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Hormone Therapy: How Do I Know What’s Safe For Me?
(05/30/2007) by Annette Owens
Many menopausal women have questions about what type of hormone therapy is safe. Bioidentical hormones in particular have recently received increased media attention, more so than ever since the release of Suzanne Somers’ book Ageless: The Naked Truth About Bioidentical Hormones in the fall of 2006. It is often argued that bioidentical hormones are more natural and safer than other types of hormones. Is this really true? Let’s take a closer look at this debate.
Definitions
The term "bioidentical" means that the hormones are made in a laboratory, but are identical to hormones produced in the human body. FDA approved pharmaceutical products that are bioidentical (identical to the human estradiol and progesterone) include (using American trade names) estradiol patches (Vivelle Dot, Climara, etc.), estradiol gel (Estrogel), estradiol lotion (Estrasorb), oral estradiol tablets (Estrace, Gynodiol, etc.), local vaginal estradiol in various forms (Vagifem tablet, Estrace cream, Estring, etc.), oral micronized progesterone (Prometrium), and vaginal progesterone preparations (Crinone, Prochieve). These pharmaceutical hormone products are actually made from an estrogen-like molecule derived from yam or soy plants. They all are sold in set dosages only, as they were tested that way and eventually received FDA approval.
"Bioidentical" therefore does NOT mean that these hormones are "natural" (as opposed to "artificial"). In fact, the only available truly "natural" hormone is Premarin, which is a type of estrogen isolated from pregnant mares’ urine.
"Compounded" hormones are preparations mixed (custom made) by a compounding pharmacist. Since these compounded hormone preparations vary with respect to dosages used, they have not been scientifically tested for safety in the same manner that FDA approved hormone preparations have.
Efficacy and Safety
It is popular to claim that compounded hormones are natural, not synthetic, and have fewer side effects. This claim is unfounded. Currently, there is no published, scientific evidence that bioidentical, compounded hormones are any safer than other hormone products available. According to Dr. Utian, Executive Director and Honorary Founding President of The North American Menopause Society (NAMS), women should assume that all hormones, whether made by drug companies or pharmacies, likely carry the same risks and benefits.
More Solid Information
There are no simple answers as to whether a menopausal woman should or should not opt for hormones. The best online summary of scientifically based information I have found is the CBSCares series on menopause (see resources below). Several experts in the field provide a balanced view of why hormone therapy may or may not be appropriate for someone. I encourage each woman to take charge of her own health by getting informed about this important issue. Knowing the facts will help her address her specific situation with a health provider. NAMS offers a list of credentialed menopause practitioners on their website.
References
Huang, J. (2007) Hormones and female sexuality. In Owens, A. F. & Tepper, M. (Eds.) Sexual Health; Volume 2: Physical Foundations; Westport, Connecticut: Praeger Publishers.
Taylor, M. (2005). "Bioidentical" estrogens: Hope or hype? Sexuality, Reproduction and Menopause, 3 (2), 68–71.
Internet Resources
CBSCares Menopause Pages http://www.cbs.com/cbs_cares/menopause/index.shtml
The North American Menopause Society (NAMS) http://www.menopause.org/default.htm
Source: www.loveandhealth.info This article appears in the following topics:
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