Bioidentical hormone replacement therapy, also known as BHRT, is an alternative to traditional hormone replacement therapy (HRT). Hormones are chemicals that act as messengers in the body. Some hormones regulate things like growth or metabolism. Other hormones are specifically associated with reproduction or sexual maturity. In women, these hormones include Estrogen, Progesterone, and Testosterone.
Why women want HRT
A woman’s hormone levels fluctuate during her monthly cycle, but remain generally steady through her childbearing years. As she reaches middle age, her body’s production of certain hormones slows, triggering the symptoms of menopause. At this point, some women chose to supplement their body’s natural hormones with hormone replacement therapy. You can read more about this in the HRT Overview article.
What are bioidentical hormones?
Hormones used in all types of hormone replacement therapy are manufactured in a lab or pharmacy. Bioidentical hormone replacement therapy involves the use of hormones that are considered to be exact duplicates (or bio-identical) to the hormones naturally produced by the body. Hormones used in other types of HRT are chemical compounds that are not exactly the same as a woman’s natural hormones. This is done in part because pharmaceutical companies are not able to patent a natural substance. In order to hold a patent to their particular formula, the companies are forced to alter the chemical construction of the hormone to make it unique from those made by their competitors.
Is BHRT right for me?
There is significant controversy in the medical community about bioidentical hormone replacement therapy. Some doctors who prefer to prescribe BHRT believe it is safer and more effective for their patients. Other doctors protest that BHRT has not been studied in the same way by the scientific community and therefore might not be as safe as other types of HRT.
The U.S. Food and Drug Administration conducts careful studies to determine the safety of drugs before it approves them for public use. Some bioidential hormones have been approved by the FDA and are produced in mass quantities by pharmaceutical companies, just like any other drug. These BHRT products are available from your local pharmacy with a doctor’s prescription. Some bioidentical hormones have not been approved by the FDA because they are created specifically for an individual patient at a special pharmacy known as a compounding pharmacy.
Most pharmacies receive prepared pills and other medications from pharmaceutical companies. The pharmacy then counts out the medication and sells them to patients. Compounding pharmacies take raw ingredients and mix the drugs themselves in the pharmacy. This allows doctors to be more specific about how the ingredients are to be combined, and allows the pharmacist to leave out any ingredients to which a patient might be allergic. Compounding pharmacies are regulated by their state and can be accredited by the Pharmacy Compounding Accreditation Board. But the nature of a compounded drug requires that it be made one batch at a time for a specific patient. This increases the possibility of error when the drug is mixed. And because compounded drug are made on for one individual, the FDA does not approve any compounded drugs for general use.
Bioidentical hormones can be taken as pills, gels, creams, patches, or vaginal inserts. The doctor will request a test to determine the level or hormones present in the blood to decide how much hormone needs to be added. Blood tests are considered to be effective for this. Some doctors prefer to test the saliva or spit, however this test is not universally recognized as giving an accurate reading for the purpose of prescribing hormone replacement therapy. The FDA provides a list of approved hormones for the treatment of menopause, which includes traditional and some bioidentical hormones.
Those in favor of bioidentical HRT argue that studies using traditional or non-bioidentical hormones should not be used to judge bioidentical hormones because they are not the same drug. Studies using non-bioidentcal estrogen indicate that hormone replacement therapy can cause increased risk of breast and endometrial cancer. The FDA warns that no matter what kind of hormones a woman might chose to use, she should take the smallest effective dose for the shortest possible time to limit possible damaging side effects.
In recent years, celebrities including Oprah Winfrey have announced that they are using bioidentical hormone replacement therapy. This is a very personal decision each woman needs to make for herself. If you are considering HRT, talk to your health care providers to decide whether traditional or bioidentical hormones are best for you.
Sources:
Harvard Medical School
Wikipedia: Compounding Pharmacy
Women to Women
Answers.com: Hormone