Bio-identical Hormones
Like the synthetic hormones used in hormone therapy for menopausal women, bio-identical hormones are factory-made or compounded by natural pharmacies to resemble natural estrogen made in women’s bodies. Their supposed advantage is that these hormones are designed to mimic the molecular structure of natural hormones; in other words, they are bio-identical. Conventional hormone therapy is different for a simple reason. If it were made as an exact replica of what women make in their bodies, pharmaceutical companies could not patent it and therefore, would have no interest in producing and marketing it.
Estrogen Replacement
Estrogen replacement goes back to the 1950s when it first became possible to manufacture compounds with estrogen-like activity. The primary source of mass-produced estrogen from that time until recently has been the urine of pregnant mares. The first marketed medication of this kind was Premarin, made of conjugated equine estrogen, which was the most prescribed medication in the industrialized world in an earlier day. Women liked the relief from menopausal symptoms that the drug afforded them and the feeling that they were their normal selves again. It wasn’t until the eighties, with growing recognition that conventional estrogen therapy could be linked to higher cancer rates in women, especially breast cancer, that use of Premerin and other estrogen replacement drugs began to fall off. The addition of synthetic progesterone (Progestin) to conventional estrogen therapy was an attempt by drug companies to stop erosion of their market. Wyeth developed Prempro as a new, improved, and presumably, safer drug than its old stand-by, Premarin, because it contained progestin as well as estrogen.
Estriol
One bio-identical hormone, estriol, has been promoted for decades by alternative and complementary medicine advocates as particularly effective for safely reducing the severity of menopausal symptoms. Is it any safer than the hormones that were found to be so dangerous for women in the Women’s Health trial (WHI) that caused the government to shut down the trial prematurely?
While it hasn’t been well-studied in North America, estriol has been the subject of numerous studies in Europe, all of which have found estriol to be both safe and effective. Estriol is a weak estrogen. In high doses it is effective for treating hot flashes and other symptoms of menopause. It also is believed to help in maintaining bone density and preventing osteoporosis. Some practitioners of alternative medicine prefer to use a combination of three bio-identical forms of estrogen: estrone, estradiol, and estriol (Tri-Est), for menopause symptom control.
Often, a natural progesterone cream is prescribed along with the estrogen compound, theoretically, to protect the uterus from the effects of estrogen. However, progesterone creams are not well enough absorbed to provide this protection, according to the Association of Reproductive Health Professionals (ARHP). Instead, the Association recommends using an oral form of progestin for protection against endometrial cancer (cancers of the lining of the uterus) common in postmenopausal women. Although estriol is promoted as a form of estrogen that does not cause cancer, some gynecologists feel that there isn’t enough clear evidence to support the claim that it is safer than estrodiol or other synthetic forms of estrogen.
The Search for a Miracle Treatment Continues
So far, no one has found a magic bullet that can safely treat the symptoms of menopause that some women find difficult to tolerate. Natural hormones, like synthetic ones, are powerful drugs with health risks as well as possible benefits. However, there are other approaches besides hormones that you can rely on to reduce the discomforts of menopause, including dietary and lifestyle changes.
Recently, the FDA, at the behest of Wyeth, maker of Prempro, the synthetic hormone pill used in the WHI trial, tried to ban the use of estriol in women’s hormone therapies. According to Christiane Northrup, M.D., who has been called America’s favorite gynocologist:
‘Last January, the FDA announced that estriol could no longer be used in estrogen medications customized for women by compounding pharmacies. Estriol has long been a component of 90 percent or more of these customized preparations prescribed for women by their doctors. But in a big win for a woman’s right to choose her best health care options, Congress resolved to protect the doctor-patient relationship from FDA interference!’
A victory for consumers! If the FDA had succeeded in banning estriol, women would be left with no choice but synthetic hormones, known to pose grave health risks for them.