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The Endocrine Society defines bio-identical hormones as ‘compounds that have exactly the same chemical and molecular structure as hormones that are produced in the body’. These hormones are a natural and safer alternative for menopausal women considering conventional hormone replacement therapy.
Menopause is a natural stage of every woman’s life and many women turn to hormone replacement therapy (HRT) to relieve the unpleasant symptoms that can occur during this time. Unfortunately HRT can have serious, life-threatening side effects so it is definitely worthwhile considering a more natural alternative such as bio-identical hormones.
WHAT ARE BIO-IDENTICAL HORMONES?
Bio-identical hormones give you the benefits of hormonal replacement with a much lower risk of side effects than conventional HRT. They are normally synthesised from a plant chemical that are extracted from yams and soy which have a similar molecular structure as the hormones in the body. This is how they differ from synthetic hormones that have a different molecular structure with a greater possibility for side effects.
SIDE EFFECTS OF HRT
There is a growing trend amongst women to explore their options when they go through menopause. The reason being that over the past 10 to 15 years there has been more and more negative reporting about the possible side effects of HRT. The most prominent study to alert both physicians and women was the Women’s Health Initiative (WHI) study done by the US government in 2002.1 The conclusion of the study was that the risks of using preparations containing equine oestrogen (derived from pregnant mare urine) combined with synthetic progestin (progesterone) far outweighed the possible benefits it had on bone health, colorectal cancer prevention and relief of menopausal symptoms such as hot flushes and vaginal dryness. Hormone replacement therapy in this particular form resulted in:
■26% increased risk in invasive breast cancer
■29% increased risk of heart attacks
■41% increased risk of stroke
■200% increased risk of blood clots.
An additional study from the following year, the Women’s Health Initiative Memory Study (WHIMS), demonstrated that the combination therapy also doubled the risk of developing dementia in women of 65 years and older.2
There are many other reasons why women are sceptical about HRT. They often experience uncomfortable side effects like bloating, weight gain, breast tenderness and breakthrough bleeding.
THE NEED FOR ADDITIONAL HORMONES
Some women prefer not to take additional hormones for menopause which is after all viewed as a natural transition in a woman’s life. Earlier generations seemed to have coped well without any support, so why should women use additional hormones today?
What is different now is that we are living longer, very often more stressful, lives in an environment that is becoming increasingly toxic. We are exposed to xeno-oestrogens (foreign oestrogen-like substances) in the environment, often eat nutrient-depleted food and don’t exercise regularly. These are some of the factors that contribute to hormonal imbalances.
Fortunately there is more and more scientific evidence of the benefits of bioidentical hormones in that they carry a lower risk of contributing to breast cancer development, have a lower risk for blood clots and improve heart health.3 It remains important to make an informed decision when considering if bio-identical hormone replacement is for you.
WHEN AND HOW TO START
Bio-identical hormone replacement can be an option before, during, as well as after menopause depending on your unique health needs. When opting for bio-identical hormone replacement, it is important to do this in conjunction with a medical doctor who will monitor hormone levels in the body on a regular basis. The best advice is to use the lowest effective dosage for the least amount of time necessary. Therefore it is not the best choice to buy products over the Internet or counter or from anybody who is not a qualified professional in this field.
After an initial medical examination and laboratory tests to determine your hormone imbalances, an individual prescription is made up that is based on your unique hormonal profile. This is a huge advantage to the ‘one size fits all’ approach. Biological identical hormones ideally should be compounded under strict quality standards by a compounding pharmacy.
The most common prescriptions include a progesterone, oestrogen, testosterone and dehydroepiandrosterone (DHEA). The bio-identical hormones are administered as creams, gels or pellets which are made up in a natural base that is paraben and perfume free. The non-sticky cream is easy to administer once or twice a day and can be used on the body or intra-vaginally. Ideally, progesterone and oestrogen should always be used in combination, even if the uterus has been removed. This is to mimic the normal balance in the body and is a different approach to conventional HRT. When you replace one or two hormones it will have an effect on all the other hormones in your body and balance is a key factor.
BENEFITS OF BIO-IDENTICAL HORMONES
■Relieve menopausal symptoms like hot flushes, night sweats, fatigue, depression, vaginal dryness or low libido
■Boost memory and alleviate brain fog
■Improve sleep and moodiness
■Support bone and teeth health
■Decrease the risk of colon cancer
■Support a healthy heart and prevent atherosclerosis4
■Regulate the growth of and repair tissues in the body to prevent premature ageing
■Prevent thinning of skin and hair.
The greatest advantage of a personalised bio-identical hormone prescription is that it recognises each individual as unique with unique hormonal needs. It is very often prescribed while also giving attention to proper nutrition, supplementation, stress management and specific botanicals to support a woman optimally.
CautionNot everybody is a candidate for bio-identical hormone replacement. Some women might be oestrogen sensitive or have a genetic tendency that makes it difficult for them to metabolise oestrogen properly. These women typically experience symptoms such as breast tenderness, breast cysts, bloating before menstruation, premenstrual tension (PMS) heavy periods or uterine fibroids. A natural progesterone cream can be helpful to achieve better hormonal balance in these cases, but oestrogen and testosterone should be avoided or prescribed with caution.
You are not an ideal candidate for bio-identical HRT if there is a history of breast or uterine cancer, an increased risk of blood clotting, liver disease, poor thyroid function, adrenal fatigue, extreme hair growth or male pattern hair loss.
CONCLUSIONWith the negative reporting about the possible yet serious side effects of conventional HRT it is important for women going through menopause to carefully consider the natural option of bio-identical hormone replacement therapy.
DR LYNETTE STEELE,MBCHB, DIP ACUP, THD.
She is an integrative medical doctor with a whole-person approach to restoring balance and function to the mind, body and soul. By incorporating functional medicine, lifestyle medicine, stress management, health coaching, biopuncture, homotoxicology, bioenergetic tools, natural medicines and body therapies, she provides unique solutions to address various health issues. Dr. Steele has a special interest in hormonal balance and women's health. She practises in Stellenbosch, Western Cape.
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