I am William Trumbower MD, a senior member of Women’s Health Associates. When I found that we had a blog, I thought it would be fun and educational if I could write some of my opinions formed after 40 years of medical practice.
There is a lot of talk about bioidentical hormone therapy. Bioidentical hormones (BH) are hormones that are molecularly identical to the ones produced by the human body. BH differ from synthetic hormones which have different structures than the ones made in your body. Most hormone products made by pharmaceutical companies are at least partially synthetic so that they can be patented to increase profits. BH have advantages over synthetics in that they fit your cell receptors perfectly, and thus cause the same effects as your own hormones. As a result, they are also much easier for your body to eliminate after their effect is completed. Based on these characteristics, in my opinion, BH is a safer product than synthetic hormones.
An example of a synthetic product is Prempro, a combination of horse-derived estrogens, Premarin (pregnant mare’s urine) and Provera a synthetic progestin. The Women’s Health Initiative (WHI) study in 2001 showed that Prempro increased heart attacks, strokes, blood clots and cancer.
Examples of BH include Estradiol, Estriol, Testosterone and Progesterone. These hormones are all made naturally by women (men also make their own bioidentical hormones—more in a later blog) and are the ones that are usually used in Bioidentical Hormone Therapy (BHT).
There has been little hormone research in this country since the WHI study. Most research is funded by government grants or by pharmaceutical companies. It is possible that the drug companies do not want to test their synthetic products as the results may mirror the WHI study findings. However, the French have done large studies on BHT. The French Cohort study was published in Maturitas, an international medical journal. It reported a 10year study looking at BHT (the French rarely used synthetic HT). The results showed no increase in heart attacks, strokes, or blood clots and a slight decrease in breast cancer rates compared with the national averages.
Not all menopausal women need hormone therapy, but many women suffer from incapacitating hot flashes, mood swings, vaginal dryness, and decreased sex drive symptoms that are not relieved by over the counter or herbal remedies. BHT may be a reasonable option for many such women. BHT requires a prescription and is often compounded by a pharmacy. Routes of administration can be oral, transdermal, sublingual, injectable, or subcutaneous pellets. The dosage level can be monitored by saliva or blood tests as well as by clinical symptoms.
Volume 2 of The Hormone Diaries will cover more about bioidentical hormones, including a brief history of how I became interested in BHT. For those persons who want to learn more, the best starting books are those written by Dr. John Lee: What Your Doctor May Not Tell You About Premenopause, What Your Doctor May Not Tell You About Menopause, and What Your Doctor May Not Tell You About Breast Cancer.