Hot flashes, brain fog, and insomnia — menopause can make your everyday life feel like a battle. If you’ve been searching for relief, you’ve likely come across hormone replacement therapy (HRT) as a potential solution, but this that the only solution? What if you want help but you aren't ready for HRT just yet.
HRT is widely recognized as the most effective treatment for alleviating the symptoms of menopause. But deciding what type is right for you can be difficult.
In this article, we'll look at the pros and cons of using bio-identical hormones, uncover why FDA-approved medications aren’t always the safest option, and explain why compounded bio-identical hormone therapy might be your best choice.
What are the differences between bio-identical, synthetic, and compounded bio-identical hormones?
Bio-identical hormones are created from natural sources. Most commonly, they’re made in a lab from a plant steroid called diosgenin, which is extracted from soy or wild yams.
These hormones more precisely resemble and have similar effects to your natural hormones because their molecular structure is identical to the ones found in your body. They also fit better with your body’s hormone receptors. This precise fit means your interconnected hormone system functions more optimally.
If you find the term "bio-identical hormone therapy" confusing, you’re not alone. Bio-identical hormones are found both in the medications approved by the Food and Drug Administration (FDA) and in custom treatments made by a licensed pharmacist — also known as compounded bio-identical hormone therapy.
Synthetic hormones are used in “traditional" or "conventional" hormone therapy. They are not derived from natural sources, meaning they’re made through chemical reactions in a laboratory. The most common forms of synthetic hormones are made with mixtures of urine from pregnant mares, known as conjugated equine estrogens (CEE) and progestin.
Synthetic hormone products have been available for a long time. However, studies like the Women's Health Initiative raised concerns about the potential risks of hormone replacement therapy and spurred the search for safer and equally effective treatments.
Compounded bio-identical hormones
Compounded bio-identical hormone therapies (cBHT) are custom-made medications designed to meet your specific hormonal needs. They may contain one hormone or a combination of several hormones, including estrogens (estriol, estradiol, and estrone), progesterone, testosterone, and DHEA. These personalized medications can be formulated into various dosage forms, such as suppositories, capsules, and creams.
The hormones and dosage in your compounded bio-identical hormone therapy might closely resemble those found in an FDA-approved medication. In fact, they're made with the same bio-identical hormones. However, there's a slight difference. Since the medication is specifically tailored to address your unique hormone requirements and hasn't undergone specific testing in that particular formulation, it's not considered FDA-approved.
What are the benefits of compounded bio-identical hormones for treating menopause symptoms?
Hormones are influenced by various factors, making every woman's hormone levels before, during, and after menopause truly unique. Additionally, when it comes to any hormone replacement therapy, experts strongly recommend using the lowest hormone dose possible for the shortest duration to minimize potential long-term risks.
One of the most significant advantages of compounded bio-identical hormone therapy is that it’s safer than synthetic therapies. Bio-identical hormones have been shown to reduce the potential long-term risks, such as breast cancer and cardiovascular disease, associated with synthetic hormone therapy. Compounded bio-identical hormone therapy reduces that risk further by providing the right hormones in the dosage your body needs.
But there’s more. Bio-identical hormones mimic your natural hormones, making them more effective and causing fewer side effects than conventional treatments. Studies have shown patients have reported notable improvements in mood symptoms such as irritability and anxiety, as well as vasomotor symptoms like hot flashes and night sweats thanks to cBHT.
Lastly, the safest method of utilizing hormone therapies is through topical applications such as creams, oils, or vaginal treatments. This way, the hormones are absorbed through the skin and circulate throughout the body before reaching the liver for first-pass detoxification. CBHTs can be specifically formulated in various bio-identical applications, ensuring the safest and most effective absorption.
With compounded bio-identical hormone therapy, you can find the relief you seek while prioritizing your individual needs, safety, and overall well-being.
FDA-Approved Doesn’t Always Mean Safe and Effective
Compounded bio-identical hormones provide a safe and effective treatment for the symptoms of menopause, but you may believe your best option is an FDA-approved medication. Sadly, FDA-approved drugs aren’t always the way to go.
Many drugs with safety issues get past FDA testing
You might think that the long and challenging process of getting a medication approved by the FDA guarantees its safety and effectiveness, but it’s not always the case. The FDA has been approving drugs faster than ever with weaker evidence to support their safety and efficacy.
This trend toward accelerated approval has its benefits — after all, we do need more medications to address women’s health conditions — but it's also concerning for our health and safety. Additionally, the FDA's reliance on industry funding from pharmaceutical companies creates a conflict of interest that may compromise its primary role in safeguarding the public.
Synthetic hormones are FDA-approved, but long-term side effects haven’t properly been studied
It's important to understand that FDA approval of synthetic hormones doesn't guarantee their absolute safety. The FDA evaluates medications based on data available at the time, but our understanding of the long-term effects and risks associated with synthetic hormones continues to evolve.
For example, the Women’s Health Initiative study in 2002 uncovered concerning findings about specific synthetic hormones, showing increased risks of cardiovascular disease and breast cancer. More recently, the WHI Memory Study revealed a higher risk of dementia in women taking progestin alone.
The women’s health research field is ever-evolving and ongoing research may uncover new risks or long-term effects of synthetic hormone therapy.
Same drug, different name
Encouraged by the FDA approval process, the pharmaceutical industry tends to release slight variations of existing drugs rather than developing new ones. And getting the green light from the FDA only requires new drugs to prove they can do what they claim, but it doesn’t mandate how well they should work.
In fact, a public, independent advisory team of physicians and pharmacists in several countries found that over 90 percent of new drugs approved by the FDA and the European Medicines Agency offered few or no advantages over existing drugs.
Synthetic hormones are patented by pharmaceutical companies, meaning the prescribed hormone is the same for every single person on the drug. In the absence of innovation in FDA-approved medications, custom-created hormone replacement therapy can provide more precise treatment with a dosage adjusted to your individual needs.
What are the risks of cBHTs?
As with all hormone replacement therapies, there are risks associated with cBHT. Because your medication is being specifically created for you, the pharmacy you choose can affect the quality and efficacy of the medication you receive. If your medication is not properly prepared as specified by your healthcare provider, there is a risk of having too much or too little of the hormones you need.
Additionally, cBHTs are not required to have safety warnings on the bottle. Using cBHTs comes with similar risks to any bio-identical hormone therapy. Side effects can include bloating, headaches, acne, breast tenderness, and swelling of hands, lower legs, or feet. Serious side effects can occur, including heart attack, stroke, blood clots, breast cancer, and uterine cancer.
It's important to meet with a medical professional and tell them about any history or risk factors affecting your ability to undergo hormone replacement therapy safely.
Why Compounded or Bio-Identical Hormones May Be a Better Choice for You
Compounded bio-identical hormones offer a more natural and personalized approach to hormone replacement therapy and effectively manage menopause symptoms.
While the FDA approval process is important, it doesn't always guarantee the safety of the drugs you find on the market. Most importantly, we still have a long way to go to improve the efficacy of hormone replacement therapies available to women, considering the nuances of our individual needs. Compounded bio-identical hormone therapy is a highly customizable treatment that allows for precise dosages of hormones based on your personal needs.
Ultimately, if you’re considering using hormone replacement therapy, you need to speak with a healthcare provider knowledgeable about compounded bio-identical hormones. With careful consultation and proper testing, cBHT could help relieve menopausal symptoms without compromising safety or effectiveness.
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