What does "bio-identical" mean?
This is a term first used by Dr. Christiane Northrup. It means identical to biology, and is used to distinguish human hormones from hormone-like drugs. They can also be called 'nature-identical'.
What are bio-identical Hormones (BHRT)?
Bio-identical hormones are supplemental hormones that are exactly identical to hormones found in the human body. This is different than conventional HRT which, in order to be patented, were synthesised to be different from, and stronger than, human hormones. It is because conventional HRT differs molecularly from human hormones that conventional HRT is a risk for cancer.
There are many different types of bio-identical hormones. They are not just one thing. Each one: oestrogen, progesterone, DHEA must be considered individually.
For a current look at research into BHRT see
what are they made from?
Bio-identical hormones are made in a lab from soy or wild yam, like all hormone supplements. The term "natural" hormone does not refer to their source, but to their identity. Bio-identical hormones are exactly the same shape as human hormones. This is a very important distinction because most forms of HRT and the Pill are not identical to human hormones. The difference for the body is profound. Think of a hormone like a key that needs to fit into the hormone receptor (the lock). If the key is the wrong shape, it can still be jammed into the lock, but it is not the right fit. This is why non-bio-identical forms of HRT and the Pill cause so many side effects.
Are they effective?
Yes, when they are used properly, bio-identical hormones definitely work. They are real hormones.
They must be used at the correct dose for the body. If the dose is too small, or too high, there will be no benefit.
Where are they available?
Bio-identical hormones are available by prescription from compounding chemists. Any doctor can prescribe, if they are willing to.
Your doctor prescribes bio-identical oestrogen every day
In recent years, standard oestrogen prescriptions have changed from horrid horse urine oestrogens to a bio-identical oestradiol in a patch or gel. Essentially these modern oestrogen prescriptions are natural or "bio-identical". They are much safer and more effective than the horse urine of 8 years ago.
The same shift is going to happen with progesterone. At the moment, progestin drugs are the standard prescription in Australia and North America. However, study after study is emerging to show that bioidentical progesterone is safer and more effective than progestin. It is only a matter of time until the official recommendations catch up. "Natural" progesterone will to become the norm.
But what happens in the meantime? Must women accept the progestins that cause breast cancer, stroke, depression and bone loss?
At the moment, if a women wants progesterone, she must obtain it through an alternative route, and then risk chastisement by her doctor. Pretty silly considering that the very same doctor may be routinely prescribing the exact same hormone in 5 years time.
Are they safe?
If used appropriately, they are considerably safer than conventional HRT.
Please read Good oestrogen-bad oestrogen and DHEA article and Progesterone article for more current information about efficacy and safety.
The safety problem with some BHRT scripts
If you obtain a script for bioidentical hormones from your doctor, be careful. At the right dose, BHRT is a fantastic treatment for PCOS, endometriosis, fibroids, PMS, depression and menopause. At the wrong dose, it will not work for you.
There are three main problems with the way that natural hormones are typically prescribed in Australia.
- They are usually given as troches or lozenges rather than creams. This means that some of the hormone will be swallowed and broken down by the liver into other hormone metabolites. Progesterone metabolites will not work as well, and higher doses must be used.
- Doses are too high. The pioneer of natural progesterone use, Dr. John Lee, recommended using no more than 20mg Progesterone per day (40mg in a troche). That is the amount produced by the ovary in a healthy woman. Higher amounts may be need for severe estrogen dominance, but never more than 60-80mg per day. A dose that is too high will produce no benefit.
- Oestradiol and oestrone are not always necessary. These strong oestrogens are the source of most of the controversy about natural HRT. Of any of the bioidentical hormones, these stronger oestrogens are the ones with some cancer risk, particularly if they form dangerous metabolites in the body. Bio-identical hormone formulas that contain oestradiol or oestrone are called: Bi-est or Tri-est. Please read Good oestrogen-bad oestrogen for more information about safety of oestrogen and oestrogen metabolites.
Can BHRT be obtained from Sensible-Alternative?
No, we do not sell bio-identical hormones directly. As Naturopaths, we cannot provide you with a medical script. We can offer you assessment and advice about bio-identical hormones. We can direct you to ways to obtain them.
Unique naturopathic low-dose approach to bio-identical hormones
At Sensible-Alternative, we advocate for a "minimal dose" hormone prescription, and almost always in a cream form. We advise you how to use the hormones within the context of a broader Naturopathic treatment including herbs and nutritional supplements.
How long do I have to take them?
It depends on why you're taking them. PMS symptoms due to progesterone deficiency can be corrected with just a few months of treatment. Menopausal symptoms may require treatment for approximately one year. Long-term use may be used for prevention of osteoporosis. If you do use hormone supplements long term, you should do a safety check with saliva or urinary hormone testing. Blood testing is not good enough.
What are Phyto-estrogens or "Plant oestrogens"?
Phyto-estrogens are plant molecules that are similar in structure to human hormones, but they are not true hormones. They can be used to gently promote the body's own hormones. They also buffer and protect tissue from excess hormone. For example, when oestrogen is deficient, phyto-estrogens will provide gentle stimulation to hormone receptors. When oestrogen is in excess, the same phyto-estrogens will block oestrogen at the receptor. In this way, they protect against reproductive cancers.
Is Wild Yam Cream the same as Natural Progesterone Cream?
No. Wild yam may work as a herbal medicine, but it does not provide progesterone.
What are Natural HRT formulas available in health food stores?
They are combinations of nutrients and herbs containing phyto-estrogens. Phyto-estrogens are effective for menopause and hormonal imbalance. They are part of the treatment plan at Sensible-Alternative, but they are not hormones.
Should hormones be supplemented?
Bottom line, try diet and lifestyle first. Do NOT smoke, take excess alcohol or eat sugar. Get enough rest, and enough sleep. And eat well including vegetables, protein and healthy fat.
Assess for adrenal hormones, and consider herbs to increase DHEA.
Consider using progesterone and/ or oestriol (a safe oestrogen). Both progesterone and oestriol are widely used in Europe, and have a growing safety record.
If all else fails, then consider a stronger oestrogen such as oestradiol. Certainly, it is preferable to anti-depressant medication. If oestradiol is used, it should be taken in conjunction with Natural Progesterone. Artificial progestins should be avoided at all costs.
Appointments at Sensible-Alternative
For professional advice regarding a Naturopathic approach to bio-identical hormones, please call to make an appointment...
Sensible-Alternative Hormone Clinic
Suite 1, Berry Rd Medical Centre
1A Berry Rd, St Leonards NSW.
phone: 02 9438 3448.
