What are the pros and cons of bioidentical hormones?

Bioidentical hormones are used to help people manage menopausal symptoms or other hormonal imbalances. Some bioidentical hormones are not approved by the FDA. All hormone replacement therapy has risks. Bio-identical compound hormones may pose a greater risk because their effects are not right studied.

Talk to your healthcare provider about the pros and cons of hormone replacement. And most importantly, know that you don't need to live with the unpleasant symptoms of a low hormone level. Your healthcare provider can help you manage your symptoms safely. Hormone replacement therapy is now a widely available treatment option that is gaining popularity among women over 35, specifically those who feel exhausted, prone to weight gain (sometimes for the first time in their lives), and who have no other options when it comes to managing menopausal symptoms.

This includes options such as bioidentical hormone replacement therapy (BHRT) to balance hormones and improve certain conditions. Hormone production increases during puberty and peaks in healthy adults in their 20s and early 30s. Whether we like it or not, hormone levels begin to decline between our mid-30s and early 40s and continue to remain at lower levels for the rest of our lives. This decline in hormones is natural and inevitable in many ways, but we can still help control how quickly or fluidly this change occurs and how we adapt to its effects.

Part of the problem is that symptoms often attributed to aging or menopause, such as weight gain and fatigue, can actually start in women before menopause because they are caused by other lifestyle factors. For example, it's not common for women, even in their 20s and 30s, to say they have trouble sleeping, digestive problems, or lack of energy. How can you tell if your symptoms are related to hormonal changes or if they are due to another health problem that needs to be treated first? Experts recommend considering how your health and your reaction to lifestyle habits have changed over time as you age. For example, if you exercised and slept a certain amount between the ages of 20 and 30 and you felt good, but at the end of your 40s, you suddenly started to feel different without changing your routine, then it's very likely that your symptoms are related to fluctuations in hormones such as testosterone and estrogen.

Certain clinical studies have shown that oral use of hormonal hormone therapy is highly effective in relieving hot flashes and night sweats, two of the most common symptoms associated with menopause and sleep disorders. A study conducted in 2001 comparing the frequency and severity of hot flashes symptoms with hormone replacement therapy (HRT) compared to the administration of a placebo, found that hormone replacement therapy reduced the frequency of symptoms by an average of 77 percent, while the placebo produced a reduction of about 50 percent. Hormone therapy also reduced the severity of symptoms and caused no more side effects or withdrawal symptoms than the placebo. The North American Menopause Society reports that about 1.4 million women now use BHRT treatments, representing about 40 percent of all hormone therapy prescriptions in menopausal or postmenopausal women.

To date, no large, long-term studies have been conducted to determine the adverse effects of bioidentical hormones, so safety issues remain a serious issue. The Women's Health Initiative, a large long-term study that tested the effects of FDA-approved hormone replacement drugs, determined that some patients may have side effects and that these drugs have not been proven to prevent any disease. BHRT products have not been proven to be safe or unsafe. Because not enough is known about their long-term efficacy or safety, they are still considered controversial. Bioidentical composite hormones are advertised as a safer, more effective, natural and individualized alternative to conventional hormone therapy.

In recent years, there has been an increase in the number of private clinics offering composite bioidentical hormone therapy to women, which is a matter of great concern. When it comes to the efficacy and safety of bioidentical hormone replacement therapy, studies also show mixed results. What's more worrying is that these compound hormones often have unsubstantiated claims, lack scientific data about safety and efficacy, and lack quality control surrounding them. The National Academies of Sciences, Engineering and Medicine recommend that composite bioidentical hormones be used only in very specific circumstances, such as in the case of an allergy to FDA-approved hormone products.

Bioidentical hormones are processed hormones designed to mimic the hormones produced by glands in the body. In fact, the hormones in bioidentical drugs may not differ at all from those in traditional hormone therapy. Over the past two decades, there has been enormous confusion regarding hormone replacement therapy (HRT). Some examples of popular bioidentical hormone replacement therapy products currently on the market are Estrace, Premphase, Prempro, Activara, and Vivelle-Dot, to name just a few (there are dozens and even more that aren't “bioidentical”).

Some of the hormones used in these bioidentical hormones contain hormones that are not approved for women, such as dehydroepiandrosterone (DHEA) or pregnenolone. Most women and health professionals are concerned about the potential risks of breast cancer in women receiving hormone replacement therapy. While personalized hormone combinations often include mixtures of the same ingredients found in FDA-approved bioidentical hormones, some include additional hormones. Certain hormone treatments are called “bioidentical” or sometimes “natural” because the types of hormones used are chemically identical (based on molecular studies) to those produced by the human body.

The term “bioidentical hormones” simply means that they have the same molecular structure as the body's hormones.