Laura G Owens ~ Writer

Humanity. Health. Happiness.

Tag: Hormone Replacement

Are bioidentical hormones safer than synthetic? Science says yes.

Photo - Sally Howard

(Photo credit: Sally Howard)

Hormone replacement understandably, (but needlessly), scares women to death.

Should we worry? Should we suffer from peri, pre or menopausal symptoms (or from surgical menopausal symptoms?)

NO.

When women ask me if bioidentical hormones are safe and if they’re safer than synthetic hormones (Premarin, Provera, birth control as hormone replacement (HRT) etc.) my answer is that hormones just need to be respected.

They’re powerful. Medterms defines a hormone as:

A chemical substance produced in the body that controls and regulates the activity of certain cells or organs. 

Cells and organs pretty much cover the gamut of the body.

But, once you test (saliva or blood spot testing? It depends) I urge women to use bioidentical hormone replacement NOT synthetic as I was instructed by my doctors to use for 20 years (due to a pituitary disorder I have called empty sella syndrome.).

Synthetic hormones are radically different than bioidenticals in their molecular makeup and in how your body uses them — and reacts.

“Unlike synthetic hormones, bioidentical hormones are structural replicas of endogenous human hormones. Bioidentical hormones are derived from soy, yams and other plant extracts, which are modified in a lab to identically mimic the molecular structure of your hormones.” (“Bioidentical Hormone Therapy.” BodyLogicMD.com, 2002)

Synthetics = more side effects.

Any HRT however, needs to be monitored. Unopposed estrogen of any kind (not balanced by progesterone) can be dangerous.

Why bioidenticals? 

Consider this:  A piece of apple and a piece of apple-flavored candy might have a teeny, tiny amount of taste in common but in reality what an apple IS down to it’s organic molecular properties and how your body USES the apple is RADICALLY different than how your body uses the apple candy.  That’s how I view bioidentical hormones vs. synthetics.

Here’s the science behind my statement:

(From Women in Balance)

The science behind bioidentical hormone replacement therapy.

Int J Pharm Compounding 2002;6(2):142-6

“Differences between synthetic progestins and bioidentical progesterone in terms of their effects on breast cancer risk, estrogen dominance, and vasomotor symptoms are discussed. The review also covers the use of testosterone for postmenopausal women who have androgen deficiency because of surgically induced menopause. Androgen deficiency is also seen in women receiving estrogen replacement therapy, which reduces bioavailable testosterone because it increases levels of sex hormone binding globulin in the blood.”

The author concludes that bioidentical hormones are more effective and safer than the synthetic alternatives, but hopes that large trials will soon be conducted to confirm their promising effects.  
Link to Abstract

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Hormone Fears Cloud Benefits of Bioidentical Hormone Therapy over Conventional

Photo - Sally Howard
    (Photo credit: Sally Howard)
For women who need hormone replacement, bioidentical hormones can offer a safe alternative to synthetic estrogen and progesterone.

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.

Click here for a few of my favorite natural hormone balancing products  

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.

Click here for saliva hormone testing kits

Click here for a few of my favorite natural hormone balancing products

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.

Click here for saliva hormone testing kits

Click here for a few of my favorite natural hormone balancing products

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.

Click here for saliva hormone testing kits

Click here for a few of my favorite natural hormone balancing products

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.

Click here for saliva hormone testing kits

Click here for a few of my favorite natural hormone balancing products

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

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Hormone Testing – Saliva or Blood? Depends.

hormone testing, blood test, saliva testing, blood work

Saliva test more accurate to measure certain hormone levels

Photo credit: Ambro

Head to your doctor because you’ve been feeling off, forgetful, sweaty, waking up in the middle of the night, increasingly stressed, unfocused, irritable and she might tell you you’re in peri or in full menopause. Or perhaps you’ve had a complete hysterectomy and your doctor wants you on hormone replacement therapy.

Or, maybe your cortisol (the stress hormone) levels are way off the charts, a condition that is all too common today, that and adrenal fatigue.  Cortisol in small doses as the fight or flight reactive hormone alerts you to take action. And, like all hormones it’s just doing its proper job. But, at chronically high levels, as in the case of chronic stress, cortisol can harm your sleep and your health.

Whatever is going on your doctor (or you) may want to test your hormones along with a number of other factors.

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

How? Likely via a blood test. Yet, while not invalid, conventional blood serum tests are not as accurate as saliva to measure certain hormones.

Saliva testing

According to ZRT labs:

When the various glands manufacture the steroids they are released into the bloodstream bound to carrier proteins. Only a small fraction (1-5%) of a given amount of steroid hormone breaks loose from the carrier protein in the bloodstream and is free to enter target tissues.

This free or unbound hormone is what we want to measure, since it is active or bioavailable to the target tissues such as the breast, uterus, brain, and skin. Many studies in the scientific literature have shown that there is a strong correlation between the levels of steroid hormones in saliva and the bioavailable (free) levels of steroids in the bloodstream.

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

ZRT labs also offers at home blood spot testing which is convenient and at times less costly than the blood serum tests your doctor orders.

Blood spot testing

The development and application of blood spot testing allows monitoring of hormone levels, cardiometabolic markers and Vitamin D.  The convenient collection of blood from a tiny nick of the finger, allows for flexibility of testing at the right time of day, month or following hormone therapy.  Blood Spot testing provides results on par with those from serum tests but without the cost and inconvenience of conventional blood draws, making it beneficial for both patient and practitioner.

ZRT labs offers saliva, blood spot and combo tests. This ZRT labs chart compares which tests are done in saliva and/or blood spot.

Hormone or Analyte Saliva Blood Spot
Estradiol (E2) Checkmark Checkmark
Progesterone (Pg) Checkmark Checkmark
Testosterone, free Checkmark
Testosterone, total Checkmark
DHEA-S (DS) Checkmark Checkmark
Cortisol, AM (C1) Checkmark Checkmark
Cortisol, Diurnal (C1, C2, C3, C4) Checkmark
Estriol (E3) Checkmark
Estrone (E1) Checkmark
Follicle stimulating hormone (FSH) Checkmark
Luteinizing Hormone (LH) Checkmark
Insulin-like Growth Factor (IGF-1) Checkmark
Insulin, fasting Checkmark
Triglycerides (TG) Checkmark
Hemoglobin A1C (HbA1c) Checkmark
High Sensitivity C-Reactive Protein (hs-CRP) Checkmark
Total Cholesterol (CH) Checkmark
LDL Cholesterol Checkmark
HDL Cholesterol Checkmark
VLDL Cholesterol Checkmark
Prostate specific antigen (PSA) Checkmark
Sex hormone binding globulin (SHBG) Checkmark
Thyroid peroxidase antibodies (TPO) Checkmark
Thyroid stimulating hormone (TSH) Checkmark
Triiodothyronine (T3), free Checkmark
Thyroxine (T4), free Checkmark
25-hydroxy vitamin D2 Checkmark
25-hydroxy vitamin D3 Checkmark

So, you have choices depending on what you want to measure:

  1. Go to your doctor. Doc orders standard blood to test hormones, etc, (ideal for measuring cholesterol, vitamin D etc, but not all hormones as you can see from above).
  2. Depending on what you want to test, you can order your own saliva and/or blood spot test from ZRT labs either directly or through a provider (depends on what is cheaper, if your insurance covers the labs if ordered by a doctor or you buy the kit directly and bring the results to your doctor).

But, if you want saliva and/or blood spot testing and your doctor won’t order them for you, take all this into your own hands.

Order your own from ZRT, bring the results to her, or ideally to a physician who understands saliva testing and will discuss options to re-balance your hormones, cholesterol and/or vitamin D levels.

 

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Testosterone HRT for Women to Improve Sex Drive, Energy Levels, Memory and Bone Strength.

testosterone, testosterone for women, testosterone to increase sex drive
(Flickr, Photo credit)

Testosterone, an androgen hormone, can provide numerous health benefits including improving libido in menopausal women and women with diminished testosterone.

Testosterone isn’t just for men. In fact, this androgen hormone is produced in small amounts in women’s ovaries and adrenal glands.

As women approach age 40 their levels of estrogen, progesterone and androgens (testosterone) begin to decline. Once in menopause or if they’ve had their ovaries removed, testosterone levels drop even further and androgen-deficiency symptoms such as low sex drive and diminished energy may appear.

This once maligned hormone was thought to be one of the culprits behind acts of violence and rage.

Yet in controlled doses testosterone can be highly beneficial to menopausal women considering hormone replacement therapy, particularly if they’re experiencing low sex drive unrelated to physical or emotional factors.

Estrogen and Progesterone Hormone Replacement Isn’t Always Enough

Although most doctors prescribe estrogen and progesterone replacement therapy to protect women against osteoporosis, bone loss, Alzheimer’s disease, and to alleviate mood changes, hot flashes and vaginal dryness, these hormones might not improve their libido or energy levels. Dr. William Regelson, MD, and author of The Superhormone Promise, suggests that testosterone is the missing piece of the puzzle for hormone replacement therapy.

“For many women who feel they are not quite themselves, the ingredient missing from the blueprint is testosterone.” Dr. Regelson found that including testosterone in the hormone replacement mix, even for brief periods of time, can mimic our “normal hormonal state” and help women better tolerate estrogen and progesterone.

Benefits of Testosterone Hormone Replacement for Women:

  • Increases sexual drive
  • Maintains and builds lean mass and reduces body fat
  • Strengthens bone
  • Promotes a sense of well-being, boosts mood
  • Supports cognitive function (ability to focus on a task)

Testosterone has also been shown to reduce vaginal dryness, urinary incontinence, and urinary tract issues, although this might be due to the fact that much of testosterone is converted to estrogen, the hormone responsible for alleviating several urogenital symptoms.

Although few studies exist regarding the risks and benefits of testosterone hormone replacement in women, one research study conducted showed that testosterone improved overall well-being, some measures of bone density, sexual drive, mood, energy and even sleep quality.¹

Types of Testosterone Hormone Replacement Therapy

Most doctors won’t prescribe testosterone pills due to the risk of liver toxicity and because this form can lower levels of HDL, the “good” cholesterol in your body. Bioidentical testosterone (bioidentical means it is similar to what your body naturally produces on its own) is available in transdermal forms such as gels, creams and patches or in sublingual drops and tablets.

Deciding if Testosterone Hormone Replacement Therapy Is Right For You

The key to bioidentical estrogen, progesterone and testosterone hormone replacement therapy is to supplement if your levels are measurably low, using the lowest dose necessary to alleviate the greatest number of symptoms. If you are considering testosterone hormone replacement therapy:

  • Test levels.  Ask your doctor to test your androgen, DHEA, estrogen and progesterone levels. Progesterone may also improve libido. Saliva testing is more accurate for some hormones because it measures “free” hormone levels (the active hormones) rather than only overall totals.  ZRT labs offers home kits, saliva and blood spotting. You can then take the results to your doctor to consult.
  • Consider DHEA. DHEA (dehydroepiandrosterone) a precursor to testosterone, is milder and in low doses can provide some of the same therapeutical effects for women. Dr. Christine Northrop, a pioneer in women’s health, recommends that if your testosterone and DHEA is depleted to take DHEA, although you need to wait about four months to feel the effect. If after four months you don’t notice any improvement, consider testosterone hormone replacement.Click here for DHEA products.
  • Avoid if you’re in childbearing years. Most younger women produce ample amounts of testosterone.

Although testosterone shouldn’t be prescribed across the board for all menopausal woman, it can benefit women who despite estrogen and progesterone hormone replacement therapy and DHEA supplementation, still experience low energy levels, diminished sex drive and reduced sensitivity to sexual arousal.

Footnotes:

Painter, Lisa. “Testosterone: A Major Breakthrough for Menopausal Women,” Discovery Health. July 15, 2008. http://health.discovery.com/centers/womens/testosterone/testosterone.html

K. K. Miller, B. M. K. Biller, C. Beauregard, J. G. Lipman, J. Jones, D. Schoenfeld, J. C. Sherman, B. Swearingen, J. Loeffler and A. Klibanski. Effects of Testosterone Replacement in Androgen-Deficient Women with Hypopituitarism: A Randomized, Double-Blind, Placebo-Controlled Study. The Journal of Clinical Endocrinology & Metabolism Vol. 91, No. 5 1683-1690.

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