5 Facts Every Woman Should Know about BioIdentical Hormone Replacement Therapy

Bio-Identical Hormone Replacement Therapy

How to Beat Menopausal Symptoms of Hot Flashes, Irritability and Depression

The Women Health Initiative (WHI) which collected data on 161,000 healthy postmenopausal women revealed over the course of a multi-year study that menopausal women taking synthetic estrogens alone or in combination with synthetic progestins such as Prempro and premarin were at increased risk for suffering strokes, breast cancer and heart disease.  In fact, Synthetic estrogen plus progestin study arm was stopped early because of increased risks of breast cancer and the synthetic estrogen alone arm was stopped because of the increased risk of stroke and no reduction in coronary heart disease [1].  The WHI collected data from 1991 to the early 2000s. The data helped shed light on the use of conjugated horse estrogens and synthetic progestins which could be harmful to millions of post-menopausal women.  Fortunately for millions of women around the world, bio-identical hormone replacement (BHRT) therapy is a safe alternative to synthetic medications and provides effective relief for night sweats, weight gain, hot flashes, irritability, moodiness, depression and other signs of menopause.

Interesting Facts Every Women Should Know about BHRT

FACT #1: Estrogens are needed for many normal physiological functions in the woman’s body, including in the brain, heart, liver, bone, adipose tissue, breast and uterus. Although estrogens act through the estrogen receptors (ERα and ERβ) in these tissues, the specific tasks of estrogens differ from tissue to tissue. For example, in the central nervous system estrogens protect against neurodegenerative diseases, and in adipose tissue, estrogens regulate adipogenesis, adipose deposition and adipocyte differentiation [2,3].

Summary: Estrogen serves as a vital compound in the female body during development and later in life serves a vital protective role in the health of a woman.  In menopause, estrogen levels drop and lower levels of estrogen predispose females to develop certain disease such as dementia, osteoporosis, and obesity.  BHRT therapy in menopausal females can protect against the development of certain disease states.


FACT#2: Postmenopausal HT (Hormone therapy) may mask the effects of obesity on breast cancer. In the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a significant association between obesity and breast cancer was found only in women who were not using HT (n=78,541 women; RR=1.31; CI= 1.08–1.59) [4]. In the same EPIC study, 24,314 postmenopausal women reported using HT (either estrogen alone or in combination with progestin) and their risk of developing breast cancer tended to be inversely linked to obesity (RR= 0.71; CI=0.50–1.01). Other studies have confirmed that breast cancer risk is not increased in obese HT users, compared with lean HT users [5,6].

Summary: Obesity is a risk factor in the development of breast cancer in postmenopausal women. Hormone replacement therapy (HRT) appears to offer a protective role in preventing breast cancer in obese postmenopausal women. 


 FACT#3:  Estrogens reduce the accelerated bone turnover induced by the menopause and prevent bone loss at all skeletal sites regardless of age and duration of therapy. Results from observational studies and randomized placebo-controlled trials have shown that estrogens decrease the risk of vertebral and non-vertebral fractures (including hip fracture) by about 30%, regardless of baseline BMD [7, 8]. When hormone replacement therapy is stopped, bone loss resumes at the same rate as after the menopause, but fracture protection may persist arguably for several years [9, 10].

Summary: Estrogen serves a protective role in bone loss. The use of estrogens in menopausal women demonstrates a significant reduction in risk of vertebral and non-vertebral fractures. Even if the HRT is discontinued, the fracture prevention persists for several years. 


Fact #4:  The onset of hot flashes is hypothesized to be related to dysfunction of the thermoregulatory nucleus, which is essential in regulating the homeostatic range and the core body temperature. The thermoregulatory nucleus maintains the core body temperature within a homeostatic range termed the thermoregulatory zone. Sweating occurs when the body’s core temperature increases above the upper threshold of the thermoregulatory zone, whereas chills occur when the core temperature dips below the lower threshold of this zone. as estrogen levels decline in menopause, norepinephrine levels rise, leading to an upregulation of hypothalamic serotonin receptors, which are involved in temperature regulation. Central α-2 receptors may be affected by estrogen depletion, leading to higher central norepinephrine levels. This activation of the noradrenergic and serotonin pathways may further narrow the upper threshold of the thermoregulatory zone, leading to a greater propensity for hot flashes [11]. Hormone replacement therapy (HRT) is widely known as an effective therapeutic means for alleviating hot flashes. Estrogen is effective in improving hot flashes caused by not only natural menopause but also by chemotherapy-induced ovarian failure, tamoxifen use, androgen ablation therapy, and the use of leuteinizing hormone-releasing hormone agonists such as goserelin [12].  To reduce the possible harmful effects of estrogen therapy, recent trials have focused on the use of lower estrogen doses in order to decrease hot flash symptomatology. For example, Bachmann and colleagues randomized healthy postmenopausal women who were experiencing hot flashes to either low-dose transdermal estrogen, microdose transdermal estradiol, or placebo. They found that even those patients who received the microdose estradiol had a 75% lower hot flash frequency than those receiving placebo (p = .003) [13].

Summary: Estrogen replacement appears to be an effective treatment for hot flashes. Recent research suggests that using the lowest effective dose carries the least risk of treatment.    


FACT#5:  Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.  Bio-identical hormones are known to be structurally identical to the body’s own endogenous hormones. these bio-identical hormones are known to bind to respective receptors more completely and correctly leading to greater efficacy and safety. Synthetic hormones do not bind to target receptors with the same level of fidelity and efficacy and can cause unwanted effects on the body [14, 15].

Summary: Bio-Identical hormones are a safer and more efficacious treatment form than synthetic or animal derived HRT. BHRT will not increase your risk of breast cancer, heart disease, stroke or blood clots. 


If you have questions or would like to stop taking synthetic hormones and start taking bio-identical hormones to improve your health and well-being, contact us today to schedule a consultation.

 

 

 

  1. https://www.nhlbi.nih.gov/files/docs/pht_facts.pdf
  2. Deroo BJ, Korach KS. Estrogen receptors and human disease. J Clin Invest. 2006;116:561–570. [PMC free article] [PubMed[] https://pubmed.ncbi.nlm.nih.gov/16511588/
  3. Burns KA, Korach KS. Estrogen receptors and human disease: an update. Arch Toxicol. 2012 Oct;86(10):1491-504. doi: 10.1007/s00204-012-0868-5. Epub 2012 May 31. PMID: 22648069; PMCID: PMC4782145. https://pubmed.ncbi.nlm.nih.gov/22648069/
  4. Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B, Berrino F, Tjønneland A, Bigaard J, Olsen A, Overvad K, Clavel-Chapelon F, Nagel G, Boeing H, Trichopoulos D, Economou G, Bellos G, Palli D, Tumino R, Panico S, Sacerdote C, Krogh V, Peeters PH, Bueno-de-Mesquita HB, Lund E, Ardanaz E, Amiano P, Pera G, Quirós JR, Martínez C, Tormo MJ, Wirfält E, Berglund G, Hallmans G, Key TJ, Reeves G, Bingham S, Norat T, Biessy C, Kaaks R, Riboli E. Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC). Int J Cancer. 2004 Sep 20;111(5):762-71. doi: 10.1002/ijc.20315. PMID: 15252848. https://pubmed.ncbi.nlm.nih.gov/15252848/
  5. Li CI, Malone KE, Daling JR. Interactions between body mass index and hormone therapy and postmenopausal breast cancer risk (United States). Cancer Causes Control. 2006 Jun;17(5):695-703. doi: 10.1007/s10552-005-0001-7. PMID: 16633917. https://pubmed.ncbi.nlm.nih.gov/16633917/
  6. Modugno F, Kip KE, Cochrane B, Kuller L, Klug TL, Rohan TE, Chlebowski RT, Lasser N, Stefanick ML. Obesity, hormone therapy, estrogen metabolism and risk of postmenopausal breast cancer. Int J Cancer. 2006 Mar 1;118(5):1292-301. doi: 10.1002/ijc.21487. PMID: 16161054. https://pubmed.ncbi.nlm.nih.gov/16161054/
  7. Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2019 Jan;30(1):3-44. doi: 10.1007/s00198-018-4704-5. Epub 2018 Oct 15. Erratum in: Osteoporos Int. 2020 Jan;31(1):209. Erratum in: Osteoporos Int. 2020 Apr;31(4):801. PMID: 30324412; PMCID: PMC7026233. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026233/
  8. Torgerson DJ, Bell-Syer SE. Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials. JAMA. 2001 Jun 13;285(22):2891-7. doi: 10.1001/jama.285.22.2891. PMID: 11401611. https://pubmed.ncbi.nlm.nih.gov/11401611/
  9. Sornay-Rendu E, Garnero P, Munoz F, Duboeuf F, Delmas PD. Effect of withdrawal of hormone replacement therapy on bone mass and bone turnover: the OFELY study. Bone. 2003;33:159–166. [PubMed[]
  10. Bagger YZ, Tanko LB, Alexandersen P, Hansen HB, Mollgaard A, Ravn P, Qvist P, Kanis JA, Christiansen C. Two to three years of hormone replacement treatment in healthy women have long-term preventive effects on bone mass and osteoporotic fractures: the PERF study. Bone. 2004;34:728–735. [PubMed[]
  11. Shanafelt TD, Barton DL, Adjei AA, et al. Pathophysiology and treatment of hot flashes. Mayo Clin Proc. 2002;77:1207–1218. [PubMed[]
  12. Shanafelt TD, Barton DL, Adjei AA, et al. Pathophysiology and treatment of hot flashes. Mayo Clin Proc. 2002;77:1207–1218. [PubMed[]
  13. Bachmann GA, Schaefers M, Uddin A, et al. Lowest effective transdermal 17β-estradiol dose for relief of hot flushes in postmenopausal women: A randomized controlled trial. Obstet Gynecol. 2007;110:771–779. [PubMed[]
  14. http://e.hormone.tulane.edu/learning/docking-receptor-binding.html
  15. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85. doi: 10.3810/pgm.2009.01.1949. PMID: 19179815.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.