Bio-Identical Hormones 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 care. 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 medication. 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- produced products. 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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