Hormone Replacement Therapy
FAQs
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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 ageing 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 your 40’s.
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Synthetic estrogen (Premarin), progestins (Provera) and testosterone (Androgel) are produced in a laboratory. They are chemically 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 it is not human identical. Provera is a progestin again not identical to humans. Both have been implicated in causing problems in some women, including breast cancer.
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Hormones that are identical to human hormones are found in yams and soy. We call these “natural” because they are natural to the body as the plant cholesterol molecule is used to create the biologically identical hormone for humans. 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.
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When first developed, synthetic hormones were well received because they provided some of the benefits of hormones replacement: controlling the symptoms of menopause and fighting osteoporosis and heart 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 contribute 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 plant based hormone is a perfect fit in the body – it is a biologically identical hormone replacement.
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Natural supplements, made from plants, such as vitamins and bioidentical hormones are protected by federal regulation and may not be patented as the chemical composition is not altered. Major pharmaceutical manufacturers are interested 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. Bioidentical hormones do not come under specific brand names. Your physician must be self-educated and experienced in prescribing and monitoring bioidentical hormones. They probably just don’t know a lot about them or must prescribe within the constraints of your health insurance.
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The Women’s Health Initiative is a study that focused 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 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. More recent studies show that plant based estrodial (the active form of 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 and estrogen from pregnant horse urine, not plant based estrogen or 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.
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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 plant based (bioidentical) 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.
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You need hormones, but you need the right kind, the plant based bioidentical hormones, in the right balance. Don’t tolerate the risks of the synthetic hormones when a safe alternative is available. Find a provider who will prescribe bioidentical hormones and then make the switch.
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The risks of not taking hormone replacement therapy include elevated cholesterol, heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer's, and menopausal symptoms. The side effects of synthetic hormones such as bleeding, swelling, weight gain and breast cancer can be almost eliminated by using plant based bioidentical estrogen, progesterone, and testosterone. 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 synthetic hormones.
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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.
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Blood tests determine deficiencies. Blood tests also determine whether adequate replacement has been prescribed. All people will absorb, assimilate, and respond to hormones differently than 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.
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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. Designer 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 and has been associated with a multitude of side effects, especially gastrointestinal problems. Neither Evista nor Fosamax are as effective as bioidentical estrogen, progesterone, and testosterone at preventing osteoporosis.
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Other bioidentical hormones that should be part of an optimal hormone replacement program are testosterone (mentioned several times), thyroid, and DHEA. Both men and women need these hormones.