Why has hormone replacement therapy been offered to me?
Through your history, physical exam, and laboratory studies a deficiency of one or more ovarian hormones has been detected. Bioidentical Natural Hormones have been suggested as a very natural way to increase the low ovarian hormone levels.
What are Bioindentical Natural Hormones?
Bioidentical Natural Hormones (BNHs) are hormones that are molecularly (biochemically) identical to your true major ovarian steroid hormones — progesterone, estradiol and testosterone. They are derived from a Natural source-soybean or yam and are Bioidentical to your ovarian Hormones — thus the name Bioidentical Natural Hormones (BNHs).
How do BNHs differ from synthetic hormones?
The synthetic agents (Prempro, Estratest, Provera, Premarin, etc.) are molecular cousins of the natural agents — estrogen, progesterone, and testosterone. They are not, however, identical in either structure or activity to the natural hormones they emulate.
Hormones work like a key in a lock. Bioidentical hormones fit that lock perfectly. Synthetic hormones fit more like a skeleton key in some, but not all, hormone receptor ("lock") sites. Side effects are more common with synthetic hormones because of poor lock and key fit and not all organs benefit from the protective effects that bioidentical hormones can offer.
Isn't the patch a bioidentical hormone?
Yes. The patch delivers estradiol in its bioidentical form directly through the skin into the blood stream and fits as a perfect key into estrogen receptor locks. The patch is the model that BNHs emulate.
What is the difference between the patch and BNHs?
There are two major differences between the patch and BNHs:
1. The BNHs are delivered in a lotion base and the dosage can therefore be controlled by the patient/physician by altering the "recipe" of the lotion, adjusting the frequency of the lotion application, or changing the site of application.
2. The BNHs include hormones not currently delivered to women in patch form. A blend of up to three hormones — progesterone, estrogen and testosterone is custom formulated to replace the deficiencies found in the hormone profile of an individual woman.
Could bioidentical hormones be given in pill form?
Yes. However, nature does not intend our hormones to be delivered into the stomach. Your ovaries secrete small amounts of hormones continuously throughout the day and night into a bed of blood vessels surrounding the ovaries. For your bioidentical hormones to be used in a natural way (true BNH therapy) the hormones should be delivered directly into the blood stream in their bioidentical form. If the hormones are swallowed as a pill they clear first through the liver and are secreted as altered forms of hormones into the blood stream.
Hormone levels also cannot be kept as stable with oral delivery systems. When using a lotion to deliver cream through your skin, your body fat acts as a storage depot for timed release of the hormones into your blood stream. Hormone levels do not peak or fall to the degree that they would with pill use - they stay steady throughout the day and night.
What benefit might I derive from the use of BNHs?
Restoring your hormone levels to those of your younger years will provide a degree of protection against hardening of the arteries, and muscle and bone wasting. Studies of traditional synthetic hormones ("copycat" hormones) show protection against heart attack, stroke, osteoporosis, and perhaps Alzheimer's disease. The natural hormones raise your hormone levels in the same way as the synthetics and to the same degree. When your hormone levels are restored naturally you will enjoy the same protective benefits that synthetic HRT offers without the side effects that have proven so troublesome to many synthetic hormone users.
Are BNHs FDA approved?
The synthetic agents were designed by pharmaceutical companies to mimic the effects of natural estrogen, progesterone, and testosterone. The synthetics have to be studied and approved by the FDA to be sure that they are both effective and safe.
No requirement exists to study nature's own hormones (BNHs) since one would really only be studying the gold standard by which the synthetics are evaluated. Additionally, patents have not been granted for substances found in nature — vitamins, melatonin, DHEA and BNHs do not come under patent protection. A pharmaceutical company will not spend 6-10 million dollars clearing a drug through the FDA if the company is not insured of exclusive sale rights to that product.
The individual ingredients that are in your BNH formula are all USDA pharmaceutical grade FDA approved natural ingredients. The composition of your individual cream or pill, however, is not FDA approved and will never likely be so. Your composition is designed to meet your needs — to replace your deficiencies and respond to your body and mood changes. We do not anticipate that one BNH formula can do this for all women. When drugs are approved by the FDA they are approved as a specific formula. This "approval" and use of one compound for all menopausal women would truly undermine the purpose of customized BNH therapy.
Will BNHs bring back my periods or PMS?
It is not the goal of replacement therapy to restore periods or cause PMS. Your formula can be adjusted with regard to the estrogen/progesterone ratio such that periods and PMS should not be a problem.
Can I get pregnant while on BNHs?
Whether on hormone therapy or not, all women within a year of their last period can ovulate "one last time." You will need to discuss your pregnancy risk with your physician.
How am I followed on BNH therapy to be sure a given formula is right for me?
The effectiveness of your therapy is evaluated by your physician as/allows:
1. Evaluation of your symptoms and physical findings during therapy.
2. Blood or saliva level testing of hormone levels.
3. Studies to evaluate the impact of hormones on:
- Your cholesterol levels
- Your bones
- Your breasts
- Your uterine lining