Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

In my recent post, I talked about bioidentical hormones in women who were going through menopause and perimenopause. This stirred up a lot of questions among breast cancer survivors. What can they do if they are suffering from the same issues? A great question that I will answer in this Note. 

Let’s dive in.  


Bioidentical Hormones 


Bioidentical hormones are safe. They don’t cause breast cancer and they don’t cause heart disease. However, what if you’ve had breast cancer? This is such a great question that I don’t talk about enough. We need to bring menopause and perimenopause out of the shadows and give women some hope. Especially those women who have had breast cancer and are scared of taking hormones. Note: breast cancer survivors cannot take any form of estrogen or progesterone because most of them are estrogen or progesterone receptor sensitive.  

So, what do they do? The answer is Testosterone

Testosterone pellets in women with breast cancer is the answer to a lot of their problems. Again, the safety and benefits of using bioidentical hormones through creams and pellets are really unquestioned now. BHRT is really a no brainer. But what about these women who have suffered through breast cancer in their lifetimes? And maybe even women who are just worried about getting breast cancer? 

Check out my last podcast if you’re worried about that, because only 1/10 women with breast cancer have any family history of it. That’s the main thing women say they are afraid of. 

The main risk factors for breast cancer are: 

  1. being a woman and 
  2. being an older woman. 

Breast cancer survivors need help because they’re often on an estrogen blocker like letrozole or tamoxifen. These medicines totally cut out estrogen. One blocks the receptors, and the other blocks the production of it. 

Side Note: Letrozole has more adverse cardiovascular effects and bone loss than tamoxifen, but with tamoxifen you see more blood clots. Letrozole may be a bit more effective than tamoxifen (in my opinion) for preventing recurrence of breast cancer in some patients. The reason I’m mentioning this is because, for women with breast cancer that have to be on these medicines, the menopausal side effects can be very difficult.


Testosterone Pellets


We know that perimenopause and menopause brings not only the symptoms (i.e., hot flashes, night sweats, mood disorder, sleep problems, pain, etc) but also, the worry about osteoporosis.  What nobody thinks about is testosterone therapy, in pellet form. We use so many pellets in our practice. It’s 4:1 over men. The women love them. 

In my opinion, pellets are the best way to do any form of hormone replacement, male or female. Whether it’s estrogen or testosterone, pellets are the way to go. It takes about a minute or two to get them in. They slowly release the hormones over several months so you don’t have to worry about it as much. You don’t get the ups and downs. 

Testosterone is the most abundant hormone of all of the sex hormones. It’s the one that people thank you for, simply because it’s the most effective. Note: Most women that don’t have breast cancer, or a history of it, need progesterone and the safe forms of estrogen (bioidentical estrogen) in addition to testosterone.

The reason the testosterone pellets are the answer is that not only does it take the menopause symptoms away, it also helps prevent the recurrence of the breast cancer in breast cancer patients. Plus, it lowers your risk of developing breast cancer in the first place. 

I’ve been using testosterone pellets for years. There’s a well known surgeon named Dr. Rebecca Glaser at Wright State University, who has been doing this for at least two decades. (I learned about her from a medical meeting in Las Vegas many years ago). She conducted an 8 year study of her breast cancer patients that were treated with testosterone pellets. Most of them felt much better from the menopausal symptom rating scale, and they’ve had no breast cancer recurrences. Zero.

There’s a lot of other studies that have shown that testosterone pellets reduce the occurrence of breast cancer in both women with a history of breast cancer and those with no history of breast cancer. 

A woman’s body requires testosterone to maintain muscle mass, energy levels, and cognitive function. It protects your bones and it protects your heart. As I’ve said before, women have way more circulating testosterone than they do estrogen. Twenty times more. Most doctors don’t know this. 

The women we put on testosterone pellets that have had breast cancer are very happy we did it. They feel great on them! When you look at all the studies and find that they’re protected against the recurrence of breast cancer, it makes you want to use testosterone pellets even more. 


Other Benefits of Testosterone


Testosterone also helps with: 

  • Hot flashes
  • Night sweats
  • Mood swings 
  • Low sex drive 
  • Problems sleeping
  • Vaginal dryness
  • Painful sex
  • Urinary Tract Infections (UTIs)
  • Incontinence 
  • Weight gain
  • Dry skin

I’ve found over the years that low testosterone levels are often mistaken in women for other conditions. 

  • Depression
  • Chronic fatigue 
  • Chronic pain

Note: most medical providers don’t even look at this. 

In women with or without a history of breast cancer, testosterone pellets seem to be protective against breast cancer and offer so many other benefits. It’s almost a no-brainer to at least talk to someone who knows about this. 


The Down Side


The only side effect I’ve ever seen from testosterone in women is facial hair, and that’s not really common. If that does happen, a quick laser treatment can take care of that. 

I rarely see acne from testosterone. 

The only type of breast cancer that I would not use testosterone pellets in is called triple negative breast cancer. This is a rare form of breast cancer where you have negative receptors for estrogen, progesterone, and something called HER2-negative. With this, you don’t want to use testosterone because it requires other very aggressive treatments.  


The Safety of Testosterone in Women 


The safety of testosterone in women has been evaluated for the past 80 years. It’s been known for at least 70 years that testosterone is anti proliferative to breast tissue and inhibits the stimulatory effect that estrogen can have. Remember that when you reach the perimenopausal age, you have way more estrogen than progesterone so you can get estrogen dominant syndrome, fibrocystic breasts, and uterine fibroids (too much estrogen in relation to progesterone). Testosterone helps this by binding estrogen receptor sites. It is very protective. 

In two recent studies of women with testosterone pellets, one showed a 38% reduction in breast cancer and the other showed a 40% reduction in risk of developing breast cancer (or recurrence, if you’ve already had breast cancer). 

When I use a testosterone pellet in women with breast cancer, I use anastrozole (another mild estrogen blocker without the side effects of heavy duty tamoxifen and letrozole). Then, I follow the levels to make sure they’re not aromatizing any of it to estradiol or any of the other forms of estrogens. In women that just need testosterone, I always do a Cleveland Heart Panel, and usually just use plain testosterone pellets (while keeping an eye on estrogen levels). 


Closing Thoughts


You’re not going to hear any of this from your gynecologist or oncologist. They just don’t know a lot about bioidentical hormones. Big pharma doesn’t make these. They’re not synthetic. They’re plant based bioidentical hormones that have to be compounded by a licensed compounding pharmacy (who the FDA doesn’t seem to appreciate)

My suggestion is to find an integrative/functional medicine doctor who knows a compounding pharmacist that compounds bioidentical hormones, and is way ahead of the game. Do your own research on testosterone pellets, the effects it has on breast cancer survivors, and its prevention of breast cancer.  

Testosterone pellets is a tool in our arsenal to treat menopausal symptoms, especially for women with a history of breast cancer. Plus, testosterone helps protect everything from your brain, to your bones, to your muscles. I think it will change the quality of your life and probably the quantity also!  

Think about this option if you, your friend, or family member has had breast cancer. If this information has helped you, share it with others! Note: be sure to complete treatment for your breast cancer before considering testosterone.