Traditional hormone replacement therapy has become the standard protocol for women as they approach menopause or for women who have a total hysterectomy. Yet not every peri or full menopausal woman has low estrogen, progesterone or suffers from hormone deficiency symptoms. Prescribing hormones to women who don’t need them may elevate their levels and produce unwanted side effects.
Yet for women who do experience the symptoms of estrogen deficiency or estrogen dominance (due to low progesterone) bioidentical hormone or natural hormone replacement is a safer alternative to synthetic.
The Controversy Over Hormone Replacement
Hormone replacement therapy became controversial after a report suggested there was a link between breast cancer and estrogen. In July 2003 The Women’s Health Initiative, the largest government study on synthetic hormones, was halted when early results showed that women using conventional hormone replacement (specifically PremPro), had a much higher risk of invasive breast cancer, heart disease and stroke. Women began to weigh the risks of using HRT against learning to live with the unpleasant symptoms of menopause
Yet critics of that study point out that the WHI study was NOT representative of women in their 40’s and 50’s, women who were likely in the early years of peri or full menopause. In fact the average age of the women involved in the study was 63 with an average time into menopause of 12 years.
Controversy exists over bioidentical hormones (BH).
But because I worked with a natural hormone mood balancing doctor who understood BH, my Ob & Gyn writes the prescriptions, adjusting my dosing after we consult about my symptoms, and I get my prescription through a reputable compounding pharmacy I have zero concern about BH, but grave concerns about synthetic BH.
I’ve been using BH for several years.
Suzanne Somers has been the bioidentical hormone poster child, and while she may or may not use levels higher than some, her message is still the same: do what works for you.
The key is to get tested, track your symptoms, and re-test. IMO, and Dr. Lee’s, replace only to levels that alleviate or eliminate your symptoms, no higher. As you age, your requirements change. But don’t accept feeling crappy as “the way it is when you age” or “what menopause feels like.”
Don’t be afraid of hormones, be afraid of not doing your hormone homework and of accepting that feeling crappy is part of aging.
I’ve greatly benefited by getting off 20 years of synthetic HRT (I had to be on HRT since age 19 due to my pituitary disorder, empty sella syndrome). Those prescriptions had levels of estrogen far higher than my body required, not to mention that bioidentical and synthetic hormones in most regards, act quite differently in your body.
Natural Hormone Replacement vs. Conventional
Although traditional hormone replacement has been shown to be safe in women entering peri or full menopause, synthetic hormones are radically different than bioidentical or natural hormones in how the body synthesizes them.
So what is bioidentical? Hormones are deemed bioidentical if they are exact duplicates of what your body makes.
Advantages of Bioidentical HormonesFirst, bioidentical hormones such as estrogens, progesterone and testosterone are administered transdermally, via a patch or cream and in much lower doses than oral estrogens. Transdermal delivery methods avoid the “first pass metabolism” by the liver that occurs with oral dosing.
Second, bioidenticals mimic what your own body naturally produces.
Dr. John Lee, a pioneer in women’s health and author of “Hormone Balance Made Simple” is an advocate of bioidenticals for hormone replacement therapy, explains, “Hormones do very complex and specific jobs in the body by fitting into part of your cells called receptors, much the same way that a key fits into a lock. Once the hormone is in the receptor, it gives the cell instructions. If the molecular structure is different, even by ONE atom, the instructions given to the cell are different.”
So, comparing synthetic hormones to bioidenticals is like comparing processed white bread to all natural unprocessed multi-grain. Both share similar properties but once consumed their by-products and how the body uses them can be very different.
Flaws With Conventional Hormone Replacement Therapy
1. Doctor’s often don’t measure hormone levels prior to starting conventional hormone replacement therapy.
2. Synthetic hormones, because they are not duplicates of what the body makes on it’s own, often produce unwanted side effects.
3. The dosing level of synthetic hormones isn’t physiologic, the level your body would naturally produce on it’s own. Instead, the synthetic dose is usually much higher than what is necessary for the body to produce a desirable effect.
Dr. Lee’s “3 Rules For Hormone Replacement”1. Use hormones only if you need them (e.g. if they are measurably low and/or you have clear symptoms)
2. Use bioidentical hormones rather than synthetic hormones
3. Use the least amount required to reduce or eliminate symptoms.
Work with Open-Minded Expert in Hormone Replacement Therapy
It’s best to consult with your Ob/Gyn or a specialist in hormone balancing with a background in endocrinology and/or gynecology. Be sure to find a physician who listens to your symptoms, is open-minded and is knowledgeable in both synthetic and natural / bio-identical hormone replacement.
They should be well-informed regarding the latest research findings. Unfortunately, hormone replacement therapy has become a profitable industry for doctors practicing in fields completely unrelated to female endocrinology. Buyer beware.
Hormone replacement has become quite common place but in reality it is a complex and specialized field. In the hands of a trained professional who understands the intricacies of a woman’s endocrine system (and more notably, the benefits of bioidentical hormones), hormone replacement therapy is safe and effective for many women.
Most doctors prescribe bioidentical hormones via transdermal delivery systems such as patches, creams, gels and sublingual (under the tongue). Some physicians however, offer hormone pellet therapy, a process of inserting concentrated pellets under the skin to provide continuous delivery of bioidentical estrogen or testosterone. Although pellets offer patients some advantages, once inserted they cannot be easily removed unlike transdermal methods.
If you’re experiencing cyclical or on-going symptoms of menopause or a hormone imbalance, ask your doctor about getting a saliva test which for some hormones is more accurate than blood. Click here for saliva hormone testing kits
Armed with accurate information and a doctor knowledgeable in bioidentical hormones, hormone replacement therapy can alleviate a number of hormone imbalance symptoms, safely and with minimal or no side-effects.
Copyright Laura Owens. Contact the author to obtain permission for republication.