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Tag: estrogen

  • Patient guide to menopause HRT, must-knows after FDA change

    What does it mean when a warning label is removed from a medication after two decades?

    On Nov. 10, the U.S. Food and Drug Administration said it will ask companies to remove most “black box” safety warnings — used on medications to warn patients of serious health risks —  from hormone drugs commonly used to treat menopause symptoms. The change comes after years of advocacy from gynecologists, patients and professional medical organizations. 

    The FDA began requiring the warnings in 2003 after results from a large study raised concerns the medications could increase the risk of breast cancer, stroke and heart attack. Patients became hesitant to take the medications, and prescriptions decreased.

    But the science wasn’t so clear cut. The study that drove the change included mostly women older than 60, and hormone formulations and delivery methods different from what’s often used today. More recent scientific research has shown the medications to be much safer than previously believed, especially for women under 60. Some types of hormone therapy slightly increase a woman’s risk for certain health conditions, but the increased risk is small. 

    We spoke with four OB/GYNs who specialize in menopause management to find out what you need to know before your next doctor’s appointment. 

    What are the types of menopause hormone therapies? 

    Menopause hormone therapy, sometimes called hormone replacement therapy or HRT, refers to medications prescribed to treat menopause symptoms, including hot flashes, night sweats, mood swings and vaginal dryness. They work by replenishing hormones, such as estrogen and progesterone, that naturally diminish during the transition to menopause. 

    The medications take several forms. 

    Local estrogen therapy comes in creams, rings and tablets. These treatments are called “local” because their impact is limited to the area where they are applied, such as the vagina. These therapies address symptoms including vaginal dryness, itching, urinary tract infections and the sudden urge to urinate.

    With local therapies, the hormones are absorbed into the bloodstream only in trace amounts, making them a low-risk option. However, it also means they can’t treat broader symptoms, such as hot flashes or mood swings.

    Systemic hormone therapy, on the other hand, is designed to circulate the hormones throughout the bloodstream. It offers whole-body benefits but also carries more risk as a result. These therapies are administered orally or absorbed through the skin via patches, sprays or gels.  

    Systemic therapies include estrogen-only therapy, progesterone-only therapy or a combination of estrogen and progesterone. Women who have had their uterus removed only need to take estrogen. Women who still have their uterus must also take progesterone, often in combination with estrogen, to  protect against endometrial cancer. The FDA said black-box warnings for endometrial cancer will remain on estrogen-only systemic medications. 

    Different versions of estrogen and progesterone carry different risks and benefits. 

    “The treatments are highly individualized,” Dr. Marcy Nagpal, an OB/GYN at the Medical University of South Carolina, said in an email to PolitiFact. Talking with your doctor is the best way to know which therapy might be right for you. 

    Which patients are the best candidates for these meds? 

    Women with menopausal symptoms who are under 60, or women who had their last menstrual period within the last 10 years, doctors told us.

    But others can be candidates, too. 

    “At this time, it’s reasonable for anyone who feels that they are experiencing symptoms related to menopause to consider evaluation and treatment options,” Nagpal said. 

    If you don’t have symptoms, you do not need to take menopausal hormone therapy, said Dr. Jennifer Howell, a Duke University OB/GYN. It’s “not generally recommended for health promotion.” 

    Some people might be less suited for systemic therapies. Among them: Women who have or had breast cancer; who suffered a heart attack or stroke; who have had blood clots in their legs, lungs or brain; or who have active liver or gallbladder disease. Alternative medications and non-hormonal options to manage the menopause symptoms also are available, doctors said. 

    What are the benefits? 

    Doctors we talked to overwhelmingly pointed to symptom relief. 

    “Hot flashes and night sweats stop, sleep improves, mood is stabilized, joint pain often improves, and vaginal dryness and pain with vaginal penetration resolves,” said Dr. Karen Adams, OB/GYN and director of the menopause program at Stanford Medicine. She said recurrent urinary tract infections and frequent urination can stop.

    Dr. Nanette Santoro, an OB/GYN and professor at the University of Colorado, said, “Depending on just how annoying and disruptive those symptoms are, (the medications) can be a godsend.”

    While taken, systemic therapy can also prevent the rapid loss of bone density that typically accompanies menopause. 

    “Women can lose up to 20% of bone mass in the first five years after their final period,” said Adams. Stronger bones can reduce the risk of fracture and osteoporosis.

    But contrary to recent claims, data on whether hormone therapy can prevent heart attacks or dementia are not conclusive, Howell and Santoro said. 

    During the FDA announcement about the removal of black box warnings, assertions made about significantly improved cardiovascular health and lower Alzheimer’s risk are not supported by evidence, Adams said. “We absolutely do not have that data.”

    Likewise, the statement that these menopause therapies are life-extending “goes very far beyond the data and is in exactly no clinical guidelines,” Santoro said. 

    What are the risks of menopause hormone therapy? 

    With few exceptions, most symptomatic women can use local low-dose estrogen without risk, Howell said. 

    “The local forms should never have had this labeling at all,” Adams said. “The black box was placed on all estrogen products without regard to whether they were local or systemic, and a correction of that was long overdue.” 

    Systemic hormone therapies carry more risk and can be navigated with a more in-depth conversation with a doctor.

    Research shows that women who take a combination of estrogen and progesterone have an increased risk of breast cancer, but it’s “very small,” Howell said, and mainly pertains to prolonged use among older women.

    “This risk increases slowly and incrementally over time,” Santoro said, and applies to those who take hormones for longer periods, usually more than four to five years. 

    The risk profile also depends on the type of hormones a patient takes. Newer formulas appear to be more neutral for breast cancer risk than the formulas used in the 2002 study that led to the warnings, Adams said. And some estrogen-only therapies have been found to reduce breast cancer risk. 

    With some hormones, the risk varies depending on how they are taken. For example, some oral medications increase the risk for developing blood clots, but when the same medication is absorbed through the skin, it doesn’t appear to have that risk. 

    “Sorting out the risks and benefits for hormone therapy is a task for a patient and her doctor,” Santoro said, to determine the best type of hormones, how long to take them, and how to manage any risks. 

    Will this change impact insurance coverage?

    Doctors said it’s unlikely. 

    Most generic hormone therapy treatments are covered by insurance, Howell said, but specialized formulations that can be more convenient, safe or less messy can be challenging to get covered.  

    Tips for discussing HRT with your doctor

    If you are approaching menopause, or already in the throes of it, here are some pointers about discussing hormone therapy with your doctor. 

    First, make sure you and your doctor are compatible. 

    “This is a topic that can require a deep well of knowledge,” Nagpal said. “It’s reasonable to ask your doctor if they are comfortable with menopause medicine and, if not, to recommend someone who is.” 

    The Menopause Society, a nonprofit for healthcare professionals focused on improving menopause care, offers a search function to find certified providers in your area who have passed a test about menopausal management. 

    When scheduling, consider making an appointment specifically to address treatment options, rather than trying to combine the discussion with other concerns, Nagpal said. 

    On the day of your appointment, Santoro recommended bringing a list of your symptoms, ordered by which you would most like addressed. 

    “It’s not always possible to take care of everything with hormones alone, and knowing the bothersomeness is very helpful to me as the doctor, so I make my best recommendation,” she said. 

    Knowing your own health history — current medications, past health events, how long since your last period — and your family health history can also help.

    Nagpal advises keeping an open mind. 

    “Therapies that are appropriate for one person may not be indicated or appropriate for someone else,” she said. Getting the right dose and regimen might take some trial and error, doctors said. So don’t be alarmed if it takes a few visits and changes to get the most appropriate treatment. 
     

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  • Eating to Downregulate a Gene for Metastatic Cancer  | NutritionFacts.org

    Women with breast cancer should include the “liberal culinary use of cruciferous vegetables.”

    Both the Women’s Intervention Nutrition Study and the Women’s Health Initiative study showed that women randomized to a lower-fat diet enjoyed improved breast cancer survival. However, in the Women’s Healthy Eating and Living Study, women with breast cancer were also randomized to drop their fat intake down to 15 to 20 percent of calories, yet there was no difference in breast cancer relapse or death after seven years.

    Any time there’s an unexpected result, you must question whether the participants actually followed through with study instructions. For instance, if you randomized people to stop smoking and they ended up with the same lung cancer rates as those in the group who weren’t instructed to quit, one likely explanation is that the group told to stop smoking didn’t actually stop. In the Women’s Healthy Eating and Living Study, both the dietary intervention group and the control group started out at about 30 percent of calories from fat. Then, the diet group was told to lower their fat intake to 15 to 20 percent of calories. By the end of the study, they had in fact gone from 28.5 percent fat to 28.9 percent fat, as you can see below and at 1:16 in my video The Food That Can Downregulate a Metastatic Cancer Gene. They didn’t even reduce their fat intake. No wonder they didn’t experience any breast cancer benefit. 

    When you put together all the trials on the effect of lower-fat diets on breast cancer survival, even including that flawed study, you see a reduced risk of breast cancer relapse and a reduced risk of death. In conclusion, going on a low-fat diet after a breast cancer diagnosis “can improve breast cancer survival by reducing the risk of recurrence.” We may now know why: by targeting metastasis-initiating cancer cells through the fat receptor CD36.

    We know that the cancer-spreading receptor is upregulated by saturated fat. Is there anything in our diet that can downregulate it? Broccoli.

    Broccoli appears to decrease CD36 expression by as much as 35 percent (in mice). Of all fruits and vegetables, cruciferous vegetables like broccoli were the only ones associated with significantly less total risk of cancer and not just getting cancer in the first place, as you can see here and at 2:19 in my video.

    Those with bladder cancer who eat broccoli also appear to live longer than those who don’t, and those with lung cancer who eat more cruciferous veggies appear to survive longer, too.

    For example, as you can see below and at 2:45 in my video, one year out, about 75 percent of lung cancer patients eating more than one serving of cruciferous vegetables a day were still alive (the top line in red), whereas, by then, most who had been getting less than half a serving a day had already died from their cancer (the bottom line in green).

    Ovarian cancer, too. Intake of cruciferous vegetables “significantly favored survival,” whereas “a survival disadvantage was shown for meats.” Milk also appeared to double the risk of dying. Below and at 3:21 in my video are the survival graphs. Eight years out, about 40 percent of ovarian cancer patients who averaged meat or milk every day were deceased (the boldest line, on the bottom), compared to only about 20 percent who had meat or milk only a few times a week at most (the faintest line, on the top). 

    Now, it could be that the fat and cholesterol in meat increased circulating estrogen levels, or it could be because of meat’s growth hormones or all its carcinogens. And galactose, the sugar naturally found in milk, may be directly toxic to the ovary. Dairy has all its hormones, too. However, the lowering of risk with broccoli and the increasing of risk with meat and dairy are also consistent with the CD36 mechanism of cancer spread.

    Researchers put it to the test in patients with advanced pancreatic cancer who were given pulverized broccoli sprouts or a placebo. The average death rate was lower in the broccoli sprout group compared to the placebo group. After a month, 18 percent of the placebo group had died, but none in the broccoli group. By three months, another 25 percent of the placebo group had died, but still not a single death in the broccoli group. And by six months, 43 percent of the remaining patients in the placebo group were deceased, along with the first 25 percent of the broccoli group. Unfortunately, even though the capsules for both groups looked the same, “true blinding was not possible,” and the patients knew which group they were in “because the pulverized broccoli sprouts could be easily distinguished from the methylcellulose [placebo] through their characteristic smell and taste.” So, we can’t discount the placebo effect. What’s more, the study participants weren’t properly randomized “because many of the patients refused to participate unless they were placed into the [active] treatment group.” That’s understandable, but it makes for a less rigorous result. A little broccoli can’t hurt, though, and it may help. It’s the lack of downsides of broccoli consumption that leads to “Advising Women Undergoing Treatment for Breast Cancer” to include the “liberal culinary use of cruciferous vegetables,” for example.

    It’s the same for reducing saturated fat. The title of an editorial in a journal of the National Cancer Institute asked: “Is It Time to Give Breast Cancer Patients a Prescription for a Low-Fat Diet?” “Although counseling women to consume a healthy diet after breast cancer diagnosis is certainly warranted for general health, the existing data still fall a bit short of proving this will help reduce the risk of breast cancer recurrence and mortality.” But what do we have to lose? After all, it’s still certainly warranted for general health.

    Michael Greger M.D. FACLM

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  • Chemical Safety, Cultivated Meat, and Our Health  | NutritionFacts.org

    More than 95 percent of human exposure to industrial pollutants like dioxins and PCBs comes from fish, other meat, and dairy.

    By cultivating muscle meat directly, without associated organs like intestines, the incidence of foodborne diseases “could be significantly reduced,” as could exposure to antibiotics, “pesticides, arsenic, dioxins, and hormones associated with conventional meat.” Currently, the U.S. Food and Drug Administration has approved seven hormone drugs to bulk up the production of milk and meat. “In the European Union, there exists a total ban on such use,” however. Even without injected hormones, though, animal products naturally have hormones because they come from animals. “Eggs, example given, contribute more to the dietary intake of estradiol [estrogens] than beef, whether the animal is legally treated with hormones or not.” After all, eggs come straight from a hen’s ovaries, so, of course, they’re swimming with hormones. But if you’re directly growing just muscle meat or egg white protein, you don’t need to include reproductive organs, adrenal glands, or any of the associated hormones.

    “Chemical safety is another concern for meat produced under current production systems.” There are chemical toxicants and industrial pollutants that build up in the food chain, such as pesticides, PCBs, heavy metals, and flame retardants, but there is no food chain with cultivated meat. We could produce all the tuna we wanted, with zero mercury.

    When the World Health Organization determined that processed meat was a known human carcinogen and unprocessed meat a probable human carcinogen, it wasn’t even talking about the carcinogenic environmental pollutants. When researchers tested retail meat for the presence of “33 chemicals with calculated carcinogenic potential,” like polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides like DDT, and dioxin-like PCBs, they concluded that, in order to reduce the risk of cancer, we should limit beef, pork, or chicken consumption to a maximum of five servings a month.

    Why cultivate meat at all when you can just buy organic? Surprisingly, “consumption of organic meat does not diminish the carcinogenic potential associated with the intake of persistent organic pollutants (POPs).” A number of studies have recently compared the presence of environmental contaminants in organic meat versus conventional meat, and the researchers found, surprisingly, that organic meat was sometimes more contaminated. Not only organic beef either. Higher levels were also found in pork and poultry.

    If you look at the micropollutants and chemical residues in both organic and conventional meat, several environmental contaminants, including dioxins, PCBs, lead, and arsenic, were measured at significantly higher levels in the organic samples. As you can see below and at 2:56 in my video, The Human Health Effects of Cultivated Meat: Chemical Safety, the green is organic meat, and the blue is conventional. 

    Cooking helps to draw off some of the fat where the PCBs are concentrated, as shown here and at 3:01.

    Seafood seems to be an exception. Steaming, for example, generally increases contaminant levels, increasing contaminant exposure and concentrating mercury levels as much as 47 percent, as you can see here and at 3:15 in my video. Better not to have toxic buildup in the first place.

    More than 95 percent of human exposure to industrial pollutants like dioxins and PCBs comes from foods like meat, including fatty fish, and dairy, but the pollutants don’t appear magically. The only way the chicken, fish, and other meat lead to human exposure is because the animals themselves built up a lifetime of exposure in our polluted world, from incinerators, power plants, sewer sludge, and on and on, as you can see here and at 3:40 in my video.

    Unlike conventional meat production, a slaughter-free harvest would not only mean no more infected animals, but no more contaminated animals either. In terms of pollutants, it would be like taking a time machine back before the Industrial Revolution.

    Doctor’s Note:

    Cultivated meat means less contamination with fecal residues, toxic pollutants, antibiotics, and hormones; up to 99 percent less environmental impact; and zero pandemic risk. Cultivated meat allows people to have their meat and eat it, too, without affecting the rest of us.

    This is the final video in this cultivated meat series. If you missed the first two, check out the videos on Food Safety and Antibiotic Resistance.

    I previously did a video series on plant-based meats; see the related posts below.

    All videos in the plant-based meat series are also available in a digital download from a webinar I did. SeeThe Human Health Implications of Plant-Based and Cultivated Meat for Pandemic Prevention and Climate Mitigation.

    Michael Greger M.D. FACLM

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  • Are Women More Sensitive To THC

    Are Women More Sensitive To THC

    It does does with alcohol, but does marijuana effect women differently?

    While we can put together people in general categories – men, women, Indian, left-handed, each person is slightly  different…and some categories are different than others.  So are women more sensitive to THC in cannabis?  Reactions to alcohol is different between women and men, some South Asians are effected differently than North Americans with alcohol….so what about with cannabis?

    RELATED: Can You Smoke Marijuana While Taking Antibiotics

    Science shows biological differences in body structure and chemistry lead most women to absorb more alcohol and take longer to metabolize it. After drinking the same amount of alcohol, women tend to have higher blood alcohol levels than men, and the immediate effects of alcohol usually occur more quickly and last longer in women than men.

    While more studies need to be done, current ones trend toward women being more sensitive to THC than men.  Meaning they tend to have a bigger reaction to less. Very similar to alcohol.

    Photo by Elle Hughes via Pexels

    One study, published in the journal Psychopharmacology found women who had consumed less of a cannabis, had lower levels of THC in blood, yet experienced the same acute effects as men.  The key take-away is that women may need a lower dose of THC to get to the same degree of intoxication as men. Females tend to progress to tolerance and dependence faster than males after initiation of regular cannabis use.

    One theory researchers posed is estrogen, a primarily female hormone, could influence the metabolism of THC. Levels of estrogen could account for the differences spotted in the study and for the reactions that women experience when consuming THC.

    RELATED: How Marijuana Affects Men And Women Differently

    Most studies are based on male participants, so the data may not hold true in females.” Historically, subjects in animal and human studies. across all of science have been male. Researchers have claimed that it is too difficult to control for the fluctuating hormones in the female body. It is important for physicians and scientists to recognize past studies have excluded females, leaving our understanding of medicine with a bias towards men. With women representing 50% of the population, it is a critical data point.

    Amy Hansen

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  • Circadian Rhythms and Our Health and Weight  | NutritionFacts.org

    Circadian Rhythms and Our Health and Weight  | NutritionFacts.org

    Given the power of chronotherapy—how the same dose of the same drugs taken at a different time of day can have such different effects—it’s no surprise that chronoprevention approaches, like meal timing, can also make a difference.

    The 2017 Nobel Prize in Medicine was awarded for “elucidating molecular mechanisms of the circadian clock,” our internal clock. For billions of years, life on Earth evolved to a 24-hour cycle of light and dark, so it’s no surprise our bodies are finely tuned to that pattern. But, even when we’re in total darkness without any external time cues, our body continues to cycle in about a 24-hour circadian rhythm. You can even take tissue biopsies from people and show the cells continue to cycle outside the body in a petri dish. Nearly every tissue and organ in our body has its internal clock.

    An intricate system of intrinsic clocks drives not only some of our behavioral patterns, such as eating, fasting, sleeping, and wakefulness, but it also drives our internal physiology—our “body temperature, blood pressure, hormone production, digestion, and immune activity.” Most of the genes in our body “exhibit daily fluctuations in expression levels, making the circadian expression rhythms the largest known regulatory network in normal physiology,” the biggest regulatory system in our body. This cycling is thought to allow for a level of “‘predictability’ and ‘functional division of labor’” so that each of our body processes can run at the best time. At night while we’re sleeping, a whole array of internal housekeeping activities can be switched on, for example, and as dawn approaches, our body can shift back into activity mode.

    Anyone who’s ever had jet lag knows what throwing off our cycle by even just a few hours can do, but now we know our circadian rhythms can be the difference between life and death. A study of more than 14,000 self-poisonings found that those who tried committing suicide in the morning were more than twice as likely to die than those who ingested the same dose in the evening. In the same vein, properly timed chemotherapy can not only end up being five times less toxic but also twice as effective against cancer. The same drugs, at the same dose, but with different effects depending on the time they’re given. Our body absorbs, distributes, metabolizes, and eliminates what we ingest differently, depending on when it is during the 24-hour cycle, as you can see below and at 2:19 in my video Chronobiology: How Circadian Rhythms Can Control Your Health and Weight. 

    We’re just beginning to figure out the optimal timing for different medications. Randomize people suffering from hypertension into taking their blood pressure pills at bedtime instead of in the morning, and not only does the bedtime group achieve better blood pressure control and suffer fewer heart attacks and strokes, but they cut their risk of death in half. (Yet, most physicians and pharmacists tell patients to take them in the morning, potentially doubling their risk of death.) If chronotherapy—the optimal timing of drugs—can have such an impact, maybe it should come as no surprise that chronoprevention—the scheduling of lifestyle interventions like mealtimes—can also make a difference.

    In the official Academy of Nutrition and Dietetics position paper on effective treatments for obesity, importance is placed not only on the quantity but also on the timing of caloric intake. “Potentially consuming more energy [calories] earlier in the day, rather than later in the day, can assist with weight management.” Some have gone further and even characterized obesity as a “chronobiological illness.” What evidence do we have to back up these kinds of claims?

    Well, the “timing of energy [caloric] and nutrient intake has shifted slightly over time, with a greater proportion of intake later in the day,” raising the question about a possible role in the rise of obesity. Middle-aged men and women who eat a greater share of daily calories in the morning do seem to gain less weight over time, and a study entitled “Timing of Food Intake Predicts Weight Loss Effectiveness” found that dieters eating their main meal earlier in the day seemed to steadily lose more weight than those eating their main meal later, as you can see in the graph below and at 4:12 in my video. 

    The obvious explanation for these findings would just be that those who eat later also tend to eat more. And, indeed, there does seem to be a relationship between when people eat most of their calories and how many calories they end up eating over the entire day, with those eating a greater proportion in the morning eating less overall. Maybe later eaters are overeating junk on the couch watching primetime TV? A tendency has been found for night owls to consume more fast food and soda, and fewer fruits and vegetables. In the field of social psychology, there is a controversial concept called “ego depletion,” where self-control is viewed as a limited resource, like a muscle that can become fatigued from overuse. As the day wears on, the ability to resist unhealthy food choices may decline, leaving one vulnerable to temptation. So, is it just a matter of later eating leading to greater eating?

    In the study I mentioned above where earlier eaters steadily lost more weight, to the researchers’ surprise, the early eaters ate as much as the late eaters, despite the difference in weight-loss magnitude. By the end of the 20-week study, the early eaters ended up about five pounds lighter than the late eaters, even though the two groups ate the same amount of food. There didn’t seem to be any difference in physical activity between the two groups either. Could it be that just the timing itself of caloric intake matters? Scientists decided to put it to the test, which we’ll cover next.

    Wasn’t that chemo data wild?

    If you are on blood pressure medications, please share this video with your physician and ask if your timing is optimized.

    We kicked off this chronobiology series by looking into the importance of breakfast when it comes to weight loss. In case you missed those videos, see Friday Favorites: Is Breakfast the Most Important Meal for Weight Loss, or Should It Be Skipped?.

    For more on this topic, check out the related posts below.

    Michael Greger M.D. FACLM

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  • Dairy Milk Hormones’ Effects on Cancer  | NutritionFacts.org

    Dairy Milk Hormones’ Effects on Cancer  | NutritionFacts.org

    What are the effects of the female sex hormones in cow’s milk on men, women, and children? 
     
    All foods of animal origin contain hormones, but most of our dietary exposure to hormones comes from dairy products. By quantity, as you can see below and at 0:16 in my video The Effects of Hormones in Dairy Milk on Cancer, it is mostly prolactin, corticosteroids, and progesterone, but there are also a bunch of estrogens, which concentrate even further when other dairy products are made. For instance, hormones are five times more concentrated in cream and cheese, and ten times more in butter. 

    When it comes to steroid hormones in the food supply, about three-quarters of our exposure to ingested female sex steroids come from dairy, and the rest is split evenly between eggs and meat (including fish). Indeed, eggs contribute about as much as all meat combined, which makes a certain amount of sense since an egg comes straight from a hen’s ovary. Among the various types of meat, you get as much from white meat (fish and poultry) as you do from pork and beef, and this is just from natural hormones—not added hormone injections, like bovine growth hormone. So, it doesn’t matter if the meat is organic. Animals produce hormones because they’re animals, and their hormones understandably end up in animal products. 
     
    About half of the people surveyed “did not know that milk naturally contains hormones,” and many “lacked basic knowledge (22% did not know that cows only give milk after calving)”—that is, they didn’t realize what milk is for—feeding baby calves. Researchers suggested we ought to inform the public about dairy production practices. In response, one Journal of Dairy Science respondent wrote that telling the public about the industry’s new technologies, like transgenic animals (meaning genetically engineered farm animals), “or contentious husbandry practices” (such as taking away that newly born calf so we can have more of the milk or “zero-grazing for dairy cows”—i.e., not letting cows out on grass), “does not result in high rates of public approval,” so ixnay on the educationay. 
     
    The public may not know the extent to which they are exposed to estrogen through the intake of commercial milk produced from pregnant cows, which has potential public health implications. “Modern genetically improved dairy cows, such as the Holstein,” the stereotypical black and white cow, can get reimpregnated after giving birth and lactate throughout almost their entire next pregnancy, which means that, these days, commercial cow’s milk contains large amounts of pregnancy hormones, like estrogens and progesterone. 
     
    As you can see in the graph below and at 2:42 in my video, during the first eight months of a pregnant cow’s nine-month gestation, hormone levels in her milk shoot up more than 20-fold. Even so, we’re only talking about a millionth of a gram per quart, easily 10 to 20 times less estrogen hormones than you’d find in a birth control pill. In that case, would drinking it really have an effect on human hormone levels? 


    Researchers analyzed three different estrogens and one progesterone metabolite flowing through the bodies of seven men before and after they drank about a liter of milk. Within hours of drinking the milk, their hormone levels shot up, as you can see in the graph below and at 3:08 in my video. 


    The researchers also looked at the average levels of female sex steroids flowing through the bodies of six schoolchildren (with an average age of eight) before and after they drank about two cups of milk. Within hours of drinking the milk, their levels shot up, tripling or quadrupling their baseline hormone levels, as you can see in the graph below and at 3:23 in my video. So, one can imagine the effects milk might have on men or prepubescent children, but what about women? Presumably, women would have high levels of estrogen in their body in the first place, wouldn’t they? Well, not all women. 

    What about postmenopausal women and endometrial cancer, for example? Estrogens have “a central role” in the development of endometrial cancer, cancer of the lining of the uterus. “Milk and dairy products are a source of steroid hormones and growth factors that might have physiological effects in humans.” So, Harvard researchers followed tens of thousands of women and their dairy consumption for decades and found a significantly higher risk of endometrial cancer among postmenopausal women who consumed more dairy, as shown below and at 4:19 in my video. 
    What about dietary exposure to hormones and breast cancer? Unfortunately, “understanding the role of dietary hormone exposure in the population burden of breast cancer is not possible at this time.” 

    For more on the relationship between cancer and dairy, see related videos below. 

    I talk about the effect of dairy estrogen on men in Dairy Estrogen and Male Fertility.

    What about the phytoestrogens in soy? See here.

    Michael Greger M.D. FACLM

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