Bio-identical Hormone Replacement Therapy

When Gail arrived at my office, she was not a happy person. She said that she had not slept through the night for more than a year. Night sweats were waking her up every couple of hours, and she had difficulty falling back asleep. Because she was not feeling rested, work was becoming increasingly difficult, and Gail’s boss was noticing some decline in her productivity. “And I get hot flashes every three hours during the day,” she said tearfully. It was as if she were carrying a 50-pound weight on her back. “My clothes get all sweaty, and it’s embarrassing,” she added. Her husband did not understand the full impact of what Gail was going through. They hadn’t had sex for six months, and that was putting a strain on their relationship. Gail was only 47 years old at the time.

Declining quality of life

Many people do not realize the significant increase in life expectancy that humans have experienced in the past 200 years. In the year 1801—when Thomas Jefferson was president—people only lived an average of 35 years. Today in the United States, individuals live an average of 78 years. And yet, quality of life declines for many, beginning during middle age. Symptoms of this include loss of energy and stamina, loss of muscle and bone mass with an increase in fat mass, loss of cognition and memory, decline of mood and sense of well-being, and loss of sexual vitality. One major culprit for these conditions is a reduced level of hormones—naturally occurring substances in the body that are required for the normal function of cells. Severe hormonal deficiencies may be life-threatening. The replacement of these hormones improves quality of life.

Hormone replacement therapy (HRT) for women may include estrogens, progesterone, testosterone, dehydroepiandrosterone (DHEA), thyroid and others.

A natural alternative

Gail’s unfortunate situation is not unusual, although her menopause may have been more severe than that which is experienced by most women. Yet, up to 75% endure some symptoms of menopause1, including hot flashes, night sweats, insomnia, mood swings, fatigue, headaches, “foggy brain,” declining libido, aching joints and increased fat around the midsection2, which is a risk factor for heart disease3. I explained to Gail that there is a more natural and safer alternative available.

The results of the Women’s Health Initiative—a major 15-year research program that was established to address the most common causes of death, disability and poor quality of life in postmenopausal women—showed that women who took Prempro* (conjugated estrogens/medroxyprogesterone acetate tablets) had an increased risk of heart disease, breast cancer and stroke. Those who took conjugated estrogens tablets alone had an increased risk of stroke, blood clots and—if the patient was older than 65—Alzheimer’s disease.

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.


Skin wrinkling in women is partially due to a decline in hormones—particularly estrogen and somatotropin, which is a growth hormone. HRT decreases skin wrinkling and sagging by naturally increasing hydration and oil secretion, as well as stimulating collagen. Growth HRT in women and men decreases skin wrinkling and sagging by naturally increasing hydration, collagen and skin thickness.

Growth hormone is commonly misunderstood. Just as female menopause—a decline in female-related hormones—exists, somatopause—a decline in growth hormone—also exists. It is listed in more than 50 references in the National Library of Medicine. Somatopause is a form of growth hormone deficiency. It leads to a reduction in muscle mass, an increase in fat mass, a loss of total body water—which is a cofactor for skin wrinkling—and a decline in energy, and it represents a cofactor for abnormal sleep. Growth HRT can be accomplished successfully in the vast majority of people who have this deficiency, but ongoing monitoring is required.

Refer your clients

If your clients are suffering from troublesome menopausal symptoms, refer them to a physician who can explain the best treatment options, and encourage them to inquire about BHRT. This natural alternative to chemical treatments may be just what the doctor ordered.


1AR Genazzani, Hormone Replacement Therapy and The Brain, Taylor & Francis (2003)

2HS Kupperman, Contemporary therapy of the menopausal syndrome. Journal of the American Medical Association 171, 1627-1637 (1959)

3KM Rexrode et al, Abdominal adiposity and coronary heart disease in women. Journal of the American Medical Association 280(21), 1843-1848 (December 2, 1998)

4B De Lignieres et al, Combined hormone replacement therapy and the risk of breast cancer in a cohort of 3,175 women. Climacteric 5(4), 332-340 (2002)

5AR Genazzani, Hormone Replacement Therapy and The Brain: The Current Status of Research and Practice, Taylor & Francis (2003)

6GM Rosano et al, Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women. Journal of the American College of Cardiology, 154-159 (2000)

7WR Shankle, Preventing Alzheimer’s, G.P. Putnam, 109-111 (2004)

*Prempro is a trade name of Wyeth Pharmaceuticals Inc., Philadelphia.

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