BIOIDENTICAL HORMONE REPLACEMENT
Millions of women today experience some kind of health issue relating to their hormones, ranging from premenstrual moodiness or sugar cravings, to severe hot flashes and sleep problems during menopause. Infertility and miscarriages are becoming more and more common. And while more and more women are searching for solutions, frequently the only solution offered to them by their doctors is to put artificial hormones into their body to relieve their symptoms. Hence the millions of prescriptions for synthetic Hormone Replacement Therapy (HRT) and the oral contraceptive pill (OCP).
Synthetic HRT was standard of care for any type of menopausal problem for quite a few years. However, recent studies have shown very discouraging side effects from these hormones, including increases in the rates of endometrial cancer and breast cancer.
Subsequently, awareness has increased as to the possible dangers of synthetic HRT and millions of women are seeking alternatives. Thankfully, there are more natural alternatives that can be used to treat a variety of female health conditions, without the dangerous side effects.
So what makes synthetic HRT potentially dangerous?
The early forms of synthetic HRT, such as Premarin® were predominantly estrogens. The logic was that replacing estrogens would ameliorate symptoms such as hot flashes, vaginal dryness and other symptoms associated with menopause; symptoms which were caused by the drop off in estrogens during peri-menopause. However, over the years evidence surfaced that giving women estrogens alone was causing a significant increase in the rates of both breast and endometrial cancers. It was discovered that giving progesterones in combination with the estrogens would offset this problem to some extent, and so Provera® was given as part of the HRT prescription.
Thankfully, rates of endometrial cancer went down; however, adding progesterone to the mix did nothing to offset the increased risk of breast cancer. Even today, women on a regimen of standard HRT using synthetic hormones such as Premarin® and Provera® may increase their risk of breast cancer by up to 30%, according to some estimates. In real numbers, this means that for every 1,000 women using one of these drugs, 300 will eventually develop breast cancer from the HRT itself.
Another major drawback of synthetic HRT is that it is made from the urine of pregnant mares. Estrogens and progesterones are extracted and made into formulas for human use. These hormones are not natural to the human body, nor are they in forms that the human body can use and metabolize via its own biochemical pathways. So while bio-identical HRT involves giving hormones in forms that are easily recognized and safely metabolized by humans (because they are manufactured to mimic the structure of human hormones), synthetic HRT is unnatural to the human body.
It only makes sense to give hormones to women that closely match the hormones that have been produced naturally by that woman’s body for years.
So how did they get so popular in the first place?
Part of the answer to this is that we didn’t have the information then that we have now, and the evidence as to the dangers of synthetic HRT. Only recently have long term studies been done and the true picture come out.
The other part of the answer is that unlike bio-identical hormones that are derived from natural plant substances and therefore not patentable, synthetic HRT could be patented by the pharmaceutical companies. This gave the pharmaceutical companies the corner on a multi-billion dollar market segment, which they have strong vested interests in protecting!!
What are bio-identical hormones?
Bio-identical hormones are forms of hormones that have been created in accordance with the natural hormones of the human body. In other words, they mimic the molecular structure of human hormones more closely than hormones made from the urine of pregnant mares.
Bio-identical hormones are manufactured in the laboratory from plant sources such as the wild yam, or Diascorea composita plant. This plant is rich in the precursors that can be easily converted by biochemists into other molecules that are identical in every way to natural human estrogens, progesterones, testosterone and other hormones.
The term “natural hormone” can be confusing to some people because these hormones are manufactured in a lab. In this case, the word natural refers to the structure of the hormone molecule, not the source. I prefer the term “bio-identical” because it eliminates this confusion and accurately describes the end result. The important thing is that the hormones produced from these plant sources, when analyzed by biochemists, are indistinguishable from human hormones.
Are bio-identical hormones just for menopause?
No, bio-identical hormones can be used for a broad range of conditions, such as irregular menstrual cycles, PMS, infertility and polycystic ovarian syndrome. When a woman is having menstrual cycles, we are able to “map” the cycle, which means that we take saliva samples throughout the month and end up with a graph of the estrogen and progesterone levels throughout the month, as well as the testosterone levels. From this we can see where hormones are deficient or dominant, or if the timing of events in the cycle is skewed. Using natural forms of estrogen and progesterone, we can augment the cycle and regulate it.
Many women who have trouble conceiving have a progesterone deficiency, especially in the latter half of their cycle. If we identify this through salivary hormone testing, we can supplement with bio-identical progesterone and enhance the woman’s chance of falling pregnant.
For perimenopausal women, that is women approaching menopause but still having menstrual cycles, mapping the cycle and balancing the cycle using bio-identical hormones can result in a smoother transition into and through menopause, with fewer symptoms. Appropriate levels of bio-identical hormones can relieve symptoms and continue the prior pattern of menstrual bleeding. When “menopausal age” arrives (this age varies from family to family), supplemental hormone levels can be decreased sufficiently to eliminate bleeding while still providing protection against cardiovascular disease, osteoporosis and loss of mental function.
Do bioidentical hormones help slow down the aging process?
Bio-identical hormone replacement will not turn back the clock and make a woman younger, but it can make her feel and look more youthful. Preventing osteoporosis and promoting good bone health will allow women to be more active into their 70’s and 80’s which also contributes to looking radiant and youthful. Many women find that on a regimen of bio-identical hormone replacement, their skin retains more of its tautness and youthful glow, they feel more sexual because of adequate vaginal lubrication and tissue integrity, they are better able to maintain a healthy weight, and they aren’t forgetting things all the time!
This time of menopause and beyond can really be, to quote Suzanne Somers, the “Sexy Years”. Menopause is a natural state and an important transition in a woman’s life. In many cultures it is associated with wisdom and deepening respect, as well as some relief to be finished with menstrual periods. In our Western culture, menopause has become regarded as a disease, but it emphatically isn’t. It’s a perfectly natural time of change that does not have to be overly problematic.
How do I know what hormones and levels are right for me?
Salivary hormone testing can provide accurate information about hormone levels in the body. For cycling, pre- or peri-menopausal women, hormone levels throughout the entire monthly cycle are measured. For menopausal and post-menopausal women, a single day or three day salivary measure is taken. From there, based on the lab data and the woman’s symptom picture, a formula of safe, natural hormones can be prescribed. This can be adjusted over time in response to changes in symptoms, if necessary.
Should hormones be dosed in a cyclic or continuous manner?
Bio-identical hormones can be dosed in one of two ways for menopausal women. They can be given to mimic the pre-menopausal hormone patterns, which means that women would continue to cycle and hence, have periods. Suzanne Somers in her book “The Sexy Years” promotes this method of dosing. Some women and health practitioners feel that this is optimal as it best mimics the natural cycles of the woman’s body. Other women do not want to continue having periods into their 60’s and 70’s.
The other method of dosing is continuously throughout the month, with no breaks. This prevents the continuation of menstrual periods, and marks the natural end of monthly cycles for menopausal women. This method of dosing is my preferred method, because I feel that it was nature’s intent for periods to stop when a woman goes through menopause. There is no evidence that one method is any safer than the other, and ultimately it is a personal choice to be made by the woman in conjunction with her health care provider.
Bio-identical hormones are natural and safe alternatives to synthetic HRT, and can be used at various stages throughout a woman’s reproductive life to eliminate unwanted symptoms, rebalance hormone levels, and enhance overall wellbeing. Whether you are trying to fall pregnant, want to get rid of PMS or are experiencing symptoms related to menopause, bio-identical hormones can help you achieve those goals naturally.