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How Safe Is Hormone Replacement Therapy? Bioidentical or Conventional?

Photo - Sally Howard

Photo: Sally Howard

After a large hormone study scared women, many now unnecessarily avoid hormone replacement and suffer from menopause symptoms such as hot flashes and poor sleep.

Flip through any newspaper and you might read another alarming article about the dangers of hormone replacement therapy. Dig a little deeper however, to reveal fact vs. fiction.

The uproar began in July 2003 when the The Women’s Health Initiative (WHI) during the largest government study on synthetic hormones ever conducted, halted their research after early results indicated that women using conventional hormone replacement therapy (specifically PremPro), had a much higher risk of invasive breast cancer, heart disease and stroke.

Click here for hormone testing kits
Click here for progesterone testing kit
Click here for testosterone testing kit
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer
Click here for DHEA products.

Largest Hormone Replacement Study Criticized

Critics of the study point out that the WHI study wasn’t 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, and therefore more likely to have other risks related to breast cancer, heart disease and stroke.

Estrogen plays an important role in your body. It’s responsible for puberty changes in girls such as menstruation, and the development of breasts and hips. In adult women estrogen contributes to the softness of the skin and to vaginal lubrication, it helps maintain bone density, and plays a crucial role in brain function. In men, estrogen serves to assist the function of testosterone and can also influence bone density and cognitive functioning.

Estrogen however, is a double-edged sword hormone. Too much of it without the balancing effects of its bedfellow progesterone, or the wrong kind of estrogen, and it can indeed, be harmful.

When Estrogen Can Be Dangerous

Dr. John Lee, pioneer in natural women’s health and author of “Hormone Balance Made Simple,” coined the phrase “estrogen dominance” to describe what happens when the ratio of estrogen to progesterone is changed by excess estrogen or inadequate progesterone .

Ten to fifteen years before menopause, a woman may actually produce enough estrogen, but not make enough progesterone, which puts her into estrogen dominance. Over a long period of time too much estrogen may put her health in danger.

Estrogen dominance is known to cause and/or contribute to:

  • Cancer of the breast, ovary, endometrium and prostate (men).
  • PMS, mood changes, anxiety, irritability
  • Menopausal symptoms
  • Weight gain
  • Bloating
  • Mood swings
  • Tender breasts
  • Headaches
  • Fatigue
  • Depression
  • Hypoglycemia
  • Uterine fibroids
  • Endometriosis
  • Fibrocystic breasts.

**Dr. Lee advises women to use bioidentical hormones. Synthetic estrogen and progesterone hormones hormones like PremPro (combines Premarin and Provera) do not act the same in your body as bioidentical and can cause unwanted side effects or risks.

Click here for hormone testing kits
Click here for progesterone testing kit
Click here for testosterone testing kit
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer
Click here for DHEA products.

Substances that Mimic Estrogen

In addition to estrogen dominance, there is a growing concern regarding Xenoestrogens, substances that have estrogen-like and potentially detrimental affects in the body. These are found in most pesticides, plastics, acetones (e.g. nail polish remover) and in industrial pollutants such as PCBs. They can be very potent and toxic, and unlike natural hormones they don’t efficiently clear from the body.  As a result, xenoestrogens tend to accumulate in the tissue over time. Even coffee can increase estrogen in the body.

Deciding If Hormone Replacement Therapy Is Right For You

Your decision regarding hormone replacement therapy should be based on clear and accurate research information, your age, health history, lifestyle, menopausal symptoms, and your individual concerns.

  • Read Between the Research Lines. Don’t let the WHI study scare you away from considering HRT if you’re suffering from peri or menopausal symptoms. Discuss the implications of the WHI results with your doctor.
  • Get Hormone Levels Checked. If you do decide to try hormone replacement therapy,measure your hormone levels first (saliva tests are more accurate than blood).Click here for hormone testing kits.
  • Only Consult with Experts. Only consult with a physician who is extensively trained in natural and conventional hormone replacement therapy (preferably an Ob & Gyn or endocrinologist), and who is up to date on all the research.
  • Consider bioidentical instead of synthetic HRT.  While bioidentical hormones (BH) are not FDA regulated, a reputable, licensed compounding pharmacist can formulate bioidentical HRT creams to provide regulated, dose-accurate HRT. Dose-regulated transdermal (on the skin) bioidentical estrogen patches are also available.

What Do the Experts Say?

Bioidenticals are not safer or more effective, according Mary M. Gallenberg, M.D, Mayo Clinic gynecologist and obstetrician:

“According to the Food and Drug Administration (FDA) and several medical specialty groups, bioidentical hormones may be riskier than standard hormone therapy, and there’s no evidence they’re any more effective.

Bioidentical hormones have become popular in recent years, partly because of celebrity endorsements and partly in reaction to reports of increased health risks with standard hormone therapy. The term “bioidentical” means the hormones in the product are chemically identical to those your body produces. In fact, they are — but so are the hormones used in many FDA-approved hormone replacement products.”

But, I put my money on Dr. John Lee, author of  numerous books on natural hormone replacement and the primary hormone expert I follow,  and on Dr. B., a former Ob/Gyn I consulted with for three years. Dr. B left her traditional practice so she could work with women and men to naturally balance their hormones and manage their mood issues, tired of trying to treat her patients with synthetic hormones only to see their symptoms remain or get worse, Dr. B moved into natural hormone balancing.

In conversations with her and after reading Dr. Lee’s book, reviewing the research and tracking my symptoms, I gave up synthetic HRT, a regime I’d been on for 20 years (due to a pituitary disorder I have called Empty Sella Syndrome). The first thing Dr. B said to me when she saw I was on Ortho Novum for hormone replacement is “Why in the world do they (decades of doctors) have you on THIS for HRT, a birth control pill and a much too high dosage of estrogen?”

My answer back then, “I don’t know, they just did.”

That was then, this is now. Today I don’t default to doctor’s orders (nor do I ignore them if they make sense to me).

Ultimately you have to decide what makes sense for you. You have to consult with a doctor who is schooled in conventional and natural hormone balancing.

Writes Dr. Lee on his website:

“The message of steroid hormones to target tissue cells requires bonding of the hormone with specific unique receptors in the cells. The bonding of a hormone to its receptor is determined by its molecular configuration, like a key is for a lock. Synthetic hormone molecules and molecules from different species (e.g. Premarin, which is from horses) differ in molecular configuration from endogenous (made in the body) hormones. From studies of petrochemical xenohormones, we learn that substitute synthetic hormones differ in their activity at the receptor level.

In some cases, they will activate the receptor in a manner similar to the natural hormone, but in other cases the synthetic hormone will have no effect or will block the receptor completely. Thus, hormones that are not bioidentical do not provide the same total physiologic activity as the hormones they are intended to replace, and all will provoke undesirable side effects not found with the human hormone. Human insulin, for example, is preferable to pig insulin. Sex hormones identical to human (bioidentical) hormones have been available for over 50 years.

Pharmaceutical companies, however, prefer synthetic hormones. Synthetic hormones (not found in nature) can be patented, whereas real (natural, bioidentical) hormones can not. Patented drugs are more profitable than non-patented drugs. Sex hormone prescription sales have made billions of dollars for pharmaceutical companies Thus is women’s health sacrificed for commercial profit.”

So what if you want to get your hormones tested? For several hormones, saliva is ideal, but for other tests, it depends. Read more: Blood or Saliva Testing for Hormones?

Click here for saliva hormone testing kits

Click here for progesterone testing kit
Click here for testosterone testing kit
Click here for Dr. John Lee’s books on hormones, peri and full menopause and HRT after breast cancer
Click here for DHEA products.

Copyright Laura Owens. Contact the author to obtain permission for republication.

 

Laura G Owens

Writer. Blogger. Essayist. My focus is wellness, social commentary and personal essays that explore the messiness of being human. Our ambivalence. Our uncomfortable feelings that when revealed, shed shame and reveal our authentic selves.

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Site last updated March 14, 2024 @ 3:00 pm; This content last updated August 30, 2011 @ 3:01 pm

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