Hormone Replacement

What do we mean by “bioidentical” hormone replacement therapy?

      Simply put, bio-identical hormones are hormones that are identical in molecular structure to the hormones women make in their bodies naturally..

      Technically, the body can’t distinguish bioidentical hormones from the ones your ovaries produce. On a blood test, your total estradiol reflects the bioidentical estradiol you’ve taken as well as the estradiol your body makes.

      Bio-identical estrogens and micronized bioidentical progesterone are made into a range of products, many of which are FDA-approved and available with a prescription at your local drugstore. Commercially available estradiol — one of the three bioidentical estrogens —  comes in several forms, including pill, patch, cream, and various vaginal preparations. Micronized progesterone comes in a capsule or as a vaginal gel.

      Most U.S. physicians are reluctant to make the distinction between “bioidentical” hormones on the one hand, and on the other hand “non-bioidentical” hormones —  which include most of the drugs prescribed for female hormone replacement therapy in recent decades.  Consequently they are likely to prescribe non-bioidentical hormones, which are generally less expensive and more common — if they prescribe hormone replacement therapy at all.

      Among a majority of U.S. physicians, hormone replacement therapy has a tarnished reputation; however, the tarnished reputation is based upon side effects data for non-bioidentical hormones.  I am among those physicians who subscribe to the understanding that bioidentical hormones do not share the same risks, and therefore are the superior choice.

      “Experienced anti-aging physicians have been prescribing bioidentical hormone replacement therapy (BHRT) for more than 20 years. For women, benefits may include: • reduced osteoporosis and restoration of bone strength • reduced hot flashes and vaginal dryness • better maintenance of muscle mass and strength • improved cholesterol levels • reduced risk of endometrial and breast cancer • reduced risk of depression • improved sleep • better mood, concentration and memory • improved libido • fewer side effects than with synthetic hormones.”  [Reed KD. Natural hormone replacement therapy: what it is and what consumers really want. International Journal of Pharmaceutical Compounding. 2001;5(5):332-335; Drusko J. Natural isomolecular hormone replacement: an evidence-based medicine approach. International Journal of Pharmaceutical Compounding. 2000;4(6):414-442; Boothby L, et al. Bioidentical hormone therapy: a review. Menopause. 2004;11(3):356-367.]