The Doctors 5-Minute Health Fixes by The Doctors

Author:The Doctors
Language: eng
Format: epub
Publisher: Potter/Ten Speed/Harmony/Rodale
Published: 2010-05-19T04:00:00+00:00

ask our Doctors

* * *

I’ve heard so much about bioidentical hormones. Can you tell me—are they safer than regular hormone replacement therapy?

Indeed, much confusion surrounds hormone therapy for women. It all started when the Women’s Health Initiative (WHI), published in 2002, showed Prempro (the most commonly prescribed hormone therapy in the United States, a combination of synthetic horse estrogen and synthetic progestin taken by mouth) caused increased heart attacks, strokes, and breast cancer. The study also found that Premarin, a synthetic horse estrogen-only formulation delivered orally, offered no protection against heart disease.

These results were followed by mass panic, and millions of women were abruptly taken off all female hormones or stopped them on their own. The FDA required all pharmaceutical companies making estrogen to include warnings about its risks on their product information, based on the WHI findings. So despite offering a different product, companies making pharmaceutical topical estradiol were forced by the FDA to include the WHI risks on their product information. Not surprisingly, women became very distrustful and fearful of all pharmaceutical hormones.

Not long thereafter, there were many high-profile endorsements for compounded bioidentical hormones, and women flocked to compounding pharmacies. Compounding pharmacists can provide a valuable service, especially for patients with allergies to pharmaceuticals or for products no longer commercially available. But compounding pharmacists have never been required to issue any warning labels on their products, so naturally women assumed compounded bioidenticals had no risks—which is certainly not the case. It is important for women to understand that any estrogen carries risks, but the risks from bioidentical topical estrogen are fewer than the risks from Premarin and Prempro.

By definition, a bioidentical hormone is simply a product identical to the molecular structure of the naturally occurring hormones that exist in a woman’s body. All bioidentical hormones, whether pharmaceutical or compounded, are made from plant estrogens, which are synthesized in the laboratory to be identical to human estradiol. (After all, we are not geraniums! So we need to modify plant estrogens.) Topical estrogens include patches, creams, and gels of estradiol, and may help reduce the risk of weight gain (especially around the middle), sexual dysfunction, heart disease, strokes, gallstones, and migraines.

The critical difference between pharmaceutical and compounded bioidentical hormones is that pharmaceutical companies have to follow stricter manufacturing standards and ensure quality control of their products. Celebrities endorsing proprietary compounded hormones make outlandish claims despite the fact there has never been any published clinical trial on compounded bioidentical hormones—any published study quoted was conducted using pharmaceutical topical estradiol products. (Note: The improved safety of topical over oral pharmaceutical bioidentical hormones has been shown in hundreds of publications from mainstream medical journals.)

In my practice, I have prescribed both compounded and pharmaceutical bioidentical products. I always prefer pharmaceutical hormone products because they provide better, more consistent results. (It’s very common for me to see an initial patient who comes in on compounded hormone products from another physician and their blood estradiol is zero!) I use compounded hormone products primarily in patients with

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.