The Basics of Women's Hormone Replacement Therapy
Natural hormone replacement therapy is used to help treat the symptooms of menopause, perimenopause, and post-menopause
Bio-identical hormone replacement therapy improves quality of life dramatically. Menopausal symptoms are related to a deficiency of estrogen and progesterone. The vasomotor symptoms of menopause include hot flashes and night sweats. The genito-urinary symptoms of menopause include vaginal dryness, pain with intercourse and urinary problems. Symptoms in other systems include dry skin, sagging breast, osteoporosis, cardiovascular disease, cognitive impairment and Alzheimer's dementia.
Treatment with natural hormones usually includes creating a unique combiation of hormones for the individual patient, based on their hormone deficiencies. These are often referred to as "custom-compunnded" hormone products. The mojor benefit of this type of treatment is that doses are individualized, and the mixture of products may not be commerically available. Blood tests need to be followed to confirm appropriate dosing.
Bio-Identical vs Natural Hormones
Non-bioidentica synthetic progestoerone analogues (called progestins) are often confused with the natural hormone progesterone. Progestins have been shown to icrease the risk of breast cancer while progesterone has been shown to decrease the risk of breast cancer Estrogens are also different: horse estrogen is the most commonly prescribed, but have been shown to cause heart attacks, strokes, and blood clots, were as Bio-Identical estroged does not. The Women's Health Intitiave Study did not use real estrogen or progesterone. Becasue of these safety concerns, Dr. Borgardt feels strongly that only Bio-Identical hormones should be used in hormone replacement.
Because these hormones are natural, they are not patentable. Studies have indicated that thsee hormones are safer than, and as effective as, non-identical (patentable) synthetic or animal hormones. The FDA has permitted the marketing of approved natural hormones in standaridized formulations.
Premarin and Provera are dangerous and should not be used for hormone replacement therapy.
The Women's Health Initiative Randomizied Controlled Trial which was published in the July 17 2002 issue of the Journal of the American Medical Association Vol. 288 No. 3, showing that PremPro, the combination of Premarin (non-human estrogens derived from pregnant mare ( horse urine) and Provera (medroxyprogesterone acetate) was dangerous. This type of "hormone replacement therapy" is not really true hormone replacement therapy since to be categorized as a "hormone" the substance must naturally exist in the human female or male body. The resuls of the PremPro study do not apply to bio-identical hormone replacement.
Why haven't there been large studies of bio-identical estrogen and progesterone? The reason is: bio-identical hormones occur naturally in the human female and cannot be patented. There is no economic motivation for the large pharmaceutical campanies to finance a study using bio-identical estrogens and progesterone. We hope a study will be done someday. So whats' the bottom line? Millions of years of evolution have created hormones in our bodies. Let's stick with them. Bio-identical hormone replacement is essential to maintaining female quality of life.
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2010 Copyright Philip Borgardt MD, FACP
NO PRESCRIPTION WILL BE PROVIDED UNLESS A CLINICAL NEED EXISTS BASED ON REQUIRED LAB WORK, PHYSICIAN CONSULTATION AND CURRENT MEDICAL HISTORY, EITHER THROUGH PATIENT'S PERSONAL PHYSICIAN OR
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No claim or opinion on this web site is intended to be, or should be construed to be, medical advice. Please consult with a healthcare professional before starting any therapeutic program.
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