Hormone Replacement Therapy: Natural vs. Synthetic

The difference between Bioidentical and Synthetic Hormones

Hormone therapy is a treatment used to supplement the body with either estrogen alone or estrogen and progesterone combination, or bioidentical hormones. Estrogen and progesterone are hormones that are produced by the ovaries. When the ovaries no longer produce adequate amounts of these hormones as in menopause, hormone therapy can be given to supplement the body with adequate levels of estrogen and progesterone.

Bioidentical hormone replacement therapy (BHRT) is a modification of conventional hormone replacement therapy. BHRT is the replacement of hormones normally produced by the body with hormones that are biologically identical in chemical structure and function.

Bioidentical hormones are synthetic or nonsynthetic chemicals which can be extracted and derived from a variety of different sources such as plants (soy or yams) or animals (pigs or horses). Then hormones are modified in such a way that the molecular structure is identical to the hormones normally produced by the body.

Problems with research studies

The Food and Drug Administration (FDA) considers bioidentical hormones to be natural regardless of their source, and as a result they cannot be patented. Since pharmaceutical companies cannot patent biologically identical hormones, they don't have enough financial interest in funding studies regarding BHRT and producing such products. Instead they invent synthetic hormones that are patentable, thus making BHRT a less visible alternative, even to some health care professionals. However bioidentical hormones have been studied in Europe and found to be safer than synthetic hormones sold by the drug companies.

Health Risks of Hormone Replacement Therapy

Bioidentical hormones, like their synthetic counterparts (HRT), are powerful substances that may offer health benefits, but also come with risks. It is difficult to determine the extent to which BHRT is associated with most risks and side effects because of the lack of long-term clinical trials using BHRT or comparing bio-identical hormone replacement with other forms of HRT in the United States.

Risks and possible side effects include associated with HRT:

• Increased risk of endometrial cancer in women with a uterus if estrogen is taken without progesterone or a progestin
• Slightly increased risk of breast cancer after 4 or more years of HRT, as shown in the WHI study that used continuous combined oral estrogen and progestin (Prempro). Estrogen alone or other HRT regimens may not raise the risk of breast cancer significantly.
• Increased breast density, making mammograms more difficult to interpret and possibly increasing breast cancer risk. This appears to be an effect primarily associated with taking oral progestin continuously with estrogen (e.g., Prempro).
• Slightly increased risk of ovarian cancer.
• Slightly increased risk of blood clots, associated primarily with oral estrogens such as Premarin
• Increased risk of gallbladder disease, associated primarily with oral estrogens such as Premarin
• Slightly increased risk of heart attack or stroke, both in women with cardiovascular disease and in healthy women. This effect may be associated primarily with HRT using continuous combined oral estrogen and progestin (Prempro) or the daily use of an oral progestin such as Provera with estrogen.
• Breast pain (often a temporary problem)
• Nausea, associated primarily with oral estrogens
• Bloating and fluid retention, primarily associated with progestins, e.g., medroxyprogesterone acetate
• Negative effects on mood, primarily associated with progestins, e.g., medroxyprogesterone acetate

Note: These side effects seem to be associated with oral estrogen and not with transdermal estrogen.

Some women find that trying a different type of HRT, such as switching to bio-identical hormones, using a transdermal product instead of pills, or trying a different regimen, may reduce or eliminate side effects and work better for them.

Women with the following conditions are especially at risk for suffering serious hormone replacement therapy side effects:

• Vaginal bleeding of unknown cause
• Chronic disease of the liver
• History of breast or uterus cancer
• History of blood clots in the veins, legs, or lung

BHRT Benefits

Advantages of bioidentical hormone replacement therapy for menopausal and peri-menopausal women include all of the well-known benefits of patented hormone replacement therapy-and often more without most of the unwanted side-effects and risks associated with traditional hormone replacement.

BHRT was prescribed for it's short-term benefits but, more and more, doctors and researchers are becoming aware of and prescribing BHRT for it's long-term benefits. BHRT is used to eliminate or reduce various problems and symptoms at different stages of women's lives, which may include:

• Premenstrual Syndrome (PMS)
• Premenopausal/postmenopausal symptoms
• Irregular menstrual periods
• Uterine bleeding
• Hot Flushes
• Osteoporosis (bone-density loss)
• Reduces risks of heart disease
• Accelerates fat burning for increased weight loss
• Reduces nights sweats and insomnia
• Enhances sex drive and libido
• Protects against fibrocystic breasts
• Helps improve memory lapses and foggy thinking
• Prevents vaginal thinning and dryness
• Increases energy and reduces depression
• Improves the skins elasticity
• Guards bones from osteoporosis and encourages bone growth
• Improves blood flow

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