This article first appeared in Dr. Jonathan V. Wright's Nutrition
& Healing newsletter
Aside from the fact that, as free citizens
of these United States, we should have the right to choose any type
of medical treatment we feel is best suited to keeping us healthy,
the ongoing threat of los Federales' taking away access to bioidentical
hormone replacement therapy puts women at a significant disadvantage
in many other ways too. If you're a longtime reader of Nutrition
& Healing, you already know that, as part of bioidentical hormone
replacement therapy (BHRT), estrogen replacement can lower a woman's
risk of Alzheimer's disease and cognitive malfunction, protect her
against cardiovascular disease, strengthen her bones, and slow down
skin aging. But one of the other important benefits of BHRT is something
you've probably never heard about.
A series of research reports from the respected Lung Biology Laboratory
at Georgetown University School of Medicine (led by Drs. Donald
Massaro and Gloria DeCarlo Massaro) dating back to 1994 have established
that estrogen is extremely important to lung health, too, especially
for women. Unfortunately, most people have no idea about estrogen's
role in lung health, since reporting about these studies has been
minimal to nonexistent in newspapers, television, radio, and major
internet websites, all of which appear to prefer reprinting financially
driven news releases from patent medicine companies, instead of
doing their own investigative research and reporting.
But despite the lack of media coverage, these studies made some
groundbreaking discoveries. Although chronic obstructive pulmonary
disease (COPD) and emphysema are obvious and well-known results
of smoking, nonsmokers sometimes develop COPD and emphysema, too.
And instances of both conditions are much higher in nonsmoking women
than they are in men. These studies help explain why – and
show just how simple it can be not only to protect your lungs, but
also to repair any damage that's already been done.
Why Women 'Outbreathe'
The first research report in this series was published in 1995.1
Working with female rats, the researchers discovered that oxygen
uptake almost doubled during pregnancy and nursing, even though
the structure and surface area of the lungs remained the same as
before (total surface area of the lungs directly correlates with
the degree of oxygen-carbon dioxide exchange). They suspected that
the hormonal increases of pregnancy were responsible for the increased
But even though the female rats' lung surface area didn't change
during pregnancy, the research team also found that mature female
rats naturally have a higher total lung surface area for oxygen-carbon
dioxide exchange than male rats of the same age. The females also
had significantly smaller alveoli (the billions of tiny oxygen-carbon
dioxide exchanging "sacs" that comprise the lungs' spongy
tissue). And the smaller the alveoli in the lungs, the more there
are, which accounts for the greater gas-exchange surface area.
A year after they made these initial discoveries, the same research
team proved that estrogen is directly responsible for the difference
between the lungs of female and male rats in two ways.2 First, they
removed the ovaries from immature female rats and found that when
they had fully matured, these females had larger alveoli and a smaller
gas-exchange surface area than female rats of the same age who hadn't
had their ovaries removed. In the second phase of the study, the
researchers gave a group of immature female rats extra estrogen
and found that these females developed smaller, more numerous alveoli
(resulting in greater gas-exchange surface area) than immature rats
not given estrogen.
And to rule out the possibility that hormones in general are responsible
for lung development, the researchers gave androgens (testosterone
and testosterone-related hormones) to a group of newborn female
rats. But the extra androgens made no difference to the ultimate
size or total oxygen-exchange surface area of their lungs. They
also discovered that male newborn rats that had been genetically
engineered to be deficient in androgen receptors (so that their
own testosterone would be less effective) had the same lung development
as newborn male rats with normal androgen receptors.
With all of the information they'd compiled, the researchers concluded
that estrogen is primarily responsible for lung function in females.
From there, they moved on to test the effects of estrogen loss –
and replacement – on lung health.
Damage with Estrogen
First they found that removing the ovaries (a procedure technically
known as ovariectomy) of adult female mice resulted in both loss
of alveoli and of lung surface area. Loss of surface area reduces
oxygen-carbon dioxide exchange (in other words, it negatively affects
the ability to breathe easily).
But when the researchers gave the rats who had had their ovaries
removed estrogen replacement, not only did they regain some of the
alveoli they'd lost, but the ones that were damaged actually got
They concluded in part that "estrogen is required for maintenance
of already formed alveoli and induces alveolar regeneration after
their loss in adult ovariectomized mice, and [this research] offers
the possibility that estrogen can slow alveolar loss and induce
alveolar regeneration in women with COPD."3 In 2006, the research
team finished their series of studies with a review article of their
own work as well as research of others.4 The review pointed out
that normal aging already results in loss of lung alveoli, and that
menopause further accelerates the loss of lung surface area, which,
in turn, reduces oxygen-carbon dioxide exchange and makes breathing
more difficult. In other words, since estrogen is critical to long-term
protection of women's lungs, after menopause, there's just not enough
estrogen for some women, and their lungs suffer.
They also pointed out that their work and work in other laboratories
"has disproved the notion that pulmonary alveoli are incapable
of regeneration," and that research indicates that the factors
regulating both alveolar loss and regeneration are "conserved"
(scientese for "the same") for rats, mice, and humans.
So what do all of these study results mean for you (or at least
the women in the audience)? Well, there are several implications
of this research work. First, even if you're healthy, you should
seriously consider BHRT if you want to maximize your lungs' ability
to absorb oxygen and get rid of carbon dioxide as you get older.
This is especially important if you're an athlete, and want to continue
your athletic activities for as long as you can – but maintaining
healthy lungs also helps make simple daily tasks like walking up
and down the stairs easier.
And BHRT may be especially important for women (nonsmokers) who
have emphysema and/or COPD. If your estrogen levels are low enough
to have caused (or at least contributed to) these problems, chances
are that you're also at a significantly higher risk for the other
problems associated with low estrogen levels, such as Alzheimer's
disease, heart attack and other cardiovascular disease, and osteoporosis.
But BHRT can help protect you from all of these conditions while
it's helping to repair the damage that has been done to your lungs.
Even if your emphysema and/or COPD can be linked to smoking, BHRT
is still worth trying. It may not help as much as if you'd never
smoked, but if you're past menopause, your estrogens are already
low, so replacing what your body is missing certainly won't hurt.
And what about men? As the researchers pointed out, male lungs and
their alveoli aren't nearly as sensitive to hormonal variation as
women's. However, there is at least one potential exception: Men
whose testosterone gets so low that their bodies can't make much
estrogen at all. (Remember, in both sexes the body makes estrogen
by converting testosterone to estrogen – a process known as
aromatization.) So if you're a man who has been diagnosed with emphysema
or COPD, you might want to get your estrogens checked along with
your testosterone. If it turns out that your levels are too low,
BHRT (in different proportions than those given to women, of course),
may very well help you too.
Whether you're a woman or a man – with or without emphysema
or COPD – if you're considering having your hormones checked
and possibly using BHRT, make sure to consult a physician skilled
and knowledgeable not only in BHRT but in nutritional and other
natural therapies as well.
This article is taken from the revised version of the book about
bioidentical hormone replacement written by Lane Lenard, PhD, and
me – the very first one published on this topic (in 1997).
It will be available (with a revised title) later in the spring
or summer of this year.
Jonathan V. Wright, MD, has degrees from
both Harvard University (cum laude) and the University of Michigan.
More than any other doctor, he practically invented the modern science
of applied nutritional biochemistry, and he has advanced nutritional
medicine for nearly three decades. Dr. Wright is credited with introducing
the nutritional remedy for benign prostate disease (BPH), the first
successful treatment to reverse macular degeneration, the safe medical
use of DHEA therapy, natural hormone replacement therapy for women,
and many other revolutionary natural cures.
To learn more about Dr. Wright's seven-volume Library
of Nutritional Cures and his newsletter Nutrition
& Healing and/or to subscribe to the newsletter, please
or call 888-213-0685 (ask for code WNAHWEB).
1. Massaro GD, Mortola JP, Massaro D.
Sexual dimorphism in the architecture of the lung's gas-exchange
region. Proc Natl Acad Sci USA.
2. Massaro GD, Mortola JP, Massaro D. Estrogen modulates the dimensions
of the lung's gas-exchange surface area and alveoli in female rats.
Am J Physiol. 1996;270(1Pt1):L110-L114.
3. Massaro D, Massaro GD. Estrogen regulates pulmonary alveolar
formation, loss, and regeneration in mice. Am
J Physiol Lung Cell Mol Physiol. 2004;287(6):L1,154-L1,159.
4. Massaro D, Massaro GD. Toward therapeutic pulmonary alveolar
regeneration in humans. Proc Am Thorac