Few areas of health care are as plagued by competing claims and confusion as hormone therapy, but when approached with a holistic perspective under medical supervision, bioidentical hormone replacement therapy can be life-changing.
Conventional hormone therapy has been the subject of several high-profile news stories, and more research needs to be done on its long-term effects. Bioidentical hormones offer an alternative to conventional hormone therapy. But, because our body’s responses to hormones vary widely, it’s important to always work with a healthcare practitioner to determine the right treatment for you.
Here are some answers to common questions about bioidentical hormone therapy (BHRT).
What Is Bioidentical Hormone Therapy?
The chemical structure of bioidentical hormones is identical to that of the hormones your body produces naturally – hence their name. The hormones are derived from plants and can be produced in a factory or by a compounding pharmacist.
The most commonly prescribed types of bioidentical hormones are testosterone, estrogen, and progesterone. These hormones are delivered to the body in many forms, including suppositories, sprays, injections, gels, and pills.
Who Benefits From Bioidentical Hormone Therapy?
Both men and women may benefit from bioidentical hormone therapy. Women often start when they enter the perimenopause years to help maintain hormonal balance. Up to 2.5 million women in the US use BHRT, by some estimates two-thirds of all women take hormonal therapy, to help with menopausal symptoms.
Men often start in their 40s, when testosterone levels start to decline.
What Conditions Does BHRT Help With?
As we age, the production of several important hormones declines. The effects of these dropping hormone levels can be profound. Women can experience:
- Weight gain
- Brain fog
- Fatigue
- Depression
- Hair loss
- Hot flashes
- Foggy thinking
- Insomnia
- Loss of libido
- Vaginal dryness
For men, a decline in testosterone levels results in very similar symptoms:
- Fatigue
- Loss of libido
- Weight gain
- Men can even experience hot flashes!
BHRT can reduce the systems of declining hormone levels. It can also provide some preventative protection against conditions like diabetes, heart disease, osteoporosis, and Alzheimer’s disease.
What Are The Risks Of BHRT?
Although many people experience relief from a myriad of symptoms thanks to BHRT, studies also point to possible health risks, including increased incidents of:
- Blood clots
- Elevated blood pressure
- Hyperlipidemia
These risks can be eliminated by replacing estrogen topically instead of orally. Oral estrogen is pro-inflammatory. Topical estrogen is anti-inflammatory.
When assessing the risks of BHRT, it’s important to consider your overall health. Smokers, for example, have a higher risk of blood clots. Women who have been diagnosed with hormone receptor-positive breast cancer in the last 5 years should avoid BHRT. Also, women with a strong family history of breast cancer need to weigh the risks and benefits. However if your risk of heart disease or dementia outweighs your risk of cancer you should consider BHRT.
This makes the decision whether or not to take hormones highly personal. Research shows that menopausal women benefit from an overall examination of their health when they’re prescribed BHRT. Typically, they experience more in-depth, personal care during the process than they do with conventional hormone treatment – and you shouldn’t expect anything less if you consider any time of hormone therapy.
As well, compounded bioidentical hormone therapy isn’t regulated by the FDA, so it’s important to work with a reputable provider. It’s generally smart to start with a low dose and see how your body responds.
What Are The Benefits Of BHRT?
- Relief of symptoms. People feel better on hormones. They relieve hot flashes, improve mood and help with vaginal dryness.
- Prevention of memory loss. The brain needs hormones to function properly.
- Heart health. Natural, bioidentical hormones prescribed in the right amount are beneficial for your heart.
- Bone protection. Hormones keep the bones strong.
- Growth and repair. People heal quicker and feel younger when their hormones are balanced.
Are There Alternatives To BHRT?
Anyone concerned about the long-term effects of BHRT, or anyone in a high-risk group, may want to explore natural alternatives for hormone support instead. Here are some effective strategies.
Include phytoestrogens in your diet. Phytoestrogens are plants that naturally contain estrogen. Good sources include:
- Flax seed
- Peas
- Lentils
- Beans
- Soy products
- Green tea
Eat plenty of protein and enjoy a balanced diet. Crash diets can slow testosterone production.
Supplement smartly. Some natural supplements have been shown to support hormone levels. As always, work with your healthcare provider.
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- Black cohosh can help ease hot flashes and other menopausal symptoms
- Vitamin D and zinc have positive effects on testosterone.
Watch your alcohol intake. Alcohol can exacerbate symptoms of hormone imbalances, such as hot flashes.
Include strength training. Lifting weights can improve testosterone in men. Although this is less of an impact in women, strength training can improve symptoms of menopause and reduce the risk of osteoporosis.
Get enough sleep Hormonal imbalances can wreak havoc on sleep, but at the same time, lack of sleep can affect hormone production. Work on creating a restful evening routine to encourage sleep.
Watch your stress levels. Stress increases the production of cortisol, and cortisol and testosterone can contradict each other – as your levels of one rise the other decreases. For this reason, optimizing the adrenals is foundational for optimal health. If it’s hard to reduce situational stress in your life, try stress-reducing activities like time in nature and meditation.
Bioidentical hormone replacement therapy can help both men and women experiencing declines in hormone production. It’s best used as part of a holistic health program to support hormones.
It’s important to work closely with an experienced healthcare team – like us. We can review treatment protocols with you, answer any questions, and develop a personalized plan tailored to you. Contact us today!
References
Pinkerton JV, Santoro N. Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among US women. Menopause. 2015 Sep;22(9):926-36. doi: 10.1097/GME.0000000000000420. PMID: 25692877; PMCID: PMC454772
Files JA, Ko MG, Pruthi S. Bioidentical hormone therapy. Mayo Clin Proc. 2011 Jul;86(7):673-80, quiz 680. doi: 10.4065/mcp.2010.0714. Epub 2011 Apr 29. PMID: 21531972; PMCID: PMC3127562.
Spetz AC, Fredriksson MG, Hammar ML. Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden. Menopause. 2003 Jan-Feb;10(1):81-7. doi: 10.1097/00042192-200310010-00013. PMID: 12544681.
Pentti K, Tuppurainen MT, Honkanen R, Sandini L, Kröger H, Alhava E, Saarikoski S. Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study. Eur J Endocrinol. 2009 Jun;160(6):979-83. doi: 10.1530/EJE-09-0151. Epub 2009 Mar 25. PMID: 19321660.
Gass ML, Stuenkel CA, Utian WH, LaCroix A, Liu JH, Shifren JL; North American Menopause Society (NAMS) Advisory Panel consisting of representatives of NAMS Board of Trustees and other experts in women’s health. Use of compounded hormone therapy in the United States: report of The North American Menopause Society Survey. Menopause. 2015 Dec;22(12):1276-84. doi: 10.1097/GME.0000000000000553. PMI
Thompson JJ, Ritenbaugh C, Nichter M. Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making. BMC Womens Health. 2017 Oct 2;17(1):97. doi: 10.1186/s12905-017-0449-0. PMID: 28969624; PMCID: PMC5625649.
Franco OH, Chowdhury R, Troup J, et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315(23):2554–2563. doi:10.1001/jama.2016.8012
Canguven O, Talib RA, El Ansari W, Yassin DJ, Al Naimi A. Vitamin D treatment improves levels of sexual hormones, metabolic parameters and erectile function in middle-aged vitamin D deficient men. Aging Male. 2017 Mar;20(1):9-16. doi: 10.1080/13685538.2016.1271783. Epub 2017 Jan 11. PMID: 28074679.
Mazaheri Nia L, Iravani M, Abedi P, Cheraghian B. Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial. J Sex Marital Ther. 2021;47(8):804-813. doi: 10.1080/0092623X.2021.1957732. Epub 2021 Jul 27. PMID: 34311679.
Timón Andrada R, Maynar Mariño M, Muñoz Marín D, Olcina Camacho GJ, Caballero MJ, Maynar Mariño JI. Variations in urine excretion of steroid hormones after an acute session and after a 4-week programme of strength training. Eur J Appl Physiol. 2007 Jan;99(1):65-71. doi: 10.1007/s00421-006-0319-1. Epub 2006 Oct 19. PMID: 17051372.
Whittaker J, Harris M. Low-carbohydrate diets and men’s cortisol and testosterone: Systematic review and meta-analysis. Nutrition and Health. 2022;28(4):543-554. doi:10.1177/02601060221083079
