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135691 tn?1271100723

Chemotherapy and Estrogen Replacement

This is a busy forum! I've been reading quite a bit lately about avoiding Estrogen replacement therapy while undergoing chemo, mainly Taxol. I was prescribed Premarin, at the highest dosage, all throughout my treatment and no one seemed concerned. What is the reason for not using ERT during chemo? Have you heard of this before?
Thank you in advance,
Becky
4 Responses
242604 tn?1328124825
MEDICAL PROFESSIONAL
Dear Becky,
The question about estrogen is a really good one! I have pasted some abstract summaries below for people to read but let me just summarize some of the issues:

-Prevention of ovarian cancer:
It has been known for several decades that the birth control pill seems to reduce the risk of ovarian cancer. (see abstract 1 and 2). However, a recent study called the Women
Avatar universal
Sorry to barge in here...but I have been following along with Becky regarding this issue.  (difficult surgical menopause, age 49, surgery 6 months ago due to complex cysts, no ovca but very interested in this issue now as a result).  
I do question the safety of estrogen for us ALL.  I noticed you said "...I would consider estrogen, low dose and without the addition of progesterone" and I wondered if you could perhaps expand on why no progesterone? Or are you referring to progestin?  Or does it matter? (see, I am SO confused!)

(abstract 3) you refer to progestin, which is different, isn't it?  

I am on the Estradot 50 patch (doctor approved) and a bio identical progesterine cream (not as much approval) after a great deal of often contradictory research. I AM skeptical and I know how the medical profession views these bio identicals but I need help!  My symptoms, like a lot of us here, include insomnia, diminished sexual desire, fatigue, headache, lethargy, depression, weight gain, vaginal dryness, stress incontinence... and LOTS of whining.  

Thank you so much for your help and all that you do, your answers are so very kind and thoughtful...
Avatar universal
Hi Katie - yes it is tough and confusing.
Progesterone also known as progestin (other names: medroxyprogesterone, megace, provera, prometrium, probably many others..) is the second female hormone that is secreted by the ovary. It is the anti- growth hormone. During the menstrual years (hey how is that for a new label?), the ovary produces progesterone after ovulation. It's job is to stabilize the lining of the uterus (the endometrium) which has been stimulated in the first half of the cycle by estrogen.

In hormone replacement, estrogen alone stimulates the lining of the uterus. It has been well established that women who take "unopposed estrogen" and who have a uterus are at risk for the development of cancer of the endometrium from direct estrogen growth stimulation. This can be completely prevented by adding a progesterone for balance.

For women who have had a hysterectomy, progesterone is unnecessary and it is safe to take estrogen alone. The most recent study (The women's health initiative WHI)on estrogen and the risk of breast cancer only showed a risk with estrogen and progesterone in the product called "prempro". To date, the WHI study has not shown an association of estrogen alone and breast cancer.
take care
Avatar universal
Thank you for your kind response!  
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