When researchers called a halt to a major government-run study of a hormone therapy used by millions of women in 2002, it was big news. In one of a series of clinical trials under the Women’s Health Initiative (WHI), researchers found that long-term use of estrogen and progestin raised the risk of heart disease, stroke, blood clots, and invasive breast cancer.
A year later, the Journal of the American Medical Association (JAMA) reported more bad news for Hormone replacement therapy (HRT), confirming that women who combine estrogen and progestin (a synthetic form of progesterone) were more at risk of aggressive breast cancer, with larger tumours and more advanced cancers.
Just a short time later, the same Journal reported that women who take hormones for years run a higher risk of Alzheimer’s and other types of cognitive decline, challenging the long-held notion that estrogen-progestin supplements can help women keep their minds sharp.
In 2016, new findings by the Institute of Cancer Research suggested the original risk of HRT-induced breast cancer had been underestimated, and that women are actually 2.7 times more likely to develop cancer than those who take nothing or only the oestrogen pill. This risk rose to 3.3 times more likely in women taking the drugs for 15 years or more.
In short, hormone replacement therapy has been at the centre of ongoing controversy for decades, and the controversy shows no signs of slowing down. Meanwhile, the effectiveness of “bio-identical”, “body-identical” or “natural” progesterone (also referred to pharmacologically as “micronised progesterone”), which is formulated to be identical to the progesterone molecule that is produced by the human body, has been somewhat ignored.
What is ‘bio-identical’ or ‘natural’ progesterone?
The distinction between bio-identical/body-identical/natural progesterone and the synthetic progestin Provera remains widely misunderstood. Progesterone is used by fertility specialists to protect pregnancy, while medroxyprogesterone (Provera) is used in the morning-after pill and in birth control pills to prevent pregnancy. Their actions are quite different and, in some aspects, directly opposed.
Because bio-identical hormones (also known as body-identical hormones) have the exact molecular structure as those made in the human body, the two are indistinguishable from each other. Bio-identical hormones, it is apparent, produce very similar physiologic responses as those of endogenous hormones.
For pharmaceutical companies, whose profits relied on synthetic formulations, this came as bad news; but for women looking to treat menopause but are concerned about the possible dangerous side effects of these synthetic formulations, a more natural alternative brought with it a great sense of relief.
Bio-identical hormones can be extracted from a number of natural sources, for example, plants such as Mexican Wild Yam. The extract from Mexican Wild Yam is called Diosgenin and once extracted, this extract is converted into the exact molecular structure that women naturally produce. The bio-identical estrogens are 17 beta-estradiol, estrone, and estriol. Bio-identical progesterone is simply progesterone.
Why are bio-identical hormones a better option than synthetic HRT?
Aside from the known health risks of synthetic Hormone Replacement Therapy, pharmaceutically made HRT is what you could call ‘off-the-shelf’ medication. Unlike compounded bioidentical hormones, the strength of HRT can be too low or too high for your symptoms, potentially bringing on unwanted side effects or simply being ineffective.
With compounded bioidentical hormones, doctors can prescribe you a biochemically identical hormone specifically compounded for you by a compounding pharmacy. This means you take the lowest dose that will prove effective in treating your specific symptoms. Doctors at AMC use both bio-identical and compounded hormone replacement therapy so you get the right treatment dose to alleviate your symptoms.
With bio-identical hormones you can:
- Be prescribed a combination of hormones to correct your specific deficiencies and bring your hormones into balance
- Feel comfortable with hormones derived from more natural sources, usually wild yam
- Have your prescription revised as deemed necessary based on your presenting symptoms and your feeling of wellbeing
Growing interest in bioidentical hormones
In the past few years, there has been growing interest in bio-identical hormones and they have attracted some high profile endorsements. In 2009, entertainer Suzanne Somers appeared on Oprah promoting her book, Ageless: The Naked Truth About Bioidentical Hormones,claiming they not only help dramatically with the relief of menopause symptoms, but that they serve as a veritable fountain of youth. She says bio-identical hormones “gives you back your lean body, shining hair, and thick skin, providing you are eating correctly and exercising in moderation”.
Whether this is true or not, there is no denying that more and more women and clinicians are turning to the use of bioidentical hormones as a way to treat menopause, and the results are positive.