BIO-IDENTICAL HORMONE REPLACEMENT - A Saner Alternative
There is a Safer, Saner Approach to HRT, and its name is “Bio-identical.”
After the release of the landmark WHI findings in 2002, millions of American women found themselves in an ocean of hormone-replacement doubt and confusion. Soon afterward, Suzanne Somers’s best-selling The Sexy Years made another splash, as a much-needed life preserver, bringing new perspectives, solutions and above all hope to women, who must continue coping with the “curse” of menopause. This inspirational book helps untangle the confusion surrounding hormone replacement therapy, and reassures women about their bodies, and their options for not merely “surviving” menopause - but transforming it into the richest period of their lives. For Ms. Somers, this transformation turns on the use of bio-identical hormone replacement therapy - a subject on which we are answering more and more inquiries. In light of the recent WHI (Woman’s Health Initiative) findings on HRT health risk: women today want facts about bio-identical HRT. This article will provide you with the basics.
What Are “Bio-Identical Hormones?”
Bio-identical hormones are precise duplications of the estrogens and progesterone produced by the human female reproductive system.
This term “bio-identical” is sometimes confused with the term “natural” - which means something else entirely. Substances that are produced in a biological organism are considered to be “natural” or “organic” - as opposed to “synthetic” or synthesized in a laboratory. However a natural substance is not necessarily bio-identical. For example, insulin was originally derived from pigs, until researchers learned to synthesize it in the lab, and then the practice was dropped. Why? Because while the pig-insulin may have been natural, it wasn’t bio-identical: it wasn’t an exact match to insulin made in humans. The synthetic insulin was a perfect match, and this rendered the pig-based “organic” product obsolete.
A similar situation exists with women’s reproductive hormones. Women have for several decades been prescribed an estrogen product derived from the urine of pregnant mares (horses) called Premarin. (PREgnant-MARe-urINe) While this substance may be “natural” it is also very different from the hormones produced in human ovaries. It’s active ingredient, “eqiillin” (from the latin for horse, “equs") is known for its powerful impact and persistence on the human uterus. The main hormone produced in the female (human) ovary is Estradiol. Premarin does not match the human hormones it replaces, it is a substitution. We were not surprised to learn that Premarin was the only estrogen replacement substance used by the participants of the WHI studies.
The second hormone substitute in non-bio-identical HHT is the chemical Medroxyprogesterone Acetate, (sold as “Provera") which is purely synthesized in the lab, and does not match the naturally occurring progesterone that it replaces. This powerful chemical has been linked to several health risks, including significant bone mineral density loss, breast cancer, and side effects including headache, nervousness, abdominal pain, dizziness, weakness, or fatigue. We were not surprised to learn that Prevara was the only progesterone replacement substance used by the participants of the WHI studies.
Again, bio-identical hormone replacement provides an exact duplication of the hormones that naturally occur in the body. In menopause, therefore, we replenish the primary estrogen “Estradiol” with bio-identical Estradiol, and we replenish diminished Progesterone with bio-identical Progesterone. The concept is straightforward: we replenish the body’s missing hormones with bio-identical ones. We don’t replace a hormone that isn’t missing.
HUMAN HORMONE SUBSTITUTE BIO-IDENTICAL REPLACEMENT
Estradiol Permarin Estradiol
Progesterone Provera Progesterone
Again, one the cardinal rules or bio-identical HRT is to mimic the body’s natural physiology as much as possible. The old method of “continuous combined therapy” violates this rule completely by “tricking” the body into believing it is pregnant - perpetually. In bioHRT we cycle the replacement estradiol and progesterone in a natural manner. Ideally during the first half of the cycle the estrogens dominate, and in the second part there will be more progesterone - thus fully restoring the woman’s natural, youthful hormone cycle. Normally this will reinstate the patient’s menses. If this is not desireable, we can adjust the therapy accordingly.
Bio-identical estrogens not only duplicate the naturally-occurring (human) estrogens, they also duplicate the effects of these estrogens. Through careful testing and monitoring we can reinstate and maintain a woman’s unique, naturally youthful hormone levels, providing natural relief from the distresses of menopause and related conditions - while minimizing potential adverse health risks.
Are Bio-Identical Hormones Safer?
While this question cannot be fully answered until appropriately-designed studies have been completed, many physicians and researchers currently believe that bio-identical hormones may be safer than synthetic HRT, for numerous reasons, including the following:
The studies linking HRT to long term health risks do not quantify bio-identical hormone use in their questionnaires or methodology.
The estrogens used in Natural HRT products are known to have weaker cancer risk associations than those used by the WHI participants.
The studies make no provisions for the type of estrogens or progestins used, but should, since studies have found that women using 17-beta estradiol transdermal patches had no increase in blood clots, while those using oral estrogens, such as Premarin, did have an increase.
Using hormones that are identical to those made by the body is a logical choice, especially when cancers are increasingly linked to environmental toxins and synthetic substances.
The Big Picture: Commercial Viability
After the WHI and other studies proved the existence of major health risks associated with conventional HRT, the major manufacturer responded by simply reducing the recommended dose. Then they went ahead promoting and marketing their product as the “gold standard” in hormone therapy ... Why physicians would continue to prescribe non-human estrogens - the very products used in the studies - mystifies a growing number of physicians - including ourselves.
However some do. We cannot understate the influence Drug companies continue to exert upon many physicians and their treatment choices. After all, their research and products have for decades been the powerful “silent partners” standing behind the physician’s results. Without the powerful solutions provided by the pharmaceutical industry drugs, how would doctors manage? (The real answer may surprise you)
Upon further observation, it is obvious that the benefits of bio-identical HRT run counter to the profit needs of the large drug manufacturers. Points in fact:
Bio-identical hormone protocols are tailored according to each patient’s unique physiology and needs, and the prescription is then formulated by a compounding pharmacy. When effects are known, the formulation can be fine-tuned or adjusted until the patient attained optimal relief levels.
Drug manufacturers prefer products that can be mass-produced and distributed to economies of scale. For example, Wyeth maintains 700-800 horse-breeding farms in Canada where thousands of mares are kept pregnant in narrow stalls, year round, for the purpose of collecting their urine. (They are kept in perpetual thirst to concentrate their urine, and rarely allowed to run since that disturbs the collection tubes.) This super-concentrated equiillin-rich urine seasonal “crop” yields billions of doses of the patented drug Premarin, which is distributed world-wide at arbitrary pricing. ("whatever the market will bear")
When a product’s attributes suggest major profit potential (patentable, mass-production, large market) then a manufacturer can justify the major expense of long-term clinical trials to document that product’s safety and efficacy.
Because they occur naturally in the human body, bio-identical hormones are not patentable. Hence the large drug manufacturer have no reason to invest money in research trials to prove their safety. In fact, just the opposite may be true. Yet smaller, short-term studies on bio-identical hormones have reported good results and more importantly; no adverse effects.
Individual clinicians must rely on observational data, and we have never encountered adverse risks arising out of bio-identical HRT, nor are we aware of any other practitioner having reported the appearance of real or apparent adverse results.
The Informed Decision
Whether or not to use bio-identical HRT (or any form of HRT) is ultimately your decision to make. Before you make it, you should familiarize yourself with the risks of HRT. There are known risks - and even bio-identicals have not yet been proven completely safe. However we believe your risks can be reduced by using bio-identical hormones and a natural therapeutic approach.
Here are some sources to read what other patients say about their experiences with bio-identical hormones, in comparison to years of conventional HRT dosing.
The next step is talking with your doctor about any additional risks you may have, based on your family history, current health, lifestyle, work and other factors that may influence your risk.
Risks must be evaluated in relation to what can be gained. For example, there are risks associated with chemotherapy, yet cancer patients willingly assume those risks because they stand to gain much more by defeating a life-threatening disease.
Only you can decide whether the symptom relief you can gain is worth the risks of hormone replacement therapy. What level of risk is justifiable, if the payoff is feeling good .. all month long?
Your doctor should be your partner, strategist and ally, sharing your goals and committed to using every means at his or her disposal to help you achieve maximum relief and quality of life - while protecting your long term health.
HOME | TOP | TEST CENTRAL FORUMS | CONTACT
DISCLAIMER: THE INFORMATION CONTAINED ON THIS WEBSITE HAS NOT BEEN EVALUATED BY THE FDA. THIS INFORMATION IS NOT INTENDED TO DIAGNOSE, TREAT, OR CURE ANY DISEASE. ALL INFORMATION PROVIDED ON WOMENSHEALTHDOC.COM IS INCLUDED FOR EDUCATIONAL PURPOSES ONLY.