Bio-Identical Hormone Replacement Therapy (Bio-HRT) is an individualized hormone replacement program tailored to meet the needs of select men and women seeking to restore hormone balance. Bio-HRT offers an alternative option to synthetic hormones and has helped countless patients frustrated by the failures of more traditional therapies in treating conditions including hot flashes, fatigue, insomnia, decreased libido, depression, weight gain, and other problems resulting from hormone imbalance.
In addition to hormone balancing, these conditions can often be improved with a lifestyle program based on sound nutrition, regular exercise and stress management. This approach has become a welcomed alternative to conventional oral hormone replacement therapy for peri- and post-menopausal women, as well as men who suffer from hormone deficiencies.
Unlike many commercially available hormones, bio-identical therapies are chemically identical to the hormones men and women have throughout their youthful life. Made from yams and purchased with a prescription at a compounding pharmacy, bio-identical hormones are available in various preparations including creams, pills, sublingual troches, injections and suppositories.
Bio-identical hormones prescribed in a cream formulation eliminate first pass metabolism (processing in the liver). It is possible that many of the increased risks associated with the Women’s Health Initiative Study may be secondary to this aspect of metabolism. Similar to the Heart and Estrogen/Progestin Replacement Study (HERS) research trial, both studies found that the use of oral conjugated estrogens (Premarin and Provera) increased (not statistically significant) the risk of breast cancer (26-27%). The Women’s Health Initiative Study also identified unacceptable increases in cardiovascular events and strokes. For this reason, the study was halted. More recently, the Premarin only treatment group was halted from further study for similar increases in cardiovascular risks and strokes, but a significant decrease in breast cancer incidence. These results are very confusing and need further explanation. Benefits from HRT include reduction of colon cancer (37% WHI and 19% HERS) and 24% reduction of osteoporotic fracture risk (WHI).
Due to the current state of research findings, it is not clear if using bio-identical hormones increases the risk of breast cancer or heart disease. While science has not provided all of the answers, men and women must make informed choices about hormone replacement and know that there are uncertainties with the recommendations for or against HRT. Patients must decide for themselves their comfort level with the potential risks afforded by both modalities and the potential risks of not taking hormone replacement. To read more about the history of HRT and these studies, please click here.