Estradiol and Dental Health

Estrogen users had more teeth remaining than nonusers (12.5 versus 10.7 teeth, P = 0.046) after controlling for age, smoking status, and education. Duration of estrogen use was an independent predictor of the number of teeth remaining (P = 0.015): for every 4.2-years of estrogen use there was retention of 1 additional tooth on average.

Long-term estrogen users (more than 8 years) had an average of 3.6 more teeth than women who never used estrogen (P < 0.02).

Postmenopausal estrogen replacement and tooth retention. Am J Med. 1997 Jun;102(6):536-42.

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Several studies have demonstrated a relationship between tooth loss and systemic osteoporosis. The recognized benefit of estrogen replacement therapy (ERT) in osteoporosis prompted this review of the effects of ERT on tooth loss.

CONCLUSION: Estrogen replacement therapy may be beneficial in preventing tooth loss and the need for dentures in older women.

Arch Intern Med. 1995 Nov 27;155(21):2325-9. The benefits of estrogen replacement therapy on oral health. The Leisure World cohort.

A study came out recently in the Journal of the American Medical Association showing exactly that: they gave very high doses of dutasteride to 102 men who were also being given testosterone replacement, and here is what they found:Changes in the International Index of Erectile Function and Male Sexual Health Questionnaire composite scores and erectile, orgasmic, ejaculatory, intercourse, or overall satisfaction scores did not differ significantly between the dutasteride and placebo groups.

?In other words, as long as they had enough testosterone circulating, dutasteride did not hurt sexual function. And that was using 2.5mg/day of dutasteride, the highest possible dose. I would actually only use 0.5mg, and probably not even every day, because the half-life is so long that it isn’t necessary to take it daily.

Here are some of the many papers showing that natural progesterone is completely different from synthetic progestins like Provera? (aka medroxyprogesterone acetate or “MPA”):

 

Climacteric, 2012

Micronized progesterone does not increase cell proliferation in breast tissue in post- menopausal women compared with synthetic medroxyprogesterone acetate (MPA). Experimental evidence suggests that the opposing effects of MPA and micronized progesterone on breast tissue are related to the non-specific effects of MPA, including glucocorticoid activity and differences in the regulation of gene expression.

Micronized progesterone and its impact on the endometrium and breast vs. progestogens. Gompel A, CLIMACTERIC 2012;15(Suppl 1):18?25

 

Journal of Steroid Biochemistry and Molecular Biology, July 2005

The addition of natural progesterone does not affect breast cancer risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. More importantly, medroxyprogesterone acetate [Provera?] can potentiate the proliferative action of estrogens.

Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. Campagnoli et al. J Steroid Biochem Mol Biol. 2005 Jul;96(2):95-108.

 

Journal of Steroid Biochemistry and Molecular Biology, December 2005

?synthetic progestins (i.e. Provera?), when added to HRT for menopausal complaints, increase breast cancer risk more than estrogen alone. However, recent findings suggest that natural progesterone, whether produced during pregnancy or administered outside pregnancy, does not increase breast cancer risk, and could even be protective.

J Steroid Biochem Mol Biol. 2005 Dec;97(5):441-50

 

Breast Cancer Research and Treatment, 2008

This was a large prospective cohort study of over 100,000 women in France. About 70% of the women used HRT for about 7 years, starting at age 52 (on average). They were then followed for about 8 years. This study found that if they combined bio-identical estrogen with synthetic progestins (Provera? /MPA or norethindrone), the risk of cancer was much worse: relative risk of 1.48 to 2.11! However if they combined estrogen with natural progesterone instead of Provera?, the relative risk of breast cancer was 1.00: no increased risk.

Breast Cancer Res Treat. 2008 Jan;107(1):103-11. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. See Table 3.

 

International Journal of Cancer, 2005

This study assessed the risk of breast cancer in relation to different types of Hormone Replacement Therapy (HRT) in 54,548 postmenopausal women who were part of the E3N-EPIC cohort study.

The relative risk (RR) of developing breast cancer was 1.2 if they used transdermal estrogen alone, and decreased to 0.9 when estrogen was combined with bio-identical progesterone. Those differences did not reach statistical significance: essentially estrogen either alone or with bioidentical progesterone had no effect on breast cancer risk. However, when estrogen was combined with synthetic progestins (such as MPA/Provera?), relative risk of breast cancer increased to 1.4, which was statistically significant.

Fournier A. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int J Cancer. 2005 Apr 10;114(3):448-54.

 

Climacteric, 2002

To evaluate the risk of breast cancer associated with the use of estradiol plus (bio-identical) progesterone, which is commonly prescribed in France (rather than MPA/Provera), a cohort of 3175 postmenopausal women was followed for a mean of 8.9 years (28,367 woman-years). There was no increase in the risk of breast cancer in the natural, bio-identical hormone users (RR 0.98, 95% confidence interval (CI): 0.65-1.5). The author concluded that HRT with natural estradiol and natural progesterone is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile.

de Ligni?res B et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002 Dec;5(4):332-40.

 

Maturitas, 2008

Hormone replacement therapy (HRT) in young postmenopausal women is a safe and effective tool to counteract climacteric symptoms and to prevent long-term degenerative diseases, such as osteoporotic fractures, cardiovascular disease, diabetes mellitus and possibly cognitive impairment. However, the expert selection of specific compounds, doses or routes of administration can provide significant clinical advantages. Recent evidence shows that natural progesterone displays a favorable action on the vessels and on the brain, while this might not be true for synthetic progestins (like Provera?). ?Recent trials (also) indicate that natural progesterone confers less or even no risk of breast cancer, as opposed to synthetic progestins.

Could transdermal estradiol + progesterone be a safer postmenopausal HRT? A review. Maturitas. 2008 Jul-Aug;60(3-4):185-201.

 

Breast Cancer Research and Treatment, 2007

The goal of this study was to compare the effects of oral estradiol given with either MPA or micronized progesterone on risk for breast cancer in a postmenopausal primate model. Compared to placebo, Estrogen + MPA resulted in significantly greater breast tissue proliferation, while Estrogen + bio-identical progesterone did not. These findings suggest that oral micronized progesterone has a more favorable effect on risk biomarkers for breast cancer than medroxyprogesterone acetate. These findings provide growing support for micronized progesterone as an alternative to MPA in hormone therapy regimens.

Effects of estradiol with micronized progesterone or medroxyprogesterone acetate on risk markers for breast cancer in postmenopausal monkeys. Breast Cancer Res Treat. 2007 Jan;101(2):125-34

 

Climacteric, 2012

Micronized progesterone does not increase cell proliferation in breast tissue in post- menopausal women compared with synthetic medroxyprogesterone acetate (MPA). Experimental evidence suggests that the opposing effects of MPA and micronized progesterone on breast tissue are related to the non-specific effects of MPA, including glucocorticoid activity and differences in the regulation of gene expression.

Micronized progesterone and its impact on the endometrium and breast vs. progestogens. Gompel A, CLIMACTERIC 2012;15(Suppl 1):18?25

 

Journal of Steroid Biochemistry and Molecular Biology, July 2005

The addition of natural progesterone does not affect breast cancer risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. More importantly, medroxyprogesterone acetate [Provera?] can potentiate the proliferative action of estrogens.

Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. Campagnoli et al. J Steroid Biochem Mol Biol. 2005 Jul;96(2):95-108.

 

Journal of Steroid Biochemistry and Molecular Biology, December 2005

?synthetic progestins (i.e. Provera?), when added to HRT for menopausal complaints, increase breast cancer risk more than estrogen alone. However, recent findings suggest that natural progesterone, whether produced during pregnancy or administered outside pregnancy, does not increase breast cancer risk, and could even be protective.

J Steroid Biochem Mol Biol. 2005 Dec;97(5):441-50

 

Breast Cancer Research and Treatment, 2008

This was a large prospective cohort study of over 100,000 women in France. About 70% of the women used HRT for about 7 years, starting at age 52 (on average). They were then followed for about 8 years. This study found that if they combined bio-identical estrogen with synthetic progestins (Provera? /MPA or norethindrone), the risk of cancer was much worse: relative risk of 1.48 to 2.11! However if they combined estrogen with natural progesterone instead of Provera?, the relative risk of breast cancer was 1.00: no increased risk.

Breast Cancer Res Treat. 2008 Jan;107(1):103-11. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. See Table 3.

 

International Journal of Cancer, 2005

This study assessed the risk of breast cancer in relation to different types of Hormone Replacement Therapy (HRT) in 54,548 postmenopausal women who were part of the E3N-EPIC cohort study. The relative risk (RR) of developing breast cancer was 1.2 if they used transdermal estrogen alone, and decreased to 0.9 when estrogen was combined with bio-identical progesterone. Those differences did not reach statistical significance: essentially estrogen either alone or with bioidentical progesterone had no effect on breast cancer risk. However, when estrogen was combined with synthetic progestins (such as MPA/Provera?), relative risk of breast cancer increased to 1.4, which was statistically significant.

Fournier A. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int J Cancer. 2005 Apr 10;114(3):448-54.

 

Climacteric, 2002

To evaluate the risk of breast cancer associated with the use of estradiol plus (bio-identical) progesterone, which is commonly prescribed in France (rather than MPA/Provera), a cohort of 3175 postmenopausal women was followed for a mean of 8.9 years (28,367 woman-years). There was no increase in the risk of breast cancer in the natural, bio-identical hormone users (RR 0.98, 95% confidence interval (CI): 0.65-1.5). The author concluded that HRT with natural estradiol and natural progesterone is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile.

de Lignires B et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002 Dec;5(4):332-40.

 

Maturitas, 2008

Hormone replacement therapy (HRT) in young postmenopausal women is a safe and effective tool to counteract climacteric symptoms and to prevent long-term degenerative diseases, such as osteoporotic fractures, cardiovascular disease, diabetes mellitus and possibly cognitive impairment. However, the expert selection of specific compounds, doses or routes of administration can provide significant clinical advantages. Recent evidence shows that natural progesterone displays a favorable action on the vessels and on the brain, while this might not be true for synthetic progestins (like Provera?). ?Recent trials (also) indicate that natural progesterone confers less or even no risk of breast cancer, as opposed to synthetic progestins.

Could transdermal estradiol + progesterone be a safer postmenopausal HRT? A review. Maturitas. 2008 Jul-Aug;60(3-4):185-201.

 

Breast Cancer Research and Treatment, 2007

The goal of this study was to compare the effects of oral estradiol given with either MPA or micronized progesterone on risk for breast cancer in a postmenopausal primate model. Compared to placebo, Estrogen + MPA resulted in significantly greater breast tissue proliferation, while Estrogen + bio-identical progesterone did not. These findings suggest that oral micronized progesterone has a more favorable effect on risk biomarkers for breast cancer than medroxyprogesterone acetate. These findings provide growing support for micronized progesterone as an alternative to MPA in hormone therapy regimens.

Effects of estradiol with micronized progesterone or medroxyprogesterone acetate on risk markers for breast cancer in postmenopausal monkeys. Breast Cancer Res Treat. 2007 Jan;101(2):125-34.

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