How Safe Are Bioidentical Hormones?

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.

Hormone Replacement Success – Rhythmic Dosing versus Low-Dose Static Dosing

Lori is a 51 year old patient who first came to my office in April 2007 for bioidentical hormone replacement therapy. She was interested in traditional low-dose, static hormone replacement therapy so I started her on a combination of progesterone cream, estradiol/estriol (“Bi-est”) cream, testosterone cream, and Armour thyroid.

After starting this therapy she felt better, but still had a hot flash when going to bed and she also felt a little hot throughout the night.

Her sleep was better, but she still woke up once in the middle of the night.

Memory was not as much of a problem but she still had some problem with recall.

In December 2007, I recommended that she switch to using rhythmic bioidentical hormone replacement therapy, following the Wiley Protocol. She started using estradiol and progesterone at dosage levels that follow the pattern that we see in healthy young women.

Within several months after starting the Wiley Protocol she noticed the following improvements:

  • Improved hair
  • Improvement of vaginal dryness
  • Improved skin (less dry).
  • Complete resolution of hot flashes and night sweats
  • Improved sleep
  • Less irritability
  • Improved quality of hair (less thin)

I recommended increasing the dosage of estradiol.

When I saw her for a routine follow up today the patient reported the following improvements:

  • Good libido
  • Improved memory
  • Improved thickness of hair with a return of the natural waviness
  • Improved skin

As compared to using low-dose, static testosterone replacement, she felt that the rhythmic testosterone replacement caused her libido to be more natural. With the low-dose, static dosing regimen her libido was at times too aggressive and she also had more unwanted hair on her legs.

The patient had also been using the Wiley Protocol Face Creme which contains insulin, estradiol, and triiodothyronine (T3) and which helps rejuvenate the skin and fade fine lines and wrinkles. This worked very well for her. I have some patients who reported that this Creme works a lot better than some very expensive skin care products that they had purchased previously.

I now have about 200 patients that have started rhythmic, bioidentical hormone replacement therapy following the Wiley Protocol. It has been a very rewarding experience for me to see many regain their sense of well being and in many cases even regain their lives after restoring their hormones to optimal levels.

Hormone Therapy Success: I have gone from feeling lifeless and dying … to enthusiastic and optimistic once again

Today, on May 28, 2009, I received the following e-mail from one of my 58 year old patients who presented to me on May 19, 2009, with severe signs and symptoms of postmenopausal hormone imbalances. I started her on rhythmically dosed bioidentical estradiol, progesterone, and thyroid hormone replacement therapy. Most patients feel significantly better within four weeks after treatment, but this patient reported significant improvement within nine days!

Hi Dr. Bloem,

I wanted to check in with you.

I have read TS Wiley’s book, Sex, Lies and Menopause and I found it very helpful and fascinating. I have underlined many sections.
I still feel great.

My brain feels more alert and I have had no symptoms to speak of, except for a little cramping last night. I am delighted that I have found you and chosen this path and I will recommend you to everyone I know.

I have gone from feeling lifeless and dying in the Wiley sense of the word to enthusiastic and optimistic once again.

Thank you, Dr. Bloem!

Kathy