Thursday, May 6, 2010

Bioidentical Hormones are Safe Bioidentical Hormones are Safe

by Candice Lane, M.D.

There is no doubt that there is improvement in the symptoms of menopause by using hormone replacement therapy. It includes elimination of symptoms such as hot flashes and night sweats, reversal of bone loss leading to osteoporosis, improved sleep, emotional stability, libido and quality of life.But extreme confusion revolves about the safety of taking hormones.

Some doctors are telling patients to get off all hormones. Some are prescribing Premarin and Provera, while others are prescribing “bio-identical hormones”. Still others are switching back and forth between the two.

Hormone replacement therapy or HRT is a broad category. Some people use this term to refer to all hormone replacement therapy. When you hear this term in the media, they are generally referring to Premarin and Provera which are not natural to the human body. These drugs are referred to as synthetic hormones because they are synthesized with molecules that do not occur in the human body in nature.

Premarin is a type of estrogen obtained from horse’s urine. Although it is natural to horses, it is a different molecule than occurs in the human body. It is a very potent estrogen that can alleviate many symptoms but has negative effects as well.

Provera is a progestin used to prevent tissue from building up in the uterine lining while taking Premarin. A progestin is NOT progesterone. It is a different molecule. Progestins actually inhibit production of progesterone by the human body and have dangerous effects on the human body.

The new classification of hormone replacement therapy is called bio-identical hormone replacement therapy or BHRT. This therapy includes estrogens and progesterone that are made from soy and wild yams obtaining a compound that has the exact same molecular structure as these substances in the human body… therefore, bio-identical.

The dangers of Synthetic HRT (Premarin and Provera) were discovered in the Women’s Health Initiative Study in 2002.

This study analyzed the outcome of women taking Premarin (conjugated equine estrogen or horse estrogen from pregnant mare’s urine) and Provera (medroxyprogesterone acetate or synthetic progesterone) and found increased rates of breast cancer and cardiovascular disease. Since the drugs used were not bio-identical hormones the results only apply to Premarin and Provera, not BHRT.

Premarin is taken orally. Any oral estrogen can be a problem for heart health. It can activate coagulation and inflammation. Descenci in Circulation in 2005, found that transdermal estrogen does not have this effect.

The main breast cancer problem is the synthetic Provera (medroxyprogesterone). When the Women’s Health Initiative patients who received only Premarin without Provera were analyzed the rate of breast cancer was not increased. (Anderson, JAMA, 2004). This indicated that it was the Provera that caused an increased incidence of breast cancer.

BHRT (bio-identical hormone therapy) does not increase the chance of breast cancer. The main danger of synthetic HRT is the non-bio-identical progestin (Provera).

In the Fournier et al. study in the International Journal of Cancer, 2005 studied 54,000 women who were taking bio-identical estrogen and either bio-identical progesterone or synthetic progestin. The women taking the bio-identical progesterone had a 10% decrease in risk of breast cancer and the women taking artificial progestin had a 40% increase in the risk of breast cancer.

The De Lignieres study from Climacteric 2002 could not show an increased risk of breast cancer with use of bio-identical hormones but showed an increased risk with the use of synthetic progestin (Provera/medroxyprogesterone). In fact, they could not justify stopping BHRT(bio-identical), which is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile without activating coagulation and inflammatory protein synthesis as in users of oral estrogens.

The real problem with synthetic HRT is the synthetic progestin(Provera). In contrast, several studies document that higher progesterone levels during pre-menopausal years or during pregnancy are protective against breast cancer. (Campanoli, Journal of Steroid Biochemistry and Molecular Biology, 2005).

In any case, estrogen should not be taken without progesterone which counters the proliferative tissue effect of estrogen on breast and uterine lining.

Bio-identical hormone therapy, which is different from Premarin and Provera, is safe, effective, and proven beyond any reasonable medical and scientific doubt

Call my office in Wilmington (815) 476-5210 or Lombard (630) 627-3700 to set up an appointment or email me at


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