Treating Menopause with Bioidentical Hormones

Menopause is officially defined as the cessation of menses for a year as a result of decreasing ovarian function. Menopausal symptoms can occur between the ages of 35 to 55, however some symptoms can occur as early as 30 years in some women.  A women undergoing natural menopause really does not know whether any given period is truly her last until a year has passed.

As menopause approaches cycles become quite erratic with the initial hormonal changes associated with perimenopause occurring by the age of 40. Contrary to standard belief, estrogen levels often remain relatively stable during perimenopause until less than a year before the last menstrual period, where levels begin to decline. Testosterone levels also usually do not fall appreciably during perimenopause. Progesterone levels however begin to decline long before changes in estrogen or testosterone. Because estrogen and progesterone are meant to counterbalance each other throughout the menstrual cycle, a decline in progesterone allows estrogen to go unopposed which results in a condition called estrogen dominance. The symptoms of estrogen dominance are decreased sex drive, irregular and/or heavy periods, bloating and fluid retention, breast swelling, mood swings, weight gain and headaches. Unfortunately there is a great deal of overlap in the symptoms of various hormone imbalances and it is not uncommon for women experiencing estrogen dominance to be given a script for more estrogen thus worsening her symptoms.

As the midlife transition continues progesterone levels continue to decline and eventually estrogen levels begin to fluctuate widely. It is at this point where perimenopausal symptoms of estrogen deficiency begin such as: hot flushes, night sweats, loss of sexual desire, vaginal dryness, fuzzy thinking, urinary tract infections and dry skin. These perimenopausal symptoms may last from anywhere between five to ten years. Continuing through the perimenopausal time-line the women finally reaches menopause where menstruation has totally ceased.

After menopause in addition to low estrogen levels, and the associated symptoms, women lose two-thirds of their remaining progesterone and within six months blood levels fall to a barely functional level. A lack of circulating progesterone may cause any of the following symptoms: swollen breasts, headache, low libido, anxiety, depression, insomnia, cramps, emotional swings, weight gain, bloating, fuzzy thinking etc.

There is no need for women to suffer through these mid-life changes as Individualised Bioidentical Hormone Replacement Therapy (IBHRT) is able to effectively treat menopausal symptoms and also potentially prevent long term diseases associated with the onset of menopause and hormone imbalances.

What are bioidentical hormones?

In contrast to traditional HRT which utilizes synthetic or animal derived hormones, bioidentical hormones have a molecular structure which is an exact match of the hormones found in the human body, hence we call them bioidentical. Because bioidentical hormones are exactly like the hormones our bodies produce and were designed to recognize their effects are more consistent with our bodies biochemistry.

The approach taken in IBHRT is to use a combination of bioidentical or "bioequivalent" natural hormones in individualised doses to suit the hormonal requirements of each individual. The doses used should ideally be based on hormone test results in conjunction with signs and symptoms. Monitoring hormone levels while on any hormones is essential in order to ensure the doses you are taking achieve optimal physiological levels. In addition testing also ensures a heathy balance of the three main estrogens in conjunction with progesterone is maintained to help minimise the risks of any side effects.  

Bioidentical hormones such as the three estrogens, progesterone, testosterone, DHEA and cortisol are all synthesized from a hormone precursor extracted from either soy beans or wild yam called diosgenin. Diosgenin has a molecular structure very similar to all these closely related hormones. Once the diosgenin has been extracted from the soy beans and purified its molecular structure is then modified in order to convert it into the appropriate hormone. Once the appropriate hormone has been made it is purified to a pharmaceutical grade purity and then micronized to maximise absorption. Although these hormones are synthesized it should not be mistaken that they are synthetic. Synthetic refers that the molecule does not exist naturally but has been designed and made by man to produce a totally new molecule that never existed before in nature.

What are the risks of using BIoidentical Hormones?

With the release of the WHI study a few years ago many women have been too afraid to use any form of estrogen replacement out of fear of developing breast cancer. What is not appropriately explained is that these findings were related to two very specifc hormones, being conjugated estrogens derived from horse urine and a synthetic progestin.  A french study however following over 3000 women for more than eight years using a bioidentical estradiol and progesterone combination was unable to find any increased risk of breast cancer using these safer bioidentical hormones.

For more detailed information on the risk of breast cancer associated with estrogen replacement click here.

For an independant view - Dr Jeffery Dach MD - on the risks of bioidentical hormones click here.

How are bioidentical hormones administered?

(1) Transdermal Creams - Hormones are effectively absorbed directly into the bloodstream bypassing the stomach and liver. This allows lower doses to be administered thus placeing less stress on the liver and decreasing the chance of side effects. Once absorbed the hormones are stored in body fat under the skin which release the hormones into the blood stream over time thus maintaining steady levels in the blood.

The cream base used in our laboratory does not contain any hidden nasties such as hormone disrupters like the paraben preservatives or propylene glycol. In addition we avoid the use of all petrolium based ingredients (paraffins), parabens, sodium lauryl sulphate, propylene glycol,  fragrances, artificial colours, waxes and heavy oils. For more information refer to our article Are your Cosmetics Causing you Harm.

(2) Capsules - Hormones taken orally come in contact with the acid in our stomaches which may decompose some and once absorbed are passed into the liver where they are further metabolised before entering circulation. Oral administration thereby requires greater doses to achieve physiological levels.

(3) Troches/Lozenges - are held between the cheek and gum and allowed to dissolve. The hormones are claimed to be absorbed directly into the blood vessels that line the buccal area thus avoiding the stomach and liver. However estimates indicate that approximately 50% to 70% of the lozenge is swallowed which inevitably encounters the stomach and liver. Clinical experience shows that doses required for troches are as high as capsules so there is no real benefit using them except in cases where creams are unsuccessful and digestion/absorption problems exsist.

For more accurate information regarding troches please refer to the article The Truth about Troches.

How to get started?

Ask your doctor, contact us for a consultation, or alternatively refer to relavent sections of this website for more details. More in depth information is available in the members section of this site however you are required to log into the free practitioners advice section in order for us to comply with therapeutic advertising laws.

Having Trouble Finding a Doctor Who Will Prescribe Bioidentical Hormones?

Unfortunately many mainstream medical doctors refuse to prescibe bioidentical hormones as they are considered unorthodox treatments and instead prefer to continue to prescribe traditional synthetic and horse urine derived hormones which are considered by many to be dangerous. Some doctors and so called "experts" even argue that there has not been any research on bioidentical hormones and women using them are guinea pigs. This is most definitely misleading and incorrect information. There have been many studies over the last few decades proving the safety and efficacy of each individual bioidentical hormone. Several studies on various bioidentical hormone combinations have favourable results in addition to a long term clinical trial using a hormone combination currently underway with very positive preliminary results. In addition estriol, estradiol, estrone, progesterone and testosterone have all been individually approved for human use by the Therapeutics Goods Administration (TGA) in Australia and have been scheduled on the SUSDP. In addition all these hormones have been approved and listed in both the US and Brittish Pharmacopoiea's which are considered to be the medical industries bible of acceptable drug therapies. Nothing gets listed in these reference texts without adequate research and evidence for their safety and efficacy. And they still argue no research has been done on these hormones? In addition hormones such as progesterone cream and DHEA are considered so safe in many other countries around the world that they are classed as a supplement and therefore available over the counter through health food stores and pharmacies while here in Australia they are only available on prescription! Where is the logic?

The confusion lies with the fact that in Australia no bioidentical hormone combination has been registered for commercial supply and therefore listed on the ARTG, even though several individual bioidentical hormones have. Estriol, estradiol and testosterone have been registered and are commercially available as single ingredient preparations. Just because these hormone combinations have not been registered on the commercial ARTG list does not mean they have not been approved for human use and are therefore unsafe. The truth is that being natural hormones pharmaceutical companies legally cannot patent these hormones. If they cannnot patent these hormones they do not develop these combinations and have them registered with the TGA as they deem them unprofitable. If the pharmaceutical companies do not pay to have these hormone combinations registered then the TGA will not register them. In the end the patient suffers because the companies will not make enough money from it. In addition there are several doctors whom are publically outspoken about the erroneous dangers of bioidential hormones and promote the use of pharmaceutical hormones such as premarin. These doctors have strong links to the pharmaceutical company whom produce these products and thus their motives for presenting much misinformation needs to be questioned?

It puzzels us why doctors prefer to prescribe synthetic or horse urine derived hormones which at the very least their safety is highly questionable, if not down right dangerous, and of which there are NO normal physiological levels. The ethics committee that was responsible for overseeing the now famous Womens Health Initiative trial deemed it unethical to continue this trial as it places women at risk by giving them these traditional hormones. If they deem it unethical why are they still being prescribed? 

Answer- The pharamaceutical companies marketing machine convinces doctors of their safety contradicting the evidence!

Bioidentical hormones on the otherhand have been produced by the human body for your entire life. In addition we are able to maintain their supplemented levels at optimal physiological levels mimicking a healthy body. Using natural hormones at physiological levels mimicking mother nature must surely be a safer alternative! In addition all bioidentical hormone levels are monitored to ensure they lie within the optimal range and that they are all correctly balanced. This is not done with standard pharmaceutical HRT as they pay little to no attention to proper hormone balance, which is extremely important, and why they are so dangerous!  Endometrial ultrasound, breast screening and estrogen metabolism monitoring should be conducted annually in order to minimise any further risks. All of these steps help reduce the risk factors of bioidentical hormones.

If you are having difficulty finding a sympathetic doctor contact us as we may be able to provide you with details of an informed doctor nearby.

Want More Information?

For detailed information on how to safely take bioidentical hormones, monitor hormone levels, various treatment options, and for specific hormone information you will be required to log into the restricted members area of this site which is free of charge. This is necessary in order to comply with Australian Therapeutics Advertising Laws. Click on either Existing members or Set up a new account to enter restricted area.

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