Jerry Block, M.D., PhD. TUlsa, OK

The Hormone Controversy - J.E. Block, MD, PhD, FACP

When a physician speaks of hormones, he is discussing the small string of amino acids called peptides that have
a specific configuration which activates a receptor on a given cell type. The hormones are secreted from an
internal nest of cells and are referred to as endocrine glands. There are many hormones produced in the body
such as thyroid, insulin, parathyroid, adrenal, gonadal (ovaries and testes) and pituitary. The rest of this article
will only address our sex hormones, which are estrogens, progesterone and androgens.

There are three types of estrogens (estrone, estradiol and estriol- E1, E2, E3) with only one progesterone and
one testosterone. Not to make this more complex, but there are metabolic products of each of these depending
where and how the hormone is degraded. There are natural (bio-identical) and synthetic (artificial) hormones.
Nature endowed us with the natural ones and little or nothing can be done to improve these essentials to a
healthy life.

Since the turn of the last century, medical science has isolated and studied the chemistry of natural estrogens.
Since they are natural, they cannot be patented. Most modern countries are, fortunately or unfortunately,
capitalistic, and there is little or no money to be made on natural products. However, if a pharmaceutical
company can patent a product which is somewhat different, although not necessarily improved, they can not
only patent the name of the product, register the use with the Federal Drug Administration, but publicize it to
physicians and the public. In the 1940's, natural estrogen was frequently given by doctors. American Home
Products Corporation thought they could improve their income by isolating them from the Pregnant Mare's urine
(PremarinR). There are equilins and equilenins, which are different from human estrogen by several atoms. Are
they as good as the natural hormones?

There have been hundreds of studies in the last 65 years, but the definitive one was initiated in 1997 by the NIH
(National Institutes of Health). In 40 centers, 17,000 women with an intact uterus were recruited. In the study,
the women took either a placebo or combination hormone therapy (estrogen and progesterone), but the
hormones were mainly foreign, being Premarin for the estrogen and Provera (Medroxyprogesterone) for the
progesterone. However, the study was cut short because of the apparent hazard of the hormones.