A growing number of women are discovering the benefits of bio-identical hormones, or ‘natural’ hormone replacement therapy, to alleviate the symptoms of menopause .
Claire from London in the UK found that it turned her nipples a rosy pink and that she stopped having mood swings. Janice from Florida in the US finally got a good night’s sleep when her hot flashes subsided, while enjoying an improved libido that meant she and her husband were ‘like newlyweds’.
So what’s their secret? ‘Natural’ hormone replacement therapy. Both in their fifties, Claire and Janice represent a new approach to ageing that is taking women by storm across the globe. They are taking hormones to replace those lost as a result of menopause – though they wouldn’t dream of taking conventional HRT. These women are advocates of the latest treatment of menopausal systems, which uses made-to-order bio-identical hormones that are biochemically identical to those naturally occurring in a woman’s body.
Health reports raised concerns on health risks from synthetic hormones
Their feelings about prescription hormone replacement therapy (HRT) is shared by a growing number of women, particularly since major research studies on both sides of the Atlantic (the Women’s Health Initiative (WHI) in the US and the Million Women’s Study in the UK) were published. Both studies reported a slight increase in the risk of serious health problems, including blood clots, heart attacks, stroke and breast cancer in women taking the form of HRT approved by the American FDA and other drug regulatory bodies throughout the world.
According to an increasing number of HRT specialists, the problem is that the most widely used prescription HRT, Premarin, is, as its name suggests, made from PREgnant MARes’ urINe. Not to mention the growing debate about the ethics surround the use of horses in this way.
‘The HRT that we read about in research trials such as WHI contains something like 55 different horse hormones,’ says Professor John Studd, chairman of the British Menopause Society. ‘It’s big business, worth about US$4bn annually. Unfortunately, it doesn’t contain hormones that the human body recognises.’
More women not content to put up with symptoms
For women who are not content to grin and bear their menopausal symptoms, there are alternatives. Many choose herbal phyto-oestrogen remedies that help them cope, or they make lifestyle changes to help alleviate the symptoms.
A growing number of women, however, are finding that they can still use hormones to balance their menopausal symptoms – without increasing their risk of ill health or experiencing serious side effects. These hormones – mainly oestrogen, progesterone and testosterone - are biochemically identical (bio-identical) to those made by the human female body. And in order to get the balance exactly right, they are prepared to spend the time and money to get their hormone levels regularly tested to make sure they receive the right mix of hormones to keep them at normal, healthy levels.
Bio-identical hormones are made from plant sources
The most popular type of bio-identicals, often called ‘natural HRT’ (NHRT), is derived from yam or soya bean. They are not available on prescription; they are made-to-order by ‘compounding’ pharmacies, which in recent years have become common throughout the US and parts of Europe.
For the many medical enthusiasts of bio-identicals, the lack of regulation is not a problem. ‘It is important for people to understand that you cannot patent a naturally occurring hormone,’ explains American holistic gynaecologist, Dr Christiane Northrup, acclaimed author of The Wisdom of Menopause.
‘The hormones that naturally occur in the human female body are altered so that the drug companies can justify the R&D (research and development) programmes to patent a hormone and therefore make their money. But I'll take my chances with the hormones that mother nature has taken at least three million years to come up with.’
Bio-identical hormones are holistic
Dr Rashmi Gulati, director of Patients Medical, a leading centre for integrative and holistic medicine in New York, is another enthusiast of bio-identicals. ‘Having seen first hand the exceptional benefits of bio-identical hormones used by countless women, I would always promote this new treatment over FDA-approved HRT,’ he says.
‘It is actually a problem that HRT comes in a standard ‘one size fits all’ form directly from the pharmaceutical manufacturer,’ says Dr Gulati. ‘It means that dosing cannot be tailored specifically for each individual, unlike bio-identical hormones. And though synthetic hormones are molecular cousins of natural agents, they are not identical in structure to the natural hormones they emulate, so inevitably side effects are more common.’
Red Clover is another natural therapy
Depending on the individual, NHRT may contain any range of hormones. For example, three different types of oestrogen can be included in different combinations: oestradiol, oestrone and oestriol. Other ingredients are micronised progesterone, as well as testosterone, which is vital in both men and women for energy and libido. The thyroid hormone, pregnenolone, and an anti-ageing favourite, DHEA (dehydroepiandrosterone), may also be included.
Bespoke HRT not 'one size fits all'
Doctors, usually hormone specialists or gynaecologists, decide on the right combination of hormones by carrying out blood or saliva tests to measure baseline hormone levels. These tests give an indication of how much of each hormone is needed to reach ‘normal’ levels.
Dr John Moran of the Holistic Medical Centre in London begins treatment with an hour’s consultation, during which time he takes a detailed medical and family history with a physical examination to check the endometrium (the lining of the womb). Blood tests are also taken and are then repeated periodically to ensure that the hormones are maintained at normal levels.
‘It really is amazing to see the benefits that bio-identical hormones can bring,’ says Dr Moran. ‘I see women whose skin is losing its elasticity, who have facial hair, aches and pains, stress incontinence, depression and a low or absent sex drive that is not helped when the vagina is very dry. All these symptoms can be reversed in weeks with the right mix of hormones.’
Hollywood actress Suzanne Somers went from 'dried up' to juicy
A champion of NHRT in the US is former Hollywood actress, Suzanne Somers. As she approached menopause, she was ‘ready to grow old gracefully and teach those around me that we don't have to dread this time of life’. But as she describes in her two best-selling books, The Sexy Years (2003) and Ageless (2006), there was a flaw in her strategy. ‘The Seven Dwarfs of Menopause arrived at my door without warning: Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, and All-Dried-Up,’ she says. ‘One by one they crept into my own private cottage in the woods and started to take over my life.’
Suzanne has written many books on the subject of ageing
Somers, now aged 66, found that bio-identicals were the ‘juice of youth’. She stopped itching, her mood levelled and her body temperature was under control. ‘I recovered the glorious ability to sleep through the night. My body slimmed down. And the look in my husband's eye was returned with a wink and lovingly reciprocated as I happily banished All-Dried-Up.’
Meanwhile, specialists in HRT within the medical profession are mounting a robust campaign to persuade women to continue to take prescription HRT, at least during the early years of menopause. The pharmaceutical industry is also fighting back. Premarin and similar HRT are now available at lower doses, making it safer and less likely to cause side effects.
Hormones as patches
There are also prescription HRTs available that are also bio-identical. Dr Northrup recommends NHRTs that are available on prescription as skin patches: Climara, Vivelle or Estraderm are all oestrogen-replacement therapies that are bio-identical.
‘The drug companies have patented the patch technology, and I consider that a beautiful marriage of technology and nature's wisdom,’ she says.
Professor Studd believes that the enthusiasm for bio-identicals is a sign that the US is finally catching up with Europe. ‘I have been using prescription bio-identical hormones for my patients for over 35 years,’ he says. ‘American menopause specialists are just catching up with us now, mainly because of the problems with Premarin.’
Today, he says, doctors have a range of bio-identical hormones that they can prescribe – though he acknowledges they are not as wide as compounding pharmacies. However, it is now possible to get bio-identical oestrodial as a patch, gel or tablet; testosterone as implant, gel and, more recently, as a patch; and natural progesterone as a tablet and intrauterine device.
Getting safety and cost right
‘In my view, there is no particular benefit in tailoring the hormone dose to the individual,’ says Prof Studd. ‘It makes just as much sense to prescribe a bio-identical hormone on the basis of age and symptoms.
‘My worry is that bio-identical hormones from compounding pharmacies are unregulated and un-researched and therefore they are unknown quantities. It is always a good idea to use medication that has been properly tested – and hormones are no exception. And it is certainly much less expensive: the cost of all those blood and saliva tests can really mount up.’
But the research conducted five years ago has undermined many women’s faith both in their physicians and the pharmaceutical industry. Women like Janice and Claire are simply relieved to have found a natural product that makes them feel ‘normal’ again – and provides unexpected anti-ageing benefits. What’s more, they like being cared for by doctors who have the time to carry out personalised tests and to treat them as individuals – and they’re prepared to pay the price.
Over the counter herbal remedies containing soya and/or red clover have been found to be helpful in alleviating symptoms. As has Evening Primrose Oil.
The Wisdom of Menopause: How to Welcome the Change, Bantam Books (2006) by Christiane Northrup. She says menopause is the greatest opportunity for growth and can promote optimum nutrition, as many of the symptoms can be eased with vitamins and relaxation. ‘And ‘tapping into your body’s wisdom can help ease your symptoms significantly,’ she says.
Individually tailored bio-identical hormones from compounding pharmacies
*Find a doctor through the International Academy of Compounding Pharmacies. This has a list of registered compounding pharmacies throughout Australia and the US.
Pharmaceutically-produced bio-identical HRT
A large number of FDA-approved HRT drugs are virtually identical to the hormones produced by women's ovaries. They come in many forms and doses, some of which have been used for years. They include:
*Bio-identical oestrogen. This is available on prescription, for instance, as Oestrogel.
*Progestogens most closely resembling naturally produced progesterone. These are available on prescription as dydrogesterone, drospirenone and medroxyprogesterone.
*Bio-identical testosterone is available as a patch in the UK.
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