Bioidentical Hormones

The History of Bioidentical Hormones

The interest in bioidentical hormone replacement therapy (BHRT), also known as bioidentical hormone therapy or natural hormone therapy, has grown since the early termination, in 2002, of the Women’s Health Initiative (WHI) trial of synthetic combined estrogen and progestin, FDA approved drugs, for relieving menopausal symptoms. The trial was stopped early because it was found that the women using these hormones had a higher risk of breast cancer, heart disease, stroke, and blood clots.

According to Harvard Medical School, “Even before the WHI results came in, many women were looking for something different to relieve hot flashes, night sweats, and vaginal dryness. Some women disliked the side effects of hormone therapy, such as breast tenderness or bleeding. Others worried about estrogen’s link with breast cancer. Still others were opposed to taking drugs for symptoms because doing so implies that menopause is a disease rather than a normal life passage. Some women objected to the use of pregnant mares’ urine — the source of estrogen in oral conjugated equine estrogens (Premarin), the only estrogen tested in the WHI trial.”

What Are Bioidentical Hormones?

Thus there was a move away from synthetic hormones, hormones synthesised in a pharmaceutical laboratory from synthetic (man-made) chemical compounds, to “natural” hormones, also synthesised in a pharmaceutical laboratory but from plant sources.

The most important difference between the two is the way they act in the human body. The body does not recognise synthetic hormones like Premarin, a synthetic estrogen, and Prempro, a synthetic progesterone, because their molecular structure is different from hormones produced by the human body. This means they are not metabolised well and some researchers believe they can release toxins into the body. However, bioidentical hormones have exactly the same structure as those produced by the body, which means they are easily recognised and used by the body and do not release carcinogens, making many women feel more comfortable about using them.

Bioidentical hormones are not just for women. Men too can benefit from using bioidentical hormones to supplement low hormone levels, thus restoring the hormone balance in their system. By restoring a man’s hormones to appropriate levels, BHRT can help eliminate many symptoms associated with aging, low testosterone, and other hormonal imbalances.

How are Bioidentical Hormones Made?

Some bioidentical hormones are made by drug companies, are approved by the FDA, and are sold in standard, usually quite high, one size fits all, doses. Other bioidentical hormone preparations are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. While these “custom-made” preparations are not approved by the FDA they are extremely valuable in that doses can be minutely adjusted in response to minute changes shown in blood tests of a patient’s hormone levels, providing the exact doses of specific hormones required for each person. This acknowledges the fact that each patient has their own unique hormonal system and that their needs may change over time due to various circumstances.

Natural Desiccated Thyroid

Natural desiccated thyroid (NDT) treatment is not usually discussed under the heading of BHRT. However, this preparation, which can also be made in compounding pharmacies, unfortunately not in Singapore, to respond to the exact needs of a hypothyroid patient’s body, is in fact a bioidentical hormone. Desiccated thyroid gives exactly what the body’s own thyroid would be giving: T4, T3, T2, T1 and calcitonin.  Many patients who have tried T4-only, or the two synthetics T4 and T3 together, or even straight T3, have found that NDT improves their health and quality of life much more. Old medical journals show that NDT has been used by patients for over 110 years.