Is Bio-Identical Hormone Restoration Right For You?

In 2002 the Women’s Health Initiative (WHI), a large study examining synthetic estrogen and progestin – which were commonly used in the only Hormonal Replacement Therapy available at the time – was suspended when subjects experienced an increased risk of breast cancer. More than a decade later, the controversy continues to haunt women who are considering HRT as they enter menopause.

The concept behind HRT is pretty straightforward. When women enter into menopause, their bodies are depleted of key hormones, notably progesterone and estrogen but also testosterone. These hormones affect everything from bone density, muscle mass and skin elasticity to memory and moods. It works for most women with minimal to no side effects but a few women the side effects it can negatively affect their health. If you weren’t warned of the side effects like blood clots, heart attacks and strokes and suffered due to this then you might be entitled to compensation. You may want to contact someone like this new york personal injury attorney for help. Side effects like this only occur in the most extreme cases though.

Since the WHI study was published, advances have been in made in HRT – including new generation bioidentical hormones – that have addressed many of the previous concerns. To bring us all up to speed on this vital topic that affects all women, sooner or later, we sat down with Dr. Marcela Dominguez, M.D., – board-certified in family medicine (with specialties in women’s health and integrative medicine).

Do you remember the WIH study and why was it was so alarming at the time?

Many women going through perimenopause or menopause recall the hormonal scare that occurred July 2002, when the news announced the preliminary results from the study. In summary, they reported that hormones can cause harm, even including breast cancer, and should talk to their doctors right away.

I was working at the time for a group practice in which I was the only female doctor, and I was inundated with women who were hot flashing and going on an emotional roller coaster ride, ever since their male doctors “cold turkey” stopped their hormonal therapy they had been taking for years.

What’s different about the new bioidentical hormone replacement therapy?

Unlike conventional hormone therapy that uses synthetic hormones or animal-based hormones that are slightly different from a woman’s own hormones, bioidentical hormones are biochemically the same as those made by the ovaries during a woman’s reproductive years.

Never in my 16 years of private practice have I been so impressed with the dramatic bodily changes hormones can do to a person as this time. I knew I wanted to help these patients, but needed to quickly learn what would be most efficacious and safe to use. I was introduced to bioidentical hormone therapy by a local compounding PhD Pharmacist and ever since then, I have become a specialist in this area for many patients throughout Southern California.

The term “natural” is sometimes used in regards to HRT, so what does this mean?

“Natural” means the hormones in the product come from plant or animal sources; they’re not synthesized in a lab. The term “bioidentical” means the hormones in the product are chemically identical to those your body produces. By definition, then, bio-identical hormones cannot be natural since they’re not found in a natural source other than a woman’s body. However, bioidentical hormones are identical in chemical structure to the hormones that our bodies naturally make, and any medication that looks identical to these hormone molecules, regardless of how it is made, is considered bioidentical. That’s their great advantage over conventional HRT.

What would you recommend to a patient who is considering HRT?

Patients can assist their body to better balance its hormone levels by partnering with a provider that is well trained in bioidentical hormone restoration. I’m usually recommending patients to seek out a “functional” medicine doctor and/or an anti-aging doctor.”

At your doctor’s appointment, all of the following should be done to best determine each patient’s customized care.

• thorough medical history
• review of prior gynecological care
• appropriate physical examination
• review of any recent labs, and new labs evaluating your hormonal and adrenal status
  

Safety and efficacy are both essential when determining hormonal management. Medical literature has abundant articles on bioidentical hormones and its safety when dosed properly. However, patients may encounter resistance to using bioidentical hormones from providers, claiming that they do not believe in it or have not been trained to use them.

I can vouch that our traditional Western medical training is not adequate to become a hormone specialist, but doctors can attend courses to become proficient in this medical service.

Are there alternatives to conventional HRT or bioidentical HRT?

For patients that prefer not to take any hormones, there are some natural herbs and vitamins that may help reduce symptoms. Examples include black cohosh, dong quai, ginseng, holy basil, ashwaganda, Vitamin C, B vitamins, and magnesium. Reducing alcohol intake and hot beverages also help reduce hot flashes and improve sleep.

Also, supporting the adrenal glands usually gives patients significant relief of these symptoms and should be a part of every bioidentical restoration program. To learn more about the adrenal glands, I encourage patients to read and follow Adrenal Fatigue Syndrome by Dr. James Wilson.

When should a woman consider exploring her option for HRT?

Women can experience significant bodily changes during perimenopause and menopause, a time that usually spans about 5 years between the ages of 40-55. Initial symptoms usually include some change in a women’s menstrual cycle, such as shorter or longer menses, heavier or lighter flow, and/or skipping monthly cycles.

Other common symptoms include temperature instability, oscillating between being cold and suddenly burning up for a few seconds; difficulty sleeping; emotional mood swings; weight gain especially around the midsection, waist, and hips; headaches; heart palpitations; vaginal dryness and decreased libido; premature aging of the skin; and brain fog.

The hormones made by our ovaries decrease and our adrenal glands, otherwise known as our stress organs, cannot make up the difference, hence the resulting hormonal imbalances.

What else do patients who are considering HRT need to know?

Based on the dozens of medical articles and hundreds of hours I have spent learning about bioidentical hormones, I do believe that this type of hormone replacement is the safest one to use. Still, providers and patients still need to be careful with its use because you can over stimulate cells. The environment that those cells live in directly affect hormone metabolism and how cells will respond, so a provider should be evaluating this as well, before beginning a bioidentical hormone restoration program.

When determining the best route to pursue, discuss all the options, medical and natural, with your doctor to find out whether bioidentical hormone replacement therapy is right for you.

Sources:

1. http://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/bioidentical-hormones/faq-20058460. Are “bioidentical” or “natural” hormones safer and more effective than hormones used in traditional hormone therapy for menopause symptoms?
2. http://en.wikipedia.org/wiki/Bioidentical_hormone_replacement_therapy. Bio-identical Hormone Replacement Therapy.
3. http://www.everydayhealth.com/menopause/bio-identical-hormone-treatment.aspx. Is Bio-Identical Hormone Therapy Safe?
4. http://www.webmd.com/vitamins-supplements/ingredientmono-936-dong%20quai.aspx?activeingredientid=936&activeingredientname=dong%20quai. Dong Quai Definition.
5. http://www.webmd.com/vitamins-supplements/ingredientmono-857-black%20cohosh.aspx?activeingredientid=857&activeingredientname=black%20cohosh. Cohosh Definition.
6. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htm. Bio-Identicals: Sorting Myths from Facts.
7. http://www.webmd.com/vitamins-supplements/ingredientmono-953-ashwagandha.aspx?activeingredientid=953&activeingredientname=ashwagandha. Ashwagandha Definition.
8. http://jama.jamanetwork.com/article.aspx?articleid=195120. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women.

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