Menopausal Health, Hormone Replacement Therapy

If you're a woman, chances are good you have lots of questions about Hormone Replacement Therapy (HRT).  Through all the controversy and confusion, the public and medical community can agree on one thing: supplementing a menopausal or peri-menopausal woman's body with hormone therapy will make her feel better.

It's a very simple formula to remedy the effects of your body's aging and gradual decrease of circulating estrogens (menopause), doctors and health care providers can increase the amount of these circulating hormones to recreate your original and healthy levels once again ? thereby significantly reducing the symptoms associated with menopause.  The public health issues of HRT that have surfaced over the past few years are as complicated as they are varied.   Our purpose here is not to address those issues, but rather to clear up some of the emerging questions about bioidentical and natural HRT.

Bioidentical HRT (BHRT) involves treatment with hormones that have the exact molecular structure as those made by your body.  This is what makes them ?natural?, and also what allows them to produce the same physiologic response as those that are naturally produced by your body.  There are many people, both patients and physicians alike, who are confused about where bioidentical treatments come from, and why they are advantageous.  In my own clinic, the Berman's Women's Wellness Center, I?ve often witnessed patients that are more concerned about the source of hormones, rather than the effect of those hormone treatments.  Bioidentical hormones originate from a variety of sources, including plants (soy and yams), animals (horses and pigs), or even, believe it or not, the laboratory (yes, this means bioidentical hormones can be synthetically produced, too).  And even the bioidentical hormones extracted from soy or yams still need a few more steps of adjustment in a laboratory to finally reach their ?natural?, or bioidentical, state.  So, the bottom line is that, regardless of where the bioidentical hormone came from, it is exactly like the one your body naturally produces.

{mosbanner:id=1:right:0}Natural HRT (NHRT) is a term that is frequently used incorrectly, usually by being used interchangeably with BHRT.  In actuality, NHRT uses molecules that have some effects similar to your body's hormones, but do not have the exact same molecular structure as your body's own hormones.  One of the most highly prescribed estrogen hormones available is advertised as being ?natural? -- and it is, because it is derived from the urine of pregnant mares (part of nature, and hence ?natural?) -- however it is not bioidentical because it isn?t structurally equivalent to human estrogen.  This doesn?t mean that it doesn?t have an estrogenic effect in your body.  It does, but this is due to its similarity to the estrogen your body produces (rather than a structural duplication of the estrogen).  It is important to note, however, that cow/pig derived insulin prescribed to treat human diabetes is ?natural? because it comes from the natural world, but is not bioidentical since it is still structurally different from human insulin.  After decades of usage, however, it's quite apparent that it does its job both effectively and safely.  

If you are going the route of using NHRT for treatment of menopausal symptoms, you can do this without even a prescription.  Simply increase the amounts of isoflavonoids (notably genistein and daidzien, both found in soybeans) and lignans (found in nuts, particularly walnuts, and flax seeds) in your diet.  All these foods are rich in phytoestrogen, which is a nutrient derived from plants that, once ingested, has estrogen-mimicking properties in the human.  

Not to fear, there is a way to receive an HRT treatment that is both bioidentical (structural replicas of your body's own hormones) and natural (derived from plants).  You will need to see a physician that understands the differences between the two, and who also understands the role of a compounding pharmacy.  A compounding pharmacy can prepare plant-derived bioidentical hormones from a prescription written by your physician following their full evaluation and analysis of your hormone levels.  

These compounding pharmacies are quite different from your neighborhood drugstore because they actually make the treatment for you, instead of functioning as a middle-man between you and a pharmaceutical company.  Compounding pharmacies are regulated by the state boards of pharmacy and are a valid alternative for your HRT treatments.  

Whatever treatment you choose, always talk to a medial professional fist.  And remember, hormone therapy can make a difference.

Additional resources on hormone therapy are available from