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Chapter 1: Why is there fear surrounding estrogen use?
So, Avram Blooming, I feel very excited to have you back on my podcast. This is the third time and we met many years ago before the podcast started and I was in London at the Royal Society. I was giving a lecture and you were there and you've just helped me open my eyes because sometimes in medicine, when you think differently, you have doubts and And you think, really? It's so obvious.
Maybe I'm missing something. And then you came and you had just written your book, Oestrogen Matters, and you had some slides that just had a few sentences on, very few, about oestrogen and heart disease and osteoporosis, dementia. And I just thought, wow, he's just speaking a language, but you're just so, it's all so obvious, but it's become so confusing.
So you are from a very esteemed oncologist position, a thinker, very inspirational. And actually, you don't know it really, but you are a great mentor to me because you're so solid in how you are. And when I wobble, I just think about you and it really helps me. But let's just think about oestrogen. It's a hormone. Hormones are chemical messengers that have a role in our bodies.
And somehow, for the last 30 years especially or so, maybe 40 years, people have become very scared of our own hormone. And it just feels a bit weird almost. If I didn't know any medicine at all and didn't know any politics, didn't know any history, if I'd come from outer space and I said, we all have this natural hormone in our body that has lots of biological effects.
We know it can be beneficial for symptoms and future health. Yet most women, when their levels are low, don't get it. They're not allowed it. They're given other medication. It just feels a bit weird, doesn't it?
As a man, I can tell you what problem. I can get hormones, and we ought to look at other hormones. Thyroid hormone saves lives because people who are deficient in thyroid die prematurely, and thyroid hormone, which they take for the entirety of their lives, allows them to live a normal lifespan. Similarly, cortisone, when used correctly, helps keep people alive.
John F. Kennedy was cortisone deficient. He had Addison's disease. And although we didn't know it when he was president, he was taking cortisone and that also kept him alive. Somehow, estrogen hasn't been invited to the party yet. And it isn't a mystery.
It is through the early 1990s up to, depending on which paper you read, 40% of eligible women, meaning peri and menopausal women, were given hormones. And it worked. And then in 2002, there was a report that came out first as a press conference, followed one week later as an article in the Journal of the American Medical Association that said,
Hormones, which means estrogen for perimenopausal women who don't have a uterus, and estrogen and progesterone for perimenopausal women who do have a uterus, are dangerous. They increase the risk of heart disease, stroke, breast cancer, and death. Wow. That's frightening. And that was a study that has cost $1,000 million.
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Chapter 2: What evidence does the Women's Health Initiative provide about hormone risks?
Close to half were smokers or previous smokers. This is a population that had a much higher risk of heart disease than the one we're talking about now. And what the Women's Health Initiative now says and has published, but the New York Times hasn't reported, nor the London Times, is that when taken within 10 years of the last menstrual period, it actually decreases the risk of heart disease.
And that's what so many studies over the years long before 2002 have confirmed.
Mm-hmm.
You mentioned osteoporosis. Yes, a hip fracture from osteoporosis, which can affect a significant number of postmenopausal women, is associated with death within one year of the hip fracture that mirrors the incidence of death from breast cancer and the best treatment.
is estrogen, much better than calcium, which alone doesn't work in a postmenopausal women and the other drugs that are used for osteoporosis that when they work in prevention, work for five years, but after that are associated with an increased risk of hip fracture. Estrogen, you can keep on using and it works as long as you use it. And
Although they originally published in 2003 it has no effect on quality of life, they've now walked that back and said estrogen is the single best treatment for menopausal symptoms. And they initially said that our findings apply to women of all ages.
Mm-hmm.
And they've walked that back and now said, no, the bad findings really were for women who were long past menopause. And now they said, we're so sorry that peri and menopausal women weren't started on estrogen. That wasn't what our intention was. Well, that's what you wrote, but you've walked it back. Let's publicize that you've walked it back. And When challenged, the disagreement isn't there.
When people say, I don't know who to believe, these two people now who I'm listening to, or other people, well, we all agree. It's just we're saying it out loud.
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