Learn the facts about bioidentical hormones
Bioidentical hormones. It’s like they’re the “new black.” They’re touted on daytime talk shows and make headlines in women’s magazines. They’re prominently featured in on-line ads, flashing promises at you from the margins of your favorite Web sites. Are you missing out? Or escaping the latest fad-gone-bad?
Out-of-the box hormones: A review
Standard hormones that are sometimes prescribed by doctors for hot flashes and other menopausal symptoms are commercially made and approved by the U.S. Food and Drug Administration (FDA). They are a combination of estrogen and progesterone (progestin) and are manufactured as pills, patches or gels at various standard doses. While most are made from animal compounds, there are also plant-based hormone preparations (phytoestrogens). These products are also available in creams, pills and patches in a variety of doses. While not a perfect match to those hormones in your body, they are very close.
These preparations are commonly called hormone replacement therapy (HRT). They even out hormone levels in women whose levels fluctuate, or rise and fall. It is these fluctuations of hormones in women that cause the symptoms of menopause.
Hormone products made by drug companies have undergone rigorous testing and approval processes and are made the same way all the time. Since standard HRT has been well studied, it’s known to be effective for relieving menopause symptoms. It’s also known that it may have some risks, such as an increased risk of heart disease and breast cancer in some women.
Doctors recommend that when hormone therapy is needed that it be started at the lowest possible dose and taken for the shortest time possible for menopause symptom relief.
Bioidentical hormones: The facts and fuss
Technically, the term “bioidentical hormones” refers to hormones that are exactly like the ones your body makes. When doctors talk about bioidenticals, they are often referring to the FDA-approved, plant-based hormone products.
But the term “bioidentical” has taken on new meaning, mostly for marketing purposes.
Marketers tout that their own hormone products are “bioidentical” because doctors prescribe them and pharmacies mix each compound for a specific woman. Prescriptions are often based on hormone levels in saliva. But, studies show testing saliva is not an accurate way to determine or monitor hormone levels.
Sellers of bioidentical hormones also claim these hormones are more natural, safer and more effective than standard hormone therapy. So far, there is no evidence to support these claims.
Women might think having hormones “mixed to order” for them sounds ideal. But experts say not only is hormone customizing hard to achieve, it’s not needed. Blood hormone levels are hard to measure and regulate accurately.
Plus, because these products are made at compounding pharmacies, they are not FDA-regulated. Each mixture is unique, and there is no oversight to assure their purity, safety or efficacy. Custom-mixed hormones are considered experimental drugs and aren’t typically covered by insurance plans.
Finally, the so-called “bioidentical hormones” are not more “natural” than other hormones. Both commercially made and compounded hormones are synthetic, or man-made. And they use many of the same components (estrogen, progesterone, testosterone) as commercially made hormones.
So here’s the bottom line on bioidenticals. At this time, the safety, effectiveness and risks of these hormones simply aren’t known. Until we know more, it’s probably better to stick with commercially prepared hormones when you and your doctor feel that hormone therapy is needed.