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 Sangeeta Pati MD -
Why Bioidentical Hormones Are Better
by Jeffrey Dach MD
This is a 7 minute video of Dr Sangeeta Pati's seminar on Bioidentical Hormones at the Annual World Congress of Anti-Aging Medicine in Orlando. I met Dr Pati at the this meeting a few years ago, and it is no accident she was selected to speak on this topic. She is one smart lady with an excellent presentation. Dr Pati is a popular speaker at these meetings, and has considerable experience in the field of Bioidentical Hormones. In this video, Dr Pati explains why bio-identical hormones are safer and more effective than the synthetic chemically altered hormones offered by mainstream medicine. For your convenience, a transcript is just below.
TRANSCRIPT of Talk
In this video , Dr. Sangeeta Pati speaks to a large audience of physicians at a national meeting. Here is the transcript of the video (edited for clarity):
Dr Pati says (begin transcript of video presentation)
Hormone Deficiency Leads to Host of Symptoms
Every organ system in the body has hormone receptors for turning on gene expression and protein synthesis. After age 25, we start to see a decline in hormone levels creating hormone deficiency. It's no wonder that hormone deficiency causes a host of symptoms, such as hot flashes, vaginal atrophy. and loss of energy. And also years later, we start to see the onset of degenerative diseases, cognitive dysfunction, bone loss, strokes, osteoarthritis, heart disease etc.
How Safe is it NOT to Do Hormone Replacement?
Many people ask, how safe is it "really", to do hormone replacement? Yet, the real question is how safe is it NOT TO DO hormone replacement. The medical standard of care is to replace and restore "what is missing" with a copy of "what is missing". For example, if you are missing thyroid hormone (and you have low thyroid levels), then you replace the thyroid hormones that are missing by giving thyroid pills.
Why the Confusion about Hormones?
So, why is it that we are so confused about the hormone deficiencies? If you think about the syndrome we are talking about, hormone deficiency, it can span 30 years and you can be symptomatic for thirty years.
Typical Symptoms of Hormone Deficiency
In women, Progesterone deficiency being first to appear, causes irritability and PMS type symptoms 10-15 years before menopause. After menopause around age 50, estrogen deficiency causes hot flashes and night sweats for a year or two. For some women, the hot flashes will continue for many more years later. Low testosterone causes loss of libido (sex drive).
Progesterone is the first hormone to decline, and many of you will notice symptoms such as mood swings, anxiety, breast cysts, ovarian cysts, because progesterone has an antiproliferative effect. Additional symptoms of progesterone deficiency are low sex drive and hot flashes.
Why Bioidenticals Are Better than Synthetics
Of course, I am going to say that we "should be" replacing these hormones, but in order to put you at ease, and anybody at ease, whether it is a patient or a doctor writing a prescription, you have to understand how to (a) decipher the WHI study and figure out what lessons we actually did learn from the WHI (Women's Health Initiative JAMA 2002). And (b) look at what kind of data there is on the bioidentical hormones that we purport may be a better choice compared to the synthetic hormones.
The WHI study included 16,000 women with average age 63, using the synthetic hormones, Premarin and Provera a synthetic progestin. For the synthetic hormone treated group, they found more heart attacks strokes and breast cancer and fewer hip fractures. The synthetic hormone treated group also had a 21 % reduction in diabetes.
You have to ask, Why did the synthetic hormone treated group have increased cancer and heart disease?
If I just said, well, that "hormones should be protective", then why would they find that these hormones, the synthetic hormones ARE NOT protective ? Could it be they had too many women with pre-existing disease? Could it be because they used the wrong hormone ratios. Or that they used the oral route rather than transdermal route of administration? Or that they were using a Progestin instead of a natural progesterone?
The Progestin Was the Culprit
Progestin is not the same as bioidentical progesterone, it has an extra molecule on it.
And if you look at the WHI results ( second arm JAMA 2004 Premarin-Only in women with hysterectomies), you find that without the progestin, the breast cancer risk is significantly decreased. The cardiac risk was also decreased. This finding is consistent with four other studies. here they are: The Breast Cancer Detection Demonstration Project ( BCDDP ) had an 8 fold increase in breast cancer when they used a progestin. The Swedish Record Review had a three fold increase in breast cancer with a progestin. The Million Woman Study had a two fold increase. In all four studies, they were using Progestins along with the estrogen, and that's why they got those results. (Progestins are chemically altered synthetic forms of progesterone)
Bioidentical Progesterone is Far Better Than the Progestins
What do we know data-wise on bioidentical progesterone? Firstly, compared to the synthetic progestins, quality of life is way better. Bioidentical Progesterone is preferred over synthetics by women who report improved mood, less bleeding, less anxiety and better sleep. I can tell you anybody here who has switched a woman from synthetic to bioidentical hormones knows what we are talking about here.
In addition, there is lower cancer risk with progesterone, which decreases the proliferation of breast cells. Bioidentical progesterone also lowers cardiac risk. Progesterone vasodilates (opens arteries) and increases nitric oxide (a beneficial vasodilator) compared to progestins which does the exact opposite.
We learned a a few things from the WHI study.
1) Start hormone replacement earlyon when hormone levels start to decline.
2) Mimic the normal ratios of the hormones in the body (estrogen-progesterone ratio)
3) Use the transdermal route of hormone administration with topical creams (to avoid hypercoagulability and blood clots inherent in oral estrogen tablets)
4) Don't use estrone which is prevalent in Premarin, instead use estradiol and estriol also called Bi-Est which is bioidential.
5) Avoid synthetic progestins, instead use a bioidentical progesterone.
Endquote for transcript of video
French Cohort Study
I would add here that the French Cohort Study showed that biodentical hormones are safe and not associated with increased risk of breast cancer compared to the general population.
Drop in Breast Cancer Rates after Discontinuing Synthetic Hormones
A new Canadian Study is in the news, showing Canadian data duplicates the United States data on the dramatic decline in Canadian breast cancer rates after the 2002 WHI study which prompted large numbers of women to stop using synthetic hormones. The earlier US report by Ravdin in April 2007 published in the New England Journal showed plummeting breast cancer rates when US women ceased using synthetic hormones in 2003.
Recommendation
If you are in the Orlando area, and need a bioidentical hormone doctor, call Dr Sangeeta Pati at the Sajune Clinic to make an appointment.
Financial disclosure: I have no financial ties to disclose, and received no funding from the A4M medical organization, nor any of the presenters at the A4M meetings, nor specifically from Sangeeta Pati who is mentioned in this article.
Articles with Related Content
Best Bioidentical Vidoes on You Tube
The Safety of Bioidentical Hormones by Jeffrey Dach MD
The Impotance of Bioidentical Hormones by Jeffrey Dach MD
The Evidence for Bio-Identical Hormones
The Battle for BioIdentical Hormones by Jeffrey Dach MD
Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD
Bioidentical Hormones and Medical Ghostwriting
Links and References
New Canadian Study Shows Breast cancer rates Decline Dramatically After Stopping Synthetic Hormones Prempro ( Premain and Provera) Note: Provera is a synthetic progestin.
http://jnci.oxfordjournals.org/content/early/2010/09/23/jnci.djq345.abstract
JNCI J Natl Cancer Inst (2010) First published online: September 23, 2010
Breast Cancer Incidence and Hormone Replacement Therapy in Canada
Prithwish De, C. Ineke Neutel, Ivo Olivotto and Howard Morrison
Conclusion During the period 2002–2004, there was a link between the declines in the use of hormone replacement therapy and breast cancer incidence among Canadian women aged 50–69 years, in the absence of any change in mammography rates.
http://www.reuters.com/article/idUSTRE68M56C20100923?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+reuters%2FhealthNews+(News+%2F+US+%2F+Health+News )
Breast cancer rates fell with hormone therapy drop
Thu Sep 23, 2010 4:20pm EDT (Reuters) - Breast cancer rates among postmenopausal women in Canada dropped nearly 10 percent after news of a big study in 2002 that found taking hormone replacement therapy could increase breast cancer risk, researchers said on Thursday.
http://abcnews.go.com/Health/wireStory?id=11713357
Breast Cancer Rates Fell With Hormone Therapy Drop
September 23, 2010 (Reuters
The Decrease in Breast-Cancer Incidence in 2003 in the United States NEJM Volume 356:1670-1674 April 19, 2007 Number 16 by Peter M. Ravdin et al.
Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://www.jeffreydach.com
http://www.drdach.com
http://www.naturalmedicine101.com
http://www.truemedmd.com
Disclaimer click here: www.drdach.com/wst_page20.html
The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician -- patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.
Link to this article
Copyright (c) 2010,11 Jeffrey Dach MD All Rights Reserved. This article may be reproduced on the internet without permission, provided there is a link to this page and proper credit is given.
FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of issues of significance. We believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.
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Why Bioidentical Hormones Are Better
by Jeffrey Dach MD
This is a 7 minute video of Dr Sangeeta Pati's seminar on Bioidentical Hormones at the Annual World Congress of Anti-Aging Medicine in Orlando. I met Dr Pati at the this meeting a few years ago, and it is no accident she was selected to speak on this topic. She is one smart lady with an excellent presentation. Dr Pati is a popular speaker at these meetings, and has considerable experience in the field of Bioidentical Hormones. In this video, Dr Pati explains why bio-identical hormones are safer and more effective than the synthetic chemically altered hormones offered by mainstream medicine. For your convenience, a transcript is just below.
TRANSCRIPT of Talk
In this video , Dr. Sangeeta Pati speaks to a large audience of physicians at a national meeting. Here is the transcript of the video (edited for clarity):
Dr Pati says (begin transcript of video presentation)
Hormone Deficiency Leads to Host of Symptoms
Every organ system in the body has hormone receptors for turning on gene expression and protein synthesis. After age 25, we start to see a decline in hormone levels creating hormone deficiency. It's no wonder that hormone deficiency causes a host of symptoms, such as hot flashes, vaginal atrophy. and loss of energy. And also years later, we start to see the onset of degenerative diseases, cognitive dysfunction, bone loss, strokes, osteoarthritis, heart disease etc.
How Safe is it NOT to Do Hormone Replacement?
Many people ask, how safe is it "really", to do hormone replacement? Yet, the real question is how safe is it NOT TO DO hormone replacement. The medical standard of care is to replace and restore "what is missing" with a copy of "what is missing". For example, if you are missing thyroid hormone (and you have low thyroid levels), then you replace the thyroid hormones that are missing by giving thyroid pills.
Why the Confusion about Hormones?
So, why is it that we are so confused about the hormone deficiencies? If you think about the syndrome we are talking about, hormone deficiency, it can span 30 years and you can be symptomatic for thirty years.
Typical Symptoms of Hormone Deficiency
In women, Progesterone deficiency being first to appear, causes irritability and PMS type symptoms 10-15 years before menopause. After menopause around age 50, estrogen deficiency causes hot flashes and night sweats for a year or two. For some women, the hot flashes will continue for many more years later. Low testosterone causes loss of libido (sex drive).
Progesterone is the first hormone to decline, and many of you will notice symptoms such as mood swings, anxiety, breast cysts, ovarian cysts, because progesterone has an antiproliferative effect. Additional symptoms of progesterone deficiency are low sex drive and hot flashes.
Why Bioidenticals Are Better than Synthetics
Of course, I am going to say that we "should be" replacing these hormones, but in order to put you at ease, and anybody at ease, whether it is a patient or a doctor writing a prescription, you have to understand how to (a) decipher the WHI study and figure out what lessons we actually did learn from the WHI (Women's Health Initiative JAMA 2002). And (b) look at what kind of data there is on the bioidentical hormones that we purport may be a better choice compared to the synthetic hormones.
The WHI study included 16,000 women with average age 63, using the synthetic hormones, Premarin and Provera a synthetic progestin. For the synthetic hormone treated group, they found more heart attacks strokes and breast cancer and fewer hip fractures. The synthetic hormone treated group also had a 21 % reduction in diabetes.
You have to ask, Why did the synthetic hormone treated group have increased cancer and heart disease?
If I just said, well, that "hormones should be protective", then why would they find that these hormones, the synthetic hormones ARE NOT protective ? Could it be they had too many women with pre-existing disease? Could it be because they used the wrong hormone ratios. Or that they used the oral route rather than transdermal route of administration? Or that they were using a Progestin instead of a natural progesterone?
The Progestin Was the Culprit
Progestin is not the same as bioidentical progesterone, it has an extra molecule on it.
And if you look at the WHI results ( second arm JAMA 2004 Premarin-Only in women with hysterectomies), you find that without the progestin, the breast cancer risk is significantly decreased. The cardiac risk was also decreased. This finding is consistent with four other studies. here they are: The Breast Cancer Detection Demonstration Project ( BCDDP ) had an 8 fold increase in breast cancer when they used a progestin. The Swedish Record Review had a three fold increase in breast cancer with a progestin. The Million Woman Study had a two fold increase. In all four studies, they were using Progestins along with the estrogen, and that's why they got those results. (Progestins are chemically altered synthetic forms of progesterone)
Bioidentical Progesterone is Far Better Than the Progestins
What do we know data-wise on bioidentical progesterone? Firstly, compared to the synthetic progestins, quality of life is way better. Bioidentical Progesterone is preferred over synthetics by women who report improved mood, less bleeding, less anxiety and better sleep. I can tell you anybody here who has switched a woman from synthetic to bioidentical hormones knows what we are talking about here.
In addition, there is lower cancer risk with progesterone, which decreases the proliferation of breast cells. Bioidentical progesterone also lowers cardiac risk. Progesterone vasodilates (opens arteries) and increases nitric oxide (a beneficial vasodilator) compared to progestins which does the exact opposite.
We learned a a few things from the WHI study.
1) Start hormone replacement earlyon when hormone levels start to decline.
2) Mimic the normal ratios of the hormones in the body (estrogen-progesterone ratio)
3) Use the transdermal route of hormone administration with topical creams (to avoid hypercoagulability and blood clots inherent in oral estrogen tablets)
4) Don't use estrone which is prevalent in Premarin, instead use estradiol and estriol also called Bi-Est which is bioidential.
5) Avoid synthetic progestins, instead use a bioidentical progesterone.
Endquote for transcript of video
French Cohort Study
I would add here that the French Cohort Study showed that biodentical hormones are safe and not associated with increased risk of breast cancer compared to the general population.
Drop in Breast Cancer Rates after Discontinuing Synthetic Hormones
A new Canadian Study is in the news, showing Canadian data duplicates the United States data on the dramatic decline in Canadian breast cancer rates after the 2002 WHI study which prompted large numbers of women to stop using synthetic hormones. The earlier US report by Ravdin in April 2007 published in the New England Journal showed plummeting breast cancer rates when US women ceased using synthetic hormones in 2003.
Recommendation
If you are in the Orlando area, and need a bioidentical hormone doctor, call Dr Sangeeta Pati at the Sajune Clinic to make an appointment.
Financial disclosure: I have no financial ties to disclose, and received no funding from the A4M medical organization, nor any of the presenters at the A4M meetings, nor specifically from Sangeeta Pati who is mentioned in this article.
Articles with Related Content
Best Bioidentical Vidoes on You Tube
The Safety of Bioidentical Hormones by Jeffrey Dach MD
The Impotance of Bioidentical Hormones by Jeffrey Dach MD
The Evidence for Bio-Identical Hormones
The Battle for BioIdentical Hormones by Jeffrey Dach MD
Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD
Bioidentical Hormones and Medical Ghostwriting
Links and References
New Canadian Study Shows Breast cancer rates Decline Dramatically After Stopping Synthetic Hormones Prempro ( Premain and Provera) Note: Provera is a synthetic progestin.
http://jnci.oxfordjournals.org/content/early/2010/09/23/jnci.djq345.abstract
JNCI J Natl Cancer Inst (2010) First published online: September 23, 2010
Breast Cancer Incidence and Hormone Replacement Therapy in Canada
Prithwish De, C. Ineke Neutel, Ivo Olivotto and Howard Morrison
Conclusion During the period 2002–2004, there was a link between the declines in the use of hormone replacement therapy and breast cancer incidence among Canadian women aged 50–69 years, in the absence of any change in mammography rates.
http://www.reuters.com/article/idUSTRE68M56C20100923?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+reuters%2FhealthNews+(News+%2F+US+%2F+Health+News )
Breast cancer rates fell with hormone therapy drop
Thu Sep 23, 2010 4:20pm EDT (Reuters) - Breast cancer rates among postmenopausal women in Canada dropped nearly 10 percent after news of a big study in 2002 that found taking hormone replacement therapy could increase breast cancer risk, researchers said on Thursday.
http://abcnews.go.com/Health/wireStory?id=11713357
Breast Cancer Rates Fell With Hormone Therapy Drop
September 23, 2010 (Reuters
The Decrease in Breast-Cancer Incidence in 2003 in the United States NEJM Volume 356:1670-1674 April 19, 2007 Number 16 by Peter M. Ravdin et al.
Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://www.jeffreydach.com
http://www.drdach.com
http://www.naturalmedicine101.com
http://www.truemedmd.com
Disclaimer click here: www.drdach.com/wst_page20.html
The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician -- patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.
Link to this article
Copyright (c) 2010,11 Jeffrey Dach MD All Rights Reserved. This article may be reproduced on the internet without permission, provided there is a link to this page and proper credit is given.
FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of issues of significance. We believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.