Bioidentical Hormones (BHRT) are not for every woman – in fact this particular therapy remains both controversial and confusing to many. The aim of this article is to provide you with an objective overview.
BHRT has been around in the U.K. for at least 20-30 years and longer in the US. Awareness was raised back in 2009 when Oprah Winfrey began to talk about the treatment she was receiving.
Some bioidentical preparations are made by drug companies and are FDA approved. Other preparations are made at special pharmacies called compounding pharmacies, which make the preparations on a case by case basis for each patient. These custom-made preparations are not approved by the FDA due to the fact that the preparations are not standardised.
BHRT is custom-made for you based on a test of your blood, saliva and urine to assess your unique hormone needs.
If you have a prescription for a FDA approved hormone therapy for menopausal symptom relief they are legally obligated to tell you the benefits and potential risks.
This safety standard is not protocol for all compounding pharmacies. Compounding pharmacies are not subject to the rigorous quality assurance standard that standard commercially available hormonal preparations have to meet.
What is a bioidentical hormone?
A hormone that is an exact chemical match to the hormones you produced when you were menstruating – oestrogen, progesterone and testosterone.
But are they an exact match?
Advocates of BHRT say that it is not the source (plants) that makes them safer than synthetic hormones – but that it is the molecular structure that is different.
*Others would argue that plant derived oestrogen from soybeans is molecularly very similar, but not identical to human hormones.
Bioidentical hormone therapy is advertised as safer and better than FDA approved synthetic hormones distributed by pharmaceutical companies.
*According to the FDA and other speciality groups, bioidentical hormones may be riskier than hormones used in standard hormone therapy. To date there does not appear to be any evidence that they are more effective.
BHRT is advertised as purely natural.
*All plant derived hormones whether they come from a compounding pharmacy or a commercial pharmacy require a chemical process to synthesize the final product – pill, patch, cream, spray. In other words,despite being derived from plants these hormones still need to be commercially processed to become bioidentical.
*Many FDA approved hormone replacement products are also chemically identical to those your body produces and some FDA approved products are also derived from plants (Vivelle, Alora, Climera, Estragel. Estrasorb, Divigel, Evamist, Prometrium, Estrace).
MHRA Medicines and Healthcare Product Regulatory Agency, UK
FDA Food and Drug Administration, US
Here you will find a post written by our Medical Adviser, Dr Karen Morton, Consultant Obstetrician and Gynaecologist ‘What do I think of ‘Bioidential Hormone Replacement Therapy’ (BIHRT)’.
BHRT comes down to personal choice. If you are interested in going down this route, ensure that you find a specialist and read up on the subject. To educate yourself is to empower yourself to make informed decisions, which includes the decision to take risks. We are all aware that there is no drug that is without side effects.
In November 2015, NICE (National Institute for Health and Clinical Excellence) UK, issued the first guideline on diagnosis and managing menopause. You can find the guideline for professionals and a simplified version for women patients here. The NICE guideline on Diagnosis and Management of Menopause states “bio identical formulations that are compounded for an individual woman according to a healthcare provider’s prescription are not subject to government regulations or tested for safety or quality and purity of constituents, therefore their efficacy and safety are unknown”
Some women find relief from menopause symptoms through a normal approach combining dietary and lifestyle changes together with nutritional supplements to support their endocrine system. Other women will retain intractable menopause symptoms and will need to make other choices whether it be HRT, BHRT or natural menopause relief.
Shannon, K., Laughlin-Tommaso. M.D. (Dec 05, 2014) Retrieved from http://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/bioidentical-hormones/faq-20058460
John. R. Lee, M.D. Bioidentical Hormones: Dr. John R Lee’s Three Rules for BHRT. Retrieved 16 September 2015. Retrieved from http://www.johnleemd.com/bioidentical-hormones.html
Consumer Reports: Food and Drug Administration US. Bio-identicals: Sorting Myths from Facts. (April 08, 2008) Retrieved from http://www.fda.gov/forconsumers/consumerupdates/ucm049311.htm
Wright Y.L. MA (2011) “Bioidentical Hormones Made Easy”