I hear from patients all the time that they don’t want to or won’t consider going on bioidentical hormone replacement therapy because of how dangerous it is, or they don’t want to get cancer, some won’t even want to have their hormone levels tested. Below I want to discuss some of the misconceptions between Bioidentical Hormone Replacement Therapy (BHRT) and Hormone Replacement Therapy (HRT). First by starting off with why many have heard that taking hormones is “bad” for you.
Hormone replacement therapy (HRT) was pioneered in the 1940’s, grew more popular in the 1960’s, and seemed to reach a peak in 1999 for more than 85 million prescriptions written for women. In 2002 there was a study called the Women’s Health Initiative (WHI) that sought to test the safety and efficacy of HRT. The results of those studies created panic and fear amongst women on using HRT, and for good reason. The results showed that women taking synthetic estrogen and progesterone had an increased risk of developing breast and uterine cancer, along with other dangers. The trial had to be stopped after running from 1993 to 2002. In 2003 another trial called the Million Women Study (MWS) made headlines when it stated HRT increased the incidence of breast cancer. However, a review of the study published in the Journal of Family Planning and Reproductive Health stated the MWS study had so many problems with the design of the study, and that “HRT may or may not increase the risk of breast cancer, but the MWS did not establish that it does”.
Unfortunately, the backlash of these studies led to millions of women not taking any hormones.
A few of the problems with the study are:
· The women swallowed the hormones
· If the women didn’t have a uterus, they weren’t given Progesterone
· All the women were given synthetic hormones
Let’s look at why these issues are a big deal. Swallowing synthetic hormones are not the best delivery method for hormone replacement. When hormones are swallowed it’s broken down in the stomach and then broken down in the liver. This isn’t how our body naturally releases hormones. When the liver starts breaking down this large amount of hormones it makes inflammatory proteins (called C-reactive protein) and blood clotting factors. Remember when you’re told if you take birth control long enough it will increase your risk of blood clotting and therefore strokes and heart attacks? This is why. So, a big issue with these studies is that the women were taking their hormones orally. The only exception to this is that it appears to be safe to take micronized progesterone made from a compounding pharmacy orally. We’ll address progesterone below.
Another issue is that the women in the trial that didn’t have a uterus weren’t given progesterone. It used to be very common for women to have their uterus removed during perimenopause. However, the body still has progesterone receptors and progesterone balances out the effects of estrogen. So, the two balance each other. Being on estrogen only can be dangerous.
A major problem with the study was the use of synthetic hormones. These hormones are made from drying out horse’s urine and then processed in a lab to make a capsule. The breakdown of estrogen produces 2-hydroxyestrone or 16alpha-hydroxyestrone. Simply put the 2-hydroxyestrone is protective against cancer but the 16-hydroxyestrone is cancer causing. So, it’s likely these metabolites from the synthetic hormones were the more cancer-causing metabolites of estrogen.
While BHRT appears to be safer than HRT when used appropriately, that doesn’t mean it’s 100% safe. Which is why you need to see a doctor that specializes in BHRT and have a thorough history and labs taken. Even the form of BHRT can come into play. For instance, it’s likely better for a woman to be on a topical estrogen if she’s at a high risk for heart attack or stroke.
The benefits for BHRT are a plenty. There’s research showing many changes in normal aging, such as osteoporosis, muscle atrophy/sarcopenia (loss of muscle mass), increased body fat, and sleep disorders are due to a decrease in hormones. Replacing these levels to optimal levels can combat these “diseases” associated with the aging process.
Unfortunately, many patients that do seek hormone replacement are often on an inadequate hormone regimen. Many doctors are not trained to target optimal levels in a patient’s hormones. The patients’ hormone levels are targeted to low-normal levels and the doctor, despite the patient verbalizing they don’t feel much better, will only prescribe hormones to keep the patient in the low-normal levels. The docs don’t know how to prescribe or monitor the blood tests.
Don’t wait for your levels to be below normal!
There are many benefits to BHRT besides reversing the ones listed above and staving off diseased. Women can see dramatic changes in skin thickness, texture, hydration, and tightness. Men can see more lean muscle mass added with decreased body fat. Both sexes can feeling increase in sex drive and more vitality and zest for life
I’ll be adding more articles in regard to the specific hormones and their benefits so keep checking back.
If you’re ready to start feeling better and think BHRT is right for you then reach out to us at Innate Healthcare at 602.603.3118 or email firstname.lastname@example.org.