Bioidentical Hormone Therapy & Menopause

Dr. Preet Khangura, ND

Production and circulating levels of specific hormones significantly decline when a woman enters the menopausal stage of her life. Specifically, estrogens, progesterone, and testosterone take a sharp decline, leading to new onset deficiencies in these hormones. This can unfortunately cause symptoms such as hot flashes, night sweats, insomnia, vaginal dryness, urinary tract infections, low libido, dry skin/hair, weight gain, water retention, anxiety, depression, and memory deficits. For some women, these symptoms can become extremely debilitating on a day-to-day basis.

One treatment option that can make a world of a difference for many patients is bioidentical hormone therapy (BHRT). It is crucial to not confuse BHRT with conventional, synthetic hormone therapy (HRT). Synthetic hormone therapy, which unfortunately is still used quite often, has been clinically linked with increased risks of certain cancers and increased risk of cardiovascular disease. BHRT on the other hand, has been shown to not promote risk of cancer or cardiovascular disease, and has actually been shown to prevent both illnesses when used properly. Another distinction to be made is that BHRT does not mean “natural” hormones. The hormones are created from natural sources, however, they are still pharmaceutical agents. The difference between BHRT and HRT is that BHRT hormones are identical to human produced hormones on the molecular level, where as synthetic HRT hormones are not.

With BHRT, the safer and protective form of estrogen, named estriol, can be compounded by a pharmacy. Estriol on its own, or mixed with a very small amount of another bioidentical estrogen, named estradiol, can alleviate symptoms such as hot flashes, night sweats, vaginal dryness, and frequent urinary tract infections. Conditions such as osteoporosis, which increases in incidence during menopause, can also be prevented using bioidentical estrogen therapy. Along with estrogen therapy, bioidentical progesterone should almost always be administered as well. Progesterone can greatly alleviate symptoms such as insomnia, slow metabolism, water retention, poor memory, and anxiety. However, on top of these great benefits, progesterone also plays an important role of balancing estrogen’s proliferation action on specific tissues in the body. This is one reason why the estrogen to progesterone balance while a woman is in her reproductive years is very important. When in menopause, and undergoing any treatment to replace, modulate, or balance hormones, the estrogen to progesterone balance is also very important. This is why it is very important to determine hormone levels via 24 hour urine hormone testing or salivary hormone testing, before undergoing hormone treatment of any kind.

Bioidentical hormone therapy can significantly improve a woman’s day to day life while at the same time help protect her from certain chronic illnesses. If you, or someone you know, are dealing with severe menopausal symptoms, don’t hesitate to see if BHRT, or any other naturopathic treatments such as herbal medicine or acupuncture, is a right fit for you.

References:

  1. Plu-Bureau G, Le M, Thalabard J, et al. Percutaneous progesterone use and risk of breast cancer : results from a French cohort study of premenopausal women with benign breast disease. Cancer Detect Prev. 1999;23:290-296.
  1. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? PostGrad Med. 2009;121(1):1-13.
  1. Dessole S, Rubattu G, Ambrosini G, et al. Efficacy of low-dose intravaginal estriol on urogenital aging in postmenopausal women. Menopause. 2004;11(1):49-56.
  1. Fitzpatrick L, Good A. Micronized progesterone: clinical indications and comparison with current treatments. Fertil Steril. 1999;72(3):389-397.

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