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Friday, December 8, 2017

Bioidentical Hormones and Hormone Replacement Therapy

In the wake of the Women’s Health Initiative, a long-term national study launched in 1993 to address major health issues in postmenopausal women, many women and their clinicians concluded that they should discontinue hormone therapy. Many women, however, suffer from extreme menopausal symptoms and are looking for answers beyond the typical hormone replacements of estrogen and progesterone combinations.

A closer look at the data from the initiative indicates that several factors, including bioidentical and "natural" hormones, could affect the safety of hormone therapy. Many people assume that “natural” hormones are safe, but the term “natural” is open to interpretation and is frequently overused as a marketing term. For example, over-the-counter yam creams claim to replace or supplement progesterone, but many of their ingredients are not regulated. Some of these “natural estrogen” products rely heavily on soy products which can be problematic for some people. So “natural” doesn’t necessarily mean “safer.”

There is a growing interest in bioidentical hormones. These are hormones that are identical in molecular structure to the hormones produced by the body. The body's levels of the three sex hormones -- estrogen, progesterone and androgens (such as testosterone) -- change with age. Bioidentical estrogens are classified as 17 beta-estradiol, estrone or estriol. Each of these types of estrogen affects different cells in a specific way.

The risk associated with any hormone product depends on more than simply how the hormone is made; for instance, the way the hormone is delivered is another consideration. In other words, hormones taken by mouth act differently from those delivered through the skin. Bioidentical therapy is often administered in the form of topical creams. Today, the delivery of hormones through pellets placed under the skin is believed to most closely mimic the body’s natural delivery system. It’s important to work with your physician to identify the combination and form of hormone therapy that is right for you.

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