(WOMENSENEWS)–More than 30 million American women take estrogen supplements. And new federal report indicates that by doing so, they may be taking a gamble on their health.
Last week, the National Institute of Environmental Health Sciences labeled steroidal estrogen a "known carcinogen"–a move that sparked concern among women who take estrogen in birth control pills and hormone-replacement therapy.
"I have ovarian cysts that rupture unless I’m on the pill, which is the only conventional treatment for my condition," says Megan Bodary, a 24-year-old teacher in Napa, Calif. "I’ll probably continue taking estrogen for the time being, but I’m working with a homeopath to develop an alternate plan."
Since the announcement, Bodary has learned that the progesterone in her pills probably protects her from estrogen’s negative effects. But as she scours the Internet for more information, she’s made an unsettling discovery: Estrogen from other sources is building up in the environment and may pose a far greater hazard to her health.
Government Labels Estrogen a Cancer Agent
The government’s decision to label steroidal estrogen a carcinogen follows several recent studies showing that the hormone can increase the risk of breast and uterine cancers. Steroidal estrogen can include the estrogen that the body produces.
In July, the leaders of a massive, federally funded study on hormone-replacement therapy discovered that the synthetic estrogen they were giving women increased their incidence of breast cancer, stroke and blood clots. The findings made national news–and made health advocates think twice about using estrogen to treat hot flashes and other symptoms of menopause.
According to Dr. Wulf Utian, director of The North American Menopause Society, sales of estrogen as hormone-replacement therapy have plummeted since the summer. That may be because doctors are now taking a more cautious approach, said Dr. Vanessa Cullins, vice president of medical affairs for the Planned Parenthood Federation of America.
"We used to let clinicians decide how frequently to talk to women about staying on hormone-replacement therapy. We’re now requiring annual assessment," Cullins says.
Now, with the National Institute of Environmental Health Sciences decision released on Dec. 12, doctors are encouraging women to weigh their options even more carefully. They’re also reassuring them that the label does not apply to estrogen taken with progesterone–the way it is prescribed for all birth control and most hormone-replacement therapy in the United States.
"The carcinogenic listing is for estrogen alone," says Christopher Portier, director of the National Institute of Environmental Health Sciences Environmental Toxicology Program. "Only women who have had hysterectomies take estrogen alone as hormone replacement."
Growing Evidence that an Abundance of Estrogen Causes Harm
An "estrogen" is any hormone that makes the uterine lining grow and helps regulate vertebrate development, reproduction and behavior. Currently, American consumers use 10 to 15 estrogens as birth control, hormone-replacement therapy and growth supplements for livestock. We also use hundreds of chemicals that mimic estrogen: pesticides, herbicides, phthalates (found in cosmetics) and polyvinyl chlorides (PVCs, found in plastics). Every time these chemicals are used–and every time an estrogen consumer excretes waste–more estrogen seeps into the soil, air and water.
Recent research shows that excess estrogen is beginning to wreak havoc with the environment. In October, the science journal Nature reported that male leopard frogs in the Midwest are developing reproductive deformities such as testicles that contain female eggs. Atrazine, the most common weed killer in the United States, has seeped into the frogs’ habitat and spurred their cells to produce aromatase, an enzyme that converts the hormone testosterone into the female hormone estrogen.
"This is hot news because of the low doses and dramatic effects," says Tyrone Hayes, the University of California at Berkeley researcher who led the Nature study. "It’s also big because atrazine is the No. 1 herbicide in the world."
Last summer, the U.S. Geological Survey tested 139 streams and rivers and found traces of estrogen or other reproductive hormones in 40 percent of waterways. For humans and other vertebrate animals, trace amounts are enough to cause trouble. In the case of the leopard frogs, atrazine triggered deformities at just 0.1 parts per billion parts water–30 times less than the Environmental Protection Agency’s limit for atrazine in drinking water.
Low doses are affecting animals across the United States. In Washington, fish that appear female have XY or male chromosomes. (Normally, females have two X chromosomes and males have one X and one Y chromosome.) In South Carolina, male juvenile sunfish make female egg yolk protein. In Florida, male mosquito fish have forgotten the moves to their mating dance while male alligators have stunted penises.
Estrogen may also be taking a toll on humans. Experts at the World Wildlife Fund, Mount Sinai School of Medicine and Silent Spring Institute all say excess estrogen may contribute to a host of health problems: obesity, diabetes, early puberty, breast cancer, endometriosis, fibroids, miscarriage, low sperm counts and testicular cancer.
"Our bodies are designed to see toxic chemicals and respond to them," says Louis Guillette, a University of Florida reproductive endocrinologist. "But they’re not designed to see several hundred in one day. We need to think twice before we use these chemicals, and we need stronger research to help us understand their effects."
Funds for More Research Stalled
House Legislation to fund research on hazardous chemicals (including those that mimic estrogen) is currently stalled in the House. In May, Democratic Rep. Louise Slaughter of New York introduced the Hormone Disruption Research Act of 2002, which would boost federal funding of that research from $50 million to $500 million over five years.
"To date, federal research on hormone disruption has been scattershot and under-funded," says Slaughter, a microbiologist. "With this information in hand, we can make sensible, informed decisions and policies about our own and our children’s future."
Supporters of the bill say its future is uncertain in a Congress that is sympathetic to big business. Estrogen makers spend millions on political contributions, ad campaigns and studies promoting their products.
"Chemical and pesticide manufacturers are forming cooperative agreements with government agencies to help design studies, determine which ones get funded and see the results before the public does," says Theo Colborn, director of the wildlife and contaminants division of the World Wildlife Fund.
Drug companies also do damage control. According to Dr. Drummond Rennie, a deputy editor at the Journal of the American Medical Association, hormone studies that "go wrong" can tempt sponsors "to stomp on investigators and say, ‘You must keep this quiet.’"
Some of Estrogen’s Problems Have Been Known for Decades
The first synthetic estrogen was developed in Germany in 1928 to treat the symptoms of menopause. In 1966, gynecologist Dr. Robert Wilson published the best-seller "Feminine Forever," arguing that synthetic estrogen could help women avoid pregnancy, the discomfort of menopause and "female troubles" including "nervousness, crying spells and melancholia."
He had powerful backers. Drug maker Wyeth-Ayerst Pharmaceuticals covered the expenses of writing "Feminine Forever," and a host of pharmaceutical companies, including Wyeth, Upjohn and Searle, funded his Wilson Research Foundation.
As Wilson and his sponsors won converts to their cause, estrogen sales boomed. By 1975, the hormone-replacement estrogen Premarin was the fifth-leading prescription medication in the United States. In the 1990s, it hit No. 1. According to the National Center for Health Statistics, 20 million women take estrogen as hormone-replacement therapy. According to The Alan Guttmacher Institute, 10.4 million more take it as contraception, in the form of pills, injections, implants and cervical rings.
Yet as early as the 1930s, studies showed that high doses of estrogen caused blood clots, miscarriage and cancers of the breast, cervix and endometrium. In the 1940s, male lab workers sprouted breasts when exposed to excess estrogen. The 1970s brought the debacle of the DES daughters: 1.5 million women whose mothers took this form of synthetic estrogen to prevent miscarriage. Exposed to the hormone in utero, 90 percent of these women developed reproductive abnormalities, including cancers that struck when they were as young as age 7.
Despite such evidence, research has been slow and incomplete. A 1994 Tufts University study was among the only ones in the United States to explore the combined effects of these chemicals. Scientists examined 10 estrogenic pesticides and polychlorinated biphenyl, a type of plastic, and found that while none had an effect when applied individually to human cells in culture, they had a potent effect when combined.
"Estrogenic chemicals are being tested one at a time," Guillette says. "But we need to investigate sum-total exposure."
Federal researchers are searching for more answers. Last summer, scientists at the National Institute of Environmental Health Science’s national toxicology program published an exhaustive report on how the estrogens in plants can affect human health. Next year they hope to publish additional studies on household chemicals, pesticides and ethinyl estradiol, the main ingredient in birth-control pills and hormone replacement therapy.
Women who rely on estrogen supplements say they’ll welcome the results of this research. "No one knows how all this estrogen will effect our children or their children, says Megan Bodary. "We need to understand how this hormone works before we continue putting it in our bodies."
Molly M. Ginty is a freelance writer based in New York City.
For more information:
Congresswoman Louise Slaughter–
Hormone Disruption Research Act of 2002 (Introduced in House)http://thomas.loc.gov/cgi-bin/query/z?c107:H.R.4709:
Silent Spring Institute, Inc.–
"Hormone Disrupting Chemicals":
World Wildlife Fund–
"Chemicals that Compromise Life: A Call to Action":
Lisa Murkowski Is New Senator From Alaska
(WOMENSENEWS)–An significant change in the composition of the U.S. Senate occurred this weekend, in addition to the Trent Lott resignation as majority leader.
A two-term Alaska state representative, Lisa Murkowski, 45, was named by her father, Frank H. Murkowski, to fill the remaining two years of his term. The elder Murkowski was elected governor last month and has represented Alaska in the Senate for the past 22 years.
Republican Lisa Murkowski’s appointment will not cause any affect her party’s control of the chamber; however, it does mean that the Senate will still include 13 women, despite the election loss of Jean Carnahan, a Democrat. Moreover, the new Sen. Murkowski is pro-choice and, while she opposes affirmative action, she did support special hiring requirements for Alaska natives.
At the same time, Sen. Bill Frist, now expected to become the Senate’s new majority leader, is nearly as anti-reproductive freedom as Trent Lott. However, Frist is supportive of stem-cell research–the only issue to have thus far splintered anti-abortion forces.