Everything You Need to Know About Bioidentical Hormone Replacement Therapy: The Myths and the Research
NOVEMBER 2022 | Dr. Ashley Southern
When it comes to the human body, hormones control everything. They are the master puppeteers of our basic bodily functions that work to ensure our bodies are performing as one cohesive machine. They manage everything from digestion and metabolic functions, energy production, immune responses, sexual function, and vital neurologic signalling. When our hormones become even slightly imbalanced, or as we become less efficient at producing them, it can throw off our entire inner ecosystem; low or imbalanced hormones are associated with a long list of health risks, including diabetes, polycystic ovary syndrome (PCOS), weight gain, weight loss resistance, depression, anxiety, hypothyroidism, hyperthyroidism, thinning hair, and many more.
Fortunately, there are treatments available to help rebalance and support diminished hormone levels. One treatment gaining traction is bioidentical hormone replacement therapy, or BHRT; while BHRT is not new to medical practice, recent and more in-depth research has brought bioidentical hormones to the forefront of hormonal treatments due to their benefits and proven effectiveness; there is a true difference between “HRT” and “bioidentical HRT,” and it is important to know the difference. BHRT is applauded for being especially beneficial when used to help support menopausal symptoms in women and andropause symptoms in men.
If you are considering BHRT, you have come to the right place. Read on, learn about the misconceptions that has normalized how we perceive HRT, and book a consultation to discuss how bioidentical hormone replacement therapy can help you!
Bioidentical Hormones: What Are They?
“Bio” refers to “plant”, and “identical” denotes “molecular mimicry,” meaning a molecule that mimics a hormone’s exact molecular structure; as we age, hormones will change and may become so disproportioned such that symptoms arise. Bioidentical hormones are human made hormones derived from natural estrogen and progesterone sources found in plants, typically yams. Having the same molecular structure as the hormones naturally produced by the body not only optimizes absorption but is also a safer, more natural alternative to synthetic hormonal treatments. Estrogen, progesterone, and testosterone are the main hormones used in bioidentical hormone therapy.
Uses of Bioidentical Hormone Replacement Therapy
Bio-Identical Hormone Replacement Therapy (BHRT) is an effective means of correcting low or imbalanced hormone levels through replacement, typically used to counteract the impacts of decreased hormone production as we age and exposure to many stressors in life. While the most common use of BHRT is to help manage menopause and/or perimenopause, bioidentical hormones can be used to treat both men and women when their hormone levels fluctuate or decrease.
BHRT has been known to improve a wide variety of symptoms and conditions including:
- Menopausal symptoms
- Cancer treatments that impact estrogen production
- Insulin resistance
- Adrenal disorders
- Thyroid disorders
- Osteoporosis and bone density loss
- Fibromyalgia
Benefits of Bioidentical Hormone Replacement Therapy
One of the most common benefits of BHRT is alleviating menopausal symptoms in women and “andropause” (i.e. low testosterone) in men. Research shows that women under the age of 60 who start BHRT within 10 years of menopause can benefit the most; many people begin experiencing hormonal insufficiency well before that, even as early as their 30s.
Over time, women’s ovaries decrease the production of estrogen, progesterone, and even a little testosterone; this leads to bone density loss, decreased libido, decreased energy, mood fluctuations, hot flashes, vaginal dryness, painful sex, and incontinence. Men as early as 30 can begin to experience a decline in their production of testosterone for various reasons. BHRT works to replenish these hormone levels, and if you begin at the right time, you can transition seamlessly through the aging process without interruption of the above symptoms due to loss of such vital hormone levels.
Bioidentical hormone benefits go beyond menopause – rebalancing hormonal levels are also associated with the reversal and improvement of many chronic diseases:
- Reversal of high cholesterol and elevated lipids
- Prevention of glaucoma, macular degeneration
- Prevention of memory & cognitive decline
- Decrease in chronic pain
- Decreased risk of diabetes
- Decreased rates of depression
- Improved mood disorders
- Improved skin health and elasticity
- Improved sleep patterns
- Muscle mass loss prevention, particularly when combined with exercise
- Decreased risk of bone density loss (osteoporosis), tooth loss
- Decreased risk of cataracts
- Decreased risk of colorectal cancer
- Decreased risk of cardiovascular disease
- Decreased risk of Alzheimer’s and Parkinson’s disease (Song YJ, 2020)
- Increased sexual function
- Improved erectile dysfunction
Types of Treatments
When it comes to treating menopause, the main types of BHRT and routes of administration are listed below, and will include any combination of testosterone, estrogen, and progesterone:
- Sub-dermal pellets
- Pills
- Patches
- Injections
- Skin creams and gels
- Vaginal rings and creams
Not all of these options include bioidentical hormones, however; and it is important to choose the correct route of administration, since the absorption and breakdown of these hormones can vary widely, leading to unwanted side effects (discussed below).
Bioidentical Hormone Pellet Therapy
Bioidentical Hormone pellets are gaining more traction in the HRT community of late, although they have been used for decades; this method involves implanted a small pellet of bioidentical hormones just beneath the skin where it continuously releases controlled levels of hormones for up to 3-6 months. Subcutaneous pellets are considered more convenient than requiring routine hormone injections and administer more consistent and regular dosages than creams and patches (White, 2021). With minimal side effects and requiring little to no recovery time, studies show that BHRT pellets may be the most effective and safest means of administering BHRT. There are countless studies that show adequate levels of hormones are preventative for many cancers, and that correcting levels with BHRT can be protective against cancers.
Misconceptions of Hormone Replacement Therapy in Research
Historically, HRT has received mixed reviews. Originally marketed in the 1960s as an aging-preventative medication meant to preserve youthfulness in menopausal women, BHRT became popularized in the 1990s. In 2002, however, the Women’s Health Initiative released a study that linked “hormonal replacement therapy” to increased risks of cancer and cardiovascular diseases, and demand for treatments dropped.
However, the research using “hormonal replacement therapy” fails to discuss the difference between the bioidentical and synthetic versions of these hormones. Most studies that show risks of breast cancer or blood clots using “estrogen” are actually using conjugated equine (horse) estrogen (or CEE), and studies using “progesterone” are often using progestins; progestins are known to increase your risk of heart attack, stroke, and blood clots. And, as you might have guessed, the same goes with “testosterone” and its association with heart attacks and prostate cancer – the actual bioidentical testosterone has quite the opposite effect.
Since then, more research has come out that provides new scientific insight and questions the 2002 study’s initial findings and suggests that Bioidentical HRT is not only more beneficial but also safer, while newer methods such as pellet treatment have made ground-breaking advancements in BHRT.
Side effects we have all heard or read about, such as those listed below, are often experienced when using the synthetic hormone or certain delivery methods (i.e. oral versus transdermal):
- Acne
- Bloating
- Weight gain
- Fatigue
- Mood swings
- Breast tenderness
- Cramps
- Spotting
- Increased facial hair in women
In actuality, these complaints are correctible and are helpful in alluding to other metabolic issues such as thyroid dysfunction, low nutrient status, and even structural abnormalities like fibroids – these are also treatable with the right diet, supplement or medication changes, and lifestyle changes. It is extremely important and should be required to get a full medical assessment, such as updated labs and scans, before beginning HRT.
Closing Thoughts
BHRT can be an effective and beneficial tool in rebalancing your hormones. It can help to improve not just your health but your overall quality of life. Since not all forms of HRT are without risk, it is imperative to not only educate yourself, but to work with a healthcare provider who is up to date with the most recent research and using bioidentical hormones.
Our staff at Nascent Health are certified BHRT providers and are trained by the leading experts in bioidentical hormone therapies. Trained annually on the Evexipel Method, we have access to the most current BHRT advancements, including superior compounded pellets. It’s not a matter of if, but when you will need hormone replacement – Book your consultation to discuss your lab levels and options with our providers at Nascent health.
References
Biote Medical. (2021, May). Study: Testosterone Pellet Therapy Reduces Breast Cancer Incidence in Women. Retrieved from businesswire.
Farish, E., Fletcher, C. D., Hart, D. M., Azzawi, F. A., Abdalla, H. I., & Gray, C. E. (1984). The effects of hormone implants on serum lipoproteins and steroid hormones in bilaterally oophorectomised women. Acta endocrinologica, 106(1), 116–120. https://doi.org/10.1530/acta.0.1060116
Gallagher, J. C., & Levine, J. P. (2011). Preventing osteoporosis in symptomatic postmenopausal women. Menopause (New York, N.Y.), 18(1), 109–118. https://doi.org/10.1097/gme.0b013e3181e324a6
Mikkola, T. S., Tuomikoski, P., Lyytinen, H., Korhonen, P., Hoti, F., Vattulainen, P., Gissler, M., & Ylikorkala, O. (2015). Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality. Menopause (New York, N.Y.), 22(9), 976–983. https://doi.org/10.1097/GME.0000000000000450
Song YJ, L. S. (2020, March). The Effect of Estrogen Replacement Therapy on Alzheimer’s Disease and Parkinson’s Disease in Postmenopausal Women: A Meta-Analysis. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/32210745/
Tomi S. Mikkola, Hanna Savolainen-Peltonen, Pauliina Tuomikoski, Fabian Hoti, Pia Vattulainen, Mika Gissler, Olavi Ylikorkala, Lower Death Risk for Vascular Dementia Than for Alzheimer’s Disease With Postmenopausal Hormone Therapy Users, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 3, 1 March 2017, Pages 870–877, https://doi.org/10.1210/jc.2016-3590
