Bio-identical Hormone Replacement
What are bio-identical hormones?
Bio-identical hormones are derived from a plant oil called diosgenin, which is extracted from soybeans and wild yams (diosgenin is very similar in chemical structure to cholesterol). This oil is then altered, so it becomes identical in organic structure and function to human hormones. Bio-identical hormone replacement therapy (BHRT) can be compounded to replace any of several hormones that are commonly deficient in men and women. Commonly compounded formulations of BHRT include various combinations of the estrogens (estradiol, estrone, and estriol), progesterone, DHEA, and testosterone.
Why not use the commonly prescribed, Premarin (horse-derived estrogen) and Provera (synthetic progesterone)?
In 2002, the Women's Health Initiative and the Heart and Estrogen-Progestin Replacement Study data revealed that these forms of hormone replacement therapy (HRT) may increase a woman's risk for heart disease, stroke, blood clots, and cancer.
Why are most physicians not knowledgeable regarding the use of BHRT?
The answer lies in the lack of information provided to health care professionals. Because bio-identical hormones cannot be patented (because they are naturally derived), drug companies have no interest in these products. Drug companies would rather hold a patent on a drug, which would give them exclusive marketing rights. Since drug companies don't sell or promote these products, prescribers have limited opportunities to learn about them.
Why would it be safer to use BHRT than the synthetic estrogens and progesterones?
The synthetic hormones are converted into other substances that bind to our receptor sites with 2-3 times more affinity than BHRT. The chemical structure of these substances is very different from hormones that humans produce. Synthetic progestins tend to increase LDL (bad cholesterol) and decrease HDL (good cholesterol). The synthetic estrogens produce metabolites that may promote inflammation, leading to hypertension, heart disease, strokes, blood clots, and cancer.
How are the bio-identical hormones prepared?
BHRT can be formulated into oral, slow-release capsules, transdermal creams or gels, buccal troches, sublingual drops, and vaginal suppositories or creams. Each patient's formulation will be specific to their individual needs, which are determined from their hormone blood levels.