Do Bioidentical Hormones Have Side Effects?

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.

Does Estrogen Have Side Effects?

This is a response that I posted to an online message board in response to somebody’s claim that “estrogen can have some awful side effects”.

Why would the human body make estrogens (estradiol, estriol, and estrone) if they have side effects?

The link that […] provided refers to women who participated in the Women’s Health Initiative and who received PremPro.

It is very important understand that these women did not receive bioidentical hormone replacement therapy (BHRT). Instead they were POISONED with a combination of estrogens from horses (the Premarin component of the PremPro) and medroxyprogesterone acetate (the Provera component of the PremPro). None of these non-bioidentical chemicals are naturally found in the human body.

Needless to say that it is not surprising that these women had an increase of heart disease, breast cancer, blood clots, and stroke, causing this arm of the study to be aborted in 2002.

Unfortunately, many doctors and women still don’t understand this and continue to believe that these women suffered adverse reactions because of “hormone replacement therapy” or “HRT” even though these women did not receive any human hormones.

I have not seen any such adverse reactions in all my years of using properly balanced and monitored bioidentical hormone replacement therapy.

Estradiol, progesterone, and all the other hormones play an essential role in the human body, so I am not surprised that hormone replacement therapy could be helpful for women with a diagnosis of schizophrenia.

As a matter of fact, many mood disorders in women are related to hormonal disorders and I have seen marked improvements in women using BHRT.

Fred Bloem, MD

— In …@yahoogroups.com, […]> wrote:
>
> Estrogen can have some awful side effects :-
>
> http://www.estrogen-replacement-side-effects.com/html/effects.html
>
> On Mon, Jan 25, 2010 at 1:47 PM, <…> wrote:
> >
> > Estrogen in the Fight Against Schizophrenia
> >
> > ScienceDaily (Jan. 25, 2010) — Many American women are prescribed estrogen
> > to combat the negative effects of menopause, such as bone loss and mood
> > swings. Now, new evidence from a Tel Aviv University study suggests that
> > hormone replacement therapy might also protect them — and younger women —
> > from schizophrenia as well.
> >
> > Prof. Ina Weiner of Tel Aviv University’s Department of Psychology and her
> > doctoral student Michal Arad have reported findings suggesting that
> > restoring normal levels of estrogen may work as a protective agent in
> > menopausal women vulnerable to schizophrenia. Their work, based on an animal
> > model of menopausal psychosis, was recently reported in the journal *
> > Psychopharmacology.*
> >
> > *Continued at
> > http://www.sciencedaily.com/releases/2010/01/100120112212.htm

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.