Is bioidentical HRT safer than artificial HRT?

The aim of ‘hormone replacement therapy‘ is to put back into the body the hormones that are either missing, or the body is not producing in adequate amounts to offset hormone imbalance.

And women requiring hormone replacement are discovering that bio-identical hormones, like natural progesterone, that are physically and chemically identical to the hormones made in our body, appear to be safe, free of side effects and non-addictive if used wisely and in moderation.

Some women clearly do ok using synthetic hormone replacement therapy. They do not consider these drugs to be a danger to their health because they have not experienced the debilitating side effects of HRT that pushes women to seek out alternative options.

Our website does not see these women who do fine on HRT, therefore, we’re not in a position to comment on balanced statistics. We mainly see those women who’ve had bad experiences, and have nowhere else to go. They have exhausted all their options or intuitive do not want to pursue synthetic HRT.

The internet is jam packed with publications and websites containing information posted by the medical profession and lay persons for and against both forms of hormone replacement therapy. You want to be very aware, however, who is actually funding the research of the data and the trials that are being put forward.

But the confusion does not merely lie with synthetic HRT. The term ‘Super Hormones’ is used in the USA to describe the group of anti-aging hormones that are becoming increasingly popular in the post-war baby boomer generation to rejuvenate flagging endocrine systems. The hormones that belong to this group are natural progesterone, testosterone, estrogen, pregnenolone, DHEA, thyroid hormone and melatonin in the form of creams, capsules and lozenges.

To load further inconsistency upon women who are searching for answers and some objectivity to arrive at an informed decision, mostly we are bombarded with words like ‘precursor’, ‘natural’, ‘bio-identical’, ‘from natural sources’, ‘wild yam’, ‘diosgenin’, ’saponins’, ‘plants steroids’, ‘phyto-sterols’, ‘phytoestrogens’ and the constant interchanging of the word progesterone and progestogen in the same paragraph.

Here’s an example of a push for HRT taken from one reputable pharmaceutical company’s website: “Fact - Progestogens are hormones similar in action to the progesterone produced by the ovary.” Similar does not mean ‘the same’. If this were the case, why do progestins cause birth defects whereas progesterone does not?

Some drug companies DO include natural-to-the-body estrogen in their HRT, usually combined with a synthetic progestin. How do you know the difference? This is usually the scenario that catches women off guard because the drug companies CAN advertise their HRT drugs as ‘natural’ because PART of that combination hormone may contain natural-to-the-body estrogen. What they omit to state is that the combination progestin IS NOT natural-to-the-body, although originally derived from ‘natural’ plant sources.

Natural estrogens are estrone, estradiol and estriol. Premarin which most women are familiar with is not a natural estrogen. Actually the drug ‘Premarin’ comes from PREgnant MARes urINe.

Learn to familiarise yourself with the words that are going to be constantly thrown at you via crafty advertising. Then learn to be more discerning. Just remember, the body sees as ‘natural’ that which has the same molecular configuration (bio-identical). ‘Natural to the body’ is what you need to regard as most important when you are contemplating hormone replacement therapy.

Possible risks and side effects of The Pill and HRT:

• Allergic reactions
• Birth defects
• Breakthrough bleeding
• Decreased immune system function
• Disturbances in liver function
• Eye disorders (double vision, swelling of optic nerve, contact lens intolerance, corneal inflammation)
• Facial and body hair growth
• Fluid retention and bloating
• Fungal infections and tinea
• Infertility increased with The Pill
• Irritable bowel syndrome
• Hair loss
• Hayfever, asthma and skin rashes
• Loss of Libido
• Lumpy and tender breasts (fibrocystic breasts)
• Migraines and headaches
• Nausea
• Nutritional deficiencies especially zinc, B6 and magnesium
• Psychological and emotional disorders, depression, mood changes
• Secretions from breasts
• Skin discolouration
• Higher rates of suicide
• Weight gain
• Systemic Candida infection
• Urinary tract infection
• Venereal warts
• Vaginal discharges (increased incidence of vaginal thrush)
• Fatigue

More serious effects of The Pill and HRT:

• Disturbance of blood-sugar metabolism (contributing to diabetes and hypoglycemia)
• Increased incidence of thrombosis (stroke)
• Increased incidence of hardening of the arteries and high blood pressure
• Increased risk of blood clots
• Increased risk of gall bladder and liver disease
• Increased incidence of cancer of the breast, endometrium, cervix, ovaries, liver, lung and skin
• Increased risk of heart attacks
• Increased incidence of MS

Possible risks and side effects of natural progesterone:

• Because progesterone creams contain the hormone identical to that produced by the human ovary, side effects are usually minimal. If experienced these may include breast tenderness and swelling, fluid retention or slight vaginal bleeding. Dizziness, nausea, fatigue, headaches and light headedness have been reported occasionally and usually disappear with adjustment of dose.
• Progesterone is the hormone essential for promotion and maintenance of pregnancy. Ovarian output of progesterone in the non-pregnant state is 25-30mg daily during the luteal phase. The placental output during the third trimester of pregnancy is 340-400mg per day. Where as progestagens are contraindicated in pregnancy progesterone exhibits no adverse effects on the foetus.

Types of HRT regimes that might be offered by your doctor:

• estrogen only - usually only recommended for women who have had a hysterectomy (can be natural or synthetic)
• estrogen + progestogen - usually recommended for women with intact uterus to protect the endometrium (lining of the uterus)
• sequential or cyclic treatments - estrogen taken 7-14 days followed by progestogen 10-14 days, resulting in a period after the progestogen dose is taken. Usually recommended for perimenopausal women to control menopausal symptoms and to regulate bleeding whilst protecting the endometrium.
• Continuous combined - estrogen and progestogen continually to prevent the thickening of the lining of the uterus without incurring a bleed. Usually for women 2 years post-menopause who do not wish to have a period in their therapy.
• progestin - oral pill or injection, combination varies for specific purposes and treatment such as contraception, perhaps endometriosis, PCOS.

How is synthetic HRT usually taken?

• tablets
• skins patches - (can include natural estrogen or natural testosterone), combination patches have natural estrogen but synthetic progestogen)
• creams and gels (natural estrogen)
• implants
• injections
• pessaries
• associated treatments