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Designing women

According to a recent headline from WebMD Medical News, “Designer Estrogen May Be Better Than HRT.”

But if you think “designer estrogen” sounds suspiciously like a familiar old wolf dressed in sheep’s clothing, I believe you’re absolutely right.

A star is born

Last summer, when the Women’s Health Initiative (WHI) study on hormone replacement therapy (HRT) was abruptly halted, the HRT medical establishment was thrown into disarray. Since then, they’ve been trying to rebuild the tarnished reputation of pharmaceuticals that address the symptoms and diseases associated with menopause. Could designer estrogen be the answer to their prayers?

Designer estrogens – also called SERMs (Selective estrogen receptor modulators) are compounds based on synthetic variations of the estrogen molecule. Eli Lilly’s product in this class, Evista (a brand name for raloxifene), was approved by the FDA in 1997 as a preventive for osteoporosis.

Now, however, Evista is getting the star treatment – being touted as the possible future of HRT. According to one cancer researcher, the preventive and therapeutic potential of this class of drugs has just started to unfold. And based on trials that indicate this SERM may reduce the risk of stroke and breast cancer, WebMD reports that Evista is quickly becoming a popular choice for women who once took hormones to prevent various diseases of aging.

Reading between the lines of these statements, and knowing that pharmaceutical salespeople often encourage physicians to prescribe drugs for indications the drugs haven’t been approved for (which they’re allowed to do by the FDA), I believe it’s safe to assume that drug salespeople are already turning up the heat and pressing doctors to recommend SERMs to their menopausal patients to prevent conditions other than just osteoporosis.

Just a couple of little problems

A major Evista study is currently underway, involving more than 10,000 women who are at risk for heart disease. Like the Women’s Health Initiative HRT study, this is a lengthy trial, designed to create definitive results. The report on that study is due in 2006.

SERMs researcher, Elizabeth Barrett-Connor, M.D. (who lead one of the earlier SERMs trials), is enthusiastic about Evista’s prospects, but fearing the possibility of another unpleasant conclusion (as with the WHI trial), cautions that doctors should be careful to not recommend Evista for unproven indications.

And she has good reason to be cautious. Because various studies of Evista and other SERMs have shown that designer estrogens, instead of relieving certain menopausal symptoms, can actually trigger mood swings and hot flashes, increase the risk of blood clots, and sometimes cause postmenopausal women to begin menstruating again. These are not the qualities you look for in a “magic bullet.”

Ditching the designers 

Focusing on the health problem Evista was specifically designed to prevent, we have to ask, “Is there a better, safer way to address osteoporosis?” Absolutely. In a Members Alert we sent you some time ago (“The Battle For Your Bones” 7/1/99) we discussed the dilemma of osteoporosis and the best way to address it with calcium. Unfortunately, the average diet provides only about 500 mg of calcium daily. To make matters worse, calcium is very poorly absorbed. In fact, only a small percentage of the calcium we get (whether from food or supplements) actually makes it into the bloodstream.

When we sent you that Members Alert, we told you about a unique calcium supplement from Japan called AdvaCAL that had just become available in North America. The most outstanding feature about this high-potency supplement is that it’s absorbed four times better than typical calcium-carbonate supplements. More detailed information about AdvaCAL is available on the company’s web site at compassionet.com.

Osteoporosis is one of the diseases most closely associated with menopause, but that doesn’t mean that women should wait for their first menopausal symptoms to begin addressing the problem. Ideally, osteoporosis prevention should start long before menopause. The greater your bone mass and density when you enter menopause, the more easily you can sustain a post-menopausal reduction in bone density without medical consequences, without synthetic HRT, and certainly without designer estrogen.


To Your Good Health,

Jenny Thompson
Health Sciences Institute

 

 

 

 

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Allan Spreen, M.D.
Dr. Allan Spreen, Chief Medical Advisor

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