The following article is extracted from Natural Hormone Replacement for Women over 45 by Jonathan Wright, MD, and John Morgenthaler. (published by Smart Publications) It is available in U.S. bookstores and health food stores, or perhaps from any on-line bookstore. I have changed the order of some paragraphs, and for the sake of shortness I have had to snip some parts, but the idea from their book comes through. I post it here because of its importance for women's health. -Ellis Toussier
Another book titled "Stay Young and Sexy" by Dr. Jonathan Wright and Lane Lenard, MD will come out in February, 2010.
Natural Hormone Replacement
The word "natural" gets thrown around a lot in discussions of hormone replacement therapy. Premarin, for example, is widely considered to be a "natural" hormone. So is Estradiol in the estrogen "patch" and "cream" products. But are they natural? The answer depends on how you define "natural".
The "estrogen" replacement most doctors prescribe today for menopausal and premenopausal women is a pill known generically as conjugated equine estrogens (CEE). The best known brand of CEE is Premarin.... (snip...) ...it is derived from the urine of pregnant mares, hence, its brand name.... Premarin works great in female horses...
But replacing human estrogens with horse estrogens may be asking
for trouble, and here's why: For the last several million years, the human female reproductive system has been running quite well on three separate estrogens: Estriol, Estrone, and Estradiol, which occur in approximation of 90%, 3%, and 7%. Compare that with Premarin, which consists of Estrone (75-80%), equilin (6-15%), Estradiol plus two other equine estrogens (5 - 19%). And also notice that, in addition to having larger proportions of Estrone and Estradiol, Premarin also contains equilin and two other forms of estrogen found exclusively in horses; and 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 the amount found naturally. This is not an insignificant omission.
Estriol has long been dismissed as a weak or unimportant estrogen by most conventional physicians and pharmaceutical researchers. 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.
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 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. Other studies show Estriol reduces typical menopausal symptoms, such as hot flashes and thinning of the vaginal tissue.
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. To reduce this risk, women taking these drugs must also take progesterone, like Provera. This is in contrast to Estriol, which appears to actually antagonize the proliferate effects of Estrone and Estradiol, while having far less tendency to stimulate endometrial proliferation.
The female human body contains all the enzymes and cofactors it needs to process Estriol, Estrone, and Estradiol when they occur in their natural human proportions. On the other hand, it has none of the enzymes and cofactors required to metabolize equilin and the other horse estrogens, nor does it have enough of these important substances to deal with the excessively large amounts of Estrone and Estradiol found in Premarin (or in the 100% Estradiol "patch").
Horses, of course, are well equipped to handle CEE (conjugated equine estrogens) The difference in reproductive hormones is just one of many differences between horses and human females. (You may have noticed that horses have four hooves and a mane, whereas human females don't!)
It should come as no surprise, then, that the presence of Premarin in the human body induces a hormonal imbalance that can have important adverse consequences. To physicians who prescribe Premarin, this hormone imbalance doesn't seem to carry much weight. After all, the drug works, doesn't it? But, as two leading reproductive physiologists point out, when women take Premarin, "Levels of equilin can remain elevated for 13 weeks or more post-treatment due to storage and slow release from fat tissue. In addition, metabolism of equilin to equilenin may contribute to the estrogen stimulatory effect of conjugated estrogen therapy." Another metabolite of equilin, 17-dihydroequilin has been found to be eight times more potent than equilin for inducing endometrial growth, a possible precursor to cancer... According to Premarin's official labelling, taking it for a year increases a woman's risk of endometrial cancer by as much as 14%, without also taking progesterone.
Most conventional physicians, not to mention the self-serving pharmaceutical industry, are quick to rationalize the cancer and other risks of horse estrogens. Every treatment has its risks, they point out, but the risk of a postmenopausal woman dying of a heart attack or stroke if she doesn't take Premarin are far greater than her risk of dying from cancer or an osteoporosis-related factor if she does.
Well, this reasoning is true as far as it goes, but it ignores one hugely important fact: horse hormones are not the only choice human females have! What about human hormones?!! Wouldn't it make more sense to replace human estrogens with human estrogens? Of course it does! The real question, then, is why has no one thought of this before?
This realization occurred in 1982! All ob-gyn testbooks discussed the naturally occurring human estrogens Estriol, Estrone, and Estradiol but completely neglected to recommend their use for treating menopausal symptoms, inexplicably recommending horse estrogens instead!
Ed Thorp, of Kripps Pharmacy, Vancouver, B.C. designed a combination estrogen replacement regimen that closely matches the natural conditions found in premenopausal women. The result is a combination of natural Estriol, Estrone, and Estradiol using molecules identical in structure to those produced in the human body in as close-to-natural quantities and proportions as could be calculated. In the 16 years since this triple estrogen was prescribed, thousands of other physicians and their patients have found that it works as well or better than the conventional ERT regimens, while producing far fewer unwanted side effects.)
If this triple estrogen combination is so much better than Premarin, why have so few people heard about it? The answer to this question can be summed up in one word: patentability. Premarin is patentable, and hence, can be sold exclusively only by its manufacturer and licensees, whereas triple estrogen is a natural product, like vitamin C, and can be sold by anyone. Patentability has made Premarin a huge money-maker for its manufacturer, Wyeth-Ayerst Pharmaceuticals. For nearly 30 years it has been at or near the top of the drug best-seller list. In just the first half of 1997, pharmacists filled 22.1 million prescriptions for Premarin, amounting to revenues of 388.2 million dollars in the United States alone. Add in the rest of the world's women, and you get a sense of the high stakes involved in the business of menopause.
These enormous financial resources have provided Wyeth-Ayerst the muscle to practically corner the estrogen market. Through advertising, sponsorship of clinical trials, conferences, free samples, and other common marketing techniques they have created an atmosphere in which physicians virtually equate estrogen replacement with Premarin. Most physicians are completely in the dark about the use of a natural hormone combination. Their use is not taught in medical schools, nor is it promoted by any large pharmaceutical companies. With no money available to pay the enormous costs, the large, definitive studies to demonstrate the efficacy and safety of these natural hormone regimens will likely never be done." - Jonathan Wright, MD, and John Morgenthaler.
(1). Schliesman B, Robinson L. Serum estrogens, quantitative analysis of the concentration of Estriol compared to Estradiol and Estrone. Meridian Valley Laboratories, 1997, Kent WA; Data on file.
(2). Premarin (conjugated estrogen tablets). Wyeth-Ayerst Company. Physicians' Desk Reference, 52nd edition. Montvale, NJ; Medical Economics Company 1998: 3111-3113.
(3). Barnes R, Lobo R, Pharmacology of Estrogens. In: Mishell D, JR, ed. Menopause; Physiology and Pharmacology, Chicago; Year Book Medical Publishers, Inc. 1987.
(4). Heimer G. Estriol in the postmenopausal. Acta Obstet Gynecol Scand. 1987; Suppl 139;1-23.
(5). Lauritzen C. Results of a 5-year prospective study of Estriol succinate treatment in patients with climacteric complaints. horm metabol res. 1987; 19; 579-584.
(6). Iosif C. Effects of protracted administration of Estriol on the lower genito urinary tract in postmenopausal women. Arch Gynecol Obstet 1992; 251; 115-120.
(7). Utian W. The place of oestriol therapy after menopause. Acta Endocrinol, 1980; 223 (suppl) 51- 56.
(8). Lemon H. Oestriol and prevention of breast cancer. Lancet 1973; 546-547.
(9). Lemon H, Kumar P, Peterson C, Rodriguez-Sierra J, Abbo K. Inhibition of radiogenic mammary carcinoma in rats by Estriol or tamoxifen. cancer 1989;63:1685-1692.
(10). Lemon H, Wotiz H, Parsons L, Mozden P. Reduced Estriol secretion in patients with breast cancer prior to endocrine therapy. JAMA 1966; 196;112-120.
(11). Follingstad A. Estriol the forgotten hormone? JAMA, 1978;239:29-30.
(12). The writing group for the PEPI trial. Effects of estrogen or estrogen/ progestin regimens on heart disease risk factors in postmenopausal women. The premenopausal estrogen/ progestin interventions (PEPI) trial. JAMA 1995;273:199-208.
(13). Lee J. What your doctor may not tell you about menopause. New York; Warner Books; 1996.
(14). Lee J. Is natural progesterone the missing link in osteoporosis prevention and treatment? Medical Hypotheses 1991, 35;316-318.
You can buy the unique natural triple estrogen cream called Esnatri,
specially developed by Jonathan Wright MD, with the formula of 90-7-3 at
http://www.antiaging-systems.com/a2z/estrogennat.htm (Anti-Aging Systems)
Esnatri is available at 50ml/ 100mg for $44.95
"I am using a natural hormone (HRT) replacement therapy that is not only natural but the HORMONES ARE IDENTICAL TO THE ONES WE PRODUCE IN OUR BODIES. Women's pharmaceutical compounds the prescription tailored to your individual needs. The Current pharmaceutical HRT drugs are made from THE URINE OF PREGNANT HORSES. They claim they come from a natural source wich they do, but we have nothing in common with horses or have any compatibility with their source of hormones. This is why so many women have problems with them and stop taking them.
These are not one size fits all. They can compound the hormones in pills, gels, or sublingual. They can combine all the hormones (Tri-est, prog., and Test.) or you can pick and choose them individually which is what I do since it gives me the most flexibility of controlling what I take and when I take it.
If anyone is interested in this information they can go to their web site at http://www.womensinternational.com or call them for information at 1-800-279-5708."
To make things easy on your clients I will sum-up all of the time I
spent on research on only two items. 1St they MUST READ "Natural Hormone
Balance for Women" by Uzzi Reiss, MD./OB.-GYN they only need this one
book and forget all others unless they are looking to read more.
(If you decide to buy this book and you do it through this link to Amazon.com, you will also be helping me to pay for the costs of having this website which is free for you but which costs me money to maintain each month.)
Uzzi Reiss: Natural Hormone Balance for Women
In Association with Amazon.com
This is one of the most complete books that will help women understand their
body and natural HRT but it will also assist her on how to become a part
of the process. And 2nd is to get their doctor to read it! (good luck on
this one). If they experience negative response or if their doctor isn't
interested, they can call any of the two pharmacy's listed and get list
of Doctors in their area that know and work with natural Hormone
replacement. They will need a prescription for any of these hormones and
you need a doctor for this as well as the initial and follow-up blood
Here is a list of compounding pharmacies:
Kronos Compounding Pharmacy
Women's International Pharmacy (this is the one I use)
The NDC numbers for the female hormone replacement have been assigned by
the FDA. Any pharmacy that does compounding can provide them as long as
they have the NDC number. Most pharmacy's do not compound but there are
some in each city and people just need to look at a phone book and call
to ask if they compound these NDC's.
Estrogens NDC'S Numbers are: E1=12861-0222-00
Progesterone's NDC number is: 00574-0430-01
Testosterone's NDC number is: 00574-0460-00
I found two pharmacy's that were local to me but when I checked on the
price they were more expensive than the one I was using.
These hormones are available in: Pills, Creams, Gels, and Sublingual
compounds. They can be combined or they can be prepared individually.
They are tailored to YOU not the usual one size fits all.
I use the tri-est (3 estrogens) in a gel which I apply twice a day. I
use the Progesterone Sublingual drops which I use twice a day, and I use
the testosterone in a gel twice a day. Morning/Night.The actual number
of grams etc. are customized for me! The reason I use them separately is
that It gives me the flexibility to alter their use as needed, and both
the Gel and sublingual drops allow me to change the dosages.