What are Bioidentical Hormones and Are They Safe? What are the Indications for Use?
Bioidentical hormones are those hormones that your ovary used to make before you went through menopause.
There are FDA approved bioidentical hormones such as 17B estradiol and progesterone. Then there are compounded bioidentical hormones which are done by special pharmacists and compounding pharmacies.
These are contrasted with synthetic hormones, but there has never been a study that actually looked at the safety of synthetic versus bioidentical hormones with regard to safety and cancer risk. It is assumed that because something is bioidentical it is safer. There is no direct data to support this. It is assumed and inferred.
All hormone regimens in women with a uterus that include estrogen plus progesterone increase the risk very slightly of stroke, heart attack, breast cancer (from the Women’s Health Initiative Study of 2002 there were an extra 7-8 cases of stroke, heart attack and breast cancer per 10,000 women per year on combined hormones, and and extra 15/10,000 cases of blood clots).
We do not recommend compounded hormones because they are not FDA approved and there is no regulation of exactly how much hormone you will be receiving monthly. FDA approved bioidentical hormones would be encouraged, but do understand that they have similar risks and contraindications to synthetic hormones. Talk to your doctor about what is best for you. Your doctor knows you best along with your personal and family history and can help you make the best choice for your particular situation.
What are the indications for hormone replacement therapy? How long should they be used for?
Hormone replacement therapy is indicated for women who have severe vasomotor symptoms such as hot flashes and night sweats that are unremitting and interfere with the quality of life. They should be used for the shortest duration of time at the lowest dose, and risks, benefits and alternatives should be reviewed first with your doctor who will take an extensive personal and family history from you.
The use of hormones should be regularly evaluated for the patient and when symptoms abate the consideration of discontinuing hormones should be considered.
Have more questions about hormone replacement therapy and how it affects you?
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