Quick question on cancer, estrogen and menopause

Dear Dr. Milrod:

A close friend is undergoing radiation treatments for serious breast cancer. She recently said her many years of estrogen treatments may have been the cause; she went that route because she had severe hot flashes and other unpleasantness associated with menopause. I had thought estrogen has been minimized as a possible cause of breast cancer. Another friend made a decision NOT to have estrogen at about the same time, and her health is flourishing, except that her post-menopausal libido seems to have languished to occasional routine exchanges of affection, but she seems happy enough with “later life” pleasures. Would estrogen have prolonged her libido?

Confused in California

Dear Confused in California:

1. Synthetic estrogens and progesterones have all been implicated in elevated rates of breast cancer. To my knowledge, large scale trials with bio-identical hormones have not been supported by major research universities/private companies.

2. Testosterone, progesterone and luteinizing hormone surges would have prolonged her libido more than just estrogen. Remember that once ovarian function shuts down, the main source of testosterone in females is off – there is some residual testosterone produced in the adrenal glands, but no longer enough free circulating T to produce any noticeable libido. N.b. that testosterone supplements in transdermal/parenteral form do not necessarily produce increased libido in post-menopausal females, although modest elevations in some women have been noted. Some women respond favorably to estrogens, however, there is a big difference between supplementation and endogenous hormones. Some women do not respond to supplementation, regardless of the method of delivery.

Christine Milrod, PhD

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