HRT: Help Or Harm?

Flip through the health section of your newspaper and you might see another dire warning about the dangers of hormone replacement therapy. But before you run for the menopausal hills and suffer through another day of hot flashes, vaginal dryness, mood swings and low libido, get the facts. HRT can, in fact, be very safe and, for many women, radically change how they feel -- for the better.

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Woman holding pill

Dr. John Lee, a pioneer in women's health, author of Hormone Balance Made Simple, and an advocate of bioidentical hormones, explains:

"Hormones do very complex and specific jobs in the body by fitting into part of your cells called receptors, much the same way that a key fits into a lock. Once the hormone is in the receptor, it gives the cell instructions. If the molecular structure is different, even by one atom, the instructions given to the cell are different."

There are three kinds of hormone replacement therapy: Synthetic, non-bioidentical and bioidentical.

Synthetic hormones

Synthetic hormones are not created from natural substances and are not biochemically identical to your body's molecular make up. Synthetics are often (but not exclusively) taken orally and can have many metabolites (chemical byproducts) that can result in unwanted and even dangerous side effects. Synthetic hormones are created by pharmaceutical companies in an attempt to mimic the effects of female natural hormones. The difference between synthetic progestins and progesterone is very significant.

For example, Provera (a synthetic progesterone or progestin) is not the same as progesterone although it is often called progesterone. Progestins are given to women to prevent pregnancy, whereas progesterone is used to assist fertility. Progestins are actually foreign to a woman's body and they can have adverse effects on the brain, blood vessels, skin, heart and breasts.

Non-bioidentical hormones

These are conjugated equine estrogens. Yes, you read it right: equine, from a horse. They are not biochemically identical to a woman's hormones and are manufactured to "act like" human estrogens. An example is Premarin, made from the estrogens found in pregnant mare's urine. The chemical structure doesn't match a woman's biological hormone receptors and, as a result, many women experience unwanted side effects.

Natural and bioidentical hormones

These are derived from plants and most are identical in molecular structure to the hormones women make in their own bodies. They are often made from plants such as the yam (progesterone) or soybean (estrogen). Although bioidentical hormones are not found in this form in the natural world, they are plant-based chemical extracts that are then synthesized in a laboratory into the hormonal human form.

Bioidentical or natural hormones are unregulated by the FDA. They are available in oral, vaginal or transdermal methods (delivered through the skin via patches and creams, bypassing the liver). While natural hormone formulas are readily available without prescription, their concentration may not be adequate or reliable enough to relieve the symptoms in some women.

Alternately, women can obtain bioidentical estrogen, progesterone and testosterone, through a compounding pharmacist. Compounded medications are ordered by a licensed physician, nurse practitioner or other prescriber, and mixed by licensed compounding pharmacists in a safe and carefully controlled environment. Pharmacists are the only health care professionals trained in chemical compatibilities, making them the only professionals qualified to compose alternate dosages.

Synthetic vs bioidentical hormone replacement therapy

Comparing the effect of synthetic hormones in your body to that of bioidenticals is similar to comparing processed white bread to unprocessed, all natural multi-grain bread. Both breads may share similar properties but once consumed, how the body uses them is vastly different.

Next page: Is estrogen really evil? >>

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