Bioidentical Hormone Replacement: Is it Right For You?
When experiencing menstrual changes – from PMS to menopause – women are often confused about the differences between natural, synthetic and bioidentical hormones. With more than 48 million women going through The Change at the same time, it’s important for them to understand their choices and whether or not they need Hormone Replacement Therapy (HRT).
Natural Hormones come from a plant, mineral, or animal source. They are not easily, if ever, converted to an identical match to those found in the female body. Products in this category include prescription HRT formulas and over-the-counter soy and yam-based products.
Synthetic Hormones are created in a lab and are a close match to bioidentical. These are available by prescription or over-the-counter.
Bioidentical Hormones (Bi-HRT) are identical in chemical and molecular structure to hormones made by a woman’s body. They have been prescribed by doctors for years, are easily adjusted to a woman’s individual needs, and may be based on a panel of hormone tests. Many formulas are available from retail pharmacies and formulary (compounding) pharmacies, which create custom products based on a physician’s order. The molecules for which we generally seek replacement include progesterone, testosterone, DHEA, and three types of estrogen (estrone, estradiol, and estriol).
How do Bioidentical Hormones Work?
The body is swimming in hormones that act like keys in a lock. Basically, hormones are comprised of a solid steroid base decorated with “arms” and “legs.” These attachments turn hormones into specialized molecules (the keys), which plug into receptor molecules (the locks), triggering biochemical reactions in the body. If hormonal replacement therapy doesn’t follow the design our cells have evolved to recognize, women may experience side effects ranging from general discomfort to increased risk for serious illnesses.
How are Custom Bioidentical Hormones Made?
A healthcare practitioner begins with a saliva or blood test to assess hormone levels and ascertain a “recipe” for Bi-HRT unique to the patient. That formula is filled as a prescription by a compounding pharmacy, which is regulated by each state.
Is Bi-HRT a Safer, More Effective Alternative to Conventional HRT?
The long-term study, Women’s Health Initiative (WHI), looked at combined estrogen and progestin for preventing later-life illness. In 2002, the study was stopped because hormone users had a higher risk of breast cancer, heart disease, stroke, and blood clots. Fearful of these results, many women and their doctors concluded they must discontinue hormone therapy. For these women, hot flashes, sleeplessness, and other menopausal symptoms returned with a vengeance. However, it should be noted that conventional HRT is considered an effective approach and studies of Bi-HRT have had promising results; several have gained FDA approval (e.g., Estraderm, Vivelle, Estrogel) and may ease mood, sleep disturbance, anxiety and hot flashes. Bioidentical estrogens are the treatment of choice in Europe and becoming more widely used in the U.S.
Not every woman needs HRT, nor does every doctor recommend it. This is best decided on an individual basis between each woman and her holistic health care doctor.
Flaxseed (Linum usitatissimum)
While research results are mixed around flaxseed and its ability to reduce menopausal symptoms, there are enough positive findings to support use of this nutrient-rich herb. For many women it has made the difference between comfort and discomfort when it comes to reduction of hot flashes, night sweats, mood swings). Here are three nutrients unique to flaxseed, all of which play a role in supporting good health.
1. Omega-3 Fatty Acids: beneficial for preventing or treating certain health conditions, including heart disease and depression.
2. Mucilage: refers to water-soluble, gel-forming fiber that can provide special support to the intestinal tract. This makes flaxseed an excellent support to digestion and relief of constipation.
3. Lignans: provides fiber-related polyphenols that have two important health benefits. They provide antioxidants, which help prevent damage to other cells in the body and are associated with preventing disease. Additionally, polyphenols in lignans influence hormone metabolism.
Purchasing and Storing Flax
Raw flaxseed ranges in color from amber/gold to tan/brown. White or green flaxseed has been harvested before full maturity; black flaxseeds were likely harvested after full maturity. To reap the full health benefits, select the amber or brown variety. If possible, purchase the whole seed in bulk, store in the freezer and grind only the amount needed for immediate use. Flaxseed can be ground, sprinkled on cereal, added to baking mixes and used as a thickening agent in many recipes.
Could Diindolylmethane (DIM) Protect Against Cancer?
Diindolylmethane (DIM) is a compound found in “cruciferous” vegetables such as cabbage, Brussels sprouts, cauliflower, and broccoli. Scientists think these crunchy vegetables may help protect the body against cancer because they contain diindolylmethane and a related chemical called indole-3-carbinol (I3C).
Dim helps balance the sex hormone estrogen and testosterone. When the body breaks down estrogen, for example, it can form either a harmful or beneficial metabolite. DIM, in some clinical and animal studies, has been shown to help the body form the more beneficial estrogen metabolite and reduce formation of the harmful metabolite. The beneficial estrogen metabolites can have many positive effects, including reducing the risk for some types of cancer. DIM may benefit patients with certain types of prostate cancer and may help reverse abnormal changes in cells on the surface of the cervix. Some scientists think DIM will be useful for preventing breast, uterine and colorectal cancer. However, because of the variability in types of cancer and the sensitivity of the estrogen system in the body, DIM and I3C supplements may not be appropriate for everyone.
Natural Soothing for Menstrual Distress: Black Cohosh (Actaea racemosa)
There’s a long history to the medical uses of Black Cohosh. Native Americans have used it as a diuretic and to treat fatigue. European settlers used preparations of the roots to treat fever, menstrual problems, and pain following childbirth. Into the 19th century, black cohosh became a staple ingredient in medicines for “women’s complaints.” Over time, it faded from use in the U.S. while still being used in Europe. New studies in the U.S., however, are investigating the safety and long-term effectiveness of black cohosh and there’s an almost mainstream resurgence of its use for treatment of women’s health concerns.
Black cohosh is considered a menopause tonic for a number of reasons. It can improve mood and soothe anxiety. Also, herbal practitioners recommend it for taming hot flashes, night sweats, and vaginal dryness. It’s commonly prescribed for women who – for medical reasons – don’t take conventional hormone replacement therapy.
Tinctures, capsules and standardized extract are available for medicinal use. The specific dose of this herb will depend on your individual needs and health concerns. Black Cohosh should not be used during pregnancy or nursing. It is not recommended for persons who have a heart condition or liver disease. Always check with your holistic health practitioner before using an herbal remedy.