In my last blog, I discussed how the flawed research date from the 2002 Women’s Health Initiative Trial resulted in unwarranted fear of hormone replacement therapy (HRT). It’s taken 22 years to ‘right the wrong’ way of thinking about the safe use of HRT thanks to a recent study published in the Journal of the American Medical Association. The key findings from this study were that hormone therapy can be safely used by women to alleviate menopausal symptoms such as hot flashes and night sweats without significantly increasing the risk of breast cancer, heart disease, or stroke.
The latest research highlights that newer forms of hormone therapy, including low-dose estrogen delivered through patches, gels, and creams, as well as bioidentical hormones like micronized progesterone, present fewer risks compared to older formulations.
In this article, I will talk more about what bioidentical hormone replacement therapy (BHRT) is, how it differs from conventionally prescribed hormones, and how it improves the health and overall quality of life for women.
What is BHRT?
BHRT refers to the use of hormones that are chemically identical to those produced by the human body…meaning that the molecular structure of the hormones is an exact match to the hormones we naturally produce. These hormones are made from plant sources, mainly soy and yams.The most commonly prescribed hormones are estrogens (estradiol, estriol, and estrone),progesterone, testosterone, and DHEA. Some bioidentical preparations (pills and patches) can be obtained through a regular pharmacy. However, the majority of health care providers prefer to use compounding pharmacies because they offer more variety in dosing forms (creams, gels, sublingual preparations, injections, and pills).
A key advantage of BHRT is the fact that it can be customized to the individual needs of each patient. Compounding pharmacies can create specific formulations based on the prescribing doctor’s recommendations, patient’s hormone levels, and patient’s symptoms. This not only improves the way the hormones work but also reduces the potential for adverse side effects.
BHRT vs. Regular HRT?
Bioidentical hormones are chemically identical to those the human body produces. They are derived from plant sources and designed to mimic natural hormones precisely. Synthetic hormones, however, are structurally different and often made in a lab. These differences can affect their behavior in the body.
• Differences in Their Source:
• Molecular Structure:
• Metabolism:
It’s important to point out that the majority of research that’ s been done on HRT used oral estrogen (usually Premarin derived from horse urine) and progestin. This is critical for three reasons: (1) Neither Premarin or progestins are bioidentical hormones; (2) Estrogen is never safewhen given by mouth, even if it’s bioidentical, and (3) progestins are anti-progesterone hormones with numerous and significant side effects.
What Symptoms Does BHRT Help?
BHRT can safely be used by women of all ages for a variety of conditions. In pre-menopausal women, progesterone can be used to reduce menstrual bleeding, reduce breast tenderness, and improve PMS symptoms in women who are still having their menstrual cycles, have endometriosis, or polycystic ovarian disease. This is by far a safer and more effective way to manage these issues than using birth control pills!
Perimenopausal and menopausal women often need estrogen, progesterone, and sometimes estosterone and DHEA to balance their hormones. Among other things, BHRT effectively reduces hot flashes and night sweats, prevents mood swings and irritability, improves sleep quality, and helps brain focus. It also prevents weight gain, improves sex drive, reduces vaginal dryness, and improves urinary incontinence.
What Health Conditions are Improved and/or Prevented by BHRT?
Postmenopausal women are at increased risk for several health issues simply because of the absence of their hormones. There is extensive research showing that properly dosed and monitored HRT can help to prevent and even reverse some of these conditions.
1. Heart Disease
HRT has been studied extensively for its effects on heart health in women, particularly in the context of menopause. Here are some of the key benefits and considerations based on current research:
• Improved Blood Sugar Control: HRT improves insulin sensitivity and glucose metabolism, reducing the risk of type 2 diabetes, which is a significant risk factor for cardiovascular disease.
2. Obesity
HRT is also essential in helping women maintain normal body fat distribution and a healthy weight, especially after menopause. Here’s how:
3. Diabetes
As discussed above, by improving insulin sensitivity and blood sugar control, reducing inflammation, promoting lean muscle mass, and preventing abdominal fat deposition, HRT can also prevent diabetes and improve diabetes control in those with the disease.
4. Osteoporosis
BHRT plays a crucial role in maintaining bone density, preventing osteoporosis, and reducing the risk of fractures in postmenopausal women. How? by:
Studies have shown that HRT can significantly increase bone mineral density in postmenopausal women, reducing the risk of fractures.5.
Dementia and Memory Loss:
HRT has been shown to preserve cognitive function and reduce the risk of dementia in postmenopausal women. It does so by reducing brain inflammation, improving blood flow, and reducing amyloid plaque formation seen in Alzheimer’s Dementia.
6. Aging Skin
Studies have found that HRT, estrogen in particular, can enhance skin health in numerous ways:
BHRT has also been shown to improve gut health, reduce the risk of colon cancer, decrease the incidence of depression and anxiety, promote eye health (reduces the risk of glaucoma and cataract formation), and improve sleep apnea.
Where Do We Go From Here?
It’s time for the conventional medical community to take off their blinders, critically look at the flawed results of the 2002 WHI trial, and embrace the new research confirming the safety and health benefits of BHRT. One way to promote this is for women to stay educated and openly discuss BHRT with their health care providers. Doctors are quick to put women on a plethora of prescription drugs for everything from depression and insomnia to high cholesterol and high blood pressure. I can tell you based on nearly decades of experience, properly dosed and monitored BHRT can absolutely prevent the need for the medications.
In future blogs, I will discuss how women can find a knowledgeable health care provider, the nuances of BHRT, how to properly test hormone levels when on BHRT, and much more.