FAQs: Bioidentical Hormone Therapy

Hot flashes, night sweats, depression, anxiety, insomnia, muscle loss, increased central adipose/fat tissue, brain fog, vaginal dryness and recurrent urinary tract infections.

Bioidentical hormones are identical in structure to the hormones found in our body. In other words, bio-identical= human-identical hormones. They are formulated to perform the same functions in our body as our actual hormones and often come from phytochemicals in plants.

Conventional hormones are synthetic compounds made by pharmaceutical companies. They mimic some of the functions of the hormones in our body while introducing some new potentially harmful functions.

It is the most effective treatment for hot flashes! Some studies suggest a 75% reduction in hot flashes.

Reduced risk of cardiovascular disease, improved bone mineral density, reduced risk of fracture, reduced risk of colon cancer, improved sleep, reduced risk of dementia, reduced fasting blood glucose levels, reduced joint pain and stiffness, improved cognition and reduced anxiety.

Measuring levels prior to treatments allows for a more tailored careful approach. However, it is not always necessary.

It is most useful when: monitoring levels after initiating treatment, assessing menopausal status in a patient out of the normal age range, and assessing hormone levels in women before menopause with a history of a hysterectomy.

Misinformation or drawing a conclusion that bioidentical hormones are the same as synthetic hormones. They are NOT.

Unfortunately, the media and some physicians use a study called the women’s health initiative (WHI) to recommend against bioidentical hormone therapy. The problem? The study took place in the 1990’s and studied the effects of synthetic estrogen alone versus synthetic estrogen and synthetic progestin used in combination. The study found that synthetic progestins can protect against the side effects of too much estrogen (cancer of the uterine lining) but can increase the risk of breast cancer, uterine cancer, and heart disease.

Issues with this study:

  • Bioidentical hormones are formulated differently. It is human-identical remember? Your body sees the bio-identical hormone as its own hormone. It does not have some of the added functions of synthetic hormones.
  • Only about 1/3 of the women were 50-59 years old. Women farther than 10 years past menopause do not have the same risk factors.
  • One size fits all approach. Not all patients need the same dose of hormones and should be monitored to find the right dose.

If drawing conclusions based on the WHI trial the risk would be 0.1% risk of breast cancer.

When prescribed correctly, bioidentical hormone therapy can reduce the risk of breast cancer by balancing the ratio of progesterone to estrogen. How? As we age we become “estrogen dominant”. In other words, both estrogen and progesterone will go down but progesterone declines at a faster rate. Estrogen is hyperproliferative meaning it causes tissue to grow at a higher rate. Progesterone counters this action and slows the rate of growth. If estrogen is higher the risk of breast cancer is higher.

Vaginal atrophy (thinning of vaginal tissue around menopause), ovarian cysts and uterine fibroids.