Note: Dr. Susan Rako's visit to Power Surge Live! chat on Sept. 9, 2001 contained a remark about progesterone and breast cancer which evoked some comments by readers. Below are some of the concerns expressed and Dr. Rako's responses. Dear Dr. Rako, Thank you for your talk on Power-Surge. You suggested I email you because I am concerned about what you wrote about the possible connection between progesterone and breast cancer. I would like to read more about it if you have a source available. I plan to read your book in the near future. Dr. Rako's response Dear ----, Here is the information: I can refer you to a paper published in the "Journal of Reproductive Medicine" Volume 41, Noumber 5 (Supplement), May 1996 by Anita L. Nelson, M.D. with the title "Counseling Issues and the Management of Side Effects for Women Using Depot Medroxyprogesterone Acetate Contraception" (which is DepoProvera) .. in which she discusses the effects of plain progesterone. She says, "Progesterone increases ductal cell proliferation and vascular lymphatic congestion in the breast..." Another paper shows that the incidence of breast cancer was found to be higher in women who used both estrogen and progesterone for hormone replacement therapy than in women who used estrogen alone (although it is riskier to use estrogen alone in terms of uterine cancer, for sure.) The reference for that: The "Journal of the American Medical Association (JAMA), Volume 283, Number 4, January 26, 2000 by Catherine Schairer, PhD, Jay Lubin, PhD, "Begecca Tuoisis, ScD, Susan Sturgeon, DrPH, Louise Brinton, PhD, and Robert Hoover, MD and entitled, "Menopausal Estrogen and Estrogen-Progestin Rplacement Therapy and Breast Cancer Risk." The authors conclude: "Our data suggest that the estrogen-progestin regimen increases breast cancer risk beyond that associated with estrogen alone." My comments on Power-Surge reflect my concern for women who are buying in to the use of progesterone alone as a cure for their hormonal chaos in the perimenopause AND postmenopausally. While it is possible that using progesterone for ONE week per month may be helpful during the perimenopause, when women often have anovulatory cycles and when their bodies may actually be producing HIGH levels of estrogen, as their pituitary gland "tries to get the ovaries to ovulate", and when a week's cycle with supplemental progesterone may normalize the estrogen levels AND protect the uterine lining from over-stimulation by high levels of estrogen .... (As you can see, this is NOT a simple matter). But constant use of progesterone cannot be a good thing. If you read Dr. Nelson's paper (the first one to which I referred), you will understand the myriad unpleasant and potentially risky effects of progesterone. I hope that this has been helpful. My best regards, Susan Rako, M.D.
Another E.mail Dear Susan Rako - I have just read your transcript on Power Surge's website. It's very interesting, bit I am bothered by the fact you state that progesterone can cause cancer of the cells in the breast. Can you explain please. Dr. Rako's response Dear ----, I did not say that progesterone CAN CAUSE BREAST CANCER. I said that I am CONCERNED ABOUT THE RISK THAT IT MIGHT ... based on studies I have read that acknowledge that progesterone stimulates the growth of breast cells. I can refer you to a paper published in the "Journal of Reproductive Medicine" Volume 41, Noumber 5 (Supplement), May 1996 by Anita L. Nelson, M.D. with the title "Counseling Issues and the Management of Side Effects for Women Using Depot Medroxyprogesterone Acetate Contraception" (which is DepoProvera) .. in which she discusses the effects of plain progesterone. She says, "Progesterone increases ductal cell proliferation and vascular lymphatic congestion in the breast ..." Another paper shows that the incidence of breast cancer was found to be higher in women who used both estrogen and progesterone for hormone replacement therapy than in women who used estrogen alone (although it is riskier to use estrogen alone in terms of uterine cancer, for sure.) The reference for that: The "Journal of the American Medical Association (JAMA), Volume 283, Number 4, January 26, 2000 by Catherine Schairer, PhD, Jay Lubin, PhD, "Begecca Tuoisis, ScD, Susan Sturgeon, DrPH, Louise Brinton, PhD, and Robert Hoover, MD and entitled, "Menopausal Estrogen and Estrogen-Progestin Rplacement Therapy and Breast Cancer Risk." The authors conclude: "Our data suggest that the estrogen-progestin regimen increases breast cancer risk beyond that associated with estrogen alone." My comments on Power-Surge reflect my concern for women who are buying in to the use of progesterone alone as a cure for their hormonal chaos both in the perimenopause AND postmenopausally. While it is possible that using progesterone for ONE week per month may be helpful during the perimenopause, when women often have anovulatory cycles and when their bodies may actually be producing HIGH levels of estrogen, as their pituitary gland "tries to get the ovaries to ovulate", when a week's cycle with supplemental progesterone may normalize the estrogen levels AND protect the uterine lining from over-stimulation by high levels of estrogen .... (As you can see, this is NOT a simple matter). But constant use of progesterone cannot be a good thing. If you read Dr. Nelson's paper (the first one to which I referred), you will understand the myriad unpleasant and potentially risky effects of progesterone. I commented that I AM CONCERNED about women's use of "natural progesterone" (or ANY progesterone, for that matter) as "the answer to hormonal health" ... I think it may be risky to the breast and have other as yet not fully identified undesirable consequences.
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