Just What are Bio-identical Hormones?
Bioidentical hormones are manufactured in the lab to have the same molecular structure as the hormones made by your own body. By contrast, synthetic hormones are intentionally different. Drug companies can’t patent a bioidentical structure, so they invent synthetic hormones that are patentable (Premarin, Prempro, and Provera being the most widely used examples).
Though bioidentical hormones have been around for years, most practitioners are unfamiliar with them. There are several branded versions now available for use in the kind of hormone replacement therapy typical of synthetic hormones. This is often a one-size-fits-all dosage regime.
Dr. Kohani has had the greatest success with an individualized approach. She begins with laboratory tests of hormone levels (a so-called “hormone panel”). When warranted, she then prescribes a precise dosage of bioidentical estrogens, progesterone, testosterone, and/or DHEA that is prepared at a registered compounding pharmacy. Each patient is then monitored carefully through regular follow-up hormone panels to ensure she gets symptom relief at the lowest possible dosage. In the initial stages she recommends to do a hormone panel every three months. Once balance is restored, one panel a year at the time of the annual exam may be sufficient.
Dr. Kohani does not recommend that hormones be used long-term be it Bio-identical or synthetic, unless absolutely essential for symptom relief, and then only with a complete risk assessment to make sure there is no increased risk for Breast Cancer development. She also does not support the idea that bioidentical hormone therapy should be used indefinitely as some kind of fountain of youth.
Is bHRT the first step to hormonal balance?
Bioidentical hormones can work wonders, but they aren’t necessarily the first place to turn when hormonal imbalance is a problem. Dr. Kohani believes that a great majority of women can rebalance their hormones without the use of drugs, and even without HRT in any form. Up to 85% can find relief through a natural approach that combines botanical and medicinal herbs, medical-grade nutritional supplements, gentle endocrine support, and dietary and lifestyle changes. Dr. Kohani recommends that every woman start with this combination approach as the foundation to her health.
In our Individualized Program for Hormonal Imbalance, a three-pronged approach that supports a woman’s hormonal pathways upstream of where problems arise and develop into full-blown symptoms requiring stronger hormonal replacement therapy. (Our dietary guidelines are based on the latest research in clinical nutrition and dietary endocrinology.) Our Essential Nutrients fill in the nutritional gaps so common in our modern diet. And our Herbal Equilibrium offers phytocrine support to rebalance all three of the major sex hormones most prone to disharmony in perimenopause and menopause: estrogen, progesterone, and testosterone.
Even with this foundation, a minority of women will need to add prescription-strength hormone supplements to get complete relief, at least through a transition period. Dr. Kohani recommends they use bioidentical hormones, preferably in a compounded form personalized to their needs by an experienced practitioner.
Are bioidentical hormones better than synthetic hormones?
The great appeal of bioidentical hormones is that they are natural, and our bodies can metabolize them as it was designed to do, minimizing side effects but they are NOT perfect. Synthetic hormones are quite strong and often produce intolerable side effects. Moreover, the compounded bioidentical hormones can be matched individually to each woman’s needs — something that’s just impossible with mass-produced products.
Are bioidentical hormones safer than synthetics?
Many medical studies have suggested that yes, bioidentical hormones are safer than synthetic versions (please review the list of Literature provided on a separate table). This makes perfect sense. But we must be cautious here, because these studies may have some limitations and they may not be well studied, especially for long-term use. And in any case, Dr. Kohani recommends that women never think of any drug particularly hormones as “completely” safe or harmless, be it bio-identical or synthetic.
Let us note here that the WHI studies on the effectiveness and health risks of HRT were based on synthetic/equine-based hormones, and the average age of the women at enrollment was 63. These details did make a difference in their risk — please read the details of the WHI study separately.
A separate list of scientific research and articles is attached.
These statements have not been evaluated by the Food & Drug Administration. This article is not intended to diagnose, treat, cure or prevent any disease. You should not use the information on this page for diagnosing or treating a health problem or disease, or self prescribing any medication. If you have or suspect that you have a medical problem, promptly contact your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read on this site.