The controversy surrounding hormonal replacement therapy has left many women confused with limited options for managing the undesirable symptoms associated with menopause. Health care providers are hesitant to prescribe hormonal replacement therapy because of the mis-information and potential legal ramifications that exist. As women where does this leave us? What are the benefits versus risks of hormonal therapy? What are the differences between traditional synthetic hormones and bio-identical hormones?
Synthetic estrogens such as Premarin are made from pregnant mare’s urine and are called “conjugated equine estrogens”. Native or biologically identical estrogens are cleared from our blood stream within hours, while CEEs are more potent and may take weeks to be fully eliminated from our bodies. Furthermore, these types of synthetic estrogens can block our natural estrogens from binding to critical estrogen receptor sites in our body. Many researchers theorize that this is one of the reasons that synthetic estrogens have a much greater potential for adverse affects. Likewise, progestins are the synthetic pharmaceutical version of progesterone and have also been associated with various adverse affects. Conversely, bio-identical hormones are synthesized from plant sources that have the same biochemical structure as our own natural hormones and function exactly the same way in our bodies. B-HRT will be discussed in detail in my next post later this week.
We are faced with a terrible situation caused by fifty years of synthetic hormone replacement therapies and forty years of birth control pills that have left behind serious medical problems, questions of safety, confusion about hormones in general, and potentially significant health hazards. (from Christiane Northrup, MD – The 30 Day Natural Hormone Plan: Chapter on “Synthetic Suicide”.
The major studies that have been performed that looking at the safety and effectiveness of hormonal replacement therapy have all been performed using synthetic hormones. A large study was launched called the Women’s Health Initiative (WHI) which enrolled over 25,000 menopausal women. The study itself was conducted by the National Institute of Health (NIH) and was fully funded by the pharmaceutical manufacturers of the synthetic hormonal preparations Premarin and Prempro. The goal of the long-term study was to look at the long-term effects of synthetic hormones on women’s health and determine their potential preventative effects on cardiovascular disease, osteoporosis, cancer, and Alzheimer’s disease. After two years, NIH released the following preliminary results:
HRT & Cardiovascular Events: WHI preliminary results – After two years the following trends have been identified; 1. An increase in cardiovascular events (heart attach, stroke, blood clots) in HRT groups versus the placebo (sugar pill), and 2. Risk is potentially higher with the addition of progestin. Lastly, a comment was made the “trend was expected to diminish over time”.
Despite the preliminary data, the study continued for another three years when one are of the study was abruptly halted due to the fact that the “risks outweighed the benefits”. Final conclusions suggested that the use of the synthetic hormones Premarin and Prempro were associated with a higher risk of breast cancer, cardiovascular disease, stroke and blood clots.
The results from the Women’s Health Initiative spurred a flurry of confusion and misinformation surrounding hormonal replacement therapy leaving a huge gap in the options for women suffering from symptomatic menopause. The conclusions have been generalized to all forms hormonal therapy, when in fact, the study was performed with Premarin and Prempro only, leaving women and health care providers in a quandary. More and more women are demanding alternatives. While the use of bio-identical hormones is slowly increasing, their use is limited by inaccurate information and lack of knowledge on the part of many health care professionals. Join me later this week for a more detailed overview of bio-identical hormone therapy.
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