Bioidentical Hormone Therapy
with Sex (Gonadal) Steroid Hormones
First let’s break down the word bioidentical. Bio references biology and your body and identical, meaning the same as something. With bioidentical hormone therapy we use compounds that have both the same chemical and molecular structure as the hormones that your body naturally produces. Made and synthesized from plant chemical extracts, which is why bioidentical hormone therapy is often referred to as natural hormone therapy.
Categorized as ‘the estrogens’, each of these ovarian hormones has its own unique and particular function.
Estrone (E1) can be converted to estradiol in some women, is the primary estrogen in postmenopausal women and is generated in fat cells. Metabolism of estrogens to 2-OH- and 4-OH-estrogens can be dangerous and cancer causing. Methylation of these “bad” hormones with an intact methylation pathway will assure a reduction in risk of cancer with HRT.
Estradiol (E2) is the most potent estrogen, primarily aids in the cyclic release of eggs from the ovaries for potential fertilization and preparation of the uterus for pregnancy. In addition to its role in cycling and pregnancy, estradiol also has powerful beneficial effects on heart, bone, brain and colon. It is the reduction in the level of estradiol that causes common menopausal symptoms such as hot flashes and night sweats.
Estriolis (E3) produced in large quantities during pregnancy and is considered by some to be the ‘gentle’ estrogen providing some of the protection without exposure to the risks associated with stronger estrogens.
Produced cyclically by the ovaries, progesterone maintains the uterine endometrium to nurture a fertilized egg and allows for fetal development throughout a pregnancy. Progesterone has been labeled the body’s anti-estrogen, partnering with estradiol to maintain the delicate balance required between a woman’s reproductive hormones. A woman’s progesterone level diminishes, along with that of estradiol, as she approaches and enters menopause and, in most women, drops to low postmenopausal values.
As a woman ages (in her 40’s or 50’s) there is the slow decline of ovarian hormone production beginning with the irregular cycling of perimenopause which can last several years followed by menopause which is defined as not having cycled for twelve consecutive months. Though menopause brings with it a variety of desirable changes in a woman’s life such as no more menstrual cycles, contraception or PMS, there can be many undesirable symptoms.
In addition to the decline in estradiol and progesterone levels, a woman’s testosterone and DHEA levels continue to drop throughout her lifetime and are responsible for some menopausal symptoms. When replacing hormones it is important to maintain a youthful balance of estrogens, progesterone and testosterone.
The “male” hormone, also enjoys a part to play in the female body. Nano-gram for nano-gram there is more circulating testosterone in a woman than estrogen at times. Testosterone in men needs no elaboration, as we see altered and depressed mood, sarcopenia (loss of muscle), lack of libido, decreased energy, thinning of bone, and cognitive decline when a man’s testosterone levels fall. HRT for men is as important for age-management as it is for women. Careful management with attention to details is of paramount importance in the proper management of men’s testosterone therapy.
Removal of a woman’s ovaries will result in immediate menopause creating a series of rapid and intense symptoms that can be debilitating and can be addressed successfully with the appropriate form of hormonal intervention.
HRT is the administration of steroid hormones (either natural, synthetic or animal-derived) to make up for the decline in those hormones (that drop naturally with age). Natural HRT refers to a regimen of hormones that is bio-identical in structure and physiological activity to what the body produces. For example Natural progesterone is derived from Mexican Wild Yam, but must be manipulated in the lab. The wild yam is only active in humans once pharmaceutical conversion has taken place. But what is really meant by Natural is the fact that the chemical/molecular structure is identical to that of what our organs produce.
Currently, more and more women and men are opting for natural HRT. Given both the short and long term health benefits, HRT is now considered by many healthcare providers as the preventive medicine of the 21st century for women and men in the second half of life. On the average, a female HRT user can expect to live up to three years longer than a non-user.