Bio-Identical Hormone Replacement Therapy for women....

[SlimmerMe]

Here is a good explanation as to what "Bioidentical" means.

WHAT YOU NEED TO KNOW by Dr. Christiane Northrup

There seems to be a lot of confusion around the definition of "natural" versus "bioidentical versus "synthetic" hormones. One thing to remember when making this distinction is that "bioidentical" refers to the shape of the molecule itself rather than the source of the hormone. By this, I mean that hormones can be marketed as "natural" or "plant-based," yet not come near to being "bioidentical" to native human female hormones or performing as such in the body. Examples of this are the numerous proprietary HRT options being marketed as "plant-based" and "natural," as well as purely yam-based creams.
Our bodies are literally swimming in hormones that act somewhat analogous to keys in a lock, or pieces to a puzzle. Though this analogy presents a less than complete picture, it can be helpful toward a basic understanding of their action. The puzzle to which I refer makes up the big picture of who we are as human beings and how we operate. When we take in hormonal replacement therapy that doesn’t fit the original design that our cells have evolved to recognize, the end result simply may not feel or act quite right. Hence all those side effects, ranging from annoying and uncomfortable to downright dangerous.
Many pharmaceutical companies are capitalizing on women’s quest for "natural" hormone replacement therapy by marketing proprietary hormone products that are "plant-based." Yes, many of these hormonal molecules may have been derived from plant sources, but no, the molecules themselves do not always match those found in human females. Moreover, they are often not effectively converted or used in the body and sometimes have actions that are more deleterious than the symptoms they purport to quell or stave off.
Our hormones are comprised of a solid steroid base (yes—cholesterol!), decorated with "arms," "legs," and "tails" pinned on here and there. These attachments are what turn hormones into specialized molecules, allowing them to plug in to receptor molecules throughout the body, turning on and off much of the cellular behavior that makes us tick.
Pretty slick! Bioidentical hormones are those whose biochemical structure exactly duplicates those found "naturally" in the human body—that is, the ones whose structure has evolved for millenia. Why mess with a good thing?
True Natural Hormones
The molecules naturally produced in the human female body for which we most often seek replacement include the following: a) the three basic types of estrogen: estrone (E1), estradiol (E2), and estriol (E3); b) progesterone; c) testosterone and d) DHEA, an adrenal precursor to testosterone. These truly "natural" hormones are available by prescription (or, in the case of progesterone and DHEA, over-the-counter in low doses), and can also be readily titrated to a woman’s individual needs. Though many health care practitioners are still not trained in prescribing them, the opportunity is there for them to learn, and health care providers are becoming increasingly aware of their patients’ preferences.
Bear in mind that most of the mainstream studies have been performed on conventional HRT. In addition, pharmaceutical companies cannot take out a patent on what the majority of human women make effortlessly on a daily basis and, therefore, cannot generate large sums of money by packaging and selling them. This may explain why women are commonly offered prescriptions for nonbioidentical forms of HRT, while their efforts to obtain a prescription for bioidentical HRT can be met with varying degrees of skepticism. On the other hand, unique delivery systems for HRT are patentable, and for this reason options for HRT delivered via transdermal skin patches abound, some of which are bioidentical. Examples include many of the estrogen patches, including Vivelle, Estraderm, and Climara.
Most women know that Premarin, Prempro, and Provera are not bioidentical. My colleague Dr. Joel Hargrove says, "Premarin is a natural hormone—if your native food is hay!" (It’s made from conjugated mare urine.) Provera was developed as a substitute for bioidentical progesterone (the kind found in the human female body) because you cannot patent a naturally-occurring hormone! Prempro is a combination of Premarin and Provera.
If you are in doubt as to whether a particular product offered to you by prescription is natural, check the label—if it lists anything other than the above ingredients, including "esterified estrogens," "progestins," or "progestogens," the product is essentially not bioidentical. You can also go to your library and look the product up in the most up-to-date Physician’s Desk Reference, or try plugging it into your favorite search engine on the Internet—many proprietary products even have their own site.
Many people have written to me to express their confusion about the use of progesterone creams, particularly regarding the efficacy of yam-based or other plant-based creams.
Unlike soy and flax, for example, which contain plant-based estrogens (phytoestrogens) that are adaptogenic and converted into utilizable forms in the body, wild yam (Dioscorea barbasco) cannot be converted into progesterone in the body.
The conversion can occur in a laboratory setting, however, and therefore, wild yam is sometimes used to synthesize the progesterone found in progesterone creams. The cream may technically be yam-based, but its active ingredient is not the wild yam itself but the USP progesterone that has been added. For this reason, while the body may absorb wild yam extract through the skin, which may then confer mild effects on menopausal symptoms, results of research on oral and topical applications of wild yam extract have not detected a significant change in progesterone levels in the blood.

[toooosmall]

this is good stuff! hopefully my wife can understand it. thanks for posting it.
but i was disappointed that she didn't mention any name brands that are ideal bhrt.
Do you know any? I need to know what med to request from a doc.

[SlimmerMe]

this is good stuff! hopefully my wife can understand it. thanks for posting it.
but i was disappointed that she didn't mention any name brands that are ideal bhrt.
Do you know any? I need to know what med to request from a doc.

There is no "specific" brand. Most of the time the doc prescribes a compounded cream which has estradiol/estriol and progesterone and test all in the same vial. Other protocols are compounded drops, pellets or whatnot.

There are many approaches to this. But mainly compounded no matter what. This way the script is specifically written for the person.

What you ask the doc is this: Do they prescribe bioidentical hormones? Many gynecologist are doing this now. And all the anti-aging clinics do this. It has become a huge cash cow business. They are catching on.

[toooosmall]

thanks. I have all this info printed n ready for her to read when she gets off work. unfortunately, her primary doc is also her gyno, and he's old and a pharmacist said he is old skool about medicine. my wife knows that, and she may consider another doc, if I'm lucky.

[sirupate]

I am wondering if menopausal women would benefit from bio-identical HRT? I have no idea of course, which is why I am asking. My wife is coming near the end of menopause....she thinks. Typical symptoms of lack of libido, energy..etc. She visits her gyno soon for the usual annual check. I wonder if this is worth her mentioning to her doctor?

[PPC]

Like SlimmerMe mentioned, most good anti-aging type Docs will script compounded formulas for estrogen and progesterone replacement. But there are a couple of name brand bio identical hormones. They are 'Estrace'..that is estradiol in oral form. Then there is 'Prometrium'..that is progesterone in oral form. Then there is 'Crinone'...that is progesterone in vaginal cream form.

Estrace...sounds good in theory...and it's cheap, but oral estrogen in any form raises SHBG and raises estrone (E1). Estrone is linked with the high cancer rates of post menopause, we want to keep estrone in it's place. It doesn't need to take over.

But if a general gyno or doc only knows how to script name brands, some women work around this by using Estrace in an off label manner. They use it buccally by placing pieces of the pill in between their gum and teeth until dissolved. There is more potency this way since the liver is not involved so only 1/4 doses usually are required. Another route is vaginal, but this is best for women without uteruses. The vagina is very absorbent and can work as a great systemic delivery system. However with E, there can be too much proliferation of the uterus this way, if a female still has hers intact. Insurance should cover estrace and it's generic counterparts.

Prometrium does not have the same problems with oral delivery. The progesterone molecule is more easily processed by the liver than estrogen. So, prometrium can be a sound choice if a Doc doesn't know about compounding. Insurance should cover.

Crinone is excellent. There is much evidence that vaginal delivery of progesterone is the most protective to the uterus. But crinone is so expensive. Docs will usually script prometrium before crinone and insurance may or may not pay for it.

[Termin8r27]

Yes as mentioned, my wife works with a clinic and they use a compounding pharmacy out of Utah.

[SlimmerMe]

I am wondering if menopausal women would benefit from bio-identical HRT? I have no idea of course, which is why I am asking. My wife is coming near the end of menopause....she thinks. Typical symptoms of lack of libido, energy..etc. She visits her gyno soon for the usual annual check. I wonder if this is worth her mentioning to her doctor?

YES!!! She is a perfect candidate. Absolutely worth asking and she might call first to inquire if her gyno prescribes or not before making an appointment. Some do and some don't. And if not and she wants to pursue this then she needs to look for an anti-aging doc who will certainly be up to it since this is their specialty. Good luck to her~