Jeffrey Bland explains how estrogen works in the body through two different receptors, one linked to cancer risk and one to brain and bone health. The Women's Health Initiative study upended decades of hormone therapy assumptions. Plant-based compounds like soy and hops may offer gentler alternatives during menopause.
So here I am once again sharing some thoughts with you, just for consideration, and I would like to say a couple things about the menopausal transition. You know, this has been a very big area of controversy for many years since Robert Wood Wilson wrote his book Feminine Forever back in the early 1960s. You recall, he talked about the use of estrogen replacement therapy as it pertained to premarin, which is equine hormones that were concentrated down and administered to women. And there's been a long standing concern about that in the minds of some because people said, well, these are not the same hormones, these equine horse hormones that women have. And in fact, the chemical composition of them are different because they contain what are called the B ring unsaturated estrogens, which are, for those of you not organic chemists, they are a different chemical structure than the, the types of estrogens that a woman makes in her own body and a man as well. And so the question is, what are the effects of these B ringed unsaturated estrogens? Do they have an adverse effect? Do they have an untoward effect? It's not the same thing as giving 17 beta estradiol to a woman, which is the native major estrogen that a woman's body produces. And then we have the whi, the Women's Health Institute studies in which, you know, they went and looked very extensively at the effects of HRT and this was a combination of estrogens and progestins and found that there was much to the, I think, confusion or surprise of many people, not a cardio protective effect, but actually in some cases it seemed to increase the risk of cardiac disease. And although it did help to protect against osteoporosis, and it did relieve to some extent menopausal symptoms of night sweats and hot flushing, that it didn't seem to have many of the health benefit effects that were purported to be associated with estrogen or hormone replacement therapy. And then that got into a big controversy about, well, what women are responders and what women are not. And maybe we're just measuring those that are a small subset of non responders who are having adverse effects. But for most women it's effective and so forth and so on. All of this discussion has pertained to the control of estrogen's influence around what we call the estrogen receptor, the estrogen receptor alpha, which is where estrogen estradiol operates. And now there is this new chapter which is emerging that I find very fascinating in which it's been found and reported that there are not only two types of estrogen receptors in the body. An estrogen receptor receptor alpha that is associated with activation of cellular proliferation. That's where you get worried about the risk of cancer with estrogens because it causes cellular proliferation and cellular replication. And then there's an estrogen receptor beta that's more associated with things like brain and bone and effects that might have other influence other than that of causing cells to define and replicate. And so the balance of a woman's body is this estrogen receptor alpha and beta activation. And now we know that there are specific drugs that are called selective estrogen response modulators or CIRMs that actually can influence selectively or preferentially the estrogen receptor beta without activating to the same extent the estrogen receptor alpha. These are often used for the prevention and treatment of osteoporosis because of the effect of on bone. And now, and the most recent chapter which I find fascinating is we're finding that the estrogens have effects that are off the estrogen receptor entirely. These are non nuclear effects. When I say nuclear, I mean the nucleus of cells where a book of life is kept. These non nuclear effects or non genomic effects of estrogen occur in the metabolism of cells and can influence then the effect that how cells process things like insulin and glucose and energy metabolism. And it has to do with weight and has to do with neurological function that women often experience mood swings and they may experience feelings of forgetfulness with changes in their estrogen levels. So taking all that together, what does it mean? Well, what it means is that when you start looking at natural products, things that women may have consumed in their diet for some time, soy based products for instance, or natural herbal materials, botanical medicines that have been used historically, like red clover or kudzu, which is a Chinese product that has been used for management of female health related problems, that these contain a variety of compounds, natural compounds that are made by the plant that modulate both estrogen receptor alpha and estrogen receptor beta. And it's that interrelationship between the two that might make these natural products, although more mild and more and less even, say less active than traditional estrogen, they may produce a more profound orchestrating effect on all the influences on the woman's body and the man's body that estrogen affects. And it's interesting there even now, these estrogenic substances that have been found to occur within hops, the humiliace lubulus plant that are xantho, humol and other kinds of chalcone compounds in hops that have these modulating effects on estrogen metabolism. So rather than look just strictly at kind of the nuclear effects, the genomic effects of estrogen, now we start to see this wide variety of interesting influences on cellular function that occur with natural phytoestrogens, these substances in plants that modulate both the estrogen receptors alpha and beta, but have these non genomic relationships which may then present themselves as more safe and effective compounds over the long term of a woman's body to both promote health as well as reduce some of the symptoms of the menopausal transition. Just an interesting thought as we see this whole field of phytonutrition and phytophysiology start to emerge right before our eyes.
