Bioidentical Hormone Replacement Therapy
Synthetic Hormones (ie the conventional "hormones") do NOT precisely match the hormones your body produces - sometimes it is quite different (ie Premarin is actually horse URINE containing equine (horse) estrogen and equine estrogen metabolites as a mixture). Medroxyprogesterone (ie "Progestin") is not precisely the same as your body's progesterone and is metabolized differently in your body than your own progesterone.
Since Conventional Hormones (ie Synthetic) do NOT match the precise structure of your own (endogenous) hormones, this increases the risk of several potentially fatal diseases, especially when combined with medroxyprogesterone (progestin).
The Women's Health Initiative (WHI) study, done in 2002 demonstrated that the combination of synthetic estrogen + medroxyprogesterone (progestin) = higher risk of breast cancer, coronary artery disease, stroke, and blood clots. Yikes!!
The WHI rightfully frightened physicians and patients and so many stopped using synthetic HRT (hormone replacement therapy). Statistics the following year showed a drop in overall breast cancer rates as well as estrogen-sensitive breast cancer rates.
Lesson learned? FoundationMED ONLY uses BHRT (bioidentical hormones) and used physiologic dosing (ie amounts that your body naturally produces) rather then the high doses often found in hormone protocols.
Benefits of Bioidentical Hormone Replacement Therapy (BHRT)
Bioidentical hormones are commonly used to treat symptoms of hormone imbalance - symptoms such as HOT FLASHES, NIGHT SWEATS, LOSS of LIBIDO, fatigue, weight gain, mood swings, irritability, less stamina and more. By using BHRT rather then conventional synthetic hormones, you also experience far fewer adverse reactions.
- Reduced/eliminated Hot Flashes and Night Sweats
- Reduced Vaginal Dryness
- Reduced Endometrial Cancer risk
- Reduced Breast Cancer risk
- Improved Libido
- Reduced Osteoporosis risk
- Better Muscle Mass/Strength
- Improved Cholesterol Levels
- Reduced Alzheimers risk
- Better Mood,Concentration and Memory
FoundationMED and Bioidentical Hormone Therapy
Hormones are what I consider "leveraged" - what I mean by this is that hormones are very powerful and interact in multiple complex ways within your body.
Using hormones, you can (and often do) obtain fabulous symptom reduction but at what cost? Frankly, it is not difficult to prescribe hormones or surgically make an incision and insert pellets under the skin. It is far more challenging to properly assess and address the myriad other factors that come into play when you add hormones.
Hormones physically can be provided in various ways - skin creams, under-skin pellets, injections, pills, troches, labial cream. Each method has advantages and disadvantages and must be carefully considered. For these and other reasons we do not use pellets, injections, or any form of oral estrogen, and focus on labial cream and oral progesterone as appropriate.
Your hormone therapy will be specifically tailored to your personal physiology, and take into account numerous physiological functions such as your methylation status, estrogen metabolic status, as well as the status of other associated hormones, your general detoxification function and status, as well as external influences such as unknown exposure to hormone-mimetics and other toxins. In addition, your prescribing FoundationMED physician will be monitoring and actively reducing cancer risk at all stages of hormone implementation.
It is clear that hormones play a crucial role in physiologic processes that maintain health and wellness (homeostasis).
Hormones are proteins that are produced by endocrine organs such as the pituitary, adrenal, thyroid, testes, and ovary.
- Symptoms may include hot flashes, mood swings, anxiety, depression, insomnia, bloating, hair loss, memory problems, sexual indifference and many more.
- Diseases include osteoporosis, cardiovascular disease, and dementia. As an example, it has been shown that susceptibility to cardiovascular disease, which dramatically increases with menopause, is significantly reduced with proper hormonal balancing.
Estrogen is actually available in 3 forms - estrone (E1), estradiol (E2), and estriol (E3). The production of the various forms of estrogen, and estrogen metabolism depends on your age, cycle, genetics, and other factors. Suffice it to say that the various estrogens have different potencies and effects.
In menopause, the absolute levels of estrogen and progesterone are affected, but it is also important to consider the relative levels of estrogen as it relates to progesterone (i.e. estrogen dominance vs estrogen deficiency). Failure to attend to the proper balance of estrogen to progesterone can lead to worsening symptoms.
Estrogen, progesterone, and testosterone do not act in a vacuum, but intimately interact with other hormone systems such as the thyroid and adrenals (cortisol). Hormones must be considered a web with rather complex interconnections that must be properly monitored and adjusted as needed. Remembering that systems such as the methylation system are intimately involved in the detoxification system reminds us that it is important to consider hormone use in the context of a systems approach rather then to treat hormone therapy as an isolated therapy.
Recommended PDF: "The Bioidentical Hormone Debate..."
Estrogen is metabolized into substances that may increase the risk of breast cancer (if not properly identified and managed). If you are currently on hormone therapy (or even if you are not) you should be aware if your metabolic products of estrogen metabolism are within a safe range (easily measured with a urinary estrogen metabolite test). Sadly, monitoring such data is not the norm. Equally important is the status of your detoxification systems, your toxin exposures (even if unwittingly) and so on.
Adding estrogen (hormone therapy) when your estrogen is being metabolized in such a way as to increase your breast cancer risk is obviously something that should not be done - but if you are not assessing and addressing your estrogen metabolism, how will you even know you are at risk?
Thus, it is important to identify and correct any questions about proper estrogen metabolism and detoxification sufficiency prior to (or concurrently with) adding estrogen therapy. Focusing solely on hormone implementation is not recommended - patients are strongly advised to make sure you are being treated and appropriately monitored by a properly trained physician.
The Womens Health Initiative study showed the risks involved with artificial progesterone (provera), and artificial estrogen (premarin).
In addition, hormones should be used within their physiologic ranges to minimize risk. There is very little data available concerning the risks of using long-term higher-dosed hormones.
It is our contention that symptomatic improvement without the excess risk (seen with non-bioidentical hormone treatment) is attainable but is complex and requires proper monitoring of multiple factors as outlined.
Thus: Bioidentical Hormones
+ Physiologic Dosing
+ Proper Monitoring of Hormone Metabolism
+ Risk Abatement protocols
+ Basic Functional Medicine Principles
= Better Balanced/Lower Risk Hormone Therapy and Happier Patients.
Our patients feel better, age more gracefully, and have more control of their lives when their hormones are appropriately balanced/managed and risk is actively minimized.