NOVEMBER 17 1997

CyberHealth Index

CONTENTS:

1. Killer bras, celibacy, and other breast cancer risks
2. Low-fat, high-carbohydrate diet lowers testosterone
3. Half an onion a day keeps the doctor away
4. A warning about licorice
5. A reader’s advice on chocolate chips
6. Sonya Friedman on leading the life you want

Killer bras, celibacy, and other breast cancer risks
(inconclusive but interesting)

I’ve come across another article that raises more questions than it answers, and can be easily criticized from a scientific point of view, but I think you’ll find it fascinating nonetheless.

The author, Dr. Murrell, hypothesizes that breast cancer originates when we see two conditions: 1) excessive stimulation of the glandular tissue 2) poor circulation, and consequently inadequate removal of carcinogens. He also suggests that oxytocin, a hormone whose levels rise with orgasm and nipple stimulation, helps protect against breast cancer.

The article starts with a historical survey. Already Hippocrates associated the origin of breast cancer with menopause. Stagnation of lymph in the breasts was one of the early theories. In 1700, an Italian physician published his conclusions that nuns had a much higher risk of breast cancer.

In early 1700s, an English physician observed that women who squashed their breasts with corsets and stays were at high risk of breast cancer.

Murrell states that modern women who wear tight bras (particularly those who even sleep in a bra) have been found to have higher prolactin levels—and prolactin is a potent growth factor for the glandular tissue, resulting in the distension of milk glands.

The lower incidence of breast cancer in sunny climates has generally been attributed to the protective action of Vitamin D. Murrell suggests that “an alternative explanation may be the absence of compressive clothing in hotter climates, leading to lower levels of prolactin.”

Murrell states, “An important finding in some women who present for routine breast examination is a flat, atrophic, and sometimes scaly nipple.” In Murrell’s eyes, this is a sign that the nipple is not being stimulated. He hints that having a partner would make such stimulation particularly efficient—even that partner-aided breast stimulation is a remedy for fibrocystic breast disease (pardon the stilted terminology; I think we all know what he means).

He also quotes a French case-control study that found much lower risk of breast cancer in sexually active childless women compared to the same-age celibate women. Since oxytocin rises with orgasm and nipple stimulation, and since oxytocin has been shown to inhibit the proliferation of breast cancer cells, there seems to be a plausible connection between an active sex life and lower risk of breast cancer.

Then this disquieting statement: “Nothing is known of oxytocin levels in postmenopausal women.”

I looked up the French study, and indeed it included only premenopausal women (age 25-45). The study found that having no sexual partner or rare intercourse (less than once a month) appeared to nearly triple the risk compared to that of sexually active women.

Interestingly, women who relied on withdrawal or condom for birth control also had an elevated risk (1.7), leading the authors to speculate about the possible protective effect of semen. They cite a previous study that found the relative risk of users of barrier methods to be 4.7 compared to nonusers (who relied on the Pill, IUD, or “rhythm”).

Having an infertile sexual partner also raised the risk to 1.7.

Is there some unknown protective factor in semen? Selenium, arginine, certain prostaglandins? Or perhaps it’s rather that women who use the non-barrier methods have more frequent intercourse and thus enjoy the overall health benefits of sex? It’s much too soon to tell.

I know all of this is full of huge holes and totally inconclusive until we have more evidence from experimental as opposed to epidemiological studies.

Naturally it could be said that women who have an active sex life are healthier to begin with, and/or that sexual pleasure, like all positive emotions, strengthens the immune system.

To women who seek to lower their risk of breast cancer, theoretical considerations are of secondary importance. If there is truth to the statement that frequent orgasm and breast stimulation provide protection, the women don’t care if this is due to oxytocin or beneficial neuropeptides.

And if tight bras look like a plausible risk factor, this too should be investigated further. As Dr.Susan Love suggested—perhaps her best idea—we should all march topless on Washington and demand more funding for research.

Sources:

Murrell TG. The potential for oxytocin to prevent breast cancer: a hypothesis. Breast Cancer Research and Treatment 1995; 35:225-29;

Monique G et al. Characteristics of reproductive life and risk of breast cancer in a case-control study of young nulliparous women. J Clin Epidemiology 1989; 42: 127-33)

Lynne’s comments:

The doctor who treated me for breast cancer is an outspoken opponent of bra-wearing. The studies in the book Dressed to Kill claim bc risk rises with the number of hours of bra-wearing. I have heard this debated on tv with the opponents of bra-wearing always being able to document what they say and the skeptics relying on the dubious authority of their “impressions,” which of course come right from our western cultural habit of trussing women.

I had not realized bra-wearing was such a social mandate until I suggested to one of my sociology classes that bras as we know them were a recent historical fad. many of the 20 year-old students insisted women need bras.

Need? They all used this word without realizing what it meant, that the image of women as we have learned it in recent decades promotes pert, protuberant breasts. anything less is defective or deficient and needs remedial garments, i.e., bras.

When I pointed out to the class that they were expressing a sociological position, not a medical necessity, they admitted perhaps this was true but they still didn’t want to look like the native women in natural geographic “with their nips down to their waist!”

I mentioned that when I was 12 years old in the early sixties we were convinced that we needed a girdle or our hips would spread. Now the girdle fad has passed but the bra fad remains. Dangling breasts are still considered shameful.

My question is, what do we tell our granddaughters when the ask, “Granny, why did you ever squeeze your breasts into those things called (horrors!) cups and strap them over your shoulders and around your back?” Do we answer that we thought we needed them? That they were a fad? That we didn’t believe the cancer connection way back in the 1990s?

Personally, I wear a bra only for jogging or for an occasional dress-up and I don’t choose everyday clothes that foist my braless breasts into the face of others. If my breasts were smaller I wouldn’t wear one ever. Just my .02.

Ivy replies:

It here! Just occasional dress up. I’ve discovered that if I wear loose button-down blouses, vests, etc, it doesn’t really show. And it’s so much more comfortable than, as you so correctly put it, being trussed!

On the other hand, I’ve been told that a large-bosomed woman may feel more comfortable in a well-designed, non-constricting bra. There is a company in Utah that specializes in large-size bras that don’t impede lymphatic circulation. If anyone is interested, I can easily find out the address.

True, the connection may not yet be conclusively proven. Still, why take chances? At least, for God’s sake, don’t wear tight bras, and never sleep in a bra.

Another excellent point that Lynne makes is that most women believe they NEED to wear a bra, a kind of “remedial garment.” Victorian women believed they needed corsets. They absolutely believed this! The next issue of CHW will bring you an update on lymphatic breast massage.

LOW FAT EQUALS LOWER TESTOSTERONE

Do you remember Lynne’s comment about how her husband’s triglycerides skyrocketed on the Ornish diet (very low fat, high carbohydrates), and “within weeks his curly hair straightened and his skin hung from his arms” (CHW#4)? To me, these symptoms suggested a dramatic drop in testosterone levels.

What correlates best with a man’s physiological age is his level of free testosterone. Physiological youthfulness is synonymous with high free T. The ratio of muscle to fat is a rough indicator of that, since muscle mass correlates with T levels.

There are many ways in which a man can increase his natural T production. Enjoying lots of sex and sexual fantasy is the most obvious and pleasurable way, though here of course we encounter the typical endocrinological chicken-and-egg quandary: it’s the men who already have high T who experience more sexual pleasure (T heightens sexual sensation) and have the most sex dreams and fantasies.

Diet has a lot of influence also. A vegetarian friend of mine told me that the main reason for vegetarianism was to lower sex drive; monks discovered this centuries ago. A vegetarian diet is typically a low-fat, high-carbohydrate diet—essentially the Ornish diet. Now Reuters (June 16, 1997, Reuters Internet Site) brings the news of a study conducted at Penn State University Center for Sports Medicine. Dr. William Kramer and Dr. Jeff Volek monitored T levels of 12 healthy young men in relation to the diet they consumed. Their studies confirmed earlier studies: people who derive 20% of their calories from fat have significantly lower testosterone levels than people who derive 40% of their calories from fat.

Kramer and Volek found that it was specifically the consumption of saturated and MONOSATURATED fat which correlated with higher resting T levels. I stress monosaturated, since this is one of the pivotal components of the heart-healthy Mediterranean diet, typically containing 40% fat from olive oil, seafood, cheese, and moderate quantities of meat.

There was no correlation of T levels with the consumption of polyunsaturated fats. (Translation: you can’t raise your T levels by eating more margarine. Throw out the margarine and turn to olive oil; a small amount of butter won’t hurt either.)

One interesting finding was that excess protein consumption correlated with lower T levels. Too much steak is definitely not recommended.

I can already hear the chorus of voices concerned about the cardiovascular aspect of higher fat consumption. I see no reason to worry as long as the emphasis is on monosaturated fat, and other components of the Mediterranean diet are included: seafood (a source of zinc, iodine, and selenium, also important for prostate health), red wine, tomatoes, and so forth—and the joy of life that goes with being a Latin lover or equivalent, as opposed to low-T depression (the “grumpy old men” syndrome).

As for the continuing debate as to whether testosterone is good or bad for the cardiovascular system, there is now mounting evidence that it’s low-T men who are most prone to heart disease (and many other disorders); in addition, testosterone has been found to lower the levels of apolipoprotein (a), a known cardiovascular risk factor, by up to 50%.

Source in addition to Reuters:

Morley J et al. Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: Progressive decreases in bioavailable testosterone, DHEA-S, and the ratio of IGF-1 to growth hormone. Proceedings of the National Academy of Science 1997; 94:7537-42)

HALF AN ONION A DAY KEEPS THE DOCTOR AWAY

Aged garlic may be a wonderful weapon against cancer, but let us not forget that heart disease is still the #1 killer of women and men alike. Is heart disease preventable? You bet! How? With high-fiber diet, correct natural HRT (remember that progesterone helps too!), exercise, avoiding processed carbohydrates and processed fats (don’t even think of using margarine, baked products containing partially hydrogenated oils, and commercial vegetable oils other than olive oil!); by using antioxidants, fish oil, dry red wine, arginine, grapeseed extract and grapeseed oil. Aspirin deserves further investigation.

Now listen to this: Dr. David Williams states in one of the recent issues of his newsletter “Alternatives” that eating half a medium-size RAW onion every day for 2-3 months has been found to raise HDLs by 30% in 75% of the subjects. This is nothing short of spectacular. Even relatively high doses of estrogens generally don’t raise HDLs more than 15-19%.

HDLs escort excess cholesterol out of our tissues. They even grab some from the arterial deposits, thus reducing the amount of the plaque. Need I say that high HDLs correlate very strongly with longevity? Now, I know that it’s NOT EASY to consume half a raw onion a day. I find that I must have it with something mild-tasting, such as a tomato. But onion is wonderful in salads, including various types of cole slaw and bean salads. I love red onion in all salads that include apple chunks—apple and onion are an amazingly compatible combination! And it so happens that both red onion and red apples are both excellent sources of quercetin, a bioflavonoid, a type of weakly estrogenic compound with powerful benefits for blood vessels.

Both brown and red onions contain quercetin, but red onions are the richest natural source. I find it just amazingly convenient that brown onions seem better for low-heat frying, while red onion tastes better raw, at least to me.

Onion also helps lower blood pressure, dissolve blood clots, and prevent asthma attacks. It acts as a blood thinner, making the blood flow more freely.

These benefits can be obtained by eating cooked onions. Only raw onion, however, can raise HDLs, according to Dr. Williams.

Nobody says that you won’t get some benefits if you eat less than half an onion. Just eat as much as you can. And chew some parsley afterwards to keep your breath more social.

Personally, I’ve noticed fewer colds ever since I increased my onion consumption, and have had a similar report from a friend. Some even say that at the first sign of a cold one should consume a whole raw onion! Well, if you are hardy enough . . .

A WARNING ON LICORICE—DON’T MISS THIS ONE!!!

Miranda writes:

My naturopath put me on a strong licorice root formula for adrenal stress. This particular herb is known to have powerful estrogenic effects and ought never to be recommended for a person with fibrocystic breast disease. I grew several new cysts, one containing 100 cc! You can imagine the merriment in the breast clinic. Not to mention the worry, expense, etc. I got tired of spending money having the things aspirated—started doing it myself with a big syringe. The experience falls somewhere between clipping your toenails and taking out your own appendix.

I got excited about my homemade wild yam tincture because it shrank the darn things considerably; Pro-Gest is doing more good. Mind you, no one—not my Gyn or my naturopath or anyone—ever suggested hormones as a treatment for the problem, topical or otherwise…

Ivy replies:

First, let me mention that Miranda is a health professional, so when she uses a syringe, she presumably knows what she is doing. To everyone else:

DON’T TRY THIS AT HOME.

As for licorice, it can be amazingly potent. When I was just starting NHRT and was on the very weak classic tri-est formula, I thought I’d enhance the benefits by taking a licorice tincture. Within days, I had breakthrough bleeding. Only later I read that licorice synergizes with estradiol in the endometrium, stimulating proliferation.

Licorice contains various interesting plant steroids that mimic glucocorticoids (stress hormones) and aldosterone—a mineralocorticoid hormone which makes the body retain sodium and raises blood pressure. Hence licorice can be helpful in the type of chronic fatigue that’s characterized by low blood pressure.

That’s not the end of the powerful properties of licorice. It also apparently inhibits the enzymes that break down our sex hormones. Thus the levels of these hormones rise. One holistic (but still premenopausal) woman practitioner was outraged that I was taking hormones: “Why not just take licorice?” Because trouble may follow, that’s why.

Now, the really serious matter: fibrocystic breasts. This is one of the classic symptoms of progesterone deficiency. Frequently the woman suffers from fibroids and endometriosis as well, though she may not know it, with “periods from hell” making her life more and more miserable. It is simply amazing how quickly progesterone acts to normalize both breast and uterine tissue.

I was first put on Ogen and Provera. True, my hot flashes were gone instantly, but I developed a huge cyst, with two smaller ones also showing on the ultrasound, and microcysts so abundant that my Gyn told me, “These are the lumpiest breasts I have ever seen.” My uterus was also the size of three months’ pregnancy due to fibroids.

I went off the ghastly synthetic hrt (interestingly, I typed it as “hurt”) and switched to tri-est and progesterone. I don’t exactly remember how long I was on progesterone after the aspiration of the cysts (which cost over $400) before my breasts and uterus were checked again with the ultrasound. It was either three or four months. My breast tissue was pronounced normal.

The size of my uterus was back to normal. “Your endometrium is extremely thin, ” my gyn said. Exactly what a postmenopausal woman wants. I’ve also come across some interesting studies showing that progesterone is effective against pelvic inflammation and endometriosis—as effective as Danazol, without Danazol’s nasty androgenic side effects. If you are interested in this topic, please contact me for references.

I mention endometriosis here because in a way this vindicates Dr. Lee’s views that progesterone deficiency indicates a greater cancer risk in general. A Swedish study found that endometriosis patients had a 20% greater risk of cancer, especially of breast cancer, ovarian cancer, leukemia, and non-Hodgkin’s lymphoma (Reuters, April 4, 1997). The progestin-only pill and Depo-Provera have been found to help prevent endometriosis; even the ordinary birth control pill, with six times the progestin potency compared with postmenopausal progestin dose, is known to arrest the progress of endometriosis, and hence is a commonly used treatment. Using natural progesterone instead would likely produce even better results without the side effects of progestins.

To get back to licorice: if you are still producing erratic perimenopausal amounts of your own estradiol, or taking estrogen replacement, in my view it is best to stay away from licorice, particularly the potent liquid extracts. Progesterone, on the other hand, is a must for many women during perimenopause, and for all women after menopause, including women who have had a hysterectomy.

ON THE ART OF EATING CHOCOLATE:

Susan writes:

I’ve found that chocolate chips are a great thing if, like me, you need to finish what you started: to eat as much as is there…

With the chips, I eat a few and am satisfied. With a bar (yes, I eat the pure version), I need to eat a square or two.

There are semi-sweet chocolate chips with no added sugar made by several companies out there.

Ivy replies:

Thank you, Susan, for your excellent tip. Intrepid experimenter that I am, I immediately purchased a bag of Ghiraldelli’s Semi-Sweet Chocolate chips. Results: it’s a fun way to do chocolate, what I’d call casual chocolate or chocolate on the fly. For serious polyphenols, I still prefer Hershey’s Unsweetened Baking Chocolate.

I think there is something to this “a square or two.” That’s exactly what I eat, never more. Generally just a square. Without sugar, there is no compulsive craving. My body gives me a clear signal when to stop.

Still, baking chocolate is for the dedicated, the more stoical. As Seven of Nine of Voyager says, “Taste is irrelevant.”

For those of you who disagree, there is also the semi-sweet baking chocolate. I’ve just received a report from a CHW reader who has tried it and found it quite good.

A reminder: the natural fat in chocolate, cocoa butter, is not harmful, and may even be beneficial.

If you are just beginning to trust a bit that it’s OK to eat chocolate, you might want to start with the semi-sweet chips. Or simply if you like the taste. Pleasure is just as important to our health as antioxidants.

SONYA FRIEDMAN AND OTHERS ON LIVING THE LIFE YOU WANT

“Nobody is going to save you; that’s your job. Save yourself. If you don’t like where you are, get out of there. The object is not for them to like you, the object is for them to listen to you. Nobody knows what you want except you. And nobody will be as sorry as you if you don’t have it. Wanting some other way to live is proof enough of deserving it. Having it is hard work, but not having it is sheer hell.”

Marsha Norman, quoting Lillian Hellman.

Sonya Friedman’s comment:

“Traditionally, women have been closely acquainted with the ‘sheer hell’ of not having. The more patient of us are also good at waiting for others to share their bounties with us. This is getting, then, not HAVING THROUGH ONE’S OWN EFFORTS—that glorious feeling that comes with self-generated, self-motivated, creative having.”

Sonya Friedman, “Smart Cookies Don’t Crumble,” p. 216-217.

Disclaimer

This newsletter is presented as a free service for women and healthcare professionals interested in women’s health. Publication schedule will be more or less weekly. Editorial assistants: Gail Peterson, Monica Smith The material contained herein is intended as information only, and not as medical advice.

Books by Joanna, a.k.a. Ivy Greenwell:

• HORMONES WITHOUT FEAR (available from Bajamar, 800-255-8025)
• A REFERENCE GUIDE TO NATURAL HORMONES FOR MEN
• HOW TO REVERSE OSTEOARTHRITIS (including an extensive info on hormones and arthritis)
• HOW TO HELP PREVENT BREAST AND OVARIAN CANCER