Bio-Identical Hormone Replacement: risks you should know and how to reduce them

by DR. JONATHAN WRIGHT, MD on JUNE 28, 2010

I’ve been writing about the benefits of bio-identical hormone replacement therapy (BHRT) for years. Not only does BHRT help alleviate the symptoms associated with menopause (and the male version of hormone decline, called andropause), but it also offers many other significant health benefits as well.

Whether you’re a man or a woman, there’s excellent scientific evidence that BHRT will substantially reduce your risk of Alzheimer’s disease and other cognitive decline. Other research has proven that BHRT significantly lessens risk of heart and blood vessel disease, osteoporosis, and (in non-smoking women) chronic obstructive pulmonary disease (COPD). It has also been proven to significantly reduce deaths from all causes in men (it’s very likely it will reduce all-cause mortality for women, too, though it hasn’t been proven just yet).

Another “perk” of BHRT is that it slows the progression of aging, including age-related changes in appearance. Women using BHRT for five to 10 years appear significantly younger than women of the same age who haven’t used BHRT. Wrinkling is less, and skin elasticity is better for much longer. Both women and men using BHRT frequently report improved libido and sex life, too.

And over the last 25 or more years, I’ve heard from hundreds of women and men using BHRT that they’re feeling better mentally, they’re more cheerful, they remember things better, and they have more “get up and go.” As helpful as BHRT is, though, there are a few cautions. For maximum safety, it’s always best to “Copy Nature,” using the exact molecular duplicates of human hormones, in the same quantities normally in bodies, taken into our bodies the right way (for example, swallowing estrogens is actually dangerous), and following Nature’s timing.

But even that isn’t enough: There are still some potential problems with BHRT. Most of them can be easily corrected if you’re monitoring your hormone levels regularly and working with a physician skilled and knowledgeable in both natural medicine and BHRT. But it’s important to know what to look out for. So this month, let’s go over some of the most common BHRT problems, and how you and your doctor can find them and fix them, using entirely natural means.

Why your estrogen treatment “failed” and what you can do about it

You’ve heard about all of the wonderful benefits of BHRT and how it can help women feel better—sometimes almost immediately. But when you tried it, it didn’t work very well for you. So your doctor increased the dose, but it still didn’t seem to help. If this situation sounds familiar, it’s very likely your body is retaining too little estrogen—“kicking out” most of it right away through your kidneys and bowels. This problem—technically called estrogen “hyperexcretion”—can be confirmed if there are higher than usual amounts of estrogens in a urine specimen collected for 24 hours, while estrogens in the blood (serum estrogens) are low-normal or low, and symptoms of low estrogen continue.

Why does this happen? Well, there’s no way to know for certain, but there are a few theories. This problem seems to occur more in women who previously took horse urine estrogen (Premarin®), birth control pills, or who have had high exposure to one or more environmental estrogens. Fortunately, there is something you can do about it. A decade or so ago, I found that estrogen hyperexcretion can always be corrected with very low doses—just 500 micrograms (or less) per day—of the essential element cobalt.1 These low quantities are safe, as diet surveys from around the world have found that dietary cobalt intake ranges from 10 to 600 micrograms daily.

Symptom relief usually starts within two to three weeks, and symptoms are completely corrected within two to four months. Of course, even if you’re feeling better, you should confirm that the problem has been solved by doing a follow-up 24 hour urine test. If your urine test comes back showing that your estrogen levels have diminished into the expectable range, you can likely stop taking cobalt (and, in most cases, there’s no need to resume taking it). Cobalt also helps normalize hyperexcretion of other hormones, such as testosterone and cortisol, but these situations are much more rare than estrogen hyperexcretion. What is more common with testosterone is the next potential BHRT problem on our list…

Attention men: What you should do if your testosterone “stops working”?

Here’s another common scenario—this one for the men: You’ve seen a doctor familiar with BHRT, had your testosterone and free testosterone tested, and started on a transdermal or (preferably) a transmucosal prescription testosterone crème.

Initially, you could really feel a difference. You felt stronger, and more motivated to get things done. Your libido definitely improved. But in just a few weeks, the effect wore off substantially, maybe even entirely. What happened? Is your body getting rid of (hyper-excreting) too much testosterone? While this is possible, as I mentioned above, testosterone hyperexcretion is rare. Much more likely, this initial response and then decline is due to another problem, called hyper-aromatization. Hyper-aromatization occurs when the body makes too much estrogen out of testosterone. Since this topic was covered in detail in the September 2009 issue of Nutrition & Healing, I’ll just re-cap it briefly here (you can download and view the September issue for free by visiting www.wrightnewsletter.com and logging on to the Archives).

You’re more likely to have hyper-aromatization of testosterone if you’re significantly overweight or if you have

Type 2 diabetes (or if it runs in your family)
High cholesterol
High triglycerides
Skin tags (little flaps of skin that stick out from the surface, usually on the neck, under the arms, or in the groin area)
High blood pressure
If any of these conditions apply to you, check with a physician skilled and knowledgeable in nutritional and natural medicine (as well as BHRT), and have insulin resistance testing done.2 Insulin resistance is a sign that you’re at increased risk for type 2 diabetes, and it’s almost always found when hyper-aromatization of testosterone is present.

In other words, if you’re a man using testosterone and your body is transforming that testosterone into too much estrogen, it’s very likely that you’re “on the way” to type 2 diabetes! And though there’s no outright proof, it appears very likely that the high insulin levels associated with insulin resistance are at least part of the cause of this problem, and possibly the entire cause. So it makes sense that reversing hyper-aromatization and preventing (or improving) type 2 diabetes go hand-in-hand. Getting insulin resistance under control with diet and exercise will eventually reverse hyper-aromatization of testosterone, but it can take a minimum of several months or even a year or two.


Learn More About Dr. Wright and the Tahoma Clinic - Seattle, WA
In the meantime, there are two safe, natural botanical “Band-Aids” which will slow down the hyper-aromatization in the short term, while you’re working on the permanent solution. One is Myomin, a combination of four Chinese botanicals. The other is the flavonoid chrysin. (Chrysin comes in both tablet/capsule form and a liposomal spray—the spray is much more effective.) Both of these supplements are also available from natural food stores, compounding pharmacies, and the Tahoma Clinic Dispensary. Of course, there are patent medicines which suppress hyper-aromatization, too. But they have many possible adverse effects, and should only be used if nothing else works.

4 ways to keep tabs on your cancer risk

There’s one more precaution to keep in mind with BHRT, and this one is definitely the biggest. I’m referring to cancer risk. But before you get worried, keep in mind that BHRT can actually help you decrease your risk of this dreaded disease. The key is to keep an eye on some very specific risk factors.

Let’s start with the factors women need to know about.

There are four main markers to consider. First on the list is the estrogen quotient, or EQ. The estrogen quotient (EQ) is determined by dividing the total estriol by the sum of estrone and estradiol. (In mathematical terms it looks like this: EQ = E3 / E1 + E2). An EQ that is greater than one indicates a lower risk of estrogen-related cancer.3 And in order to have an EQ that’s greater than one, your urine test needs to show more estriol than etrone and estradiol.4

One thing to keep in mind: The EQ cannot be determined from blood testing, since the half-life of estriol in the blood is very short.5 Unfortunately, conventional physicians unaware of this fact often claim that estriol is only secreted and found during pregnancy, which definitely isn’t the case. To get an accurate estriol measurement and to determine your EQ, you’ll need to do a urine test that measures urine samples collected over a 24-hour period.

The second cancer risk factor is one you may recognize if you’ve been reading Nutrition & Healing for awhile—the “2/16” ratio. Like the EQ, testing your 2/16 ratio can also be done with a 24-hour urine test. The 2/16 ratio looks at the amount of 2-hydroxyestrogens in your body in relation to the amount of 16-alpha-hydroxyestrogens. “16ahydroxyestrogens” are pro-carcinogens, but the “2” type are not, so it’s safer to have significantly more “2” than “16a.” However, you don’t want too much more “2” than “16a,” since that’s been shown to be associated with excess osteoporosis risk. As is so often the case, correct balance is the key! The last cancer risk factors women using BHRT need to keep an eye on are estrone and 4-hydroxyestrone.

Estrone and 4-hydroxyestrone are individual estrogen metabolites. If either one is elevated, it is associated with increased cancer risk. So even though every woman has some level of each, you want as little as possible. By contrast, 2-methoxyestradiol is an extremely potent anti-carcinogen, and you want as much of this estrogen as you can get! (For complete details and references concerning 2-methoxyestradiol, see the February 2008 issue of Nutrition & Healing.)

Again, a 24-hour urine test can tell you if your levels of estrone or 4-hydroxyestrone are elevated. If they are—or if testing shows any of these markers point to increased risk, there are steps you can take to reverse it.

Easy strategies for keeping cancer risk as low as possible

Let’s start with the EQ. If your EQ is less than one, you can almost always boost your estriol production with either iodine or iodide. (For the technically inclined, iodine and iodide induce the pathway from estrone → 16a hydroxyestrone → estriol, E1 → 16aOHE1 → E3). Six to eight drops of Lugol’s iodine daily (equivalent to three to four tablets of Iodoral or capsules of i-Throid) or four to six drops of SSKI daily for 30 to 60 days will usually bring an EQ back up to greater than one. After your EQ is normalized, continue taking two drops of Lugol’s iodine daily (or one Iodoral or i-Throid tablet or capsule daily), not only to support your EQ, but also to significantly reduce your breast cancer risk. Just make sure to have your thyroid function tested periodically if you exceed this amount of iodine long-term. And it’s not a good idea to use SSKI for long-term maintenance, since it’s not “balanced” with both iodide and iodine. SSKI is available by prescription (through compounding pharmacies) and over-the-counter as “Tri-Quench” from natural food stores and the Tahoma Dispensary. Lugol’s iodine is available only by prescription, but Iodoral tablets and i-Throid capsules contain exactly the same amount of iodine and iodide as Lugol’s and both are available from all three sources listed above.

Boost your protection with Brussels sprouts

If your 2/16 ratio is too low, you can often bring it into the normal range simply by eating more vegetables from the Brassica family (also known as cruciferous or mustard family vegetables). Broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, mustard greens, and kale are all good options. These foods contain natural substances which shift more estrone towards 2-hydroxyestrone and away from 16-alpha-hydroxyestrone. Flaxseed and soy also help this metabolic shift.

Supplemental indole-3-carbinol (I3C) and di-indolylmethane (DIM) can also raise the 2/16 ratio. But it is possible to “overdose” on I3C or DIM. In some people, more than a little of these supplements can shift so much estrone away from 16-alphahydroxyestrone that not enough estriol is produced to maintain a healthy EQ. In that case, you need to reduce your dose of DIMor I3C. (And just to put your mind at ease, an abnormally elevated 2/16 ratio is quite rare except in cases of I3C or DIM excess.)

The simple switch that makes a big difference

One of the most common causes of high estrone (E1) is oral supplementation of DHEA: If you’re taking oral DHEA by swallowing a capsule, the DHEA will frequently show up as high E1 on the 24-hour urine test. But if you switch your DHEA supplement to a transdermal or transmucosal crème (which is Nature’s preferred delivery route), this effect almost always vanishes. (And, even better, DHEA is much more effective this way.)

Specific supplements to consider

Since 4-hydroxyestrone is the most potent estrogenic carcinogen (and precursor of carcinogens), you definitely want as little of it as possible. And the best solution for lowering an elevated 4-hydroxyestrone level is to use “methyl-group-donating” supplements to raise levels of the very potent anti-carcinogenic estrogen metabolite, 2-methoxyestradiol. As 2-methoxyestradiol goes up, 4-nydroxyestrone usually goes down. These supplements include the methylcobalamin form of vitamin B12, the methylfolate form of folate/folic acid, S-adnosylmethionine (SAMe), betaine, and glutathione.

Follow-up testing—usually in two to three months—will tell you if these or any of the other risk factors have been favorably affected.

Men: The ratios you need to balance for ultimate prostate protection

Now that we’ve covered increased cancer risk factors—and solutions—for women, let’s talk about similar factors for men using BHRT. The most recent “mainstream” research indicates that low testosterone levels increase a man’s risk of prostate cancer. As natural medicine doctors have been pointing out for decades, prostate cancer increases with declining tesosterone levels (andropause). And estrogens may increase by up to 40 percent in men’s bodies during andropause. So suspicion is increasing that estrogens may be related to prostate cancer to a significant degree.

One specific area of estrogen-andprostate-cancer research involves low 2/16 ratios in men. Even when the level of each individual estrogen is within the normal range, if they’re out of balance, there’s increased cancer risk. As noted above, increasing consumption of Brassica vegetables and flaxseed can also increase the male 2/16 ratio (though it’s likely best for men to avoid regular soy consumption because of its plant estrogen content). And research done right here in Seattle found that men who eat Brassica vegetables four times a week have 40 percent less risk of prostate cancer. DIM and I3C can be used if dietary changes aren’t sufficient to do the job.

The second risk factor men taking BHRT need to be aware of is a low androstanediol/DHT ratio (A/D ratio).

You’ve probably heard of DHT and the potential problems it can cause. But you may not have heard about androstandiol. This substance is what testosterone eventually metabolizes into, “stopping off” as DHT along the way. But unlike DHT, androstanediol is anti-carcinogenic.

According to one logical (but as yet unproven) theory published in the New England Journal ofMedicine, the reason there were fewer cancers overall but a higher percentage of significantly more aggressive cancers among men taking finasteride (a patentmedicine which supresses DHT) in the placebo-controlled “Prostate Cancer Prevention Trial” is that finasteride suppresses androstanediol even more than DHT.6 This would create an unfavorable A/D ratio, with less of the anti-carcinogenic androstanediol and more of the pro-carcinogenic DHT—a situation parallel to an unfavorable 2/16 ratio. Because of this relationship, measurement of DHT alone is not as likely to be as accurate an indicator of cancer risk as the androsterone/DHT (A/D) ratio.

I work with many men who’ve been told that they have “too much DHT” without having their androstanediol measured, which gives them a likely-unnecessary cancer risk scare. Some of these men are told they “must” take finasteride or another similar patent medication, to lower the risk of prostate cancer—again, without any measurement of androstanediol to see what their A/D ratio is. When I ask men to have both these testosterone metabolites measured, the very large majority—with the notable exception of a few men taking the patent medicine finasteride and other patent medications with similar actions—have had an A/D ratio considerably greater than one, which indicates that they actually have less cancer risk, not more Although the value of the A/D ratio is not “scientifically proven,” it’s every bit as logical as the 2/16 ratio, and so far there is no argument against this theory.

So what advice can I give for sure about testosterone and DHT? Never take any action based on measurements of just one testosterone metabolite—DHT—alone. Always have androstanediol measured, too, look at the A/D ratio, and discuss the meaning of all of the data with a physician skilled and knowledgeable in bio-identical hormone replacement. – JVW

Thanks to Leah Alvarado-Paz, ND, Terra Sowinski, ND, and Ronald Steriti, ND, PhD for their contributions to this article.

Article Source:www.meridianvalleylab.com

Bioidentical Hormone Replacement Treatment - General Overview

Bioidentical hormone replacement therapy (BHRT) uses hormones consisting of compounds with identical chemical make-ups to hormones that are naturally found in the body. These hormones have a base made of wild yam and soy, allowing them to be compatible with the human body. BHRT is used in place of synthetic hormones, which have a foreign structural make-up to the body. The unrecognized molecular structure of synthetic hormones has been known to cause adverse side-effects, which is why many people prefer bioidentical over synthetic.

Cells are the creators of the many different hormones found throughout the body. The key role of hormones is to act as messengers by traveling through the bloodstream and relaying messages to and from the different cells. Without the transfer of these messages and signals, the different parts of the body would not be able to cooperate and communicate together for proper function. Poor communication between the cells is a major cause of ailment and disease.

Replacement of bioidentical hormones in women is used to increase low levels of progesterone, testosterone, and estrogen. These deficiencies are common in women that have had their ovaries removed, or are menopausal. This therapy is believed to treat symptoms including mood-swings, vaginal dryness, headaches, sore joints, and sleep disturbances.

As men get older, they go through a change that is similar to menopause that is called andropause. A loss of bone density and muscle mass, along with irritability, insulin resistance, periods of depression, and a decreased sex drive may occur during this time. These changes are the result of a testosterone deficiency.

Sublingual/oral pills and hormone-enhanced topical creams are all used to treat hormone deficiencies. The creams tend to absorb slower into the bloodstream, which is one reason why the topical creams are commonly preferred over the oral methods.

The targeted achievement of bioidentical hormone usage is to balance hormones before the deficiency creates bigger health problems. Successful treatment can give patients a feeling of control over their health and quality of life.

Some researchers and doctors believe that these hormone replacements are very risky, while others say that they are very useful in preventing health complications later in life. There have been some studies that have linked bioidentical replacement to a higher risk of cerebrovascular accident, heart disease, thrombosis/embolisms, and breast cancer.

Undiagnosed hormone imbalances will not only inhibit the well-being of those affected, but can eventually lead to serious health problems. Doctors use simple blood tests to determine which hormones are deficient in the body, and how much replacement is needed for a proper balance. Treatment usually starts in smaller doses, but can be increased until there are noticeable signs of improvement. Since controlling hormonal deficiencies can be a complicated process, it is best to seek guidance from an internal medicine specialist or an endocrinologist. These doctors have more specialized experience with hormonal deficiency diagnosis and treatment than family doctors. Although there are many people that are very skeptical about using bioidentical hormones, there are also many that give it a very high recommendation.

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Bioidentical Hormone Therapy - An Innovative Approach to Hormone Therapy

As opposed to many hormone therapies, bioidentical hormone therapy actually uses natural hormones that are found in the human body. Other therapies may use similar, synthetic hormones to perform treatment. Hormone therapies have helped many men and women replenish hormone levels that may be diminished thanks to certain medical conditions such as menopause or andropause.

Bioidentical hormone therapy has been beneficial to women going through menopause or early menopause. This therapy has helped treat the symptoms of menopause including hot flashes, night sweats, memory loss, mood swings, weight gain and decreased libido. This treatment helps to replace the natural hormones that may be at decreased levels during this time.

Men may also be candidates for this therapy as well. Andropause has been described as the male menopause and is described as the gradual reduction of androgens in the body. Symptoms of this condition may include weight gain, decreased libido, fatigue, stress and energy loss. Through this treatment, many men have successfully replaced their natural hormones and have found relief from these symptoms.

Patients interested in bioidentical hormone therapy are encouraged to speak with a medical professional regarding its benefits over traditional hormone replacement therapy techniques. Many clinics offer their patients a consultation in which they will discuss the treatment and will customize a treatment plan for each patient.

In conjunction with this therapy, a medical professional may recommend certain exercise and dietary programs to improve the symptoms of menopause or andropause. It is important that patients work with their physician in creating a specialized therapy program and develop healthy lifestyle practices that will be medically beneficial.

There has been a good deal of confusion and controversy surrounding this treatment in recent years and interested patients are encouraged to discuss the possible risks, benefits and alternatives associated with any treatment or procedure.

If you want more information on Bioidentical Hormone Therapy, arrange an in-depth consultation with Dr. Navarro's Laser Skin Care clinic.

Bioidentical Hormone Therapy

... Offers women freedom of choice for menopause relief and more...

Conventional Hormone Replacement Therapy (HRT) has for decades been the default choice for menopause symptom management. The emergence of conventional HRT was a breakthrough back in the 1960s and lasted up until only a few years ago, when its shortcomings have been revealed. A massive study-Women's Health Initiative (WHI)- tracking 161,808 postmenopausal women who were taking conventional Hormone Therapies was cut short after only four years of its intended 15 year span- because researchers found that the therapies' negative effects outweighed their expected benefits.

Confusion ensued, both among the health care practitioners and patients. Suddenly, women no longer knew where to turn for menopause symptom management. This became a major reason for concern not only for millions of women who were already under conventional HRT, but also for many other million women who are entering menopause as the Baby Boomer generation reaches middle age. In nowadays technological and knowledge era, women do not have to stay and suffer anymore as they care about the quality of their life. They do a little research and they educate themselves on other options available for their menopause related symptom management and approach their health care practitioners from a different position. One very exciting option- as controversial as it may be among health care professionals- is Bio-identical Hormone Replacement Therapy (BHRT). This option is now experiencing a massive surge of interest as it recently was the topic of discussion on Oprah's show, Dr. Phil's show, on "The Doctors" show, etc.

They are hundreds of doctors in the United States who implemented BHRT in their practice for many years already and they are helping thousands and thousands of patients get relief with their menopausal symptoms. And let's not forget that this is already a common medical practice for decades in Europe.

Why is BHRT compounding gaining such notoriety and such a growing demand?

1. Because hormones contained in BHRT products have chemically identical molecular structures as the ones a woman's body makes, so the body can distinguish no difference between its own hormones and those used in BHRT. This further helps BHRT deliver results that are virtually free of the side effects encountered with conventional HRT.

2. Because all these hormone components of BHRT products are FDA approved components. They are synthesized in an FDA approved lab from plants such as wild yams or soy beans.

3. Because BHRT offers customized/individualized solutions for hormonal imbalances encountered mainly by women around menopausal age.

4. Last but not least, because women need to be offered alternative choices and be allowed to decide, together with their health care practitioner, what is best for their health and quality of life.

How does a woman get access to bio identical hormone replacement therapy?

First: she has to find a knowledgeable health care practitioner who offers BHRT to the patients. This is still a challenging task for the patients as most of the practitioners are still in the dark about BHRT. But the increasing demand from informed patients motivates more and more practitioners to learn about BHRT and implement it in their practice.

Second: BHRT can be done only with a compounding pharmacy, which the practitioner should be working in close collaboration with. Each woman going through menopause will have her unique combination of symptoms, therefore she will need a uniquely tailored hormone formulation to be prescribed by her health care practitioner and prepared by the compounding pharmacist. A compounding pharmacy has access to superior, USP grade ingredients for these hormone formulations. (USP stands for United States Pharmacopeia)

Based on patient's or practitioner's preferences, the pharmacist will then compound/prepare the end product in any combination, form, shape, strength, or route of administration, whether it be a tablet, capsule, cream, gel, sublingual drops, suppository, etc.... ultimately providing an individualized, customized formulation based on the doctor's prescription.

Is hormone replacement therapy only for menopause symptom management?

No. Women may encounter hormonal changes leading to uncomfortable symptoms because of the hormonal imbalance as early as in their pre-teen ages to as late as age 70 and over. In other words, our hormones should act in our body in total harmony for us to feel good. When the harmony is broken, imbalance occurs altering our well-being.

The main goal of BHRT is to restore the hormonal balance in order to restore the well-being.

At any reproductive age: irregular menses, heavy menstrual bleeding, PMS, migraines, acne, mood swings, irritability, sleep disturbances, etc. can occur as a result of hormonal imbalances. A good practitioner would be able to determine, after a thorough assessment, if this is the case and provide the adequate help with BHRT.

What do menopausal symptoms refer to?

Menopausal symptoms refer to the different degrees of discomfort women encounter due to hormonal imbalances around menopausal years. Menopausal years consist of a few stages:

· Pre-menopause, the years before typical menopause symptoms occur. It can start as early as age 30, usually after age 35.

· Peri-menopause, the years immediate before menopause, usually starts around age 45.

· Menopause is officially installed after twelve consecutive months without menses.

· Post- menopause, all the years coming after menopause.

Is bioidentical hormone replacement therapy used for other purposes besides helping restore hormonal balance?

Yes. Besides helping restore the body's hormonal balance, bio identical hormone replacement therapy helps restore the physiological functioning it had years ago. This is why BHRT is at the core of anti-aging medicine. According to anti-aging medicine practitioner's belief, achieving hormone balance at physiological levels will help women get healthier, feel better, even get back in time... get younger and stay younger. All this is possible in combination with other healthy lifestyle factors such: proper nutrition, exercise, stress elimination techniques, etc.

Conclusion:

Compounding is like a finely tailored dress that is created to fit a woman's unique body perfectly while matching her personal preferences for color, fabric, and style, BHRT enables women to face the most important change in their lives with optimism and hope. When it comes to hormones, one size cannot fit all.

5 Things to know before starting hormone or estrogen replacement therapy

Prior to 2002, Hormone Replacement Therapy (HRT) was recognized as the "go to" treatment for women experiencing the many symptoms of menopause after having a hysterectomy. Although still offered to women before and after hysterectomy surgery, there has been a sharp decline in the sale of estrogen and progestin hormone therapies since 2002. Side effects, bio-identical alternatives, and other holistic alternatives have prompted many doctors and women to seek other ways to assist menopausal women with their symptoms. The common menopausal symptoms that women seek a solution for include: hot flashes, difficulty losing weight, vaginal dryness, painful intercourse, constipation, bladder instability, anxiety and mental sluggishness. Although HRT is still widely used today, it is imperative that you know the following 5 things before starting HRT in your own life.

1.) Premarin (including Prempro, Premphase, Prempac, and Premelle) is a drug made up of conjugated estrogens obtained from the urine of pregnant mares and its name is derived from its origin: Pregnant Mares' Urine (PREgnant MARes' urINe). Premarin is an estrogen/progestin hormone replacement therapy that utilizes conjugated equine estrogens (CEEs) as active ingredients.

2.) The Journal of the American Medical Association (Vol. 288 No. 1, July 3, 2002) published a study on the effects of estrogen replacement therapy derived from conjugated equine estrogens and its effects on coronary heart disease (CHD). This study found that women on estrogen replacement therapy did not reduce their chances of coronary heart disease, but had an increased risk of CHD within the first year of use. Estrogen replacement has been shown to increase chances of deep vein thrombosis (blood clots in a vein) and pulmonary embolism (blot clot in the lungs).

3.) In The Archives of Internal Medicine (Vol. 165 No. 17, September 26, 2005), The Women's Health Initiative (WHI) reported the results of another clinicaltrial of conjugated equine estrogens (CEEs), that involved 10,739 postmenopausal women with hysterectomy, aged 50 to 79 years. This study was stopped early "owing to lack of overall health benefit and increased risk of stroke."

4.) It has been demonstrated through multiple studies that hormone replacement therapy increases the chance of cancer in the lungs, uterus, endometrium, and the ovaries. The New England Journal of Medicine (Vol.360 No. 6, February 5, 2009) concluded "The increased risk of breast cancer associated with the use of estrogen plus progestin declined markedly soon after discontinuation of combined hormone therapy [in the study] and was unrelated to changes in frequency of mammography."

5.) There are natural alternatives to toxic and harmful drugs used as hormone replacement therapy that may help you with your female related symptoms. Whole food nutritional supplements (not chemical imitation supplements) that include mineral support such as calcium, magnesium, copper, manganese, iron, etc. often assist in hormone production. Increasing good fats through the diet and supplements such as cod liver oil, black currant seed oil, evening primrose oil, etc also assist in hormone production and provide the building blocks that your hormone system will need. Herbal tincture approaches often include chaste tree, withania, and licorice which stimulate hormonal activity. When minerals, healthy fats, and herbal tinctures do not provide the desired relief, phyto-hormone extracts are often successful. Phyto-based hormone alternatives are plant derived compounds that mimic the natural hormones your body should already be creating, and these are generally used after nutritional supplementation if your hormone imbalance remains symptomatic.

By working with a holistic doctor that encourages diet modifications, exercise, nutritional supplementation, and phyto-hormone approaches, many women often have amazing success in reducing the symptoms related to menopause without the side effects that come from traditional hormone replacement therapy. Always remember there are alternatives to your health and wellness goals.

Dr. Chase Hayden, DC, QN is a holistic doctor that incorporates applied kinesiology, quantum neurology rehabilitation, and functional nutrition in his practice. He is the owner of The Hayden Institute in Houston, TX where the majority of his general practice are women seeking the relief of PMS, menopause, infertility, and other female related symptoms through alternative approaches. He is happily married and currently has two children. For more information regarding Dr. Chase Hayden and his services, please visit http://www.DrChaseHayden.com

 

Bioidentical Hormone Therapy For Menopause

Hormone replacement therapy has been one of the major means of treating women suffering from signs and symptoms brought about by menopause. During this treatment, estrogen, progesterone, and a cocktail of other inactive components are injected into the woman to provide the much needed levels of hormones lost because of the physiological state of menopausal characteristics.

However, there had been times when synthetically engineered hormones have proven fatal. Even if there was the same match of estrogen per se, the preparation and synthetic ingredients to hold the hormones in its active state may have proven too dangerous to ingest in several accounts.

Make It Bioidentical

Scientists have released bioidentical hormones for therapy of hormone slumps during menopause. These bioidentical hormone preparations are standardized copies of chemical composition of those of humans. The effect therefore is a less intrusive and potential aggravating formula that delivers the intended purpose of hormone replacement. There are also come pharmaceuticals which prepare a more defined and custom bioidentical hormone formula to suit the individual's needs.

Though there are some setbacks for custom bioidentical hormone preparations such as non approval by the FDA, or perhaps untested results, scientists and researchers are optimistic that the limitation of having a custom formula would have to be with lessening some other agents or natural ingredients used in the creation of the standard formula. This is to address the issue of some hyper reactivity and allergic risks by a few individuals to some of the components.

Forever Therapy?

Even with the theory that if the bioidentical hormone used is the same one produced and used by the body during premenopausal stage, it does not necessarily mean that the bioidentical therapy would be optimal for an indefinite time. Even naturally occurring and produced components in our bodies sometimes contribute to a wide range of complications, mood swings, anomalies, and discomforts.

Nevertheless, the use of the bioidentical composition lessens the added factors that may contribute to unexpected reactions by the body. Studies and researches have not been extended to attacking the effects of using hormones and determining how to use these HRT methods as a means of a curative agent.

So Far So Good

Not promoting or brushing aside any opinion regarding this method, it would still be wise to seek first the advices of doctors and approved physicians to order this type of drug and prescribe the correct dosage for menopause. Nevertheless, it would be so bad either to include the method of natural means such as meditation, mind setting, activity diversions, and the like. Having these alternative drugs are intended for a good purpose of helping women cope up with this stage in life and therefore should be met with positive concern rather than doubt.

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Pros and Cons of Hormone Replacement Therapy and Estrogen Use Alone

Combination hormone replacement therapy and estrogen only replacement therapy are not prescribed as much as they were at one time for the relief of symptoms associated with menopause, due mostly to studies performed by the Women's Health Initiative. Those supporting estrogen replacement therapy have noted that these studies focused on the risks associated with long-term use and that no studies have been completed to date concerning bio-identical hormones. Dietary supplementation with herbs and other plant components may provide a safe and effective alternative to women seeking relief from menopausal symptoms.

Many women have questions about the safety of hormone replacement therapy and estrogen replacement therapy for the prevention of hot flashes, night sweats and other menopausal symptoms. The latest research supporting estrogen replacement at lower doses than were prescribed in the studies performed by the Women's Health Initiative indicates that women may experience a 60-70% reduction in hot flash symptoms. Doctors hope that lower dosages of hormones will be safer, but continue to advise that they should be used for the shortest period of time possible. This may leave many women frustrated, since some menopause related symptoms may appear five or six years before the onset of menopause and may continue for several years after their last period.

Research supporting estrogen like substances found in plants, which are called phytoestrogens or isoflavones, show that dietary supplements containing soy isoflavones can reduce hot flashes by 87.8%. This is about equivalent to the relief experienced by women who use traditional dosages of combination hormone replacement therapy and estrogen only replacement therapy.

The health risks associated with combination hormone replacement therapy and estrogen only replacement therapy include blood clots and stroke. Those supporting estrogen use that is bio-identical believe that since the hormones used are molecularly identical to those produced by the human body, it should be safe. Opponents of hormone replacement therapy and estrogen replacement therapy of any kind believe that menopause is a natural part of a woman's life, and that efforts to keep hormones at a level similar to those of a younger woman will ultimately cause health problems of many kinds.

As with many drugs and other compounds created by pharmaceutical companies, the initial research focuses on relief of symptoms and unwanted side effects. Estrogen replacement therapy first became popular for the relief of menopausal symptoms during the sixties and continued to grow in popularity, until a study published by the New England Journal of Medicine in 1975 reported that women using estrogen were seven times more likely to develop endometrial cancer than women who had never used estrogen. The study showed that the risks increased with continued use and that those women who used estrogen for seven years or more were 14 times more likely to develop endometrial cancer.

In order to reduce the risk of endometrial cancer, pharmaceutical companies added synthetic progestin (similar to the hormone progesterone) commonly referred to as combination hormone replacement therapy and estrogen only replacement was typically reserved for use by women who had undergone a hysterectomy at some time in their past. Those promoting and supporting estrogen and progestin use theorized that estrogen causes the lining of the uterus to build up, but without progesterone, it is not shed, thus adding synthetic progestin would cause the endometrium to be shed and reduce the risk of cancer.

Opponents of hormone replacement therapy and estrogen use quote studies indicating that estrogen can cause breast cancer, heart disease, stroke and other health problems. The majority of experts now advise that if a woman chooses to use HRT, of any type, she should use the lowest dosages for the smallest amount of time possible. For information about alternative solutions for the relief of menopausal symptoms and special nutritional requirements for women, please visit the Menopause and PMS Guide.

Patsy Hamilton was a health care professional for over twenty years before becoming a freelance writer. Currently she writes informational articles for the Menopause and PMS Guide. Read more at http://www.menopause-and-pms-guide.com.