A Thumbs Down Book Reviews
Perfect Balance
By Robert A. Greene, M.D.
Review by Lynn Wright
Clarkson Potter Publishers This book’s subtitle, “Dr. Robert Greene’s Breakthrough Program for Finding the Lifelong Hormonal Health You Deserve” is misleading. Dr. Greene actually promotes mainstream medicine’s decades-long dogma: supplemental estrogen for whatever ails the pre-, peri- and post-menopausal woman as well as for general disease prevention. With the author’s celebrity association as the OB/GYN consulted by actress Suzanne Somers and author of the foreword to her bestseller, The Sexy Years, this book will certainly gain undeserved attention.
While Dr. Greene covers remedies other than outright hormone replacement, including dietary suggestions, herbal remedies, exercise, relaxation techniques and lifestyle changes, estrogen supplementation gets most of his attention. He finds use for every form on the market, and employs the terms “BioIdentical, BioSimilar, BioLimited, BioUnknown and BioAntagonist” to categorize and explain the differences in how they are created and the risks associated with each type. He does emphasize those formulations identical to what our bodies produce, but keeps the door open for synthetic pharmaceutical concoctions and supports their use if other methods do not relieve symptoms.
Surprisingly, in this book on hormone balance, he fails to discuss blood or saliva testing to determine existing levels in the body. Dr. Greene ignores the fact that estrogen dominance is a reality in many women, due to environmental exposure to the innumerable “exogenous” estrogens in today’s world.
On the other hand, the true balancing hormone, progesterone, is treated as necessary but largely to be avoided. He portrays progesterone as the hormone that causes us to become fatigued, lethargic, clumsy, foggy-headed, emotionally vulnerable, and that provokes us to memory loss and fat storage.
Nowhere does he show us the highly informative “steroid hormone tree,” which demonstrates how all our sex and stress hormones derive from cholesterol. Estrogens are at the end of the conversion pathway, which means that the body can produce estrogens from various other hormones if needed. He does not recognize the overwhelming evidence indicating that what most women need is progesterone, not more estrogens.
My guess is that the real problem with progesterone is that it can be purchased over-the-counter, inexpensively, without pharmaceutical patents or doctor prescription. Compared to over 50 years of damning evidence of the dangers inherent in estrogen replacement, progesterone has never been shown to have serious side effects, yet the doctor continues to prescribe estrogen and ignore progesterone as an alternative.
In Raquel Martin’s well-researched book, The Estrogen Alternative one can read page after page of evidence supporting minimal risk methods of hormone balancing that do not require estrogen supplementation. She includes 50 pages of footnotes establishing a large body of research and studies that support her views. This book contains sound nutritional advice and is truly a comprehensive, natural approach to hormonal balance without the risks associated with estrogen replacement.
How can we trust a doctor who answers with an emphatic “no” the question so many women are asking: do birth control pills increase the risk of breast cancer? In 2002, the Federal Government’s official list of Known Human Carcinogens marked the addition of “steroidal estrogens used in hormone replacement therapy and oral contraceptives.” Yet the doctor tells us not to be concerned about taking the Pill and breast cancer, but leaves us to worry about the Pill’s possible influence on other cancers.
In addition, he actually promotes the use of patented hormone preparations as protection against some cancers (colon, uterine/endometrial, ovarian). One of these, Seasonale, an oral contraceptive that subjects women to nine more weeks per year of synthetic hormone exposure than conventional monthly birth control garners this comment from Dr. Greene, “Seasonale is another good alternative. . . designed so that you have one menstrual cycle per season. This kind of menstrual regulation is totally safe and preferred by a great many women for its convenience and predictability.”
Meanwhile, the manufacturer’s prescribing information states, “Like other birth control pills, SEASONALE® has serious risks, which can be life threatening, including blood clots, stroke, and heart attack and are increased if you smoke cigarettes. Cigarette smoking increases the risk of serious side effects, especially if you are over 35. Women who use the Pill should not smoke. Some women should not use the Pill, including women who have blood clots, certain cancers, a history of heart attack or stroke, as well as those who are or may be pregnant.”
To make matters worse, Dr. Greene lists Seasonale under the heading, “Best Hormone Treatments” at the end of the section on sleep problems related to the menstrual cycle as well as after a discussion of cognitive decline. Birth control is not just for birth control after all. Similar suggestions for dangerous pharmaceuticals can be found for migraines, acne, mood problems, depression, bloating, improving skin appearance, dizziness and of course, hot flashes and night sweats. He keeps alive the conventional credo that estrogen replacement protects against Alzheimer’s, certain cancers, and many other age-related afflictions even though there is a growing body of evidence that says otherwise.
Perhaps most disturbing is his nutritional advice. As a vegetarian he says, “The only thing meat has to offer is protein, calories and iron, and you can easily get that from cleaner plant protein sources.” Four pages extolling the virtues of soy come under “Soy: One of the Best Sources of Protein” with the summation, “Since soy is a complete protein and provides all your essential amino acids, you could technically eat it as your sole source of protein.”
Along with his love affair with soy, he wants us to consume lowfat/nonfat dairy, use canola oil for cooking, spread trans-free margarine instead of butter on our bread and toss our salads with fat-free vinaigrette.
Equally disturbing are his suggestions for calcium sources: lowfat yogurt, fortified soy, fortified orange juice and even Tums EX antacid for calcium carbonate.
And for vitamin D: fortified milk, cereals and supplements. He cautions to keep vitamin A intake below 500 IU per day, erroneously asserting that it counteracts the benefits of vitamin D thus preventing calcium absorption.
Fats are rated according to conventional cant: the lower the consumption the better. On the “Know Your Fats” table, under “Health Risk” saturated fats earn “Cause of high LDL levels” and for “Health Benefit” a single word: “None.”
To his credit, Dr. Greene strongly promotes choosing organically produced foods, wild rather than farmed fish and avoidance of trans fats. At least he’s got a few things right.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2006.
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