Phil Altman, Compounding Pharmacist
of The Healthy Choice Compounding Pharmacy
Answers Your Frequently Asked Questions About:
Bio-Identical Hormone Replacement Therapy
What Are Bio-Identical Hormones?
Bio-identical hormones are an exact replica of the hormones that are naturally produced by the body. They match your body’s hormones molecule by molecule. They are natural hormones because they are made from soy, yams and other plant extracts and are termed “bio-identical” because they are compounded to match each individual patient.
What Is The Difference Between Bio-Identical Hormones and Synthetic Hormones?
The difference between bio-identical hormones and synthetic hormones is that, although both are created in labs, synthetic hormones are not identical to the hormones naturally created in your body, whereas bio-identical hormones match your body’s hormones molecule by molecule.
Synthetic hormones are derived from plant progesterone and animal estrogens, but are not identical to the hormones your body uses. Synthetic hormones act as toxins because their chemical makeup cannot be metabolized properly. Premarin is a non-bio-identical hormone which is obtained from the urine of pregnant horses. Provera is also an example of a synthetic hormone. It causes bone loss or osteoporosis. Their combination called Prempro has been marked with a black-box warning for causing serious health risks.
Bio-identical hormones or natural hormones are replicas of the body’s own natural hormones. Bio-identical hormones are made from soy, yams and other plant extracts, and are compounded to match each individual’s needs.
Do I Need A Prescription?
Yes, bio-identical hormones are compounded prescription medications that we produce in our specialized pharmacy. Each prescription is made with only the highest quality ingredients and to fit each patient’s individualized need.
Can You Recommend A Physician That Prescribes It?
Yes, we have a large list of participating doctors. These doctors are highly trained and comfortable working with bio-identical hormones. They will work closely with you, and our compounding pharmacists. A list of our BHRT providers can be found on our “Patients” page.
What Are My Options?
First of all, you have to decide if you are a candidate for hormone replacement therapy, since not everyone is. This is a personal choice and one you must be educated in because in order to have a successful experience you have to be an active participant.
Everyone may not be a candidate for estrogen. They might just need some progesterone and/or testosterone, DHEA, Pregnelone etc.. Once the forms of hormones you need for restoration are determined, then you must decide what dosage form to use. Do you want to use a cream ,capsule or drops etc.? These are all of the basic questions that you must ask yourself, your practitioner and your compounding pharmacist. Everyone must be on the same page. Your options are as varied so please EXPLORE THEM.
Are They Safe?
Everyone is concerned about safety as they should be. We feel that bio-identical hormones give you the best risk/reward ratio. We feel that whenever you take any form of estrogen there is some risk involved. But bio-identical hormones, since they are structurally identical to what your body produces, get excreted very quickly.
Progesterone vs. progestins is also very important. Progesterone opposes estrogen throughout your entire body, not just your uterus. Progesterone will also increase cell death while progestins do not. Progesterone acts as a natural diuretic to help prevent weight gain.
Estriol is the weakest of all the estrogens and has the most cancer protecting properties. Just another reason why bio-identical hormones are safer than commercially available products. Even when estriol E3 is combined with estradiol E2 the estriol will help reduce the negative benefit of estradiol.
Opposes estrogen throughout your entire body
Acts as a natural diuretic
Acts as a mood elevator
Helps balance thyroid
Helps balance blood sugar
Helps build bones
When Will I Feel Better?
Everyone is different. Everyone’s stress level is different, as well as their pre-existing hormone level. People’s lifestyles vary. You are what you eat! Are you a big meat eater or a vegan?? Are you overweight?? Estrogen is stored in fat cells. Overweight people release more estrogen into there system therefore, they may not need estrogen replacement therapy. Stress also plays a large part of when you feel better. It‘s all about balance. Balancing your hormones, lifestyle, stress etc. The quicker you can put all of that in balance the quicker you are going to feel better.
What Forms Does BHRT Come In? What Dosage Form Is Best For Me?
One of the keys to bio-identical hormone replacement therapy, is the different dosage forms it can come in. We have the ability to customize dosage forms to fit each individual patient. Using a compounding pharmacist to help you decide what dosage form to use, will be key in having a successful therapy. Although, the American preference has usually been to take a pill over using creams, if you have any digestive disorders we strongly recommend using the transdermal route. If you decide to go the transdermal route, there are different delivery systems, i.e. syringes, pumps, jars etc. There are also different bases that we can use depending on the sensitivity level of the patient. Also, when you use the transdermal route you have more dosing flexibility. You can take 1 1/2 doses of a cream, whereas it’s more difficult to take 1 1/2 capsules. There are also lozenges you can suck on, vaginal suppositories, vaginal creams, drops, etc. The key with dosing is finding out what is going to work best for the individual patient.
How Do These Products Work?
There is a lot of misinformation about this. Physicians, as well as patients, do not always understand the structure function statement. That is, if you change any part of the chemical structure of any chemical, you will change the function of that product. So what that means, is Bio-Identical Hormones are structurally identical to what your body produces. This is more of hormone restoration. Replacing hormones (structurally identical) to what your body is no longer producing. It is like tricking your body into thinking you are producing more hormones, thus putting you in a pre peri-menopausal phase. The goal of these products is to put you back in balance!
Will I Gain Weight?
Hormones are chemical messages that cause the body to make changes affecting weight gain or weight loss. When your hormones are out of balance, it can, in some cases, makes it easier to gain weight or harder to lose weight. When your hormones are in balance you get the most out of your nutrition therefore, making it easier to lose weight. For instance, men as they get older get less active and have a decline in testosterone. This particular hormone boosts metabolism which helps lower body fat. When a man’s testosterone levels are balanced an ideal weight is easier to achieve.
Do I Need To Take These Hormones Forever?
Not necessarily, it depends on how well your body responds to bio-identical hormone therapy. Also important, it’s how well you manage your diet, sleep patterns, exercise, and stress levels that will assist you in regaining hormonal balance. Some patients can wean off various hormones once they become balanced and have fewer symptoms of menopause or andropause. There are also patients who can wean off adrenal and thyroid support once their adrenals or thyroid glands have healed. There is no single answer for everyone, it depends on your individual hormone stability and how well your diet and lifestyle will support everything else. In the worst-case scenario, if you decided to stop bio-identical hormone therapy, your body would return to the state it was in before initiating your therapy.
What Is The Women’s Health Initiative?
The National Institutes of Health (NIH) established the Women’s Health Initiative (WHI) in 1991 to address the most common causes of death, disability and impaired quality of life in postmenopausal women. The Women’s Health Initiative was designed to define the risks and benefits of using synthetic hormone therapy to potentially prevent heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women.
It is important to note that the women in this study were all postmenopausal, average age of sixty-eight. This fact is significant as most of these women had 15 years since the loss of their hormones to develop diseases that estrogen, progesterone, and testosterone might have prevented. Most importantly, the study used synthetic hormones and not natural bio-identical hormones. This was a 15 year research program and the women in these studies are now participating in a follow-up phase, which will last until 2010.
Why Is There So Much Confusion About Bio-Identical Hormones?
Bio-identical hormone preparations are medications that contain hormones that are an exact chemical match to those made naturally by humans. Some bio-identical hormones are made by drug companies, are approved by the FDA, and are sold in standard doses. Other bio-identical hormone preparations are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. Those “custom-made” preparations aren’t approved by the FDA. The FDA doesn’t approve any compounded products, for any condition, because compounded products are not standardized. But, the purpose of compounding is to do it on a patient-by-patient basis.
How To Know If Bio-identical Hormones Are Right For Me?
Some women just know when they are not feeling “quite right” or “like they used to.”
To help answer this question, ask yourself:
Do I have hot flashes?
Can I not sleep at night?
Do I wake at night sweating excessively?
Is my menstrual cycle more irregular than when I was in my twenties and thirties?
Do I have alterations of heavier bleeding one cycle and lighter the next?
Do I have difficulty concentrating?
Do I have mind fog?
Do I feel more anxious now, and for no reason?
Do I have vaginal dryness or painful intercourse?
Am I more depressed?
Do I lack energy?
If you answered yes to even one of these symptoms, and it has been bothersome enough to diminish your quality of life, take our FREE Hormone Analysis to determine if you should talk to your doctor about Bio Identical Hormone Replacement Therapy (BHRT).