Recent upset in the news about all Hormonal Replacement Therapy (HRT) needs to be laid to rest. The Women's Health Initiative (WHI) study was intended to recognize the potential risks and benefits of HRT. A part of the clinical trial was stopped early after results showed that a synthetic hormone combination increased the women's risks of developing invasive breast cancer, heart disease, stroke, and blood clots. The data and safety monitoring board concluded that the risks of using a synthetic estrogen - synthetic progestin drug combination outweighed the benefits.
It is worthy of note that the scientist considered this finding to be "news". In reality, many studies have previously reported that the risk of breast cancer is increased by long-term use of conjugated equine estrogens, and further increases when the synthetic progestin (medroxyprogesterone acetate) is added to the regimen. This is a common regimen still prescribed by most physicians.
, we compound customized Bio-identical hormones including estriol, estrone, estradiol, progesterone, and testosterone, using the precise dose of the specific bio-identical hormones needed by each woman in the most appropriate dosage form (oral capsules, topical creams or solution, highly absorbable gels and vaginal cream) for that individual. This custom made prescription allows the physician to make best use of the therapeutic results that can be attained through the use of Bio-identical hormones, while minimizing the possibility for adverse effects.
In the WHI study, Bio-identical hormones were NOT used. Bio-identical hormones are structurally identical to hormones that are naturally produced by the human body, and intended to replace these hormones when their levels drop either as a result of aging, disease, or surgery. Studies have revealed that bio-identical hormones can successfully control symptoms of menopause, including hot flashes, vaginal dryness, insomnia, and frequent urinary tract infections. A women's experiences and response of HRT differ very much depending on whether the hormones are synthetic or bio-identical, the dose, dosage form, and route of administration. For many years now, physicians have been prescribing these bio-identical HRT for women who have experienced problems or have other concerns about the use of synthetic hormones.
Synthetic progestins (also called progestogens ) are derivatives of bio-identical progesterone, and have been developed because they are longer- lasting, more potent, and basically the drug manufacturers can patent them. Although these versions are clearly helpful in preventing estrogen-induced overgrowth of the uterine lining and/or endometrial cancer, their other effects are much more unpleasant. Medroxyprogesterone can cancel out the valuable effects of estrogen on lipids, atherosclerosis and vascular reactivity. Natural progesterone, alternatively, maintains all the benefits of estrogen on cholesterol without any of the ill effects linked with synthetic progestins.
Medroxyprogesterone has shown to reduce the dilatating effects of estrogens on coronary arteries, increase the progression of atherosclerosis, increase the clot-forming potential of atherosclerotic plaques, promotes insulin resistance and consequent hyperglycemia (high blood sugar), and can significantly lower high density lipoproteins (HDL, "good cholesterol"), thereby decreasing the benefits of estrogen therapy. Studies have concluded that synthetic medroxyprogesterone, in contrast to bio-identical progesterone, increases the risk of coronary vasospasms, a narrowing of major blood vessels surrounding the heart which could lead to a heart attack. However, bio-identical progesterone plus estradiol protected against vasospasms.
Besides the prevention of endometrial cancer in women who are receiving estrogen replacement, Progesterone can build bone density, promote glucose utilization, and improve sleep patterns. Mayo Clinic researchers surveyed 176 women taking natural micronized progesterone who had previously taken synthetic progestins. After one to six months, the women reported an overall 34% increase in satisfaction on micronized progesterone compared to their previous HRT, reporting these improvements: 50% in hot flashes, 42% in depression, and 47% in anxiety. Micronized progesterone was also more effective in controlling breakthrough bleeding.
LIVING WITHOUT HORMONAL REPLACEMENT.
Without HRT, many women (and consequently, their families) feel totally miserable, exhausted, and unable to cope and function to their fullest. Yet, only 20% of women continue to take synthetic hormones after two years, mainly due to the development of side effects. The quality of many of our client's lives has been significantly improved through the use of bio-identical HRT.
The numbers and fears continue, yet the absolute risk of cancer attributable to HRT remains low, and the risk of some forms of cancer is reduced. For example, an analysis of various studies involving thousands of women concluded that the risk of developing colorectal cancer is reduced by 34% in current estrogen users.
Decisions about whether to stop, start, or change your HRT should made on a personal basis only after consulting your doctor and a knowledgeable pharmacist. Our goal at S&P; is to work together with physician and patient to solve medication problems and optimize each patient's health and welfare.
As studies and the media continue to provide conflicting and confusing information, S&P; is here to help clarify the issues that surround HRT. Your questions and comments are welcome.