On Hormone Replacement? Hopefully It Contains Estriol And Here's Why

So I think by now everyone knows that I customize hormone replacement therapies for men and women. I just met with two OB/GYN's today in their clinics to discuss current studies, treatment options, and best practice approaches.  They are fully on board and refer patients for the custom therapy ALL THE TIME!!  Yeah!  Because of  making a full time living at the helm of the hormone ship, I am privy to many published studies, online networking groups, clinical consultant forums, and so on. 

I rarely ever customize a therapy without including this "magic" estrogen, Estriol.   It's not magical because it makes all of the symptoms go away (it can), but it's magical because it's been found to have an anti-cancer effect and it critical to have on board for women truly wanting to mimic the body's normal production.   There are plenty of studies out that that also show us that Estrogens are protective and can delay the onset and progession of Alzheimers Disease if that is a risk factor in your family blood line.  We also know that hormone replacement therapy builds bones and prevents or retards osteoporosis. 

Plain and simple ladies, we all have estriol in our bodies and it's needed to protect us on many fronts.  Sadly, commercial and synthetic versions of hormone replacement therapy DO NOT include Estriol in the mix.  Not in the U.S. anyway.  In Europe, they use Estriol and have for 40+ years as you'll see from the information I'm sharing below.  Conversely, Premarin, one of the largest marketed hormones to hit Western medicine, does NOT include estriol, but rather a conjugated mix of horse estrogens.  Yes horse urine is used as the source of human hormone replacement for one of the top selling products of all time Premarin.  What a tragedy.....   Pre'MARE'in. (the name is the guide) I'm not kidding, look it up for yourself. Who wants that in their body?  Not this girl.  EVER!! 

Here's a clip from an article I was able to read today on the topic of Estriol.  I have formulated just estriol alone for hot flashes, vaginal dryness, painful intercourse, wrinkling on the face and neck, and many other things that patients are experiencing. However, I mostly include it in a multi-ingredient formulation to mimic the body's normal production.  Now that makes sense!  AND I CAN TEST THIS HORMONE TO SEE IF YOU ARE DEFICIENT!!! 

Estriol, the missing-in-action hormone

You may have noticed that one estrogen, Estriol, is completely absent from Premarin and other forms of conventional estrogen replacement regimens, although it comprises as much as 80-90% of triple estrogen. This is not an insignificant omission. Most conventional physicians and pharmaceutical researchers have long dismissed estriol as a weak and unimportant estrogen. They have considered it to be primarily a metabolite of Estradiol and Estrone, which are far more potent in producing estrogenic effects, such as inducing endometrial tissue growth. "Why go through all the trouble of putting Estriol into a pill if you don’t really need it?" seems to be their reasoning.

Well potency isn’t everything. In fact, Estriol is vitally important precisely because it is a weak estrogen. A number of studies, published over four decades, have demonstrated that estriol’s unique and perhaps most important role, may be to oppose the growth of cancer, including cancer promoted by its more potent cousins, Estrone and Estradiol. We’ll talk more about this in a moment.

Estriol plays more than just a defensive role though. European physicians have been open to the potential benefits of Estriol in menopausal women than those in the US. As a result, most of the clinical research evaluating Estriol has been conducted in Europe. In general, these studies show that menopausal women who use natural Estriol to replace their natural estrogen experience a reduction in typical menopausal symptoms like, hot flashes and thinning of the vaginal tissue (vaginal atrophy) (4).

• In one major trial, 22 practicing gynecologists from 11 large hospitals in Germany treated 911 premenopausal women with Estriol and evaluated them regularly for 5 years. They found Estriol to be "very effective" against common menopausal symptoms and "well-tolerated" with "no significant side effect." (5)

• A Swedish study evaluated 40 postmenopausal women with urinary incontinence (leaky bladders) for up to 10 years. The researchers found that Estriol treatment resulted in significant improvement in 75% of the women, including eight whose ability to regulated urination completely returned to normal. (6).

• The same Swedish study found that symptoms of vaginal atrophy disappeared in 79% of the women after just 4 months of Estriol treatment. After 12 months, all but one woman were symptom free (6).

Built in cancer protection

There is no doubt that reasonable doses of horse estrogens and 100%Estradiol patches and creams stimulate excessive proliferation of endometrial cells, a precursor to endometrial cancer.

It is to reduce this risk that any woman taking these drugs must also take natural progesterone or a synthetic progesterone substitute (or "progestin") like the Provera (see box). This is in stark contrast to Estriol, which appears to actually antagonize the proliferate effects of Estrone and Estradiol, while having far less tendency to stimulate endometrial proliferation, itself. Studies in experimental animals have shown that the proliferate dose of Estriol (the dose that produces full endometrial growth) is at least double that of horse estrogens and Estradiol (7).

Estriol apparently accomplishes its protective role by benignly binding to estrogenic receptors in the uterine lining and possibly the breast. Unlike the more potent estrogens though, it does not stimulate growth nearly as much. At the same time, receptors covered by Estriol are shielded from more carcinogenic Estrone and Estradiol (4).

This is thought to be the same mechanism by which other weak estrogens, such as those found in soy products, protect against cancer. In laboratory animal studies totaling more than 500 rat-years, Estriol has been shown to be the most protective estrogen ever tested against cancers of the breast induced by several potent carcinogenic agents, including radiation (8,9).

There is important evidence dating back to the 1960’s suggesting that Estriol may protect against breast cancer as well. At that time, Henry Lemon, MD, who was head of the division of gynecologic oncology at the University of Nebraska College of Medicine, hypothesized that some women who develop breast cancer have too little Estriol relative to Estradiol and Estrone circulating in their bodies.

To test this hypothesis, Dr. Lemon ran a preliminary study in which he employed a urinary estrogen quotient (EQ), which was simply a measure of the ratio of Estriol to the total of Estradiol and estrogen in the urine over a 24-hour period. The higher the quotient, the more Estriol there is relative to Estradiol and Estrone (10).

In a small study of 34 women with no signs of breast cancer, Dr. Lemon found the EQ to be a median of 1.3 before menopause and 1.2 after menopause. Only 21% of the women had an EQ <1.0 (i.e. Estriol was less than Estradiol and Estrone combined). For 26 women with breast cancer, however, the picture was quite different. Their median EQ was 0.5 before menopause and 0.8 after menopause; 62% of these women had an EQ <1.0.

Thus, the women with breast cancer seemed to be making substantially less Estriol relative to the other estrogens, compared with the women without breast cancer.

...............  There you have it!  Make an educated decision, call me, and get with your doctor ASAP if you need to make a BIG change in what you are doing.....or, should I say, not doing to better your hormone health.

Just sharing for your good hormone health,

Dr. Sonja