What's the Deal with Bio-Identical Hormone Therapy?

Bio-identical hormone therapy is NOW OFFERED at our clinic by Dr. Andrea Hilborn, ND. The hormones that may be prescribed are estrogen and progesterone in a cream or vaginal suppository. 

Who is this for?

Bio-identical hormones are mainly used to treat the symptoms of menopause. The second most common use is as an anti-aging measure. They can also be used to treat just about any condition related to women's health: fertility, heavy bleeding, polycystic ovarian syndrome, acne, painful periods, and vaginal atrophy for example.

What are bio-identical hormones?

Bio-identical hormones, which are also called natural hormones, are exact replicas of the hormones our body produces. They may come as ready-made products or be custom compounded. 

First, your body's hormone levels are tested, then we supplement the appropriate hormones until your symptoms are managed, without exceeding what your body would normally produce. 

Taking hormones topically, rather than orally, allows you to take lower amounts of hormones and still receive the benefits. This is because the hormones entering through the skin do not have to pass through the liver before reaching the bloodstream. 

The most important factor is to have a prescription that is based on the most up-to-date understanding of female physiology. Many people are under the impression that all menopause and perimenopause symptoms are caused by low estrogen, which is not the case. 

Menopause

Menopause is the time from one year after the woman's final menstrual period to the end of her life. Levels of estrogen, progesterone and testosterone are lower, and at different levels in relation to one another. There is no more cyclic fluctuation of hormone levels. During the early years of menopause, women may still experience symptoms like hot flashes, which bio-identical hormones can help with. Bio-identical hormones are also used for anti-aging during this time of life. 

Perimenopause

Perimenopause is the period of time just before menopause. It is characterized by wild fluctuations in hormone levels that can be compared to what women go through at adolescence. This stage begins in the mid-thirties to early-forties, and ends one year beyond final menstrual flow. This is the period of time when symptoms arise and can become life-disrupting. 

The earliest symptoms of perimenopause are: new onset and/or longer menstrual flow; short menstrual cycle lengths of less than or equal to 25 days; new sore, swollen and/or lumpy breasts; new or increased menstrual cramps; new mid-sleep wakening; onset of night sweats especially around flow; new or markedly increased migraine headaches; new or increased premenstrual mood swings; and notable weight gain without changes in exercise or food intake.

Many women are inappropriately treated for fibroids when they experience heavy bleeding in perimenopause. Heavy bleeding is rarely caused by fibroids. The heavy bleeding is caused by high estrogen and lower progesterone. Hormonal treatment should be attempted before surgery.

During perimenopause, using bio-identical hormones can alleviate these symptoms. 

Conventional Hormone Replacement Compared to Bio-Identical Hormone Replacement

Conventional hormone replacement therapy contains conjugated equine estrogens (CEE) (to mimic the action of estrogen) and progestins (to mimic the actions of progesterone). 

Conjugated equine estrogens are derived from the urine of pregnant horses. There are a variety of molecules in the urine that stimulate the same cell receptors as the three different estrogens that we produce in our bodies. Premarin contains conjugated equine estrogens. 

Widespread use of conventional HRT was discontinued when the Women's Health Initiative Study found that using HRT increased risk of cardiovascular events and cancer. 

There are different forms of estrogen, which complicated the research findings. The estrogen-like molecules found in CEE modify estrogen receptors on breast cells in a cancer-promoting way. Synthetic progestins do too. Additionally, CEE contains at least one potent carcinogenic estrogen, 4-hydroxy-equilenin that promotes cancer by inducing DNA damage. 

The progestins in conventional hormone replacement therapy include medroxyprogesterone acetate and norethrindone. Provera contains medroxyprogesterone acetate. 

Prempro contains a combination of conjugated equine estrogens and medroxyprogesterone acetate. 

Medroxyprogesterone acetate has breast cancer promoting properties, negates the heart protective actions of estrogen, causes blood vessels to constrict, and causes insulin resistance.

Using estrogen and bio-identical progesterone is a lesser risk than conventional HRT, but still imposes an increased risk compared to not using hormone replacement therapy. 

Before booking an appointment to receive bio-identical hormone therapy, you should know:

We cannot prescribe bio-identical hormones to anyone with a history of breast cancer.

We use topical hormones and vaginal suppositories. We do not prescribe pills or injections. 

We do not prescribe testosterone. 

Every patient will have to have testing done, or bring results from within the last 6 months, and have repeat testing once per year. 

Patients must agree to undergo their regular cancer screening tests (mammography and Pap smear). Any patient taking estrogen will have to have a pelvic or transvaginal ultrasound within 4 months of starting estrogen. This will have to be requested through her family doctor. 

BHRT will be offered only WITH naturopathic care: a full naturopathic assessment, and diet, lifestyle, herb and nutrient recommendations.  

Is BHRT right for you? Call 613-767-6982 today to book a complimentary 15-minute appointment with Dr. Hilborn, ND.