Bio-Identical Hormones


What is Bio-Identical Hormone Replacement Therapy?

Over 40 million American women are currently experiencing or have experienced menopause. The symptoms of menopause may include hot flashes, night sweats, depression, anxiety, irritability, sleep disturbances, mood swings, headaches, memory problems, decreased libido, vaginal dryness and loss of bladder control. These disturbances often begin during perimenopause, five to seven years before menopause, when the production of estrogen and progesterone hormones decreases. Testosterone and dehydroepiandrosterone (DHEA) are additional hormones that decline during menopause. The replacement of estrogen and progesterone is termed hormone replacement therapy (HRT).

Only about 20 percent of postmenopausal women use HRT long-term. This is partly due to unresolved questions about synthetic HRT, its potential cause for breast cancer and intolerable side effects. Synthetic estrogens have been used to alleviate major symptoms of menopause since the 1930′s. A synthetic hormone is not found in nature and is a molecule similar to, but does not match, a human hormone. For example, ethinyl estradiol (a synthetic estrogen) may be up to a thousand times stronger than natural estradiol. Premarin, another commonly prescribed estrogen, is derived from the urine of pregnant mares. Premarin contains equilin, a horse estrogen that can remain in women for about 13 weeks.

Since the 1980′s, synthetic progestins (a progesterone-like substance) have been widely prescribed to counter the dramatic rise of uterine cancer resulting from the replacement of estrogen alone. While these drugs may mimic the effects of hormones, synthetic estrogen and progestins may not be properly processed and disposed of because their structure is foreign to the body. They may be stronger and have longer-lasting negative side effects. For example, progestins can cause irritability, depression, bloating, weight gain, irregular bleeding, anxiety, high blood pressure and a premenstrual-like syndrome. Other common HRT complaints include breast tenderness, headache, nausea, fluid retention and intestinal discomfort. As a result, many women end their HRT within the first year of treatment.

Not All HRT Is Created Equal

Most menopausal women in the United States are unaware of bio-identical hormone replacement therapy (BHRT). BHRT is derived from plant sources. The word “natural” or “bio-identical” refers to the structure of the hormone, not its source. BHRT is minimally altered to match the structure and mimic the function of human hormones. As such, it produces significantly fewer side effects.

Why We Are In The Dark

Why do so few health care providers offer BHRT when it seems to be more “user-friendly”? One simple answer is that natural hormones cannot be patented. A patent grants the exclusive rights to sell a drug for 17 years. Pharmaceutical makers alter estrogen and progesterone molecules from their natural structure which allows them to obtain patents. The patented HRT drugs grant pharmaceutical companies the financial resources to research and market them to doctors and their patients. Furthermore, studies demonstrating the beneficial effects of HRT on heart disease and osteoporosis have only been performed with synthetic and equine hormones. It is important to obtain a baseline bone density test and lipid panel (total, HDL, LDL cholesterol and triglycerides) when beginning BHRT.