Bioidentical hormone replacement therapy
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"Bioidentical" hormone replacement therapy (BHRT) is the exogenous (external) use of supplemental doses of synthetic sex steroid hormones in the same chemical structure that they exist in the human body. This is a modification of conventional hormone replacement therapy. Conventional hormone replacement therapy often involves the use of synthetic hormones which have been modified so that their chemical structure is not the same as endogenous human hormones (hormones the body naturally makes). For example, a molecule is added to synthetic progesterone to make medroxy progesterone acetate, which makes this form of synthetic progesterone more bioavailable.
The term "bioidentical" is used by some marketers because the administered hormones are chemically synthesized and identical to the endogenous hormones of the human body: estradiol, progesterone, estriol (another natural estrogen), and testosterone are the most common. Whether these exogenous, synthetic hormones are safer or more or less effective than synthetic hormones which are not replicas of endogenous hormones has not been proven. All synthetic progesterone is considered a suspected human carcinogen. [1] These synthetic substances are called Progestins and are often confused with the natural hormone called progesterone.
The sex steroid hormones can be administered orally, but when administered in this way most of the hormone is destroyed by the liver soon after entering the body. Particularly for progesterone, the resulting metabolic by-products can cause unwanted side-effects. In the case of estrogens, oral administration can alter the production of clotting factors by the liver, increasing the risk of dangerous strokes. For these reasons, topical administration of sex steroid hormones is increasingly popular. [citation needed] Some hormones have been made available as manufactured transdermal patches, particularly estradiol. Progesterone and estriol are mostly available in the form of topically applied creams made by a trained pharmacist from a compounding pharmacy.
Bioidentical hormone replacement therapy has received increasing attention since the termination of the Women's Health Initiative hormone replacement therapy clinical trials (PMID 15354510). A 2004 book by Suzanne Somers, The Sexy Years: Discover the Hormone Connection (ISBN 0-609-60721-9), has also served to publicize bioidentical hormone replacement therapy. More recently a book titled Your Perfectly Pampered Menopause by WebMD writer Colette Bouchez also explores bio identical hormones. The most recent book in October 2006 by Suzanne Somers illuminates bio-identical hormones and their current application in Western Medicine with interview and findings of sixteen doctors October 2006 Ageless: The Naked Truth about Bioidentical Hormones.
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[edit] Potential advantages over conventional hormone replacement therapy
- Emphasis on topical administration; avoids problems such as blood clotting that are caused by the rapid metabolism of orally administered hormones (PMID 12927428).
- Progesterone may work differently in the body than medroxyprogesterone acetate (PMID 15358673).
- Emphasis on individualized doses rather than "one dose fits all" approach of conventional hormone replacement therapy (PMID 12478948).
- Inclusion of estriol may be protective against hormone-induced cancer. Unlike estradiol, estriol binds preferentially to the second estrogen receptor (ERbeta). ERbeta may function as a tumor suppressor (PMID 15369453).
[edit] The Basics of Bioidentical Hormone Replacement Therapy
Bioidentical hormone replacement therapy is a method used to help treat the Progesterone Estrogen symptoms of menopause, perimenopause, and post-menopause. A common misconception is that bioidentical hormone replacement therapy is only for women. Andropause or "male menopause" Men's hormonal imbalance symptoms, are also alleviated by biologically identical hormone replacement therapy. Although bioidentical hormones are not yet FDA approved, they are being used more and more across the world everyday. The FDA says that since they are considered to be natural, regardless of their source, they cannot be patented.
Bioidentical hormones, sometimes referred to as natural hormones, are those that are molecularly identical to the hormones that we produce in our bodies. Hormones and steroids are taken from plants and animals and altered to a state of identical molecular structure, then put into a form that can be taken by the patient: cream, oral, vaginal or injections.
The plants that are used to extract the hormones are soy and yams, while the animals are pigs or horses. Although these hormones become molecular identical to the ones we produce, they cannot be considered completely natural due to the fact that they are altered in a laboratory. Most women are worried about the source of the hormones more than the actual hormones, due to the fact that synthetic hormones, which have been around for years, have been found to carry health risks. A comprehensive list of Bioidentical Hormones by brand namesis published, however below is a partial list of products that are bioidentical, and non-bioidentical:
[edit] Bioidentical Estrogen
- Micronized estradiol/Estrace-Synthesized from soy and yam.
- Estradiol/Alora-Synthetic.
- Estradiol/Climara-Synthesized from soybeans.
- Estradiol/Estraderm-Synthesized from Mexican yams.
- Estradiol/Fem Patch-Synthetic.
- Estradiol/Vivelle, Vivelle-Dot-Synthesized from Mexican yams.
- Estradiol/Estring-Synthesized from Mexican yams.
[edit] Non-Bioidentical Estrogen
- Conjugated estrogens/Premarin-Pregnant mares' urine.
- Conjugated estrogens/Cenestin-Synthesized from soy and yams.
- Esterified estrogens (estrone, equilin)/Estra Tab-both estrone and equillin are synthesized from soy and yams.
- Esterified estrogens (estrone, equillin)/Menest-Both estrone and equillin are synthesized from soy and yams.
- Micronized estradiol/Estrace-Synthesized from soy and yams.
- Estropipate/Ogen-Synthesized from Mexican yams.
- Estropipate/Ortho-Est-Synthesized from yams.
- Ethinyl estradiol/Estinyl-Synthesized from Mexican yams.
- Estradiol cypionate/Depo-Estradiol-Synthetic.
- Estradiol valerate/Delestrogen-Synthetic.
[edit] References
- Bioidentical Medical Dictionary
- Somers, Suzanne (2004). The sexy years: discover the hormone connection: the secret to fabulous sex, great health, and vitality for women and men. New York: Crown Publishers. ISBN 0-609-60721-9.
- T.S. Wiley (2004). Sex, Lies and Menopause: The Shocking Truth About Hormone Replacement Therapy. New York: Harper Collins. ISBN 0060542349.
- Somers, Suzanne (2005). Suzanne Somers' slim and sexy forever: the hormone solution for permanent weight loss and optimal living. New York: Crown Publishers. ISBN 1-4000-5325-0.
- Somers, Suzanne (2006). Ageless: the naked truth about bioidentical hormones. New York: Crown Publishers. ISBN 0-307-23724-9.
