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Bio-identical Hormone Replacement Therapy

By: Harvey S. Bartnof, MD
Posted: June 9, 2008, from the December 2006 issue of Skin Inc. magazine.

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However, a safer alternative is bio-identical hormone replacement therapy (BHRT). Because “bio-” means “life” and “identical” means “the same,” the concept is to replace the exact same hormones that nature provides in the female body before it begins menopause—nothing more, nothing less. They are natural and have a much better side effect profile than the chemical options discussed. Bio-identical hormones originate from soy or yams. They require some minor processing in order to become bio-identical, so a woman would not get the same result if she simply consumed these foods. They are prescribed more commonly in Western Europe. A major study from France showed that, among more than 3,000 women who took bio-identical hormones for more than nine years, there was no increased risk of breast cancer.4

Preserving organ function

BHRT for menopause involves much more than treating hot flashes, night sweats and insomnia. These natural hormones have beneficial effects on the brain, heart, blood vessels, bones and sex organs.

If a woman is not suffering from menopausal symptoms, does she still need BHRT? The answer, which is supported by the medical literature, is yes.5 There are receptors for hormones throughout the body. Why did nature put them there? To allow for the normal function of those cells and the body as a whole. If there are not enough hormones, which is what happens during menopause, cells do not conduct normal messaging and do not function as usual. Eventually, this leads to a decline in the utility of those cells, as well as the organs that contain them. Replacing these hormones helps to preserve the function and integrity of the organs.

In a published medical study, menopausal women who have atherosclerosis of the heart experienced partial blockages in arteries, causing angina and abnormal treadmill tests.6 When BHRT was prescribed, the amount of time on the treadmill until the symptoms appeared increased twofold to threefold. Nature’s own hormones behave as vasodilators, improving blood flow to the heart. When synthetic progestin was added, there was no change in treadmill time until heart symptoms occurred.

In another major medical study, women who had surgery to remove their ovaries were twice as likely to develop dementia throughout a period of 20 years.7 Ovarian hormones—especially estrogen—are important for normal brain function.

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