Clearing Up the Air About Bioidentical Hormone Replacement Therapy

Bioidentical Hormone Replacement Therapy consists in treating the patient with a source of natural chemicals high in estrogenic properties.   These are taken from soy or wild yam plants or pigs and horses to be biolochemically altered in a laboratory to exactly match your body's natural hormones- estradiol, progesterone, estriol and even testosterone- chemical and molecular structure and function.   When used in precise, exact quantities, these natural chemicals have a huge influence in the body and its functioning.

Let us clarify that the term “natural” refers to two facts: bioidentical hormones are taken from a natural source, like beta- sitosterol in the case of soybeans and diosgenin in the case of wild yams, and they are manipulated to exactly match your natural ones, but they do not come from nature as they are manipulated in a laboratory.   In this sense, they are not a natural product.

Many women during the years of pre- menopause, menopause and even post- menopause, often successfully use Bioidentical Hormone Replacement Therapy to enhance, in a more body friendly way, hormone activity lost when aging and at the same time to lessen symptoms of hormone imbalance like hot flashes, night sweats, depression, mood swings, sleep problems, aging skin, vaginal dryness, low libido, fatigue, brain fog, memory loss and weakness, among others.

This therapy has shown lots of short- term benefits like the above with minimal side effects and more recently, even long- term ones at different stages of life, like reduced chances of osteoporosis, heart disease- in people with no prior history- and some types of cancer- in people with no prior family history.   

However, there is no clinical proof of the efficacy or even superiority of the Bioidentical Hormone Replacement Therapy over a synthetic one.   Several studies have been performed and confirmed the high health risks synthetic therapy poses, but the bioidentical one can be equally dangerous if taken by a patient with breast, ovarian or uterine cancer family history, history of blood clots, gallbladder disease and cardiovascular diseases, among others, without exhaustive and continuous control from a certified doctor.   

Bioidentical hormones harmonize with your physiology, so, your body is designed to efficiently recognize, absorb, use and dispose of them, which could lessen uncomfortable, unpredictable and sometimes life threatening side effects and, in general, enhance your wellbeing.  

Believing that natural hormones- even if manipulated in a laboratory- are better for your health than hormones that are alien to your body's functioning, makes a lot of sense.

Many doctors approve and recommend the use of Bioidentical Hormone Replacement Treatment based on their experience and personal studies with it as well as with synthetic hormone therapy.   However, there are a great number of doctors that do not recommend it basically because of the lack of more clinical research and FDA regulations.   This is a list of important facts:

- The FDA considers bioidentical hormones natural substances; these hormones are individually tailored by compound pharmacies to fit the person's needs and symptoms so it is not possible for the FDA to verify its purity, composition, potency and effects, thus, they are not FDA approved.  

- Some FDA- approved drugs have bioidentical hormones as well as synthetic ones in them, but they do not identically match yours, making them less gentle on your body and organism.  

- Compound pharmacies are legal, regular pharmaceutical companies and are approved, but not regulated, by the FDA.   They have a kind of old fashioned way of working, since they individually mix remedies per a doctor's prescription, customizing the product to the patient's needs. Every ingredient used by them is micronized, meaning, easy to absorb.   In theory, this is a very positive and client centered way of working, but these pharmacies pose a problem, probably bigger than the hormones themselves, because of the ways in which they mix and dispense them.   It is hard to confirm the potency, efficacy and purity of the product so you have to thoroughly research to make sure your doctor is working with a professional, serious and integral company.

- Bioidentical hormones cannot be patented due to its natural origin, everything that is found in nature is impeded from patenting, therefore, regular pharmaceutical companies are not interested in investing money to study its positive and negative effects when they won't be able to profit in return.   All their efforts are directed towards reinforcing the image and use of patented products, this means, synthetic hormone replacement therapies based on substances fully manufactured in a laboratory, meaning, their molecular structure is genetically different from the body's.       

- In a chain reaction, the lack of research can also be attributed to the fact that insurance companies generally do not cover preventive medicine and also, the medical community is not educated about the different options available, the pharmaceutical industry is the main promoter of educational conventions and conferences, they offer doctors interesting and appealing amenities to promote their products among them.   Visibility towards synthetic, patented options is far greater than towards more natural options like the Bioidentical Hormone Replacement Treatment.

It is important to state that we mean no judgment or disrespect towards doctors or companies, but it is a reality that we live in a business driven society where economic interests have a huge impact in many areas of life, so facts have to be presented clearly.  

It is vital that anyone personally interested in this topic searches for individual advice from a qualified physician- or more than one- prior to choosing any treatment.   Make sure you thoroughly research and confirm, through different sources, every fact in favor or against any type of therapy.

Always remember that taking drugs should never be the first option and if it is necessary, always take the lower dose necessary for the shortest time possible to achieve optimal health.  

You should always look first for the most natural alternatives to deal with the problem, trusting your body's own capabilities, resources and strength.   In this sense, a healthy lifestyle, balanced diet, regular exercise routines and stress control techniques should be your main priority.

It is every person's obligation to get educated on the best options regarding personal health issues.   You have a great deal of power and you know there are alternatives for every case; it is not black or white.   Smart, informed choices are being made based on research, evidence and the patient's main interest instead of over economical influences.    

Your health and wellbeing comes first and every person is unique, what works for one might not work for another, so make sure you think of yourself when deciding what will benefit your body and soul.



Contact Kenton Bruice, M.D. with your questions about bioidentical hormone therapy.