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 All Thumbs 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.
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