Bioidentical (Natural) Hormones

Bioidentical Hormones

Sometimes custom-compounded hormones are referred to as “bioidentical hormones” or “natural hormones.” These terms mean different things to different people. To scientists and healthcare providers, bioidentical hormones are those that are chemically identical to the hormones produced by women (primarily in the ovaries) during their reproductive years.

A woman’s body can make various estrogens (such as 17beta-estradiol, estrone, and estriol) as well as progesterone, testosterone, and other hormones. Thus, bioidentical hormone therapy can mean a medication that provides one or more of these hormones as the active ingredient.

Bioidentical hormones have been produced commercially to be chemically exact duplicates of naturally occurring hormones. Some of these hormones are made available in well-tested, government-approved, brand-name prescription drugs. Several FDA-approved drugs contain 17beta-estradiol (see Charts on pages 50 and 52), and those that are not taken orally remain in the body as 17beta-estradiol. Oral products break down into another estrogen type that is not bioidentical. There is one governmentapproved bioidentical progesterone product (see Chart on page 50). It is not necessary to custom-make a hormone product to have one that is bioidentical or natural.

Contraindications : Any Risks Or Side-Effects?

Some women have contraindications to using ET/EPT. These are reasons not to use the treatment. In a few cases, the potential benefits may outweigh the potential risks, leading women with such contraindications to accept therapy after careful consideration. Government guidelines indicate that, in general, women who have the following conditions should not use ET/EPT. The guidelines do not make a distinction between systemic and local therapy, and advice that even local vaginal hormones should not be used in these instances.

However, many experts think systemic and local hormone therapies have different risk profiles.

• Known or suspected pregnancy
• History of breast cancer
• History of hormone-sensitive cancer
• Unexplained uterine bleeding
• Liver disease (this especially applies to oral ET)
• History of blood clots
• Confirmed cardiovascular disease

Cigarette smoking is not a contraindication for ET/EPT, as it is with oral contraceptive use in women over age 35, but smokers are urged to stop before treatment starts for general health reasons.

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