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suzieq

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Reply with quote  #1 

IS THIS A TRUE MEDICAL CONDITION. I HAVE SUFFERED THE SYMPTOMS OF THIS FOR THE PAST 10 YEARS. I WAS DIAGNOSED 10 YEARS AGO WITH BC AND DID CHEMO / RADIATION AND LUMPECTOMY. JUST B4 I HAD A MISCARRIAGE ..I WAS 34. FOR THE NEXT 10 YRS I SUFFERED WITH MIGRAINES, OVARIAN CYSTS AND HAD TO HAVE A HYSTERECTOMY THE CYSTS WERE SO BAD...A COUPLE OF YRS AGO I HAD A COMPLETE HYSTERECTOMY WITH OVARIES TAKEN...I HAD SURGICAL MENOPAUSE AND IT WAS OBVIOUS....HOT FLASHES/MOOD SWINGS/NIGHT SWEATS/INSOMNIA AND A NUMBER OF OTHER LITTLE THINGS....THEN I WAS REDIAGNOSED LAST SEPT 09 WITH A NEW BREAST CANCER AND I CANT HELP BUT WONDER IF MY LAST 10YRS OF OBVIOUS ESTROGEN DOMINANCE LET TO IT...PLS REPLY THANKS SUZIEQ

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Reply with quote  #2 
i don't really know what estrogen dominance is as a dx. i struggled with terrible ovarian cysts and high estrogen level since i was 15. my first breast cancer was in 2001 and it was triple negative- not fueled by estrogen. my second breast cancer in 2007 was lobular and estrogen responsive. now i am on lupron and femara.

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suzieq

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Reply with quote  #3 
i don't really know what estrogen dominance is as a dx. i struggled with terrible ovarian cysts and high estrogen level since i was 15. my first breast cancer was in 2001 and it was triple negative- not fueled by estrogen. my second breast cancer in 2007 was lobular and estrogen responsive. now i am on lupron and femara.
[I don't think doctoc's actually know what Estrogen dominance is..at least not a GP..maybe an OBGYN but I just know that for years I had alot of the symptoms listed under estrogen dominance and have read alot about it...and I too suffered for a very long time with ovarian cysts and I always wondered if this was caused by too much estrogen and not enough progesterone...It is very frustrating when doc s do not support alternate therapies such as hormone balancing with suppliments and bio identical hormones....I don't know what way to go....My second cancer was also ER/PR + and I am being advised to take the AI's.....I feel that I have done the chemo and the reconstruction ect...and that I do not want to take pills for 5 yrs that have side effects of blood clots and stroke not to mention the lack of estrogen in your body....what will that mean for your quality of like and sex. I am so confused.........Talk soon, Suzieq]
Cynt

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Reply with quote  #4 
You're already in menopause, Suzieq, and although I know that the estrogen blocked menopause is more severe, the women I've spoken to that were already in menopause when they went on the AIs didn't really experience much in the way of more side effects. I don't have anything to compare to; I was premenopausal, and crashed into menopause. It hasn't been pretty. 

However, I still have a sex drive. It's not physical, no. But I think a female's libido is more mental, anyway. I do have problems (I'm on tamoxifen, not AI's, am considering switching because I think my problems might be due to the blocking action of tamoxifen, whereas AIs inhibit production), but as to chances of blood clots etc, why don't you check and see what the actual incidence is of the effects you're worried about, and compare it to the rate of metastasis in women with your type of cancer? There are things you can do to help with the sex parts, and you've already had to deal with a lack of estrogen. I completely understand your feelings, because it's been the thing I've cried the hardest about!  I'd just encourage you to know as much as you can about both sides of your choice, so you can make the wisest possible decision. Also, trying them might give you more of an idea as to if they would be acceptable for you. What would that hurt?

Also, as to supplements, lot of research of late into anti-breast cancer properties of melatonin (20mg/night), green tea (EGCg, not sure of optimum dosage; 1000mg?) and Resveratrol, (5mg/per kg weight is optimum); research I read (think was from Mayo Clinic) said that the melatonin was attaching to the same receptor as estrogen and tamoxifen, on breast cancer. If you decide not to go hormone therapy, maybe supplements would help.

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suzieq

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Reply with quote  #5 
You're already in menopause, Suzieq, and although I know that the estrogen blocked menopause is more severe, the women I've spoken to that were already in menopause when they went on the AIs didn't really experience much in the way of more side effects. I don't have anything to compare to; I was premenopausal, and crashed into menopause. It hasn't been pretty. 

However, I still have a sex drive. It's not physical, no. But I think a female's libido is more mental, anyway. I do have problems (I'm on tamoxifen, not AI's, am considering switching because I think my problems might be due to the blocking action of tamoxifen, whereas AIs inhibit production), but as to chances of blood clots etc, why don't you check and see what the actual incidence is of the effects you're worried about, and compare it to the rate of metastasis in women with your type of cancer? There are things you can do to help with the sex parts, and you've already had to deal with a lack of estrogen. I completely understand your feelings, because it's been the thing I've cried the hardest about!  I'd just encourage you to know as much as you can about both sides of your choice, so you can make the wisest possible decision. Also, trying them might give you more of an idea as to if they would be acceptable for you. What would that hurt?

Also, as to supplements, lot of research of late into anti-breast cancer properties of melatonin (20mg/night), green tea (EGCg, not sure of optimum dosage; 1000mg?) and Resveratrol, (5mg/per kg weight is optimum); research I read (think was from Mayo Clinic) said that the melatonin was attaching to the same receptor as estrogen and tamoxifen, on breast cancer. If you decide not to go hormone therapy, maybe supplements would help.
[Hi Cynt.....Thanks for all of your imput. I am just 8 weeks post op from my reconstruction and finished chemo in Feb...I think I am still feeling some effects of the chemo after the fact.....but I do feel that some of how I felt prior to all this is coming back ...libido for me has been lacking big time since after the hysterectomy 2 yrs ago. I am working on it. As for taking Tamoxifen vs AI's because I am menopausal...the AI's are usually given...when I asked my onc.about the differences she did explain that when you take Tamoxifen....it inhibits the receptors but does not block estrogen and when you take AI's they block both...so my fear is to not have any estrogen when I already feel the the negative effects of its decline in me....I may get a some advise from a endocronologist (re hormone balance ) or what else can help if I do go on the AI's. Either way, I will take a bit of time to decide and maybe I will try it and see like you said....Thanks again and talk soon ]
DoreenF

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Reply with quote  #6 
suzieq: your posts are hard to read since you're quoting someones reply and then putting your response into the quoted reply ... it's hard to find where your response starts.   I don't think there's a reason to quote someone's entire reply ...  can you try to just reply instead of quoting ?

Thanks,
Doreen


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suzieq

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Reply with quote  #7 

Thanks Doreen....I just figured out how to do this...I thought I had to reply using the quote format ..I think this is alot easier to read...thanks
DoreenF

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Reply with quote  #8 
thanks suzieq! It is much easier to read now ...

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Cynt

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Reply with quote  #9 
suzieq,

I am somewhat confused by your answer to me.

First of all, if you thought I was saying take tamoxifen: no, I was not suggesting that. AIs are better than tamoxifen. I was saying that I am on tamoxifen, so I have no real experience with the effects of AIs, tho the effects of tamoxifen have been awful, and that's only the expected ones of sapping the estrogen from my vagina. I don't need to go into those problems here, I have elsewhere.

As to the action of AI's and tamoxifen...well, I've been told something different than what I understood you to be saying. Actually I'm not entirely sure what all you were saying, what "AIs block both" means. Tamoxifen is a weak estrogen. Its action is to block the body's estrogen from getting to the receptor that takes in estrogen on the cancer cell. Tamoxifen can handle premenopausal estrogen levels, which is why I'm on it, because I was premenopausal. Apparently, women who go into menopause from chemo can pop out of it again, usually within 2 years, and my estrogen levels are on the rise. Again, tamoxifen blocks estrogen's effects in the body by replacing your estrogen with its weaker form.. It does not inhibit production.

AI's, or aromatase inhibitors, inhibit the production of estrogen. They are used in menopausal women, so they don't have to try and overcome high levels of estrogen. They will not work on a premenopausal woman (unless she's being put into menopause chemically).

As to hormone balancing, menopause has more or less done that for you. "Balancing" in the case of estrogen dominance means adding progesterone to counter the estrogen. The level of estrogen in your body is very low, and the level of progesterone would be even lower; progesterone all but disappears during menopause. Adding progesterone, however, is likely not a good idea; one nurse practitioner prescribed that for me, and my gynecologist was fairly horrified. I did not mind getting off of it, it hadn't done a thing for me. But she said that, first of all, adding progesterone didn't typically help symptoms, and secondly, any of the hormones your body gets, it can convert to estrogen. So no testosterone either. THAT is one of the things I'd be curious to try; it is a hormone much involved with sexual desire, and I'm sure I'm low in it because my ovaries were chemofried, so they're not producing much of anything. Well, weren't; not sure now. They seem to be recovering.

With libido, I've found that once things got going, even if I wasn't interested in the beginning, I'd get interested. There are other problems because of the estrogen lack, but libido, at our stage of hormones, is more of "get going and get into it" than "Oh, boy! SEX!" from nothing. I miss those days...but I know they are not coming back.

Still, as I said. Since you're already menopausal, seems like you don't really have much to lose by trying the AIs, except losing a higher risk of metastasis, and that's a good thing to lose, yes?  

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nosurrender

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Reply with quote  #10 
Hi everyone!
Aromatase inhibitors, or AIs, prevent adrogen from being converted into estrogen in the post menopausal body. It is converted with the enzyme aromatase. In order to take an AI you must be in true menopause, have your ovaries removed or have them suppressed with an agent such as Lupron.

Studies have shown that Femara is superior to Tamoxifen in preventing breast cancer recurrence in estrogen positive women.

The side effects of Femara, and other AIs, can be mitigated by maintaining a high blood value of Vitamin D and exercise. Every woman should have her D level checked and make certain she is not deficient. It protects against cancer.

As far as the sexual side effects, they can all be overcome. I have a book out now that teaches you how to reverse atrophy and get your sexuality back.

As far as bio-identical hormones, personally, I am afraid of them. I am afraid of anything that might ring the dinner bell for cancer cells. It is something that really needs to be thoroughly discussed with your oncologist and gynecologist.


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edge

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Reply with quote  #11 

Cynt, and others:

 

Warning Re Bio-identical Hormones and Estrogen Dominance

 

So-called bio-identical hormones are currently being prescribed by some as an 'innovative therapy' with not a scintilla of peer-reviewed published evidence. These putative natural hormones, including estradiol, estriol, estrone, and progesterone, including the individually compounded natural estrogens like (1) biestrogen (Biest), a combination estrogen preparation of 20% estradiol and 80% estriol, and (2) triestrogen (Triest) containing 10% estradiol, 10% estrone, and 80% estriol, among many others, can be expected to have the same adverse event profile as conventional menopausal hormone regimens.  Compounded bio-identical hormones are promoted as natural, safer, and in some cases more efficacious than conventional hormone therapies, despite the absence of robust  scientific evidence to support these claims, and they  in addition lack well controlled studies examining their route of administration, their pharmacokinetics, their safety, and any critical, science-based rationale for the mixture and ratios of bio-identical estrogens employed.  To take one example of the lack of superior, or any, safety, a study conducted Henry Lemon at the University of Nebraska Medical Center found that when older women with breast cancer were treated with estriol (the main component of bio-identical hormones) 25% had if fact increased growth of metastases.  Similarly, despite the claims of proponent Dr. John Lee (What Your Doctor May Not Tell You About Breast Cancer! How Hormone Balance Can Help Save Your Life) - echoed by  Dr. Christine Northrup (an Oprah regular), Dr. Lila Nachigall, actress Suzanne Somers, among many others - that progesterone cream can eliminate "estrogen dominance secondary to relative insufficiency of progesterone" that is putatively characteristic of various medical conditions, such as breast cancer, uterine fibroids, fibrocystic breast disease, and premenstrual syndrome, these wholly lack credible or compelling supporting data, and natural progesterone, particularly when used as a skin cream, does not reliably prevent endometrial proliferation or endometrial hyperplasia, and there have been three documented cases of endometrial cancer reported in Australia among women using bio-identical progesterone as troches or skin cream along with estrogen.

 

To buttress their claims, and sale motivation, with pseudo-science, salivary tests are often used, irrationally and without any evidence, to persuade asymptomatic consumers to use hormones (or symptomatic patients to use higher doses than those needed to mitigate symptoms), a practice virtually guaranteed to result in adverse, if not wholly tragic, events. Such salivary testing is used on the claim that  it indicates what hormone levels are in the tissues, as opposed to the bloodstream, for example, when salivary progesterone levels are used to “confirm” the protective effect against the development of uterine cancer. In fact, not one study has shown a correlation between salivary progesterone levels and uterine progesterone levels, and the correlation of any salivary hormones with serum levels has been shown to be poor, unreliable and inconsistent (as per Michael Cirigliano at  University of Pennsylvania, Lisa Boothby at Columbus Regional Drug Information Center, among many others) so such tests provide no relevant information and, worse, may give misleading information about uterine and other claimed protection.

 

Furthermore, the claim that 'synthetic' hormones have more side effects, solely by virtue of being synthetic, is irrational on the pharmacokinetic science, and lacking in any substantiation, and the claim that 'synthetic' HRT is derived from an animal, but 'natural' HRT is derived from plants, defies logic, and is internally inconsistent, as proponents conjunctively also claim that the bio-identical hormones are "exact replicas of what we make in our own bodies" - the human body has no discriminative ability to detect the source of a metabolite or elemental hormone. Furthermore, whether compounded or pharmaceutically manufactured, all estradiol, even if it comes from “natural” sources, is still synthetic: hormones in compounded creams and most pharmaceutical hormone therapy products are synthesized from yams or soy - which in fact themselves contain absolutely no estrogen nor progesterone whatsoever - by using a compound extracted from the yams or soy called diosgenin which has a similar structure to that of human cholesterol, from which all human sex hormones are made, and the diosgenin is then exposed to a series of enzymes in the laboratory and synthesized to bioidentical estradiol so that labeling these hormones as “nonsynthetic” is purely unscientific hokum and market PR.

 

In sum, several critical appraisals, systematic reviews, and meta-analyses, found that the main hormone found in bio-identical hormones is estriol, used alone or in combination with estradiol and estrone, with the total daily oral dose used, on the average, being at least ten-fold greater than that used in traditional HRT, and based on the current evidence, the same cardiovascular and other risks that were recently found associated with oral HRT are likely to be associated with the administration of oral estriol in bio-identical hormone therapies. There is a standing FDA guidance that specifically recommends bio-identical hormone product labeling include a statement that there is no evidence that these putative 'natural' products are safer than their synthetic counterparts, and to use these products for the "shortest duration" possible, but most suppliers and physicians bypass that by the simple ruse of personal compounding. In my own review, I have not found even the remotest compelling scientific evidence for any benefit or safety advantage of bio-identical hormones, or the related claims of hormone balancing of putative estrogen dominance (approaches primarily associated with Dr John Lee and Christine Northrup), and my reviews have concluded that no safety or adverse event advantage is compellingly evidenced, and in addition the lack of regulatory standard and quality control puts the consumer at unknown risk of harm.

 

One final note on the wholly foundationless claims of Suzanne Somers (who otherwise seems a fine person albeit gullible and scientifically naive): these have been debunked many times, and I should note that Somers actually underwent wholly standard mainstream/traditional surgery for a highly prognostically favorable, small, estrogen receptor-positive (ER+) stage I breast cancer (there is no more favorable breast cancer type to have), along with standard radiation therapy, so it is definitely not in any way amazing that Somers is still alive after having as she says “rejected chemotherapy”, and in many such cases surgery and radiotherapy are of their own curative, and her claims re bioidentical hormones, as shown above, are irrational and against the scientific evidence (and the doctors she cites and credits are themselves highly questionable (see for instance: The Suzanne Somers Vanity Calamity, part 4: All her quacks in a row).

 

The public, and especially women with breast cancer who understandably seek hope where they can find it, deserve better, and both celebrities, entertainment brokers, and health professionals should not exploit these hopes.  We  have scientific foundations for hope and promise in breast cancer, but from traditional medicine, and CAM, and their rare but sometime integration into a true evidence-based integrative oncology. We need more of this,  not the modern pseudo-science attired snake-oil being promoted, sincerely or otherwise.

 


Constantine Kaniklidis

Breast Cancer Watch

edge@evidencewatch.com 

Cynt

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Reply with quote  #12 
Well...thanks...I'm not sure why that was directed at me by name?

I'm sorry if I gave any indication I thought bioidentical meant safer. Natural hormones, after all, are what fed the cancer to begin with, why would "natural" hormones be better than synthetic anyway? If you read all of my posts, I hope you'll see that I was discouraging, not encouraging "balancing" at this stage of the game. 

Or maybe my brain's messed up, and I only THINK I'm being clear. Sigh.

Personally, I think the whole "estrogen dominance" bit smacks of a big sales tactic. There is undoubtedly some truth to parts, but the symptoms read like a list of everything women ever complain about, with progesterone being the touted cure all. Uh uh. I don't buy it. And if you read the latest research, they've found a link between progesterone and tumor spread, no matter what cancer type it is.

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Blessings,
Cynt
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