Q & A: Evista or Natural Hormones
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Evista or Natural Hormones?

Q: What is your opinion about Evista versus a compound of natural estrogen and natural progesterone, such as E2P4?

I always find it interesting that part of the role of knowledge is to help overcome prejudice, and all knowledge is really prejudice. (We judge a new situation based on our experiences with old but similar situations.)

I am not an authority on Evista by any stretch, but here are my reasons for my prejudice in favor of natural hormones (those already in people) or bio-identical hormone replacement rather than Evista or whatever:

  1. In my 28 years of patient contact, I have seen the drug detail men hawking all kinds of products for our patients. Currently, I see them hawking Premarin, and a wide variety of other drugs. They really don't seem to care about our trust, only to sell as much of the product as they can.
  2. I saw Tamoxifen sold as the "be all, end all" agent to protect the breast tissue. Now, it is a major risk factor for endometrial cancers. Seldane was marketed as a non sedating antihistamine, until they found if you took it with E-mycin, you could die. Qualuud was brought in as "a non habit forming sleep aid," until it started selling for $5 a pill on the street and was taken off the market.

In brief, drug companies are not benign sources of information about what is good. They also pay for about 90% of the continuing medical education. They even ply medical students with goodies. Now, big companies don't sink 20% of profits into advertising because it doesn't work. Bringing docs goodies that range from lunch to ball-point pens and paper really affects the way docs (people) see products.

When I work with hormones already in a person, I know that receptors the it will interact with are there, and that the hormone is the chemical that fits. The mechanisms to degrade the hormone are already in place, and I know that the hormone has been tested in almost every living human being. Hippocrates suggested that one should never be the first nor the last to try a new treatment. I'd concur.

Hope this helps,

Don Michael, MD


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  Disclaimer: Opinions expressed here are for informational purposes only and do not constitute a physician-patient relationship. The information should not be considered as medical advice or as a substitute for a visit to your healthcare provider. You are strongly encouraged to seek the advice and supervision of a physician or other certified practitioner regarding any medical issue.











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Updated 09/29/2010