Bio-Identical Hormone Therapy
What are hormones and why do I need them?
Hormones are an essential part of the metabolic process of living. Hormones are important for the cells, organs, and metabolism. Our hormones decline through aging, menopause, disease or trauma. When this happens, we begin an accelerated aging process. Loss of hormones is one of the major reasons for our deterioration as we get older, both physically and mentally. Hormones are beneficial at any age, but the best long term protective benefits are achieved if hormones are replaced when you begin to lose them, usually in our 40's.
What are the typical hormones that prescribed?
Synthetic estrogen (ie. Premarin) and progestins (ie: Provera) are produced in a laboratory. They are clinically altered so that they can be patented by the pharmaceutical companies. They are not identical to human hormones. They are designed to try to elicit the same responses in your body as your natural hormones. Because synthetic hormones are not identical to human hormones, they might adversely stimulate the cells and lead to side effects or cancer. Premarin is an estrogen obtained from pregnant horses and is not human identical. Provera is a progestin. Both have been implicated in causing problems in some women, including breast cancer.
How are bio-identical estrogen and progesterone produced?
Hormones that are identical to human hormones are found in yams and soy. We call these "natural" because they are natural to the body. The hormones are extracted from these vegetables and then processed by a specialty compounding pharmacy into a prescription dose and form. The body accepts and metabolizes these hormones as if it made them.
What are the problems with synthetic hormones?
When first developed, synthetic hormones were well received because they provided some of the benefits of hormone replacement controlling the symptoms of menopause and fighting osteoporosis and heat disease. However, the long-term results have shown that synthetic hormones sometimes elicit a negative metabolic response. Some women can't tolerate synthetic hormones - often suffering with side effects such as bloating, bleeding or mood swings. In some patients, synthetic estrogens and progestins contributed to the development of breast and uterine cancer.
Synthetic hormones are not a perfect match in the body. Synthetic hormones produce abnormal metabolites that can cause side effects and increase the risk of cancer. A natural hormone is a perfect fit in the body - it is a biologically identical hormone replacement.
Why doesn't my gynecologist prescribe bio-identical hormones?
Natural supplements such as vitamins and hormones are protected by federal regulation and may not be patented. Major pharmaceutical manufactures are interested only in patentable drugs that are exclusive and profitable. A lot of what physicians learn is from the drug companies who are promoting their products. Therefore, your doctors are primarily taught only about synthetic products. Bio-identical hormones do not come under specific brand names. Your physician must be self-educated and experienced in prescribing and monitoring natural hormones. They probably just don't know a lot about them or must prescribe within the constraints of your health insurance.
What is the truth about the recent publicity about the risks of taking hormones?
The Women's Health Initiative (WHI) is a study that focuses on synthetic estrogen (Premarin) and progestin (Provera). NOTE: Progestin is not progesterone. There were different "arms" of the study using different drug combinations. The arm of the study using Premarin and Provera (PremPro) was discontinued before completion because an increased risk of breast cancer was detected in the early stages of the study. This risk is attributed to the Provera portion of the regimen. This is not the first time progestins have been implicated in increasing risks for women. The arm of the study using Premarin did not show an increased risk of breast cancer, but was discontinued because of an increased incidence of strokes in older women. A recent study showed that natural estrogen did not have the same effects.
Unfortunately, the media has misrepresented the facts of this study by targeting all hormone therapy. THIS IS WRONG! Again, the culprits are synthetic progestin, Provera, and horse estrogen (equilinin) not natural estrogen or natural progesterone. There are numerous studies showing the long term benefits of hormone therapy. You just need to make sure you are receiving the right hormones (bio-identical) in the right balance. It is also important to begin hormone replacement as soon as you begin to lose the hormones to avoid any length of time without their protective benefits.
What are the signs of low Progesterone and what are the health benefits?
Progesterone is responsible for balancing estrogen and the female reproductive cycle. Deficiency results in symptoms of PMS, bloating, headaches, cramping, mood swings, breast tenderness, and irritability. A deficiency in progesterone can be a factor in frequent miscarriages.
Research shows that natural progesterone stimulates bone building osteoblasts, thus providing protection against osteoporosis. Progesterone reduces the mitotic change in breast and uterine tissue, thereby protecting against cancer (Provera does the opposite). Progesterone protects against heart disease. Progesterone is necessary for adequate sexual response, lubrication and vaginal vasodilation. Progesterone is responsible for the physiologic equilibrium with estrogen. At menopause, women lose both estrogen and progesterone and both should be replaced. Progesterone replacement is important, even if you have had a hysterectomy because it does much more than just protect the uterus.
What if I have been taking synthetic hormones?
You need hormones, but you need the right kind, the natural bio-identical hormones, in the right balance. Don't tolerate the risks of the synthetic hormones when a safe alternative is available. Find a physician who will prescribe natural hormones and then make the switch.
Should I take estrogen and progesterone or not?
The risks of not taking hormone replacement therapy, include elevated cholesterol, heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer's Disease, and menopausal symptoms. The side effects of the synthetic hormones such as bleeding, swelling, weight gain and breast cancer can be almost eliminated by using the natural estrogen and progesterone. Overall health and well-being are improved, long term survival is greatly improved and the quality of life greatly enhanced. The risks of not taking hormones are tremendous. Just don't take the synthetic hormones.
What about over-the-counter creams and saliva tests?
Products purchased over-the-counter are not usually of a strength sufficient to produce a long term therapeutic difference. A sufficient dose requires a prescription. Over-the-counter products might give you some symptomatic relief, but it is necessary to maintain certain hormone levels to achieve the long term protective benefits.
Because hormones are delivered to the organs by the blood and not saliva, we rely on blood tests to determine accurate and optimal levels. Blood and saliva tests do not correlate. Saliva testing has consistently been shown to be inaccurate in medical studies.
How does one know whether they are receiving adequate amounts of replacement hormones?
Blood tests determine deficiencies. Blood tests also determine whether adequate replacement has been prescribed. All people will absorb, assimilate, and respond to hormones differently that others. If the proper level (and therefore tissue level) is not achieved, then the full benefit of hormone replacement is not realized. We want hormone levels to be optimal and protective.
What about Evista and Fosamax?
Evista (Raloxifine) is in a class of drugs known as designer estrogens. Studies show that these compounds are somewhat effective in increasing bone mass although not as effective as estrogen, progesterone and testosterone. Designed estrogens do not relieve any of the side effects of menopause and might even increase them. Fosamax is a non-hormone treatment to block bone loss and prevent osteoporosis. It has been associated with a multitude of side effects, especially gastrointestinal problems. Neither designed estrogens nor Fosamax are as effective as natural estrogen, progesterone and testosterone at preventing osteoporosis.
Are there other hormones I should replace? What about men?
Other bio-identical hormones that should be part of an optimal hormone replacement program are testosterone, thyroid, and DHEA. Both men and women need these hormones.
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