How Safe Are Bioidentical Hormones?

January 4th, 2010 | Posted by Fred Bloem, MD in Cancer | Hormone replacement therapy

Bioidentical hormones therapy is safe as long as the amounts of hormones used and the levels of hormones in the body are carefully monitored. I recommend the Wiley Protocol, which uses bioidentical estradiol and progesterone in a rhythm that mimics the cyclical fluctuation of hormone levels that we see in healthy young women.

The word bioidentical means that the hormones are exactly the same as the hormones that the human body produces. Bioidentical hormones include estradiol, progesterone, testosterone, cortisol, human growth hormone, thyroxine (T4), and triiodothyronine (T3). I don’t recommend non-bioidentical chemicals such as medroxyprogesterone and norgestimate because they are not produced by the human body and because they have known side effects such as cancer, hypertension, depression, and fluid retention. They are more appropriately referred to hormone disrupting chemicals.

Can bioidentical hormone replacement therapy be used in “asymptomatic perimenopausal or postmenopausal women”?

Yes, they can. Not all women experience hot flashes, night sweats, insomnia, or any of the other classical symptoms of perimenopause. However, sometimes there more subtle changes that occur. These may include decline in memory (“senior moments”), decreased libido or sexual satisfaction, skin changes, hair changes, vaginal dryness, and loss of sense of feminity.

There are two main reasons for recommending bioidentical hormone replacement therapy: 1) Relief of symptoms, 2) Reduction of disease risk. We know that properly dosed and monitored bioidentical hormone replacement is a safe and effective therapy for relieving symptoms of perimenopause. We also know that the risk for heart disease, cancer, osteoporosis, and Alzheimer’s disease increases as people get older and their hormones levels decline. Young people with high hormone levels tend to be at very low risk for these health conditions. There are indications that bioidentical hormone replacement may reduce the risk for developing such health problems and allow people to have a better quality of life.

For how long can bioidentical hormone replacement therapy be used?

Bioidentical hormone replacement therapy can be used for as long as a patient desires. Suzanne Somers is 63 years old and is using the bioidentical Wiley Protocol hormone replacement regimen. She takes very good care of herself in many different ways and it shows! She intends to use this therapy for as long as she lives. Bioidentical hormone replacement therapy can be stopped at any time. This will return the patient to their previous (usually) hormone deficient state.

Does bioidentical hormone replacement therapy increase the risk of cancer?

I have not seen any evidence that it does. Bioidentical hormones such as estradiol and progesterone are a normal part of the human body. Why would the human body produce messenger chemicals that are carcinogenic? I believe that bioidentical hormones are as safe as water as long as they are dosed and monitored correctly. At least 70% of our bodies consists of water. Are we demanding proof or double blind, randomized, placebo controlled studies to prove that water does not cause cancer?

On the other hand, we know that the Women’s Health Initiative Study showed that women using a combination of non-bioidentical chemicals (Premarin and Provera) had an increased risk of heart disease, blood clots, stroke, and breast cancer. These women did NOT receive hormone replacement therapy. Instead they were drugged with chemicals that are not normally found in the  human body.

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