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Because bio-identical hormones are identical in structure as those hormones produced by the human body, they are safer and more effective than synthetic hormones. this is especially true for bio-identical estrogen, progesterone and testosterone.

What are Bio-identical Hormones?

The interest in a more natural approach to hormone therapy has focused attention on bio-identical hormones -- hormones that are identical in molecular structure to the hormones women and men make in their bodies.They are created from a plant chemical extracted from yams and soy. Bio-identical estrogens are 17 beta-estradiol, estrone and estriol which decrease as we age. Bio-identical progesterone is natural progesterone finely ground in the laboratory for better absorption in the body.

Bioidentical hormone therapy is often called “natural hormone therapy” because bio-identical hormones act in the body just like the hormones we produce.

What is Bio-identical Hormone Replacement Therapy?

Bio-identical Hormone Replacement Therapy (BHRT) is a natural approach to treat symptoms of hormone imbalance that satisfies three key principles:

1. All hormones used are chemically identical to human hormones

This means that if your body makes progesterone, which has a specific chemical structure, only that specific hormone is given as a replacement. Bio-identical hormones are derived from natural sources such as wild yams and soy. These natural sources are then modified in the lab to become identical in molecular structure to human hormones. The image below provides an example of “biologically identical” progesterone versus synthetic, a non-bio-identical medroxyprogesterone acetate (Provera).

In bio-identical hormone replacement, only chemically identical progesterone is given since it is exactly the same molecular structure as what the body produces.This kind of hormone replacement therapy allows for more predictable activity on human cells and more predictable metabolism of the hormones. Synthetic or non-bio-identical hormones may have some of the properties of the natural hormones produced but not all. In addition, these synthetic hormones are not able to be metabolized effectively and therefore can be more potent at the cell receptor site increasing the risk for overstimulation of the cell and possibly cancer.

2. The dosage is individualized to a patient’s specific hormonal needs

Bio-identical hormone replacement therapy requires testing to determine an individual’s baseline hormone levels and rigorous symptom evaluation to create a customized dosage based on the individual’s particular hormone needs.

3. The goal is to achieve balance, improve quality of life and prevent certain symptoms and disease.

Since its introduction in 1942, the goal of conventional pharmaceutical hormone replacement therapy (HRT) using synthetic hormones was only to alleviate menopausal symptoms. The goals of bio-identical hormone replacement therapy (BHRT) are not only to ease unpleasant symptoms of menopause, perimenopause and andropause (male menopause), but more importantly to restore youthful hormonal balance as well as provide the body with the same protective health benefits that the body’s own natural hormones would provide. This can be accomplished through optimization and balancing of bio-identical hormones levels in a safe, natural way.

All hormones work together in concert in the body, so optimizing the activity of one hormone enhances the effects of others, and vice versa. Balance is probably the most important concept in bio-identical hormone replacement therapy, and one that can often be overlooked, as there is a tendency to focus on only one or two hormones or one or two organs in the body. The human body is incredibly complex and intricate, and the purpose of treatment is not to override the body’s innate intelligence, but to facilitate it, restoring balance and improving quality of life.

What hormones are most often used in bio-identical hormone replacement therapy?

The hormones used in bio-identical hormone replacement therapy can be separated into two groups -- steroid hormones and peptide hormones. The general definition of a steroid hormone is any hormone based on the chemical structure of the cholesterol molecule. Steroid hormones can be used to balance hormones to treat menopausal symptoms and to treat adrenal dysfunction and fatigue. Peptide hormones are basically long chains of amino acids used to address thyroid dysfunction.  

Steroid Hormones

When people hear the word “steroid,” they often think of athletes using high doses of drugs to enhance their performance. This type of steroid is more accurately called an “anabolic steroid.” Anabolic means “building up,”, and these hormones, like testosterone, build up muscle. Testosterone is used in bio-identical hormone replacement therapy, but only at physiologic doses as a way to balance hormones and treat symptoms. Prednisone is also a steroid used in high doses for short periods of time to treat pulmonary infections or inflammatory conditions like Rheumatoid Arthritis flare ups or Poison Ivey.

Although there are several steroid hormones, bio-identical hormone replacement therapy generally consists of the following hormones:

Peptide Hormones

The most important peptide hormones are the thyroid hormones, namely levothyroxine (T4) and liothyronine (T3). T3 is the active thyroid molecule, meaning that it is the form that exerts its effects on the body’s cells. While T4 is mostly produced by the thyroid, it is converted to T3 in the cells.  

The most commonly prescribed thyroid supplementation is oral T4 or levothyroxine (i.e. Synthroid, Levoxyl). For many people, this is an adequate treatment for their symptoms of low thyroid. However, some need T3 supplementation to effectively treat their symptoms. T3 can be given orally by a prescription medication called Cytomel, in combination with T4, or can be made by a compounding pharmacy in a sustained-release form. Another popular thyroid supplementation product is derived from the desiccated porcine thyroid gland (i.e. Armour thyroid, Nature-throid); it contains T3 and T4 as well as other constituents of the thyroid gland, which some have found helpful in supporting normal thyroid activity.

How are Bio-identical Hormones made?

Bio-identical Hormones for men and women are made in a laboratory from compounds found in plants (usually soy beans or wild yams).

The raw material for bio-identical hormones are United States Pharmacopoeia approved for compounding prescriptions. A compounding pharmacy that has been approved by State Boards is obligated to use only those official raw materials that have certificates of analysis as being appropriate for the production of bio-identical hormones. Once the plant-based hormone is processed, its structure is identical to the estrogen, progesterone, and testosterone hormones produced naturally by the human body. This is what makes bio-identical hormones natural and is the reason our bodies can metabolize them safely and naturally as it was designed to do unlike the artificial or foreign hormones that have so many adverse and potentially serious side effects.

Bio-identical hormones come in various forms including topical creams, gels, troches, sublingual lozenges, intramuscular injections, and subcutaneous pellets. All of these hormonal delivery methods can be prescribed based on the preference of each individual patient. Bio-identical hormone delivery methods and dosages are chosen based on laborotory test results, weight, and your individual symptoms and specific needs. In our experience, the modality of subcutaneous pellet therapy creates the most optimal method of copying the normal function of nature.

Why not Synthetic Hormones?

Synthetic or Bio-Similar hormones are made from plant and animal sources, but are not identical to the hormones your body uses (generally extra covalent bonds or molecules are added so that it can be patented by the pharmaceutical companies that then become proprietary allowing the pharmaceutical company to charge more for the product). Natural, bio-identical hormones are not allowed, by law, to be patented by pharmaceutical companies.

Synthetic or Bio-Similar hormones act similar in some hormonal functions but not all, and cannot be metabolized properly. That is why traditional synthetic hormone replacement therapy prescribed since the 1940s carry risks and adverse side effects that in many cases may be worse than the symptoms they treat.

Synthetic hormones offer a one-size-fits-all option whereas compounded bio-identical hormones can be customized to meet each individual woman’s need Initially and can be adjusted based on the patient's individual, personalized needs.
Historically, hormone replacement has involved the use of synthetic hormones, especially synthetic estrogen, progestins (e.g., Premarin® (derived from Pregnant Mare’s Urine) and Provera® or Prempro®) and testosterone (methyl testosterone in Estratest®). These synthetic hormones have been shown to increase the risk for health problems including breast cancer, heart disease, stroke, blood clots, pulmonary embolus, and liver problems whereas the natural hormones have not been associated with these adverse events.

Bio-identical hormones are prescribed in individualized dosages (based on clinical symptoms, weight, and lab results). Because bio-identical hormones are identical in structure as those hormones produced by the human body, they are safer and more effective than synthetic hormones (this is especially true for bio-identical estrogen, progesterone and testosterone).

When is bio-identical hormone replacement therapy used?

Bio-identical hormone replacement therapy is used to treat hormonal imbalances most often noted during the peri-menopausal or menopausal phase of women’s lives and usually during the mid-life phase of men when the body goes through hormonal changes. However, this kind of therapy can be used for anybody experiencing symptoms of hormone imbalance, including symptoms of low thyroid or adrenal dysfunction, a condition often caused by chronic stress.

How does a person know if she or he could benefit from BHRT?

Not all women or men experience bothersome symptoms when their hormone levels change during mid-life so treatment for these people may not be warranted. General symptoms of hormone imbalance include hot flashes, brain fog, mood swings, low energy, acne, insomnia, breast tenderness, changes in menstrual cycles, fatigue, weight gain, decreased sex drive, and headaches. If a person is experiencing such symptoms, they can:

  1. Go through a symptom checklist.  If a person experiences several symptoms on the checklist, that may indicate that she/he might benefit from hormone balancing.  Click here for a comprehensive checklist of hormone imbalance. Menopausal Rating Scale, (MRS Scale); Androgen Rating Scale/Aging Male Syndrome (AMS)
  2. Talk with us about hormone balancing.  In order to address a hormone imbalance, it is important to work with a practitioner with experience in this field. An experienced practitioner can help the patient evaluate the numerous factors that may be contributing to their symptoms, many of which can be addressed by incorporating healthy habits into one's daily life, such as a balanced diet, exercise and stress reduction techniques. An experienced practitioner will also be knowledgeable in the appropriate use of bio-identical hormones. Click here for a checklist for healthy living.
  3. Get tested.  A person must measure their hormone levels in order to know if a hormone imbalance exits and to measure the extent of the imbalance in order to treat the their symptoms appropriately. Hormones can be tested with a saliva, urine, or blood, and there are pros and cons to each method. Most authorities prefer blood serum testing.The hormones that are most tested are progesterone, estradiol, testosterone, DHEA-S, cortisol and thyroid.

Do women and men need bio-identical hormone replacement (BHRT) for life?

Humans are a unique species when it comes to the fact that we live much of our lives outside our reproductive years. Most animals in the wild do not live beyond their ability to reproduce – many don’t even live beyond puberty. Our increased life expectancy is relatively recent. The average life expectancy 400 years ago was age 35 and in 1900 it was only age 47. However, today many men and women live into their eighties and even nineties.  Our endocrine glands have difficulty producing hormones at appropriate and optimal levels as we age. This is why so many men and women choose to replace hormones to feel good again. Although there is controversy about whether or not it’s appropriate to restore hormones to youthful levels as people age, many people want to feel their best as they age.

Bioidentical hormones replacement therapy (BHRT) is beneficial for all who have hormonal imbalances. Hormonal imbalances can occur at any age and can affect both men and women. Some of the ways hormonal imbalances can manifest themselves include peri-menopause, menopause, andropause (male menopause), PMS, infertility, ovarian cysts, breast cystic lesions, uterine fibroids, polycystic ovarian syndrome (POS), hypothyroidism, hyperthyroidism, insomnia, irritability, depression, foggy memory, decreased libido, irregular periods, and adrenal fatigue

There are two main perspectives when it comes to hormone replacement. The first guideline opinion is to use the lowest dosage for the shortest time possible only to treat symptoms. The opposing opinion is to use individualized physiologic dosages for longer periods of time to maintain youthfulness and prevent diseases of aging. Both perspectives require proper evaluation of your specific risks and goals, as well as appropriate follow-up.

Safety of Bioidentical Hormones

The safety of bio-identical hormones is assured by several factors:

Furthermore, bio-identical hormones are prescribed by and administered under the care and guidelines of qualified medical doctors. Bio-identical hormones have a lower side effects rate then synthetic hormones or horse hormones. Based on the positive clinical results from thousands of patients treated with bio-identical hormones worldwide, bio-identical hormones should be the preferred and standard method for hormone replacement therapy.