Compounded Bioidentical Hormone Replacement Therapy
So if body identical HRT is prescribed routinely by doctors, what is compounded bioidentical hormone replacement therapy , also known as bioidentical HRT?
You may have seen compounded bioidentical HRT advertised by clinics and providers who are unregulated or who may not have appropriate training, according to the British Menopause Society .
These providers test blood or saliva samples with the aim of determining your exact hormone requirements. As there are actually several different types of oestrogen in the body, the idea is to replace these in the most effective ratio possible. The providers then create a bespoke mixture of hormones for the patient on the basis of the test results. These are often given as either lozenges or a cream. This may sound good, but lets find out why its not that simple
Five Symptoms Of Hormone Imbalance
Hormone imbalance can refer to too little or too much of one or more hormones. It is a condition common during puberty, but can also result from pregnancy, menopause, or the simple aging process. Some of the symptoms of hormone imbalance are common in both men and women. These include: Mood changes such as irritability
Are Bioidentical Hormones Safe
The bioidentical hormones that are approved by the FDA have been tested for safety. They have passed the FDA’s strict standards and are safe for people to use. Like all hormone treatments, there are risks involved. You should weigh the pros and cons of even the FDA-approved bioidentical hormones with your healthcare provider.
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Bioidentical Hormonal Replacement Therapy Conclusion
Bioidentical Hormonal Replacement Therapy is considered a natural form of hormonal replacement therapy because the compounds used are chemically identical to the endogenous hormones. There is no sufficient evidence to confirm the effectiveness and risks of BHRT. However, the risk of any hormonal replacement therapy will depend on the method of preparation. It is important for the patient to work closely with their medical practitioner or a specialist in menopausal health to find the best option for their condition.
The Truth About Bioidentical Hormones
In increasing numbers, women who are candidates for hormonal replacement therapy are requesting bioidentical rather than synthetic hormones. Although there is a tendency to think of bioidentical hormones as all-natural, they, like synthetic hormones, are manufactured in the laboratory. In contrast to synthetic hormones, they are chemically identical to the hormones produced by the human body synthetic hormones are structurally different yet are designed to have similar biological effects as naturally produced hormones.
In the media, women are often given the message that bioidentical hormones are safer and more effective however, the bottom line is that we have no information to suggest that bioidentical hormones are any safer or more advantageous for women than traditional hormone treatments.
An excellent review posted on the US FDA site addresses some of the myths surrounding bioidentical hormones:
A natural, safer alternative to dangerous prescription drugs
Can slim you down by reducing hormonal imbalances
Prevents Alzheimers disease and senility
All of these claims have been made by marketers of compounded bio-identical hormones, also known as bio-identical hormone replacement therapy . But these claims are unproven. FDA is concerned that claims like these mislead women and health care professionals, giving them a false sense of assurance about using potentially dangerous hormone products.
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Q: Are There Side Effects Undergoing Bio
A: With the body not being used to using a new level of hormones through BHRT, side effects may occur after the first dose of treatment. Some side effects may be due to a particular hormone mixture. In contrast, many side effects get better as the body becomes well-adjusted to these new hormone levels. Some of the most common ones are:
- Increase hair in the face of women
In addition, redness or itchiness around where you got the shot or where the hormones are applied using creams, gels, or patches may occur in some cases. It is best not to panic if these symptoms happen. Consulting your doctor will be the best thing to do in situations like this.
Is Bioidentical Hormone Replacement Safe
Is Bioidentical Hormone Replacement Safe?
Chances are youve heard all the good stuff about bioidentical hormone replacement therapy pellets, and you think the benefits for men and women sound amazingmore energy, better sex drive and performance, stronger mental clarity and improved muscle tone and mass, to name just a few.
But maybe you still have concernslike, how can you be sure BHRT pellets are really safe?
Lets dig into your key questions, and see what the experts have to say.
What exactly are bioidentical hormones?
Just to recap hormones are chemical messengers produced by glands in your body. They control almost all your physiological functionslike blood sugar regulation, growth, brain function, and of course sex.
When hormone levels arent what they should be, a person can experience certain problems and symptoms. For men, low testosterone can leave you feeling lethargic, worried about low sex drive, and even struggling with erectile dysfunction . For Women, hormone imbalances involving testosterone and estrogen can create fatigue, loss of libido, weight management issues, anxiety, depression, muscle weakness and more!
Some prescription forms of bioidentical hormones are pre-made by drug companies at set doses. Other formsincluding the bioidenticals used in pellet therapyare custom-made for a patients individual needs by a specialist compounding pharmacist working closely with the patients doctor.
Is BHRT a more natural choice?
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Is Bioidentical Hormone Replacement Therapy Safe
The hormonal changes that womens bodies go through during the middle and later stages of their lives can be significant. Fortunately, the understanding around what is happening inside the body due to menopause has come a long way, and doctors can now address the changes and decreases in hormones with an effective solution. Bioidentical Hormone Replacement Therapy, or BHRT, is used by manybut is it safe?
Five Reasons To Add Bhrt To Your Holistic Practice
BHRT is a safe, natural, and effective treatment for a comprehensive range of physical and emotional conditions. Suitable for both women and men, BHRT can treat the symptoms of menopause, age-related bone loss, sleep disruptions, and complex conditions such as PMDD. In addition, bio-identical hormone replacement therapy can improve sexual function, increase lean body mass, address diminished libido, assist with weight management,
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What Is Bioidentical Hormone Replacement Therapy
Bioidentical hormone replacement therapy is the use of hormones to help resolve symptoms related to hormonal imbalance or decline in hormone production tied to aging. Certain hormone treatments are called bioidentical or sometimes natural because the types of hormones used are chemically identical to those produced by the human body.
Specific hormones that BHRT aims to increase or balance include those tied to reproduction and youth, such as estrogen , progesterone, and sometimes testosterone, dehydroepiandrosterone and adrenal hormones. During the years leading up to menopause, and then through this transition, a womans body produces less of these hormones , which may lead to symptoms like fatigue, hot flashes/night sweats, vaginal dryness and thinning bones. Various hormone therapy products are used to overcome these symptoms, some of which have been approved by the FDA and are available by prescription through health care providers, but many of which have not.
BHRT treatments include creams, lotions, injections, gels, sprats or tablets that have the goal of raising hormone levels back up to a more youthful state. Examples of popular bioidentical hormone replacement therapy products now on the market include Estrace, Premphase, Prempro, Activara and Vivelle-Dot, just to name a few .
Custom Compounding Is Misleading
To buy bioidentical hormones, you canât just go to any chemist. First, you see a health practitioner. They will often conduct a saliva test, or order a blood test to check your hormone levels. You then take their prescription for biodentical hormones to a compounding pharmacist, who makes up the hormones especially for you.
This customised compounding makes women think that bioidentical hormones are better suited to their specific hormonal imbalances, but this is untrue. In fact, saliva tests are not considered a reliable method for establishing hormone levels. Blood tests are also not necessarily reliable, as womenâs hormones during perimenopause and menopause can change from day to day, or even hour to hour, says Dr Newman.
âWomen respond in different ways to this hormonal chaos,â she says. âFor some women it makes no difference to how they feel, whereas other women may suffer severe symptoms, despite having similar blood results.â
The cost of bioidentical hormones is also considerably higher than conventional HRT.
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The Dangers Of Compounded Bioidentical Hormone Replacement Therapy
Louise NewsonADDRESS FOR CORRESPONDENCE Louise NewsonCopyright
The menopause is a normal life event for women, not an illness or a medical condition. However, the effects of the menopause often have a negative impact on womens wellbeing and quality of life, and are frequently underestimated by noth women and their doctors. Furthermore, the low estrogen levels and other biological changes that occur in menopausal women are also associated with an increased risk of cardiovascular disease, osteoporosis, type 2 diabetes,1 and dementia.2
Around 75% of menopausal women experience symptoms, with around one-third of these experiencing severe symptoms which are having a negative effect on their lives, both at home and at work.1
Over the past two decades, there has been a huge amount of confusion regarding hormone replacement therapy . We now have clear, evidence-based guidelines available to ensure women have individualised care and treatment for their perimenopause and menopause.2,3
Compounded Bioidentical Hormones Have Been Associated With Endometrial Cancer
If you still have your uterus, your doctor can prescribe conventional MHT containing progestogens to protect your uterus and reduce the risk of endometrial cancer.
Of concern, compounded BHTs have been associated with cases of endometrial cancer, after the compounded progestogen component did not protect women from endometrial cancer.
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What Evidence Links Bioidentical Hormones To Breast Cancer
The research on bioidentical hormones varies, and there are no conclusive findings on the impact of bioidentical hormones on the development of breast cancer. Estradiol and progesterone often have opposing effects on the development of cancer and other health outcomes, which are reflected in the studies on bioidentical hormones as well.
- Post-menopausal primates administered a naturally occurring estradiol showeding increased breast cell growth compared to primates given a synthetic estradiol.
- A study found that women taking bioidentical progesterone had a lower risk of developing invasive breast cancer than women taking a synthetic progesterone.
What Are The Risks Of Bioidentical Hormones
It has been shown in research studies that there are risks to taking hormones. It can increase the risk of blood clots, stroke, and gallbladder disease. Your risk of heart disease and breast cancer may also increase if you are older or use hormonal therapy for an extended period. Many healthcare providers who use bioidentical hormones claim they are safer than traditional hormone therapy treatments. But there have been no large research studies of bioidentical hormones to show evidence of this.
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Why Bhrt Is Different
BHRT is used around the world primarily to help with age-related hormone changes and associated symptoms.
More and more people are turning to this popular option over non-bioidentical hormones, which include:
- Conjugated Equine Estrogen
- Medroxy Progestin Acetate
BHRT has been used successfully for decades, and its popularity continues to surge.
Bioidentical hormones are derived initially from a molecule called diosgenin found in either soy or yam. The resulting hormone is then manufactured into FDA-approved prescriptions or prepared by compounding pharmacies to patient-specific doses.
Bioidentical hormones are different from these synthetic hormone therapies because the hormones are identical to endogenous hormones in our body.
Unlike most synthetic hormones, bioidentical hormones are molecularly identical to endogenous hormones and have the same:
- Biological action, effect, and response
- Receptor binding affinity
- Metabolic pathways
Because bioidentical hormones have the same structure as those made in the body, they have the potential to be extremely safe and effective.
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How Does My Healthcare Provider Select My Dose
People on hormone treatment are watched very closely by their healthcare providers. The goal is to relieve symptoms with the lowest dose possible for the shortest amount of time. Depending on your healthcare provider, you might have routine blood, urine or saliva tests to check your hormone levels. Your healthcare provider may adjust your dose based on your changing hormone needs.
The FDA recommends against using hormone levels to guide the dosing of hormone therapy in women, as normal levels fluctuate day to day. In particular, salivary hormone levels are known to fluctuate and have not been shown to be related to menopausal symptoms.
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What To Know Before Stopping Bhrt
If you choose to stop your treatment with BHRT, it is best to do so gradually. Practitioners recommend tapering down the doses so the body can slowly adjust to the changes in hormone levels that will startle your system. Tapering down doses, however, should not be done without expert guidance from Kellie Lewis in Lehi, UT.
For most patients who stop BHRT, unpleasant symptoms associated with menopause for women and andropause for men may recur. These symptoms commonly include:
Hormone Replacement Therapy And Body Identical Hormones
HRT is an effective treatment for menopause symptoms including hot flushes, mood changes and sleep problems. However, there is still a lot of confusion and misunderstanding surrounding this treatment. Read more about HRT risks and benefits.
As the symptoms of menopause happen due to decreasing hormone levels, HRT works by replacing oestrogen and progesterone. The debate around body identical and bioidentical hormones happens because of one question: which is the best way to replace these hormones?
A logical approach is to use HRT products which are identical to the bodys own hormones. The good news is that these are available as regulated and prescribed products, many of which are routinely recommended by doctors for HRT.
These are generally known as body identical HRT, although you may also see them called regulated bioidentical HRT . Yep, it sure is confusing! For the sake of simplicity, we will call these body identical in this article.
Body identical HRT may help with:
The majority of oestrogens doctors prescribe for HRT are in fact body identical, using a form of oestrogen called estradiol which is extracted from natural sources .
If you also take progesterone, the only currently regulated and prescribed bioidentical form is called Utrogestan, also known as micronised progesterone.
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What Happens If I Stop Taking Bioidentical Hormones
Bioidentical hormone replacement therapy is an innovative procedure designed to be a long-term approach to restoring your overall health and wellness from the age-related deletion of your natural hormones. As we age, the bodys natural hormones can drop or become unbalanced for many different reasons and can lead to multiple different symptoms, including mood swings, weight gain, headaches, fatigue, and hot flashes.
The effectiveness of this treatment relies on individualized dosing to bring the most relief with the least amount of hormones and may require time for your body to adjust. Some common side effects may occur, such as breast tenderness, acne, and bleeding. Most of the time, these are minimal and temporary issues, and often resolve with dose adjustments.
While BHRT is a safe and effective treatment for andropause and menopause symptoms, it may not be recommended for all patients, especially if you are at a higher risk for heart disease, stroke, dementia, and breast cancer.
Whether stopping BHRT is influenced by personal health issues or side effects, it is helpful to re-examine why you chose to start BHRT and reconsider its many short-term and long-term benefits. Skilled family nurse practitioner Kellie Lewis and the expert practitioners at Avanti Medical Center in Lehi, UT are ready to discuss any questions and concerns that you may have.
Are There Any Scientifically Proven Advantages For Rbhrt Over Conventional Hrt
Tolerance
Progestogens may not be alike with regard to potential adverse metabolic effects or associated breast cancer risk when combined with long-term estrogen therapy. Micronised progesterone and some progestogens have specific beneficial effects that could justify their use besides their expected actions on the endometrium. Synthetic analogues of progesterone bind to the glucocorticoid, mineralocorticoid and androgen receptors. This can lead to unwanted side effects such as fluid retention, acne and weight gain. Progestogens and progesterone can lower mood through stimulation of the neurotransmitter gamma amino butyric acid whilst progesterone has sedative effects through its intermediate metabolites, progestogens can cause PMS-type side effects including anxiety and irritability.
Venous thromboembolism
It is well recognised that unlike oral estrogen, transdermal estrogen does not appear to increase the risk of VTE. Observational and case control data suggest that the use of certain progestogens e.g. dydrogesterone and micronised progesterone may reduce the increased risk of VTE conferred by oral estrogen, compared to that noted with other synthetic progestogens.
Cardiovascular risks
Breast cancer
Endometrial protection
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A Closely Monitored Approach
Doctors take a closely monitored approach when it comes to optimizing bioidentical hormone replacement therapy. Not only does each patient receive hormones specifically designed for her needs, but a doctor carefully monitors her and makes hormonal adjustments as needed.
Since the goal is optimal health, it is not simply a case of receiving the hormones regularly, either in tablet, injectable, intradermal, or cream form. The doctor also puts together a custom-tailored diet and exercise plan for each patient. Unlike simple hormone replacement therapy, bioidentical hormone replacement therapy is never just a patch and a pill.