In recent years, one of the most important shifts in menopause research and treatment is the recognition that body-identical hormone treatments have proven to be much safer than synthetic hormone treatments. This is something that the doctors at the Centre have supported since our inception in 2003. This has also meant that commercially produced TGA-registered body-identical hormones are available in specific doses.
‘Body identical’ hormone therapy refers to a hormone that is identical to those produced by the body. These are TGA approved treatments and have a documented profile of benefit as well as short term and long-term risk. Commercially available body-identical oestrogen is available in Australia as tablets, transdermal patches or gel in specific doses. Examples of these include Estraderm, Estradot, Climara, Estrogel and Sandrena gel. It is also available for topical vaginal treatment – Ovestin and Vagifem.
Commercially available body-identical progesterone is now available in capsule form in Australia (as Prometrium). Prometrium is currently available as a 100mg capsule. Many of the studies/research available on commercial products do not extend to bioidentical hormones alone, as they predominately focus on synthetic hormone preparations. In studies that use bioidentical hormones, it does appear that the health outcome is more favourable compared to the synthetic alternative.
Compounded bio-identical hormone replacement therapy (BHRT) are products are compounded to an individual prescription from your doctor. Although the active constituents are pharmaceutical USP grade bioidentical hormones, the preparations are not individually TGA approved. Some large cohort studies including the French E3N study, have been conducted on patients using compounded bioidentical hormones and these studies have contributed to the development and controlled trials of set dose products that have been listed on the TGA register. However, because each prescription is compounded for an individual’s needs, there is no data available from controlled studies on these specific preparations regarding efficacy and safety.
Compounded bioidentical hormones may provide an option for patients where a commercial/pharmaceutical product does not achieve the desired therapeutic outcomes for patients and an alternate strength or mode of application, which is not commercially available, is indicated.
Their chemical and molecular structure are the same as the hormones the body produces. In addition, BHRT is derived from plant sources such as wild yam.
The doctors and clinical team at AMC take into consideration a women’s weight and symptoms before prescribing a dose that best suits a patient. The dose can be adjusted, which is a tremendous bonus especially in per-menopause where hormones are fluctuating regularly. A standard dose often leaves patients with symptoms of overload or insufficiency which is not ideal. If this occurs, a compounded BHRT may offer an even greater benefit as the dose can be adjusted according to a patients needs.