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By Sheila M. McNutt, Nurse Practitioner
The demand for hormone replacement that effectively relieves the hot flasher, fatigue,
and irritability of menopause without causing more problems with painful side effects has
brought bioidentical hormones onto center stage. Movie actresses and books promote
them. Patients who take them describe their sweet relief from menopausal symptoms.
Some women talk about how they have made them feel younger and even brought their
sex life back again.
As a result, we see new patients who want to talk about bioidentical hormones every day.
The basic question women ask if, “Are they for me?” Let’s explore what we’ve learned
about biodentical hormone replacement (BHRT) in the more than 10 years we’ve used
them in our clinical practice, and help you answer that basic question for yourself. Just what are “bioidentical hormones?”
Bioidentical hormones are manufactured in the lab and are dispensed by a pharmacy with
a prescription. They have the same exact molecular structure as hormones made by your
own body. That is important. It means your knows how to use and rid the hormones
effectively without the bloating and side effects synthetic hormones have. By contrast,
synthetic hormones are intentionally different. Drug companies can’t patent a bioidentical
structure, so they invent synthetic hormones that are patentable.
(Premarin, Prempro, Provera, and Activella being the most widely used examples).
Though bioidentical hormones have been around for years, many doctors and
practitioners are unfamiliar with them. There are several branded versions now available
for use in this kind of hormone replacement therapy (HRT). Those and others are
available at a compounding pharmacy where they make the prescriptions that your doctor
or practitioner has written with your name in mind. We call this individualized or custom
In our practice, the Nurse Practitioners have the greatest experience and success with the
individualized approach of bioidenticals. We begin with a comprehensive review of your
symptoms. Testing is doe either with saliva or blood analysis. When appropriate, we then
prescribe a dosage of bioidentical estrogen, testosterone, progesterone, or DHEA. Each
patient is then monitored carefully through regular follow-up visits to ensure we get
symptom relief at the lowest possible dose.
Balancing of the hormones is something else we consider. We used to believe that the
decline of just estrogen caused all the major problems of menopause. We now know that
just replacing estrogen is not enough. Some of the hormones must be balanced with each
other. For instance, having too much estrogen that is not balanced with natural
progesterone can cause the same symptoms as being too low an estrogen. Once balance is
restored, we see you one time a year when it is time for your annual exam. Are bioidentical hormones better than systhetic hormones?
Many of us long ago concluded that the answer to this is yes. But that doesn’t mean
bioidentical hormones are perfect. As practitioners, we are constantly alert to new
research and information on hormones. As new ideas come forward, we adjust our use of
hormones in our clinical practice. We are always cautious when prescribing any
The great appeal of bioidenticals is that they are natural, and our bodies metabolize them
as it was designed to do, minimizing side effects. Synthetic hormones are quite strong
and often produce intolerable side effects. Moreover, we are able to adjust the doses to
match individual women’s needs-something that’s just impossible to do with mass-
Are bioidentical hormones safer than synthetics?
European medical studies that yes, bioidentical hormones are safer than synthetic
versions. Indeed, a second look at the World Health Initiative study which showed more
women taking hormones to have breast cancer and strokes has caused many to blame the
Provera part in the synthetic hormone studied to be the culprit. Other studies using the
natural version of Progesterone have shown protective benefits of hormones. Isn’t menopause just a natural part of aging and shouldn’t we just let it happen?
No. Menopausal symptoms are no more a natural, healthy part of aging then is
hypertention (high blood pressure). If you had high blood pressure, would you think it
should be treated? Yes! Not all women have problems with menopausal symptoms. If a
woman does, treating her can have great health benefits and improve quality of life.
It takes a good ear to listen as well as the knowledge of hormonal chemistry to treat every
woman individually with bioidenticals. Because of that, you’ll want to consider
scheduling your appointment with one of the three Nurse Practitioners in our office. We
have not only knowledge but the experience to help.
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