Bioidentical Hormones - Description, Advantages, and Cautions

Some women whose symptoms are severe have found relief in hormone replacement therapy (HRT), which uses synthetic hormones to replace the ones that are deficient. But these synthetics are strong and can have their own, occasionally severe, side effects. Now, women are beginning to find hope in a new form of treatment that uses natural alternatives - bioidentical hormones.

A basic description
Bioidentical hormones are natural plant-based forms of estrogen and progesterone that are custom-mixed to match the hormones in an individual woman. In order to determine the types and amounts of hormones needed, the woman's own hormone levels are first measured with a saliva or blood test. Then the physician prescribes a "blend" that is calculated to replace what the woman's body is missing. This blend is made up by a compounding pharmacist and dispensed to the woman, whose hormone levels are retested on a regular basis in case the doses need to be adjusted.

Advantages
Many patients and quite a few doctors believe that bioidentical hormones are better than their synthetic counterparts for a number of reasons. Natural substances can be used (metabolized) by the body more effectively. Unlike synthetic hormones, whose doses are standardized, natural ones can be adjusted - customized - to fit the needs of the individual patient. And in research studies in Europe, they've been shown to be quite safe.

Disadvantages
There are still many doctors that don't like bioidentical hormones. Their objections are mainly based on the lack of research in the United States. Synthetic drugs go through a testing process before they can be approved by the Food and Drug Administration (FDA) for use by patients. This approval process has not been used for many natural substances - including bioidentical hormones. As a result, some physicians don't recommend and won't prescribe them for their patients. The American Medical Association (AMA) has even asked the FDA to start regulating their use.

Part of the problem is that it's very hard to test, and approve, any treatment that is individualized. The testing process for synthetic drugs includes the establishment of a "recommended dose" which is used not only by physicians but also by the drugs' manufacturers. (For example, if the standard dosage is 10 milligrams, the manufacturer will produce tablets in that strength.) This kind of standard goes against the normal process used for prescribing and dispensing bioidentical hormones. In fact, it might actually render them useless, since their main advantage is that they're tailored to each patient.

There was a study done earlier this year in Wisconsin in which bioidentical hormones were effective in reducing symptoms of estrogen deficiency in 82% of the participants, and effective against symptoms of progesterone deficiency in 74%. But some physicians have said this study missed some points; none of the women received a placebo, and their diets were not standardized, so it's possible their symptoms might have abated for other reasons.

There have also been concerns raised about the long-term effects of these hormones, and in this case testing right now wouldn't help; they're just too new for women to have taken them for a long period of time.

Alternatives
Women who are having problems with menopausal symptoms, but are uncomfortable with hormone therapy - natural or not - do have other choices. As a matter of fact, even doctors who have no trouble prescribing bioidentical hormones say it may be best to save them for severe symptoms. Instead, they recommend other supplements, over-the-counter progesterone, and possibly changes to diet and lifestyle.

If you're experiencing the "challenges" of menopause, you don't have to suffer in silence. Talk to your health care provider and explore your options. There's a very good chance that there is some form of treatment available that can help you enjoy this time of your life - rather than dread it.