Hormone Replacement Therapy

Most women experience some form of hormone-related health condition during their lifetimes. For many, help comes in the form of Bioidentical Hormone Replacement Therapy (BHRT). Traditionally, women have used synthetic estrogens and progestin supplements to treat menopause symptoms or to protect against osteoporosis and heart disease. While these hormones often help relieve some menopausal symptoms, they also have many unpleasant side effects. Most recently, studies have shown that these synthetic hormones can also increase the risk of heart attack, stroke and certain forms of cancer.

Many patients and doctors are turning to BHRT, which attempts to mimic the normal human estrogen levels using natural products derived from soy or yam. Other hormones that are used as part of hormone replacement include progesterone and testosterone – both of which can have significant effects on symptoms for menopausal women.

World Health Initiative Study

Ever since the now infamous World Health Initiative (WHI) study came to a halt in 2002, skittish physicians, fearful of putting their patients at an increased risk for breast cancer, coronary heart disease or stroke, were reluctant to prescribe hormone replacement therapy for their patients. Likewise, frightened women avoided hormone replacement therapy for fear of developing breast cancer or suffering a stroke. Recently this trend has been reversed and increasing numbers of women are choosing to use hormone replacement therapy.

While the results of the WHI study were certainly noteworthy, two very important points which are not as widely known should be made. First, it was the synthetic progesterone, Provera, which actually proved to be the problem, though not by itself. When Provera was taken with Premarin, an estrogen derived from pregnant horse’s urine (marketed together as Prempro), the women in the study group, all over the age of 60, showed a 24-percent increased risk of breast cancer and heart disease.

However, the women who started taking hormones before the age of 60, and took estrogen without Provera, had no increased risk of breast cancer. In addition, this same group of women showed 61 percent less calcified plaque of their coronary arteries after five years of using the estrogen than did their counterparts who took only the placebo. This suggests strongly that estrogen plays an important role in protecting against heart disease and breast cancer in women. Second, bioidentical hormones were not used in any of the study groups.

Finally, despite the foreboding results of the study, most researchers still agree that women should not hesitate to use hormone replacement therapy for treating perimenopause and menopause. Multiple organizations (for example, the North American Menopause Society) that are focused on women’s health have come forward supporting the use of hormone replacement therapy for the right patients., The right patients are usually women who are younger than 60 years old or who are within 10 years of menopause onset and have no contraindications.

What Makes Bioidentical Hormones Different?

Some people will tell you that synthetic hormones and bioidentical hormones are exactly the same because they are both created in a lab. While it is true that bioidentical hormones, like synthetic hormones, are made in a lab, what is not true is that they are exactly the same. The difference lies in the molecular structure of the hormones and the source they are derived from.

Bioidentical Hormones Are Not New

In response to the now known problems with synthetic hormones, modern consumers have been demanding “natural and alternative” treatments for perimenopause and menopause. But it might surprise you to know that bioidentical hormones have actually been around for a very long time. In the late 1930s-early 1940s, a young physical-chemistry graduate student named Russell Marker devised a way to convert a chemical compound, disogenin, found in Mexican wild yams, into a progesterone with the exact molecular structure of the progesterone produced in a woman’s ovaries. What made Marker’s discovery so significant is that prior to this time, progesterone could only be obtained from sows’ ovaries (yes, a pig) or by way of a very complicated and time-consuming laboratory procedure which made it very expensive. With Marker’s method, however, progesterone that looked exactly like the progesterone made in your body could be produced at a cost of fifty-cents per gram, as opposed to a very hefty cost of $80 per gram via the previous methods. It wasn’t long, unfortunately, before pharmaceutical companies discovered that this first bioidentical progesterone could be chemically altered to create synthetic variations which, unlike the natural substances found in nature, could be patented. Since then, the subsequent campaign to sell and market them to physicians and their patients has been fierce and relentless.

How do Bioidentical Hormones Behave in Your Body?

Unlike chemically-altered synthetic hormones, bioidentical hormones contain the same molecular structure as those produced naturally by your body. Once in place, our bodies shift back into balance and all of those nasty symptoms of hormone imbalance begin to subside. Synthetic hormones are not metabolized efficiently in the body and interfere with the normal ebb and flow of hormonal function, potentially causing detrimental side effects.

A key point about a product like Premarin is that it is derived from horses. Most bioidentical hormones made in a laboratory are derived from yams. So, while the pharmaceutical companies would have you believe that bioidentical hormones are the same as synthetic hormones, they are not. Most patients prefer to have a product derived from a plant source rather than an animal source.