Bioidentical Hormones for Women
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 bioidentical hormones and uses physiologic dosing (ie amounts that your body naturally produces) rather than the high doses often found in hormone protocols.
Symptoms of Hormone Decline in Women
- 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
- Better Mood, Concentration and Memory
Estrogen is made in the ovaries but is also made in the corpus luteum, adrenal glands, and fat cells. Once the ovaries stop producing estrogen on a regular basis, the adrenal glands become the main source of estrogen (primarily as E1).
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 than to treat hormone therapy as an isolated therapy.
Proper monitoring and management of hormone therapy is paramount.
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.
Not all hormones are alike. Bioidentical hormones are, well…. identical to the hormones your body produces. This seems to be an appropriate approach (and it is the one that we strictly adhere to – using only bioidentical hormones) but many are still being treated with hormones that are not bioidentical (such as Premarin – derived from horse urine, and medroxyprogesterone – Provera – a chemical analog of progesterone that is absolutely NOT the same as your own progesterone). The Women’s Health Initiative study showed the risks involved with artificial progesterone (Provera), and artificial estrogen (Premarin).
Once a year goes by without menstrual bleeding, menopause is said to be present. In menopause, estrogen and progesterone levels are dramatically decreased (but are not completely gone). Incredibly, the peri-menopausal period can start up to 15 years before actual menopause is seen. Learn more about Menopause and Perimenopause