as the “free” non-protein-bound fraction, is often within the range of that found in postmenopausal women, and not at the higher levels found in premenopausal women. Serum levels that do not distinguish between protein-bound and “free” estradiol are irrelevant. Estrogen supplements are needed only in those women who are truly estrogen deficient!