How do I find bioidentical hormones?

 

Bioidentical hormones are made into a range of products, many of which are FDA-approved and available with a prescription at your local drugstore.  For example, commercially available bioidentical estradiol comes in several forms, including pill, patch, cream, and various vaginal preparations. Micronized progesterone comes in a capsule or as a vaginal gel.  Others including testosterone, DHEA, and thyroid hormone are available in different forms as well.

 

Are bioidenticals safer?

No one knows for sure. Few large studies have investigated the differences among the various hormones and methods of administration. More research is needed to further understand these differences and compare the risks and benefits. But proponents of bioidentical hormones say that one advantage they have over synthetic ones is that levels can be monitored more precisely and treatment individualized accordingly.

 

What about compounded hormones?

 

Much of the confusion about bioidentical hormones comes from the mistaken notion that they must be custom-mixed at a compounding pharmacy. But custom compounding is necessary only when a clinician wants to prescribe hormones in combinations, doses, or preparations (such as lozenges or suppositories) not routinely available — or to order hormones not yet fully approved for women, such as testosterone and DHEA. Compounding pharmacies use some of the same ingredients that are made into FDA-approved products, but their products are not FDA-approved or regulated.

 

One size doesn’t fit all

 

Compounded hormones can certainly help to individualize treatment, but if you’re considering them, be aware of the following:

 

• Compounded drugs are mixed to order, so it is important to choose the tight compounding pharmacy that performs thorough tests of their safety, effectiveness, and dosing consistency.

• Some clinicians who prescribe compounded hormones order saliva tests to monitor hormone levels. Most experts say these tests are of little use because there’s no good evidence that hormone levels in saliva correlate with response to treatment, particularly in postmenopausal women.  Our center absolutely does NOT use saliva hormone testing, and we believe you should be wary of any provider who does!

• Heath insurers don’t always cover compounded drugs.

 

This doesn’t mean that you shouldn’t consider compounded hormones. Just realize that, in a sense, you’re going to be experimenting a bit with what works best for you.  Everybody (and every body) is different.  Unless your clinician has considerable experience with bioidentical hormones and a particular compounding pharmacy, you may be better off with a “traditional” prescription for commercially available hormones, many of which can be bioidentical.

 

 

Considering bioidentical hormone therapy?  Or already on hormone therapy and not sure if it is working or right for you?  If you are interested in a FREE, no oligation second-opinion laboratory evaluation and review of your hormone levels, contact us today! 

 

 

 

Also check out these two informative Health Matters video clips from Lee Memorial Healthcare System reporting on the controversies and confusion surrounding hormone replacent therapy:  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

More evidence-based information on Bioidentical hormones:

 

Many people are quick to dismiss bioidentical hormone therapy (BHT) as controversial, wacky or dangerous. But in reality, there is scientific research that confirms the benefits of BHT, particularly for women about to go through menopause. BHT is so successful because it goes beyond simple symptom control to proactively address the root of a given patient’s health issues.  One recently released research paper on the potential benefits of BHT, especially in comparison to conventional hormone therapy (CHT) was particularly enlightening.

 

Here’s a sampling of what was discovered.

 

Is BHT more effective than standard hormone replacement therapy? 

 

• Four studies that compared BHT with CHT found that women on BHT reported greater satisfaction, fewer side effects, and improved quality of life when switching from CHT to BHT.

• In one survey, researchers found that patient satisfaction, quality of life, and body and psychological symptoms—including anxiety, depression, sleep problems, menstrual bleeding, hot flashes, cognitive problems, and sexual function—improved significantly more for women on BHT (specifically, with bioidentical progesterone) than for women on CHT (including the progestin drug MPA).

• Sixty-five percent of the 176 menopausal women in this same survey felt that the BHT combo was better than the CHT combo including MPA.

• Women using BHT with progesterone had less breast tenderness than women using CHT.

 

Is BHT safer for breast tissue than CHT? 

 

• Fourteen studies showed that synthetic progestins from CHT may reduce apoptosis (the natural, good cell death that works against cancer growth) and may increase the formation and growth of cancerous cells in breast tissue.

• Other research showed that progestins in CHT upregulate cellular activities linked to breast cancer growth, and that progestins may increase conversion of less dangerous estrogens into more dangerous ones.

• Overall, the studies show that progestins have pro-carcinogenic impact on breast tissue, while progesterone has neutral or opposite effects.

• In the  monumental EPIC study, which involved 50,000 postmenopausal women, researchers studied two groups of women: one that took estrogen plus progestin, while the other took estrogen plus bioidentical progesterone. The women that were given progestin increased their risk of breast cancer by 40 percent; the other had no impact on risk.

 

Does BHT or CHT increase the risk of heart attack or stroke?

 

• The well-known WHI study found that adding MPA to Premarin substantially increased risk of both heart attack and stroke.

• MPA and other progestins negate the proven cardiovascular benefits of postmenopausal estrogen hormone therapy. Progesterone does not have this effect; it supports and promotes the protective effect of estrogens on the cardiovascular system.

• When given after menopause, estrogens raise “good” HDL cholesterol levels. Progestins cancel out this positive effect of estrogens, but progesterone has no impact on HDL.

• Synthetic progestins increase insulin resistance, while bioidentical progesterone decreases it. Insulin resistance is a precursor to Type 2 diabetes, which dramatically increases the risk of heart disease

      

For those willing to look for it, there is an abundance of scientific support in favor of the judicious and well-timed use of bioidentical hormone therapy for women entering or already experiencing menopause. Progestins are clearly the “problem child” in this family of medicine, and given the health risks associated with progestins, they should be avoided at all costs.

 

The ideal time to explore BHT is right around menopause; there is evidence that the benefits of BHT drop and the risks rise by about five years post-menopausal transition. Seek out the guidance of an integrative medicine doctor to get started today.

 

REFERENCE:

Holtorf, Ken, “The Bioidentical Hormone Debate: Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy?” Postgraduate Medicine, Volume 121, Issue 1, January 2009.