Hormones are chemical messengers that allow the body to communicate between one part and another.
Bio-identical hormone therapy (BHRT) is mostly focused on the replacement of the primary sex hormones, estrogen and progesterone. BHRT uses hormones that are structurally identical to these same hormones in the body. They differ from hormones found in the birth control pill because the molecular structure of synthetic hormones found in the birth control pill do not exist in the body naturally. They also differ from conventional hormone replacement therapy (HRT) that uses pregnant mare's urine (Premarin), as this chemical hormone contains many different types of estrogens that also do not exist in the human body. For this same reason, BHRT also differs from the use of compounds like Provera/Progestin which is not a progesterone.
Make no mistake, the estradiol, estriol and progesterone used in BHRT are synthetic hormones. They are synthesized from plants to create chemical compounds, but they are not foreign to the body. However, it is thought that they may be safer than non-identical HRT because not only are they identical to human hormones, but also because very low dosages can be triturated and individually prescribed. Bio-identical hormones are produced by compounding pharmacies.
While there exist small scientific studies that show efficacy and safety for BHRT, there are no confirmatory large randomized control trials that elucidate the safety of these alternative hormone treatments. Therefore, it is prudent to use this therapy wisely, and have regular blood work, PAP tests, and mammography done as is appropriate during this therapy.
The following are some conditions where BHRT is beneficial:
At times, hormone testing through saliva or a 24-hour urine test can guide the prescription. However, more often than not, the patient's symptoms guide the prescription and titration to the lowest and balanced dose possible that achieves the greatest benefit and symptom relief, is how I approach this type of medicine.
There is a place for all types of hormones, even the birth control pill, Premarin and Provera. The question is always this: What is best for the patient for a given situation? The answer could be no hormones, or pharmaceutical hormones, or BHRT.
Hormones may be the chemical communicators in the body, but the brain is the organ that governs the excretion of these sex hormones from the glands, and thus brain health becomes all important in balancing hormone health.