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You have no doubt heard about it. It's on many of the talk shows and in many of the newspapers and magazines that you read. It is bio-identical hormone replacement therapy and many women and men are starting to ask for it and benefit from it.
As a woman heads toward menopause the normal cyclical rise and fall of estrogen and progesterone decreases. It is at this point that she and her doctor may start to explore the options of hormone replacement therapy (HRT). The same is true for men. As men age the levels of many hormones decrease, including progesterone and testosterone. As women experience menopause men experience andropause.
Although a woman may choose to go through menopause without hormone therapy, many physicians recommend it. Hormone therapy may help to control the hot flashes and other symptoms that come with this time of life.
If you decide to utilize hormone therapy, you have two alternatives - synthetics or bio-identicals. Traditional hormone replacement therapies (synthetics) include estrogen products (Premarin, Estratab, Vivelle, Climara, Estrace) and progestins (Provera, Cycrin, Aygestin).
We have had many women complain that traditional therapies make them "not feel right". They have tried various products and are just not happy. Uncontrolled hot flashes and other various complaints lead women to discontinue hormone therapy altogether. Women have stood at our counter and sobbed because the "best years of my life" are uncomfortable and intolerable. This is very unfortunate.
Bio-identical Hormone Replacement Therapies (BHRT) include Tri-Est or Bi-Est
(bio-identical estrogens) and progesterone. In addition, some doctors practicing
BHRT will add small amounts of DHEA and testosterone. Progesterone and estrogen
in the correct combinations may provide relief of symptoms associated with
change of life. Many have also told us that have not had the same experience
with side effect that they did on commercial products.
To fully understand what BHRT is, we must look carefully at the body's
bio-identical composition. In women, circulating estrogen is made up of six
compounds of which only three are in any significant quantity. Those compounds
are Estriol (80%), Estrone (10%), and 17 b-Estradiol (10%). The ovaries produce
estradiol, the primary estrogen. Estrone is formed by the conversion of estradiol
in the body, and is thought to be the estrogen primarily responsible for breast
cancer. Estriol is produced in very high amounts during pregnancy. It is thought
of as the estrogen that is responsible for preventing breast cancer.
Premarin, the number one prescribed synthetic estrogen replacement, is made from the urine of pregnant horses (mares – thus the name PRE-MAR-in). The end product after urine collection contains six chemicals: estrone, 17 a-estradiol and 4 other chemicals only found in horses. As you can see, Premarin is far from bio-identically occurring, unless you are a horse! The only major synthetic progesterone replacement commercially available (progestin) is medroxyprogesterone. Just from the name you can tell that medroxyprogesterone is not the same as progesterone.
BHRT products are made from bio-identical plant products in a laboratory and are the only product that is structurally identical to the bio-identical hormones made in the human body. It is their identical structure that allows them to work like bio-identical hormones.
Hopefully by now you're asking yourself what BHRT is and how you can get it. There are numerous over-the-counter products that claim to be estrogen and progesterone therapies. Most are creams and gels made from soy and yams. I would recommend none of these.
The person looking for BHRT really needs to open a good dialogue with their physician. This should include an evaluation of symptoms, testing for hormone levels, and writing of a prescription designed to meet the individual's specific needs.
Bio-identical hormones can only be obtained with a physician's prescription and from a compounding pharmacist. Compounding pharmacists have the ability to obtain the bio-identical products in powder form. We then make them into the preferred delivery form (lotion, cream, gel, capsule, or suppository) according to your doctor's exact orders in the specific amounts for you.
At Specialty Medicine Compounding Pharmacy we have had great success with BHRT products. People in our care truly enjoy the difference that bio-identical hormones have made in their lives.
Another benefit of BHRT is that the medicines are made for each individual patient. Since we compound them one prescription at a time they are the exact strength and dosage form that the physician and patient want. If you are considering a switch to BHRT there are a few books that I can recommend. It really pays to educate yourself about these issues, so you can work in partnership with your doctor to help discover the best therapy for you.
Speaking of doctors, we recognize that many doctors are unfamiliar with prescribing
BHRT products. For that reason we provide BHRT training for physicians and
their staff. Have your doctor contact us if he or she would like to take advantage
of this service.
If all of this has raised questions in your mind, or if you'd like additional
information, please stop by the pharmacy or give
us a call.