What is Bioidentical Hormone Replacement Therapy?

The term “Bioidentical Hormone Therapy” is now everywhere. You may have heard the “buzz” on Oprah, Dr. Phil, or Dr. Oz? Perhaps you have read one of Suzanne Somers’ best-selling books.

In any case, these celebrities have prompted a surge of calls to clinics everywhere. Many callers are asking about bio-identical hormones and their ability to relieve symptoms of menopause, peri-menopause and even PMS or infertility.

Suzanne Somers, other celebrities, popular doctors and talk show hosts have brought bio-identical hormones to center stage where they belong.

Bio-identical Hormone Replacement Therapy (BHRT) is, as far as we know, a safe, natural alternative to synthetic hormones.

In the early 1940’s the medical industry began using the unopposed estrogens from pregnant mares’ urine to treat human females. The use of this unopposed estrogen was promoted through clinicians and doctors as being protective against heart and cardiovascular disease. This information was supported by the Framingham Heart Study of 1948-1986.1 Through this period of time, however clinicians and statisticians were noticing increases in uterine and breast cancer in the population of women using the estrogens of pregnant mares. Finally, in 1976 The New England Journal of Medicine documented “For an estrogen user, the risk from endometrial cancer appeared to exceed by far the base-line risk from any other single cancer.” 2(p1262)

In the sense of safety, opposing the unopposed estrogen with a progesterone-like compound was considered in the 1980’s. Production of a non-bioidentical progesterone-like compound, called a progestin, was added to many hormonal replacement formulas.3 Unfortunately, the long term evidence of women using hormonal replacement for more than 20 years may have shown a lower risk for heart disease with estrogen replacement alone and/or combined, still showed a significant high rate/risk of breast cancer (the Nurses’ Health Study – 1976, & 1989).4,5 The reports in 2003 of the Women’s Health Initiative Study, beginning in 1991 demonstrated significant negative outcomes with respect to increased cancer rates, and in fact, was terminated before the study could be completed, or compromise the politics of hormonal replacement any further. It was clearly reported that the unopposed mares’ urine estrogen combined with progestins in a woman increased her risk of heart disease, blood clots, and stroke after only 4 years, while estrogen alone was showing increased risk of clots and stroke after 7 years.5,6

So, knowing all of this scary information, Is there a place in medicine for hormone therapy? Enter Bioidentical Hormonal Replacement Therapy!

Bio-identical Hormone Replacement Therapy (BHRT) is a hormonal therapy that uses plant-derived sterols, compounded in a pharmacy by highly trained compounding pharmacists. This produces hormone structures that are identical to the hormones produced by the human body.

The chemical modification of synthetic hormones is foreign to the human body and only mimics some hormonal activity. These chemical differences can mean that synthetic hormones act differently in your body and produce substantially different effects.

Bio-identical hormones are exactly the same chemical structure as is produced by the human body. They are compounded specific to each patient and based on personal deficiencies, imbalances and health goals.

Does Bioidentical Hormone Replacement Therapy make sense?

If a hormone is missing, should we replace it? If present, but insufficient, should we optimize it? In type I diabetes, do we not try to optimize/replace the hormone deficiency with bioidentical insulin? In hypothyroidism, do we not try to optimize/replace the hormone deficiency with bioidentical T4? In Growth Hormone Deficiency, do we not provide these patients with bioidentical growth hormone? In Adrenal Insufficiency, do we not provide these patients with bioidentical cortisol? Of course we do. It only makes sense. Should we not continue this practice with hormones lost to aging, stress, or medications, such as pregnenolone, DHEA, the group of estrogens, progesterone and testosterone?

Estrogens, progesterone, testosterone and DHEA are essential to cellular growth and function in ALL tissues in both sexes. These hormones are important to maintain brain function. They are modulators of mood, cognition, pain, etc. As well, these hormones maintain the immune system and help maintain the connective tissues including skin, hair, bone, muscle and blood vessels.

Studies provide that bioidentical hormone restoration shows expected benefits with NO proof of harm!

“In both peripheral and cerebral vasculature (of live animals), synthetic progestins caused endothelial disruption, accumulation of monocytes in the vessel wall, platelet activation and clot formation, which are early events in atherosclerosis, inflammation and thrombosis. Natural progesterone (bioidentical) or estrogen (bioidentical) did not show such toxicity”7

The Cohort Study of 54,000 women over 5.8 year follow up compared to the Women’s Health Initiative Study of 16,000 women over 6 years follow up clearly demonstrates that bioidentical estradiol plus progesterone (bioidentical) decreased the risk of breast cancer!8

It has been demonstrated that the higher the progesterone concentration delivered to women, the lower the risk of breast cancer.9

“The balance of the in-vivo evidence is that progesterone (bioidentical) does NOT have a cancer promoting effect on breast tissue.”10 In fact, the balance of evidence indicates that progesterone (bioidentical) protects against breast cancer. The evidence indicates that women can be given estrogen providing it is bioidentical, it is in normal human physiological reference ranges and it is opposed by bioidentical progesterone and testosterone. 12-31

Bio-identical hormones are prescribed by a doctor and closely monitored to ensure results are safe and effective.

Testing options for hormone optimization include (1) Blood testing, measuring mixed bound and unbound fractions, (2) Saliva testing, measuring only the unbound, bioactive fractions and (3) Urine testing for hormone metabolites

Clinical preference of Bioidentical Hormone Replacement prescribing physicians is favouring the perfected saliva testing, offering the following: (1) A multiple sample panel showing the fluctuations of many hormones throughout the menstrual cycle; (2) A single sample panel providing values for all three Estrogens, Progesterone, breast and uterine proliferation indexes, free testosterone, DHEA, Cortisol, Melatonin, Prog/E2 ratios, as well as DHT levels.11

Scientific research and clinical evidence clearly indicate that BHRT is responsible for alleviating many of the symptoms of menopause and andropause (male decline in testosterone) as well as offering other significant health benefits.

For women, the benefits may include:

o Reduced osteoporosis and restoration of bone strength
o Reduced hot-flashes and vaginal dryness
o Better maintenance of muscle mass and strength
o Improved cholesterol levels and reduced blood pressure
o Decrease in menstrual pain and breast tenderness
o Reduced risk of endometrial and breast cancer
o Reduced risk of depression
o Improved sleep
o Better mood, concentration and memory
o Decrease in irritability
o Improved libido
o Decrease in Alzheimer’s disease and other cognitive declines

For men, the benefits may include:

o Increase in over-all life span
o Reduced osteoporosis and restoration of bone strength
o Better maintenance of muscle mass and strength
o Improved cholesterol levels and reduced blood pressure
o Decrease rate of heart attacks
o Reduced rate of prostate cancer
o Reduced risk of depression
o Improved sleep
o Better mood, concentration and memory
o Improved libido, erections and sexual stamina
o Decrease in Alzheimer’s disease and other cognitive declines

It is finally becoming an accepted practice that restoring hormones in hypothyroidism, diabetes and AGING is essential preventative medicine. Replacement of hormones is essential to the treatment of disease. Restoration of hormones is essential to quality of life! We have the need and the right to restore hormones lost to aging!

If you or a loved one is interested in bio-identical hormone replacement therapy or considering alternatives to synthetic hormone therapy, speak to your Naturopathic Doctor, Endocrinologist, Gynecologist or BHRT-trained family physician.

In my practice over the past 15 years, I have witnessed countless patients experience positive results from Bioidentical Hormone Replacement Therapy.

In health,

Doc Al

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3. Bradley Law Frm. Prempro. http//www.stlawhelp.com/lawyer-attorney-1478336.html. Accessed Feb. 2, 2013
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