This is Part 1 of our 3 part series.
Like every health treatment, man-made hormones, or “bioidentical hormones,” have both risks and benefits. Here’s what you need to know to make an informed decision.
If you are postmenopausal or entering perimenopause, then chances are, you’ve heard about hormone replacement therapy (HRT). And if you’re considering HRT, then chances are also good you’ve heard about “bioidentical” hormones. Claimed to be more effective than FDA-approved hormones, their popularity got a big boost from Suzanne Somer’s 2006 book, Ageless: The Naked Truth About Bioidentical Hormones. (And, of course, from the Oprah interview that followed.)
But what exactly are bioidentical hormones? Are they safe, and do they work? Are they really the fountain of youth they are sometimes made out to be? Let’s dig into the facts.
WHAT ARE BIOIDENTICAL HORMONES?
It’s important to make a distinction between bioidentical hormones and other forms of HRT. We like Dr. Christine Northrup’s succinct explanation :
“All hormones are “natural.” But, what most women mean when they say they want natural hormones, is that they are interested in using bioidentical hormones. The distinction is that bioidentical hormones are identical in their molecular shape, make-up, and structure to hormones made in the human body. This is what makes bioidentical hormones the perfect “keys” to unlock the body’s receptor sites. In other words, it’s the shape of the molecule, not the source. Today, most women know that, while natural, the hormones Premarin, Prempro, and Provera, are not bioidentical.”
So in other words: bioidentical hormones are no more or less “natural” than other forms of HRT. But, their molecules are shaped in such a way that makes them immediately recognizable by the body, because they have the same chemical and molecular structure as hormones that are produced in the human body.
If you’re currently taking hormones, you can check the label to see if they are bioidentical. If the ingredients include “esterified estrogens,” “progestins,” or “progestogens,” the product is not bioidentical.
ARE BIOIDENTICAL HORMONES SAFER?
Plenty of women are concerned about risks associated with HRT. But are bioidentical hormones safer than synthetic hormones? Depends on who you ask.
As Harvard Women’s Health Watch says, “To many, the claim that bioidentical hormones are safer because they have the same chemical structure as those produced by our own bodies would seem plausible.” It does seem to make intuitive sense, especially when weighed against research evidence associated with conventional HRT. Again, from Harvard Women’s Health Watch:
“It’s understandable that women would be interested in a new approach after hopes that conventional HT would prevent cardiovascular disease were dashed by the Women’s Health Initiative (WHI). In 2002, study researchers stopped giving HT to women with an intact uterus when it became clear that the risks of taking combined hormones (estrogen plus a progestin) — higher rates of stroke, breast cancer, heart attack, and blood clots in the lungs and legs — outweighed the benefits, namely, reductions in osteoporotic fractures and colorectal cancer. In 2004, WHI researchers also stopped giving HT to women who had undergone hysterectomy, because those taking estrogen alone had a higher rate of stroke than those taking the placebo. Finally, in the WHI Memory Study, women over age 65 who took hormones were twice as likely to develop dementia as those taking a placebo.”
Yikes! Who could blame women for wanting a different approach?
Here’s the thing, though: while bioidentical progesterone and the bioidentical estrogen estradiol are now FDA approved, they haven’t been studied in large, long-term trials like the WHI. They have been shown in trials to relieve menopausal symptoms, and to bring down the risk of osteoporosis. Which is great news! But it’s not confirmation that they don’t carry any health risks.
So, long story short: the science is still coming in with bioidentical hormones. As with so many emerging treatments, we just don’t know the full story yet – and we won’t for a number of years.
Sourcing is critical, too. Compounding pharmacies — which are not FDA-approved, and make some 3% of drugs dispensed in the U.S., according to WebMD — do not insert WHI warnings with bioidentical hormone packaging, giving the illusion of being safer than commercially marketed drugs. This isn’t to say that all bioidentical hormones come from compounding pharmacies; rather, it’s important to know who’s making your medicine, and to ask questions. (According to Endocrine News, huge numbers of women are taking bioidentical hormones from compounding pharmacies.)
DO BIOIDENTICAL HORMONES WORK BETTER?
Here again, the answer is nuanced.
Dr. Northrup (an advocate of bioidentical hormones) has this to say:
“Our hormones are comprised of a solid steroid base (cholesterol), decorated with “arms,” “legs,” and “tails” pinned on here and there. These attachments are what turn hormones into specialized molecules, allowing them to plug into receptor molecules throughout the body, turning on and off much of the cellular behavior that makes us tick.
When we take hormonal replacement therapy that doesn’t fit the original design that our cells have evolved to recognize, the end result simply may not feel or act quite right. Hence all those side effects, ranging from annoying and uncomfortable to downright dangerous can occur.
Bioidentical hormones duplicate the structure of our hormones exactly as they are found in our bodies. This is why they work better in our bodies.”
There’s the question of time, though. Harvard Women’s Health Watch says that “If you want to use FDA-approved bioidentical hormones for menopausal symptom relief, you can be confident that they are safe and effective, and contain what their labels say they do,” but they also wanted to look at treatment time. Is it safe to take bioidentical hormones indefinitely? They took the question of bioidentical hormone therapy to two actual practitioners, to see how long is considered safe:
“We took the question to two gynecologists who have followed the field for decades and treated thousands of midlife women — Harvard Women’s Health Watch advisory board member Dr. Martha K. Richardson, and Dr. JoAnn Pinkerton, who led a workshop on bioidentical hormones at the North American Menopause Society’s annual meeting in September 2011. Both usually prescribe FDA-approved bioidentical hormones, but only for symptom relief and only for the shortest time that works (often three to five years but sometimes longer).”
SO, ARE BIOIDENTICAL HORMONES “NATURAL?”
As we said earlier in this article, they’re no more or less natural than other forms of HRT – bioidentical hormones are still manufactured.
But if you are looking to balance your hormones naturally though, lifestyle, nutrition, and targeted supplementation can help. Asensia® can raise your progesterone levels to what’s normal for a younger woman, by helping the body make more of it on its own. Healthier progesterone levels = healthier estrogen levels, which in turn, improves sleep, energy levels, your outward appearance, and quality of life, with less mood swings, improvement of brain functioning, and increased vascular and cardiovascular health.
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