Hormone replacement therapy has become an increasingly popular option for women seeking relief from symptoms occurring in menopause, menstrual irregularities, PCOS, amenorrhea and hypogonadism. Furthermore, people have been moving towards bio-identical hormones in hopes of a more biologically similar therapy with fewer risks and side effects. However, before embarking on hormone replacement therapy, it is important to understand the pros and cons of this form of treatment.
Signs of Shifting Hormones
As women age, estrogen and progesterone levels start to decline. The decrease in hormones can be the cause of a number of the following symptoms:
Perimenopause — the period leading up to menopause — and menopause are often the culprits behind fluctuating hormonal balances and their resultant side effects.However, you do not have to be a middle aged adult to have hormone irregularities. Some women experience a lack of cycle (amenorrhea) in their mid 20s, following a birth control pill, or in cases of polycystic ovary syndrome (PCOS), endometriosis, or untreated thyroid conditions.
Risks and Benefits of BHRT
The use of bioidentical hormone replacement therapy has sparked intense debate. Like all compounded hormones, BHRTs are regulated medications made from Health Canada approved substances that require a prescription from a licensed professional. They are held to the same standards as pharmaceutical prescription substances.
The primary differentiation between HRT and BHRT is the biologically identical component of the compounded formula. The chemically synthesized structures of bioidentical hormones are identical to those produced by the human body, vs biologically similar chemicals found in HRT (fun fact: birth control pills are a form of HRT).
Molecular differences between synthetic progestins and progesterone result in differences in their pharmacological effects on breast tissue. Studies have found pro-carcinogenic effects of synthetic progestins on breast tissue, compared to data demonstrating ‘bio-identical hormones are associated with a lower risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts’ (1,2). Furthermore, transdermal vs oral estrogen preparations have been considered less likely to pose risk for blood clots, stroke and coronary artery disease (3). Some studies even go as far as to say that bioidentical hormones are the preferred method of HRT when considering safety and efficacy (2).
At the present moment, naturopathic doctors in Ontario have the ability to prescribed transdermal (topical) and suppository estradiol, estrone, estriol, progesterone, and oral natural desiccated thyroid.
The one biggest gap research for the safety of topical hormones is that bioidentical benefits of progesterone over progestins is shown with the use of oral dosing. Topical progesterone’s have not been show to increase blood serum values high enough to offset the impacts of estrogens on the endometrial lining, which when used in conjunction with estrogen replacement therapy (oral, topical, and transdermal), may increase the patients risk for endometrial hyperplasia and cancer. Therefore, I always advise working with the right team of doctors to ensure you’re on the most efficacious and safe BHRT for your concerns.
BHRT and Menopause:
When diet and lifestyle measures fail, bioidentical hormone replacement therapy can be helpful in treating some of the side effects of hormonal imbalances caused by menopause.
Other Lifestyle Changes Can Improve Hormonal Health:
A healthy lifestyle, including regular exercise, can drastically improve overall health and help balance changing hormones.
It is important to understand what is causing an imbalance in natural hormone production before embarking on a course of treatment. Oftentimes, simple changes in lifestyle can achieve positive results and provide most – if not all – of the same benefits of hormone replacement therapy.
To evaluate your hormonal health and to discuss your treatment options, please contact your Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule your appointment today.
© 2018 Courtney Holmberg ND. All rights reserved. Dr. Courtney Holmberg, ND does not endorse or have professional affiliation with any discussed supplement or lab companies. All material provided is for general education and may not be construed as medical advice. The information is not intended to assist in diagnosing to treating a medical condition. Legal & Medical Disclaimer, sitemap