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Frequently Asked Questions about Bioidentical Hormone Replacement

Posted: 2018-01-21 12:30 Permanent Link

Julia Fountain ND

What’s the difference between bioidentical hormones and synthetic hormones?
Bioidentical hormones include natural progesterone and natural estrogens (of which there are 3 – estrone, estradiol and estriol). Bioidentical hormones are derived from wild yam and soy, chemically modified in the lab to be identical to our naturally occurring hormones. This is contrast to synthetic hormones which are similar, but not chemically identical to naturally-occurring hormones.

How do I know if I need bioidentical hormones?
If you have tried other natural ways to manage uncomfortable hormonal symptoms with limited success, you may be a candidate. Or, if you’re currently using synthetic hormone therapy to control symptoms (birth control pill, Premarin, for example) and looking for another way, you may be a candidate. We also run baseline labwork and have you complete a detailed hormone questionnaire to ensure we’re not misinterpreting symptoms.

Are bioidentical hormones safe?
Based on a literature review of 200 hormone studies, bioidentical hormones remain the preferred method of HRT. They were associated with lower risks, including the risk of breast cancer and cardiovascular disease and were more effective than their synthetic and animal-derived counterparts (Postgrad med 2009:121 (1): 73-85). However, they are not without risk and they’re not for every woman. This is why our naturopathic approach encompasses prescription bioidenticals only in the context of a diet, lifestyle and supplement/herbal regime which promotes healthy hormone balance, and with close clinical and lab monitoring. If women need bioidentical hormone therapy it’s generally for a shorter amount of time, and at a smaller dose, when these other factors are controlled for. There’s more to hormone balance than hormone replacement!

What is the advantage to using prescription bioidentical hormone creams vs pills? Hormones are normally produced by glands in the body, secreted directly into the blood stream and reach their target organs for effect. Hormone creams allow absorption through the skin, directly into circulation and reach their target organs without having to pass through the digestive system or liver. Effective doses of creams are generally much lower than pills, and the dose can be titrated more tightly (it’s easier to use ¼ dose of cream vs take ¼ pill). Transdermal (skin absorbed) estrogens also carry less of a risk of gallbladder disease, clotting and increasing triglycerides.

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