Everyone's Health

Bioidentical is not another word for 'safe'

Question: Bioidentical hormones are identical to the hormones the body produces. But aren't they constructed synthetically? That is, they are not taken from the human body (or is there a ranch somewhere in Montana where they are extracted from humans?)

“Bioidentical” and the word “natural” makes it sound like it's “safe”. But if it's estrogen, it comes with all the possible dangers of excessive estrogen. It seems to be all marketing and driven by the power of the words “bioidentical” and “natural.” No one is saying what they really are, and the consumer is misled. Whats the real story?

Answer: You have good and ample company in your shaky view of bioidentical hormones.

Here's a stab at clarifying the picture using estrogen as an example.

It may help to use the term “laboratory-manufactured” instead of “synthetic.”

The prescription product Premarin consists of conjugated estrogens extracted from equine sources (pregnant mares). This estrogen is not laboratory-manufactured. It's “natural” but different from the natural estrogen produced in the human body.

The prescription products Cenestin and Enjuvia are conjugated estrogens that are laboratory-manufactured from plants. This estrogen is derived from natural sources, but is different from the natural estrogen produced in the human body.

Enter “bioidentical” estrogens, which also are laboratory-manufactured from plants (yams and soy), a natural source. In this case, though, the derived estrogen products are identical in chemical structure to the estrogen produced in the body.

For this reason, the body can't tell any difference between its own estrogen and manufactured bioidentical estrogen.

Bioidentical estrogen products would be expected to carry the same risks (and benefits) as the body's own estrogen. Bioidentical estrogens include estradiol, estrone and estriol. Bioidentical progesterone is micronized in the laboratory to increase its absorption.

Bioidentical hormones are available in numerous FDA-approved prescription products. An increasingly popular practice is to have bioidentical hormones custom-mixed at a compounding pharmacy. This allows individualized combinations, doses and preparations.

The interest in bioidentical hormones has surged since 2002. That's when the Women's Health Initiative (WHI) trial was shut down early when Prempro was found to slightly boost the risk of breast cancer, stroke and blood clots in postmenopausal women.

Prempro is a combination of estrogens and progestin (conjugated equine estrogens and medroxyprogesterone acetate). These hormones are not bioidentical.

There are reasons to hope that bioidentical hormones might pose less risk, but there's little evidence to support this view currently. Research is needed to compare the various hormone products, doses and forms of administration.

When hormone replacement therapy is prescribed, bioidentical or not, the lowest effective dose should be used, and treatment can be stopped once menopausal symptoms subside.

Lastly, it's important to realize that the body stops making its own estrogen for a reason. To everything there is a season. Menopause is not a disorder but a natural phase of life.

Prior | Tell us what you think | Next

Add to Your Social Bookmarks: Del.icio.us Digg Furl Reddit Simpy Spurl Y! MyWeb - StumbleUpon