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bioidentical hormone replacement therapy (BHRT) research

Hormonal replacement therapy is approved to treat hot flashes, vaginal dryness, and to prevent osteoporosis.  Currently this treatment is not promoted as a treatment to prevent heart disease, cancer, or as an anti-aging strategy.     However,  research exists that suggests hormonal replacement, when done safely and with the bioidentical forms,  might provide many health benefits outside of just controlling symptoms of PMS, menopause, or andropause. 

Everyone wants to know, however, is BHRT safe?  Are the risks the same as with synthetic hormonal therapy? 
Read below to learn more about what the research is saying at this point: 

BHRT and Heart Health

- bioidentical progesterone might increase "good cholesterol" or HDL levels, whereas synthetic progestins cause a decrease in "good cholesterol" : Saarikoski et.al.1990/Fahraeus et.al. 1983/ Ottosson et.al 1985
- natural progesterone significantly enhances effect of estrogen on exercise induced heart muscle damage in post-menopausal women with coronary artery disease: Rosano et.al. 2000
- estradiol and progesterone or MPA protects again coronary spasm, improving vascular function in rhesus monkeys: Minshall et.al. 1998
- women with severe hot flashes have a higher risk for heart disease: Franco et.al. 2015 

BHRT and Osteoporosis

- transdermal estradiol is an effective treatment to improve bone mineral density and reduce further fractures in post-menopausal women with osteoporosis: Lufkin et.al. 2009
- estrogen-treated patients whose therapy started within 3 years of menopause showed improvement or no increase in osteoporosis: Nachtigall et.al. 1979
- continuous low-dose HRT combined with adequate calcium and vitamin D provides a bone-sparing effect that is similar or superior to that provided by other, higher-dose HRT regimens in elderly women: Recker et.al. 1999

BHRT and Breast Cancer

- no risk of breast cancer in patients using combination estrogen and progesterone vs using synthetic estrogen alone. 
 Fournier et.al. 2008
-risk for breast cancer was significantly increased if synthetic progestins were used but reduced if progesterone was used: Fournier et.al. 2005 
- compared to placebo, increased breast tissue growth with estrogen and MPA, but not seen with combination of estrogen and progesterone: Wood et.al. 2007
- 10 times as many deaths in low progesterone group compared to normal levels: Cowan et.al. 1981
- progesterone level was inversely associated with breast cancer risk for highest versus lowest tertitle: Micheli et.al. 2004
- progesterone reduced estradiol induced breast cell proliferation in vivo: Foidart et.al. 1998
- transdermal hormones were not associated with venous thromboembolism.   Synthetic oral forms increased the risk of thromboembolism 4 fold: Canonico et.al. 2007
- data does not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms: American College of Obstetricians and Gynecologists Committee March 2016
- topical estrogen does not seem to be associated with an increased risk of recurrence of breast cancer: Dew et.al. 2009

BHRT overall safety

- physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly: Holtorf et.al. 2015

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