About Bio-Identical Hormone Replacement
Click on the articles below to learn more about HRT.
Researchers believe that significant differences exist between hormones which are natural to human bodies (bio-identical) and those which are synthetic (including animal). They also believe that it is the chemical structure of the synthetic hormones which may be responsible for side effects when used in replacement therapy.
- According to a study by the Mayo Clinic, women reported an overall 34% increase in satisfaction when used micronized progesterone as apposed to their previously used synthetic progesterone.
- They also reported a 50% improvement in hot flushes, 47% in anxiety and 42% in depression levels.
- Immediate-release dosage forms might cause unwanted side effects due to producing a higher peak blood level of hormones. Slow-release capsules could be prepared to dampen high peaks and low valleys to prolong absorption over several hours to enable less-dosing and improve results.
- A 1999 study showed women who have had PMS to have a higher chance of developing postpartum depression and those who have had postpartum depression once have over 60% chance of developing it again after another pregnancy.
- Preventive progesterone treatments can reduce the recurrence to less than 10%.
Bio-identical hormones have the same chemical structure as hormones produced by the human body. Only hormones whose chemical structure exactly matches the body, will reproduce the same effects. These hormones are able to follow normal metabolic pathways so that essential active metabolites (breakdown products) are formed. “Bio-identical” does not refer to the source of the hormone, but rather indicates that the chemical structure of the replacement hormone is identical to that of the hormone it is replacing. Natural hormones are transformed to the human bio-identical hormones from sterile analogies (precursors) found in many plants, primarily wild yams and soy products.
Natural substances can not be patented. Therefore, side chains are added to a natural substance (i.e. chemically altered) to create a synthetic product that can be patented by a manufacturer, which in turn would be profitable for mass productions!
ANDROGENS, THEIR ROLE IN HORMONE REPLACEMENT THERAPY
RESTORING THE “BALANCE”
In keeping with the intent to restore hormones in a bio-identical manner one must assess the androgen levels and if found to be deficient they should also be replace. Not to do so is to leave the woman’s therapy incomplete. We cannot improve upon human physiology. Estrogen, progesterone, DHEA and testosterone are involved in a complex symphony and to leave out one or more “instruments” could change the beauty of the final arrangement. Which “instruments” are needed and which “notes” they will play must be individually determined with and for each woman. Hence, the “art” and “science” of medicine.
WHAT ARE ANDROGENS?
Testosterone and dehydroepiandrosterone (DHEA) which is actually an androgen precursor hormone. Androgens are metabolically active in skin, muscle, and are thought to have an important role in maintaining libido. (3) Androgens help maintain muscle mass and strength. In the skin, they support collagen and help maintain oil production. Estrogens and androgens are necessary to maintain the optimum integrity of the musculoskeletal system.
WHAT HAPPENS TO ANDROGEN AFTER MENOPAUSE?
After “natural” menopause a woman’s ovaries continue to produce androgens. However, the majority of the androgens produced in the body even before menopause, some from peripheral conversion of DHEA. As the body ages, production of DHEA declines so that by the time a woman goes through her transition into menopause, and is in need of support from her adrenal glands, the production of DHEA is often inadequate. Symptoms provoked by this potential deficiency vary substantially, again, this is unique to each individual. Replacement must be provided to maintain physiologic levels. (Normal in this instance is defined as comparable to the replacement levels of estrogen and progesterone used) 3, 25
“Customized” prescriptions provide assurance of most appropriate dosing for each individual…attempting to establish reasonable hormone replacement based solely on management of symptoms defies logic.” (19) Estradiol levels can be kept at levels that are currently known to be protective against osteoporosis and cardiovascular disease. (3, 19)
- Natural Progesterone is superior to synthetic progestins in preventing cardiovascular disease. Natural progesterone does not adversely affect lipid levels. (22)
- Certain progestogens, such as micronized progesterone, can be administered concurrently with estrogen replacement therapy, providing protection against endometrial hyperplasia without significantly affecting the beneficial effects of estrogen on lipid profiles, atherosclerosis and vascular reactivity.
After physical examinations, personal and family medical history analysis, and laboratory testings are considered, your physician will prescribe a precise compound to meet your exact needs. Hormones typically prescribed for BHRT are:
* Estrone (E1)
* Estradiol (E2)
* Estriol (E3)
* Dehydroepiandrosterone (DHEA)
Often prescribed combinations to re-establish body’s normal physiological balance include:
Tri-estrogen(Tri-Est) = 80% Estriol + 10% Estradiol + 10% Estrone
Bi-estrogen = 80% Estriol + 20% Estradiol
It’s been found that estradiol, when prescribed by itself (as sometimes happens in conventional HRT) can raise the risk of cancer after several years. Estriol, on the other hand, is anti-carcinogenic. Healthy women naturally excrete much more estriol than estradiol and estrone. But when hormone production slows down during menopause, it’s important to replace all three estrogens in the same proportions your body would produce on its own if it could.
Another substance used in hormone replacement therapy is progesterone. Pharmaceutical progesterone (medroxyprogesterone) isn’t necessarily bad for you in one way—it can lower the risk of developing cancer from taking horse estrogen or estradiol by itself. But it raises the risk of heart problems, so why bother with “fake” progesterone when the natural kind has the same benefits and virtually no risk? The natural form also helps rebuild bone mass, which gives it a major advantage over synthetic.
The next step in natural hormone replacement therapy involves getting in touch with your masculine side. When testosterone levels go down during menopause, it can negatively affect your sex drive. DHEA works along with testosterone in controlling your libido, as well as keeping your body’s tissues healthy. Please have your levels of these hormones tested and if your levels are low, ask your doctor to prescribe identical-to-natural replacements. This is especially important for testosterone replacement, since the major synthetic version (methyltestosterone) is a known carcinogen. Fortunately there is no synthetic form of DHEA (yet), so you can only take the natural form.