Hormone replacement therapy (HRT) has been used for treating menopausal symptoms in women for a long time. The startling results of the Women’s Health Initiative study and its abrupt termination in 2002 have created fear and confusion among women regarding the safety and efficacy of conventional HRT.
Lack of reliable evidence and aggressive endorsements by the media has only added to the confusion. Hence only complete awareness and detailed knowledge about various types of HRT can help you in making the correct choice.
Bioidentical hormones are typically derived from plant extracts and chemically processed to produce a molecule identical in structure to endogenous human hormones. Sources often include plants (soy or yams), although de novo synthesis of hormones in the laboratory is also possible. Synthetic HRT are artificially derived and most often do not simulate the endogenous hormone milieu.
Since bioidentical hormones mimic endogenous hormones, standard blood tests for estradiol levels measure the sum of bioidentical plus endogenous estradiol in the body, making it easy to monitor the total estradiol levels in the body. This helps in adjusting and individualizing a dosage schedule for each patient. Standard lab tests cannot measure the different metabolites of synthetic hormone, thus clinical response to therapy is the only guide to titrate hormone dosage.
Compared to the synthetic progestins, bioidentical progesterones like premetrium have a higher bioavailability and hence can be more efficacious. These are available in various routes for administration like creams, gels, transdermal patches, vaginal tablets, rings, etc. This has overcome the common side effects of oral HRT like gastrointestinal discomfort, bloating, and weight gain.
Bioidentical progesterones are lipid friendly when compared to their synthetic counterparts. They also carry a lower risk for arteriosclerosis, cardiovascular side effects, and stroke. A review of progesterone’s effect on the nervous system suggests possibilities for the prevention of neurodegenerative diseases, as well as preservation of cognitive function with age. Synthetic progestins do not share these physiological effects and may even increase the risk of developing dementia. Both physiological and clinical data have indicated that progesterone is associated with a diminished risk for breast cancer.
Bioidentical hormones have a larger proportion of estriol in their formulations. Estriol is expected to carry less risk for breast cancer, although no randomized controlled trials have been documented. Estriol has been reported to be safer for the uterine endometrium and does not induce bleeding.
Greater satisfaction and acceptance is reported among patients with HRTs that contain bioidentical compounds. Custom Compounded Bioidentical HRTs are tailor-made according to the physician’s prescriptions to deliver optimum dosage according to patients’ needs. Bioidentical hormones are also available in FDA-approved formulations which have undergone extensive testing, scrutiny, and standardization.
Thus with a battery of choices at our disposal, it’s high time that we awaken and listen to our body’s call for help. It’s only you who knows your body the best. Go ahead, make the right choice and achieve freedom from menopausal symptoms.
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