FAQ: Bio-identical Hormones

Addressing issues and alternatives to Hormone Replacement Therapy

Today’s generation of women who are facing menopause are actively involved in medical decision making. For more than a decade there is mass confusion among women on whom and who is not a candidate for hormone replacement therapy and more importantly whether they are safe. Myths about hormone replacement are abound in the consumer press and can cause mistrust and concern among women. Being informed about as many treatment options as possible, and sharing reliable, clinically supported information with patients will help establish trust and make it easier to design an individual treatment regimen that alleviates symptoms.

The discussion of treatment should include realistic expectations for outcomes and reassurance that treatment can be adjusted and individualized, as necessary. Promoters of BHT know this and encourage women to be clear with clinicians in demanding the products they want. Encouraging a frank exchange with women about their health is an important part of any clinician-patient relationship, and part of that discussion should include identifying misconceptions as well as addressing notions that are uncertain.

Treatment options are often very simple as women merely want to regain the benefits that hormones offered them at an earlier time in their life. Patients want a healthy hormonal balance and look to their clinician to address the key factors that affecting their hormonal health.

The information offered to you is designed to allow you to explore options in the process of hormone replacement, and allow you to understand the underlying causes of hormonal imbalances and helping you decide what hormones replacement options are appropriate for your current health condition.

Information on the Pharmaceutical Industry

  • The pharmaceutical industry is unable to patent bio-identical hormones because they share a molecular structure with a natural hormone.
  • It has not been cost-effective from a business standpoint to promote the use of these bio-identical hormones until now.
  • Bio-identical hormones are pure biologically identical hormones extracted from plants or synthetically manufactured.
  • They are identical molecule for molecule to a human hormone and work in the body just like the hormones our bodies produce.
  • Bio-identical hormone prescriptions are developed in a compounding pharmacy.
  • A compounding pharmacy conducts itself like any other clinical pharmacist and formulates each prescription
  • A doctor sends the compounding pharmacy instructions from the results of your clinical workup to the compounding pharmacists to develop the appropriate hormone replacement consistent with your clinical symptoms and hormone levels.

What is Bioidentical Hormone Replacement Therapy (BHRT)?

Simply stated BHRT is an alternative medical treatment method in comparison to current traditional hormone replacement therapy (HRT). Unlike traditional hormone replacement therapy bio-identical hormone replacement therapy uses natural hormones that have an identical chemical, molecular structure as hormones produces by the human body. The bio-identical aspect of these hormones allows the body to utilize them as such in that they then follow the same metabolic pathways as hormones produced within our own bodies (endogenous). They are also converted to other hormones as well as important hormone metabolites as those produced in our own bodies.

The category of bio-identical hormones includes bio-identical estrogen hormones such as estrone (E1), estradiol (E2) and estriol (E3), bio-identical progesterone, bio-identical testosterone, bio-identical adrenal hormones such as DHEA and cortisol.

Many organs of the human body have receptors for specific hormones. Bioidentical hormones can attach easily to those receptors. Bioidentical hormones, just like human hormones fit perfectly into the receptors, “like a key into a lock”. Horse hormones (Premarin) or synthetic hormones (Provera) due to the fact that they are molecularly different than human hormones, do not provide an exact fit for the receptor. Horse and synthetic hormones can distort the receptor and create damage to that receptor, including damage to the DNA. This can result in numerous side effects that are often associated with the use of most synthetic hormones.

Where do Bio-identical hormones come from?

Bioidentical hormones are originally derived from a molecule called “disogenin” in either soy or yams and are then transformed to a compound structurally identical to steroid hormones produced by our own bodies (estrogen, progesterone, and testosterone).

How are Bioidentical Hormones produced and are they regulated?

The initial by-products of bio-identical hormones are derived from plant sources (soy, yam) then transformed through a series of chemical processes to a product structurally similar to a human steroid hormone (estrogen, progesterone, testosterone). The final product has no trace of the plant, just the pure newly formed bio-identical hormone. Even though bio-identical hormones are originated from plant sources, does not mean they cannot be converted into products that have the same chemical structure as those produced in our own bodies so in reality they are bio-identical hormones, and are not plants extracts or plant hormones. When these bio-identical hormone by-products are produced they are then prepared by a certified compounding pharmacist into an appropriate “vehicle’ for administration (topical creams, gels, capsules or pellet implants).The plant extracts used in the processing of bio-identical hormones are approved for use by compounding pharmacists/pharmacies. Compounding pharmacies are regulated at the state level, and do not fall under FDA jurisdiction. The FDA approval process is designed for pharmaceutical company manufactured medications. A compounding pharmacy that has been State approved is obligated to use only those official raw materials that have certificated by analysis to be safe, pure (non-contaminated) and confirmed and identified to a substance or precursor that is appropriate for the production of bio-identical hormones.

What are the affects and benefits of Bioidentical Hormones?

Since bio-identical hormones have the same identical molecular structure as those produced by our own bodies their actions within the body should have the same metabolic effect as those which were previously produced by the ovaries, adrenal glands and those converted peripherally in adipose/fat cells.

Bioidentical hormone replacement therapy (BHRT) is highly effective therapy in re-establishing hormonal balance in those individuals with hormone deficiencies.

As their name implies, because the chemical structure is identical to our own body’s hormones, bio-identical and bio-identical hormone replacement therapy do not cause the unpleasant and dangerous side effects that synthetic/manufactured hormones do which are pooled from various sources other than plants or vegetables.

Bioidentical hormones have been proven to alleviate symptoms in women of all age groups, those as young as teenagers and also women in their pre and post reproductive years (menopause, peri-menopause). BHRT has been utilized in patients suffering from PMS, menstrual irregularities in addition to peri and post menopausal symptoms. They have been shown to be efficacious in treating mood disorders (anxiety, stress, depression), insomnia, uterine fibroids migraines, fatigue, obesity, bone loss, fibrocystic breast disease, skin disorders and connective tissue and inflammatory disorders to name a few.

More importantly, bio-identical hormones have many health protective benefits enhanced quality of life issues such as:
•    preventing urinary tract infections
•    preventing pelvic organ relaxation and prolapse
•    enhancing sexual desire and arousal
•    orgasm dysfunction
•    improving painful sexual intercourse
•    preventing osteoporosis, improving bone density
•    enhance the integrity and quality of the skin
•    preventing tooth loss
•    maintaining muscle mass
•    improve and maintain proper body mass (BMI)
•    improving lipids and cholesterol levels (HDL, LDL)
•    preserving cardiovascular function
•    reducing risk of heart disease
•    protecting youthful brain function
•    improve memory
•    balancing mood
•    improving quality of sleep
•    enhancing energy

What are the goals of Bioidentical Hormones Replacement Therapy (BHRT)?

The traditional and historical goals of conventional hormone replacement therapy (HRT) using synthetic hormones was essentially only to alleviate bothersome menopausal symptoms and not necessarily replace with the intent on correcting an imbalance. The goals of bio-identical hormone replacement therapy (BHRT) are focused not only on easing unpleasant symptoms of menopause, peri-menopause, but more importantly to restore hormonal balance by addressing hormonal deficiencies and imbalances by accurately assessing each patients individual hormonal status (based on medical history, signs and symptoms, lab work and patient expectations) and subsequently developing an individualized management plan tailored and prescribed to each patients unique needs. Therapy is then modified and maintenance is established as a result of a patients clinical response ongoing laboratory results. This can be accomplished through optimization and balancing of bio-identical hormones levels in a safe, holistic approach.

Can anyone benefit from Bioidentical Hormones Replacement Therapy?

Bioidentical hormones replacement therapy (BHRT) is of benefit to anyone experiencing signs and symptoms that are linked to deficiencies or imbalances of those hormones in the body. Hormonal imbalances have no bias in that they can occur at any point in a person’s life in addition to affecting  both men and women. Hormonal imbalances are often the presenting signs and symptoms for individuals transitioning into menopause (peri-menopause) andropause (male menopause). Imbalance can also be implicated in PMS, infertility, ovarian cysts, breast cystic lesions, uterine fibroids, polycystic ovarian syndrome (POS), thyroid disease and adrenal gland dysfunction.

At what point does a person need Bioidentical Hormones Replacement Therapy?

If a person is manifesting signs or symptoms which are clinically linked to what your clinician feels is a hormonal imbalance and is diagnosed by assessing hormone levels which are found to be deficient then they can be treated using bio-identical hormones. Keeping in mind that the ideal time to address hormone deficiencies is when they are evolving and not when those deficiencies have already significantly impacted the quality of daily life.  Many hormonal imbalances evolve with minor or subtle warnings or symptoms and it is usually during this time that these deficiencies are very often undiagnosed and untreated.