Do Bioidentical Hormones Have Side Effects?

February 1st, 2010 | Posted by Fred Bloem, MD in Hormone replacement therapy

Many people are afraid of the therapeutic use of hormones, even when topic is bioidentical hormones. Bioidentical hormones are plant derived (usually from soy or yam) and they are prepared in compounding pharmacies. As such, they are considered pharmaceutical preparations. Most are only available by prescription.

Bioidentical hormones are also classified as drugs in the sense that they are chemical substances that are used in the treatment, cure, prevention, or diagnosis of disease or used to otherwise enhance physical or mental well-being.

This is where it may get confusing. Almost everybody wants to avoid using drugs unless absolutely necessary. One of the reasons is that many drugs have side effects. Some will create chronic dependency, and patients may experience withdrawal symptoms when attempts are made to stop the drug. Although some drugs may effect cure of an illness, many only suppress certain symptoms or physical signs without eliminating the underlying causes or supporting the body’s innate ability to heal.

How does this apply to bioidentical hormones? I believe there is a difference between bioidentical hormones and most other drugs because the former are biochemically exactly the same as the hormones that the human body makes. For that reason the molecules cannot be patented.

Most other pharmaceutical drugs are not normally found in or produced by the human body. Their biochemical structure is unique and patentable. Because they are foreign to the human body they will almost always have side effects to some degree. A possible explanation is that the body’s metabolic and enzymatic systems are not prepared to handle  these foreign molecules.

For example, even a well known over the counter drug such as acetylsalicylic acid (Aspirin) has side effects which include the development of stomach ulcers and allergic reactions.

I believe that the various chemicals and hormones that the human body makes do not have side effects and that the same is true for bioidentical hormones. The human body contains water and sodium chloride, and synthesizes estradiol, progesterone, testosterone, prostaglandins, and many other chemicals. Does water have side effects? Of course not! However, it is possible to experience SYMPTOMS of an excess or deficiency of water or any other chemical that the human body makes. Examples are symptoms of thirst and physical symptoms of dehydration or water intoxication. These are NOT side effects of water.

Likewise, I believe that bioidentical hormones are among the safest pharmaceuticals that a physician can prescribe. Although I don’t believe that a patient may experience side effects from using bioidentical hormones such as estradiol, progesterone, and testosterone, I do believe that patients may experience symptoms of deficiency or excess of these hormones.

Although I don’t believe that bioidentical hormone therapy has side effects, I do want to emphasize that this type of treatment needs to prescribed carefully. Patients need to be monitored for symptoms of  hormone deficiency and hormone excess. Laboratory testing needs to be performed to ensure optimal results and patient safety.

The layperson may see no difference between drug side effects and the symptoms and signs of hormone deficiency or excess. However, to the experienced clinician the difference is usually quite evident and steps can be taken to optimize therapeutic balance and to protect the patient’s health and well-being.

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