Finally, some clear information on hormone replacement therapy
By Stacey Colino
Ever since Suzanne Somers’ book Ageless: The Naked Truth About Bioidentical Hormones hit bookstore shelves last year, there’s been a flurry of attention focused on this alternative form of hormone replacement therapy (HRT). And yet there are still loads of misconceptions about what bioidentical hormones are and how they work.
This is partly because there’s no standard definition of the term bioidentical hormones. The literal meaning is hormones that are biochemically similar or identical to those made by the body, but in practice it’s often applied to “natural” forms of hormones rather than synthetic or manufactured ones, or to compounded plant-derived hormones that are custom-mixed by a pharmacist. No wonder confusion on the subject is rampant!
One big claim often made by manufacturers is that bioidentical hormones are safer than conventional estrogen and progestin supplements for the treatment of hot flashes and other menopausal symptoms.
“That’s the way they’re being sold, but that’s wrong,” says Wulf H. Utian, M.D., Ph.D., executive director of the North American Menopause Society and a consultant in women’s health at the Cleveland Clinic.
While it’s true that “bioidentical hormones have the same molecular structure as our body’s natural hormones, women should be aware that there’s little research to suggest that they’re safer or more effective than conventional hormone therapy,” says JoAnn Manson, M.D., chief of preventive medicine at Brigham and Women’s Hospital in Boston and coauthor of Hot Flashes, Hormones & Your Health.
The supposed benefit of compounded bioidentical hormones is that a pharmacist can prepare, mix and package a customized blend of hormones—a hormonal cocktail of sorts—for a particular patient, based on her unique needs.
The reality, says Dr. Utian: “It’s absolutely impossible. The claims are based on the idea of taking a sample from a woman’s saliva or hair or blood, seeing what her hormone level is, then compounding [a blend of hormones] to try to bring it up to some hypothetical level someone says is normal.” The trouble, he notes, is that not only is the target level arbitrary and artificial, but a woman’s hormone levels can vary widely depending on the time of day and month, her diet and other factors, so even trying to get a clear reading of her baseline level is futile. “And we do know from research that if you give hormone levels that are too high, a woman is more likely to get complications such as bleeding problems,” adds Dr. Utian.
Nevertheless, bioidentical hormones are attractive to some women, especially in the wake of the Women’s Health Initiative trials that appeared to determine that long-term use of traditional HRT carried an increased risk of breast cancer and stroke. But newer research suggests that traditional HRT may not be as risky as was previously thought.
“There’s mounting evidence that timing makes a difference,” Dr. Manson points out. “The closer a woman is to menopause, the more favorable the benefit-to-risk ratio for hormone therapy and the lower the risk of adverse effects from treatment.” Talk to your doctor about the issue.
Flash! You Can Cool It
Don’t suffer in silence. If you’re being driven around the bend by menopause-related symptoms such as hot flashes, irritability and sleep disturbances, talk to your doctor about whether you’re a candidate for hormone therapy. Generally, doctors try to stick with the lowest dose possible to relieve symptoms, preferably for no more than three to four years to minimize the risk of long-term complications. Keep in mind, too, that newer formulations such as transdermal patches, creams and gels may also deliver hormone therapy, with lower risk of blood clots and other adverse effects.
Show hospitality to strangers for, by doing that, some have entertained angels unawares.
Never stop helping others because others think that they abuse you. That stranger can be Jesus and you lose the opportunity to serve, even in something simple.
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