Bio-identical hormone replacement therapy is a natural hormone replacement to treat the symptoms of menopause, perimenopause, post-menopause, infertility and hormone imbalances. Bioidentical hormones have a molecular structure that is exactly the same as that of hormones produced by our bodies so it can treat the symptoms of hormonal imbalance such as hot flashes, night sweats, depression, moodiness, weight gain, acne, fatigue, insomnia, loss of libido, memory loss, depression, difficulty concentrating and more.
Traditionally, doctors have prescribed synthetic hormone replacement therapy (HRT) to treat the symptoms of menopause. These symptoms include hot flashes, irritability, insomnia, vaginal dryness.
While HRT is effective, it can also be very dangerous. Studies show that women who have been treated with conventional HRT are at greater risk of developing breast cancer, heart attacks, strokes and life-threatening blood clots, compared to those who have not used HRT. (WHI, 2002)
The problem with conventional HRT is that it is created from synthetic chemicals that our bodies do not recognize as naturally occurring hormones. While many doctors continue to prescribe synthetic HRT in spite of dangerous outcomes, the Naturopathic Doctors at Bronte Wellness Boutique are trained to prescribe bioidentical hormones – a safer and more beneficial therapy.
Bioidentical hormones are an effective alternative since they are biologically identical to our own hormones and, therefore, are broken down in exactly the same manner as our own hormones. Researchers have concluded that bioidentical hormones are associated with lower risks of breast cancer and cardiovascular disease, and that they are even more effective than conventional HRT. (Holtorf, 2009)
Hormone Replacement Therapy: Rules for Treatment
I recently read a study by Dr. RD Langer published in 2016 entitled “ The evidence based for Hormone Replacement Therapy (HRT), what can we believe?” It reviewed many studies dealing with the hormone replacement therapy and concluded that not all women have indications to use hormone replacement therapy but for those who do, there are clear benefits: reduction of hot flashes, less vaginal atrophy, improved bone health, reduced risk of coronary artery disease just to name a few. He believes that “the “facts” that most women and clinicians consider in making the decision to use or not use HRT are frequently wrong or incorrectly applied.”
There is a lot of evidence to support using bioidentical hormones before and/or within the first 10 years of menopause. When used correctly, women have a decreased risk of breast cancer, heart attack, strokes, alzheimers and osteoporosis. Proper dosing also improves mood, short term memory, libido and sleep. Women are also less likely to gain weight with bioidentical hormones. The key to ensure the benefits and safety of HRT is to ensure you follow these three simple guiding principles.
1. Give hormones only to those who are truly deficient in them.
You wouldn’t give insulin to a patient who wasn’t diabetic would you!? Shockingly, medical doctors routinely prescribe estrogen or other sex hormones without testing. First it’s assumed that menopausal women have estrogen deficiency, however the aromatase enzyme in fat and breast tissue continues to convert androstenedione, an adrenal hormone, into estrogen. Women with more body fat often have a lot of estrogen beyond menopause. If you don’t test, you won’t know. The best test is a saliva hormone panel because serum blood tests are irrelevant as sex hormones are fat-soluble. The “free” hormones circulate in the blood stream before quickly entering tissue and binding to specific hormone receptors. Any remaining hormones are processed by the liver, which become enveloped by a protein that makes them water soluble rendering them impossible to be absorbed by tissue. Serum blood tests for hormones measure the levels of unavailable hormones and are of no relevance to hormone levels in tissue. The salivary gland picks up bioavailable hormones giving saliva a hormone level that is a far better reflection of bioavailable hormones. Once proper hormone levels are measured, it’s much easier to prescribe hormones appropriately.
2. Use bioidentical hormones rather than synthetic hormones.
You don’t need a biochemistry degree to see that synthetic molecules and progesterone from different species have a different molecular configuration to those found within the human body. In general, we have learned through studies that substitute synthetic hormones differ in their activity at the receptor level. Synthetic hormones don’t provide the same physiological effect and can often be associated with unwanted side effects. Human insulin for example, is preferred to pig’s insulin. So why use synthetics? Pharmaceutical companies can patent synthetic molecules where as natural products cannot be patented and are thus less profitable.
3. Only use dosages that provide normal physiological levels
Don’t over dose or under dose for the best outcome. This seems logical but most patients receiving synthetic HRT are overdosed. Appropriate dosing requires hormone testing and it’s rare that doctors prescribing synthetic hormones test hormones, let alone salivary hormones. We have already determined that serum blood levels are irrelevant. Synthetic HRT is also only available at significantly higher dosages. If physicians were to test saliva after their typical estrogen dose, they would find levels up to 10 times higher than normal physiological levels. If you test and apply appropriate bioidentical hormones, a much smaller dose is required to obtain normal physiological levels. Ongoing monitoring of salivary hormone levels is also essential. I recommend yearly testing. When transdermal progesterone is given, saliva levels quickly rise and are readily apparent in saliva testing where as serum levels will show little to no change. When measured and dosed appropriately, you can minimize risk and maximize benefit. Sometimes less is more.
In the past 10 years, more studies are showing us the positive short and long-term benefits of bioidentical hormone replacement therapy. Let us help you with your hormone journey where you can be assured of appropriate testing and guidance for your complete well-being. To see if Bioidentical Hormone Replacement Therapy is right for you, contact our team of experienced Naturopathic Doctors and book an appointment today.
What is the process of starting on Bioidentical hormones?
You need to do a complete intake with one of our experienced Naturopathic Doctors to ensure that bioidentical hormone replacement therapy is safe for you. Laboratory testing is required to obtain a baseline level prior to hormone prescribing. Hormones if indicated are usually prescribed after carefully reviewing diagnostic testing. More than one visit is typically required to establish a hormone protocol that is in alignment with a patients health goals. Visits are required at least every 3 months for clinical monitoring and diagnostic testing is required every 6-12 months unless otherwise specified. We require our patients to obtain PAP tests every 3 years, mammograms every 2 years and transvaginal ultrasounds yearly when taking bioidentical estrogen therapies.