Here are the facts:
1. Many peri-menopausal women (and men!) suffer symptoms (which in worst case scenarios have driven depressed women to suicide)& need therapy to function day to day.
2. Since the WHI report about increased risk of breast cancer, many people & doctors have turned away from HRT (hormone replacement therapy).
3. The void for HRT has to be filled - voila - bioidentical hormones!
What are bio-identical hormones (BIH)?
They are structurally identical to hormones naturally secreted by your own body. They can be plant-derived or they can be manufactured artificially.
What's the controversy of BIH v. synthetic hormones?
Proponents of BIH say that BIH is safer than synthetic hormones because the structurally dissimilar synthetic hormones tend to bind incompletely to hormone receptor sites & they break down very slowly leading to side-effects such as increased lipids, blood clotting risk, blood pressure, etc. Opponents say that there is no evidence-based large trials to support this claim that BIH is safer.
Synthetic hormones have been in use the last 5 decades so there has been plenty of pharmaceutical company money poured into large scale randomized double-blind placebo controlled studies. The conclusion is synthetic hormones pose an increased risk of breast cancer for women. Bio-identical hormones have largely been used small scale by compounding pharmacies until it came into vogue in 2002 when the cancer scare about synthetic hormones erupted. At least there are no studies to prove that BIH increase your risk for cancer! In fact, there are small scale European studies showing safety of BIH. There are increasingly available in the market, USA FDA- approved or Australian TGA-approved bio-identical hormones. These products will produce constant, low levels of natural hormones required to reduce menopausal symptoms, with proven endometrial safety profiles.
As to opponents who say that BIH are not effective for menopausal symptoms - this I can say is absolutely untrue because I've had 1st hand information of people whose quality of lives have been vastly improved on BIH (the good quality product), not to mention countless celebrities, individuals & doctors round the world who trumpet its cause.
What say me?
As doctors, we cannot simply condemn something just because it is new, endorsed by celebrities & unproven by large scale trials. If someone said stomach ulcers were caused by bacteria 30 years ago, they would be proverbially burnt at the stake. Today, we know this as a proven fact.
Moreover, if we, as doctors, prescribe synthetic hormones to acne sufferers, menopausal ladies & dwarfs, we would be hypocrites to condemn bio-identical hormones which intuitively would seem safer as it's closer to nature.
What should a consumer choose?
As always, if something ain't broke, you don't try to fix it. If you ARE suffering from peri-menopausal symptoms, i.e. hot flushes, mood swings, sleep disturbances, depression, etc, then you should defintely opt for BIH. But, DO YOUR BLOOD TEST and work with your doctor.
If you're aging & life gets too unbearable with milder symptoms - dry vaginas, wrinkly skin, droopy breasts, forgetfullness, and you want some therapy, BIH over conventional hormones is the way to go. Do discuss with your doctor the pros & cons.
How about the "preventative" anti-aging effects of hormone replacement therapy?
The preventative anti-aging effects of hormone replacement are very real. As an informed consumer, you have to decide if the possibility of a small risk in increase of relative risk of cancer is worth the trade-off of staying younger for longer. But even before jumping on the band wagon, look at your diet, lifestyle & environment - it's more important to "take charge" of your life than sticking on hormone band-aids. There are many women who go through menopause without any symptoms at all because they have stayed healthy, not stressed their hormonal glands & just breezed through it by just eating right, exercising right & living right.
The good thing about all this debate is that it makes people more aware of their own bodies & encourages people to take charge of their own lives.
