Bio-identical Hormone Replacement Therapy (BHRT)

Bio-identical hormones are identical to hormones occurring in the human body.  Bio-identical has to do with the chemical structure of a hormone and not its source.  Other hormones like Phytoestrogens (from plants) or Premarin (from animals) or Synthetic hormones are not identical in structure or function to our body's own hormones.

Examples of bio-identical hormones include:

• Estrone (E1), Estradiol (E2), and Estriol (E3)
• Progesterone
• Testosterone
• DHEA

Is there a difference between bio-identical and synthetic hormones?

YES!! Bio-identical hormones cause the same response as your own hormones.  Synthetic hormones cause some of the same actions, but because they have been chemically altered have many different and/or unintended effects. 

Why should I consider bio-identical hormone replacement therapy anyway?

Lot of younger women have signs and symptoms of hormonal imbalance (breast tenderness, fibrocystic breast disease, migraines, headaches, bloating, mood swings, anxiety, and hot flashes.) Use of bio-identical hormones in the proper doses will not only control menopausal and peri-menopausal symptoms, but will greatly improve quality of life both short-term and long-term.  Protection against heart disease, reduced risk of breast cancer, improved cholesterol and lipid profiles, and osteoporosis prevention are all valid reasons for using individualized bio-identical hormone replacement therapy (BHRT). 

Are there side effects associated with use of bio-identical hormones?  Can these hormones increase the risk of breast cancer, stroke or heart disease?

Because bio-identical hormones are identical to the hormones produced by your body, there are relatively few side effects.  The main risks identified are primarily associated are with excess or inadequate treatment with BHRT. Excess estrogen levels, whether the excess occurs naturally or as a result of BHRT, can be countered by body's natural mechanism of progesterone, and studies have demonstrated its effectiveness in decreasing the risks of breast cancer and cardiovascular disease. Bio-identical hormones must be dosed properly in order to avoid adverse effects and levels frequently monitored.

Should bio-identical hormone replacement therapy (HRT) be individualized?

YES!! HRT is not a one size fits all situation.  A woman's need for hormones is as individual and unique as she is.   Bio-identical hormones can be compounded to exact amount based on individual hormone levels. 

What are the different types of hormones? There are 3 types of estrogens natural to the human body:

Estriol (E3) - The Gentle & Safest Estrogen

• about 80% of circulating estrogen prior to menopause
• Weakest estrogen, not stimulating to breast and uterine tissues
• May be protective for cancer
• produced in high amounts during pregnancy
• excellent for vaginal dryness
• available through compounding pharmacies

Estradiol (E2)

• about 10% of circulating estrogen prior to menopause
• most potent human estrogen; stimulating effect on breast and uterus
• deficiency or excess is often related to symptoms
• precursor to estrone and estriol
• available through compounding pharmacies, and commercially as tablets, patches, and vaginal products

Estrone (E1) - The Worst Hormone for Risk of Heart Disease and Cancer

• about 10% of circulating estrogen prior to menopause
• most abundant estrogen after menopause due to formation in fatty tissues
• can be metabolized from estradiol
• available through compounding pharmacies

Benefits of BHRT: Estrogen has many benefits including helping with hot flashes, night sweats, vaginal dryness, sleeplessness, mood and mental clarity.  Cardiovascular benefits include increasing HDL and decreasing LDL cholesterol.  Estrogen is important for preventing bone loss.

Side Effects of BHRT:  Are usually minimal if the correct dose estrogen is balanced correctly by bio-identical progesterone.  Side effects may include headaches, breast tenderness, nausea, water retention, and anxiety or irritability.  Risk of breast cancer may be decreased by balancing with progesterone.

Hormones Imbalance

Estrogen dominance (too much estrogen in relation to progesterone) can be created by both an excess of estrogen and a deficiency of progesterone. 

Excess Estrogen may be caused by:

1.  Foods that have hormones added to them, such as commercial meat, BST produced milk, eggs, and dairy products

2.  Herbs that have an estrogenic effect in the body, such as licorice, black cohosh

3.  Birth control pills that contain estrogen

4.   Environmental toxins that mimic the actions of estrogen (known as xenoestrogens); the largest source of xenoestrogens is pesticides

5.   Exposure to radiation, which increases estrogen levels in the blood

6.   Chronic constipation which interferes with the body's ability to eliminate estrogen properly; estrogen then builds up in the colon and can be reabsorbed by the body

7.    Estrogen supplements as part of a hormone replacement therapy for menopausal symptoms

Progesterone Deficiency may be caused by:

1. Birth control pills or HRT with synthetic progestins, which decrease the body's natural production of progesterone.

2. Chronic stress

3. Lack of insufficient ovulation (which is a natural consequence of going into menopause)