is easy to confuse the term “natural hormone replacement
therapy (NHRT)” with “bio-identical hormone replacement
therapy (BHRT).” The term “natural” is everywhere
in our society today as the demand for natural foods, pharmaceuticals,
home products, and skin care products continues to rise. However,
when talking about hormones, it is important to make the distinction
between natural and bio-identical. A natural hormone can be any
hormone derived from a natural source, such as an animal or plant.
Premarin, for example, is a “natural” estrogen because
it comes from pregnant horses, but it is not bio-identical because
it differs greatly from the human estrogen milieu.
Bio-identical means that the hormone has the identical molecular
structure to hormones made by your body. When hormone levels
begin to drop below normal, as in perimenopause or aging, bio-identical
hormones are the safest way to supplement. When hormone balance
is restored and maintained using BHRT, there are fewer side effects
and risks than with synthetic HRT. Hormones that are commonly
used as BHRT are the estrogens (estrone, estradiol, and estriol),
progesterone, testosterone, DHEA, thyroid, and growth hormone.
Bio-identical progesterone has many uses and benefits. It can
help immensely with symptoms of PMS or perimenopause, as these
are often associated with “estrogen dominance,” a
term coined by John Lee, MD. Using bio-identical progesterone
can help to correct the ratio of estrogen to progesterone, thus
decreasing symptoms of estrogen dominance such as irritability,
mood swings, headaches, breast tenderness, and heavy bleeding.
Bio-identical hormones are generally available by prescription
and can be individualized by a compounding pharmacist. Some bio-identical
hormones are available over the counter through your naturopath.
Pharmaceutical companies are also providing some bio-identical
options for their prescription medicines.
The process of making bio-identical hormones requires that substances
go through a lab process to reach the end product. For example,
soy and wild yam must be processed to become natural progesterone
or estrogen. Just taking plain soy or wild yam doesn’t
have the same effects as taking the bio-identical hormone.
BHRT is not completely without risk. Anytime you take a hormone,
you need to monitor your levels with blood or saliva testing.
Just as deficient levels of hormones can cause discomfort, excessive
amounts can also cause symptoms. For example, too much estrogen,
whether it’s synthetic or bio-identical, can put you at
increased risk for certain cancers, endometrial thickening and
blood clots. If you are taking any hormones, make sure to have
your levels monitored periodically to optimize the benefits and
minimize the risk of taking hormone replacements.