Bioidentical Natural Hormone Replacement

Most pharmaceutical hormones are synthesized from animal sources. The widely prescribed estrogen replacement Premarin, for example, is made from pregnant mare's urine. Each formula for synthetic hormones is a specific "brand" and is chemically slightly different from other brands, which allows pharmaceutical companies to patent the drugs. They are generally available in only a few standard dosages. Traditional hormone replacement therapy (HRT) involves blood tests to determine hormone levels, prescribing of pharmaceutical hormones and then periodic retesting to assure hormone levels are back in balance. The process is complex because two main hormones are involved, and their levels vary cyclically and in reaction to illness, activity and other stressors.

Bioidentical or natural hormone replacement therapy uses pharmaceuticals created from plant sources, such as soy. Advocates believe it is possible to synthesize hormones that are bioidentical to human hormones by using plants. One famous advocate is actress and author Suzanne Somers, who credits natural hormone replacement therapy with improving her health and slowing her aging process. Bioidentical pharmaceutical hormones can be patented, not by chemically altering the substance so it is unique but by using a unique administration method. Drug companies cannot patent a chemical that is identical to human estrogen, for example, but they can patent the dermal patch or nasal spray method by which the patient takes it. The major difference between natural and traditional hormone therapy is that, in natural therapy, the hormones are created in specific dosages by compounding pharmaceuticals, tailored to the exact amounts the doctor decides the patient needs. Blood tests or saliva tests are used to determine hormone levels, and naturopathic doctors skilled in endocrinology adjust the dosages.

The federal Food and Drug Administration has been an outspoken critic of natural HRT and recently issued warning letters to some of the compounding pharmacies, mainly Internet-based companies, who supply the drugs, saying their claims for the drugs are "false and misleading." But the pharmacies say they are just creating compounds as ordered by doctors. Those opposing natural HRT, including the American College of Obstreticians and Gynecologists, say: * Since neither nonhuman animals nor plants create exactly the kind of hormones human beings do, both sources must be chemically manipulated, so neither is really "natural." * Claims about natural HRT benefits aren't supported by medical evidence. * Because the substances haven't undergone standard testing, the plant-source hormones might contain contaminants.

In addition to anecdotal evidence from thousands of female patients currently using natural HRT, two studies help support the case for the plant-based hormones: * In a Wisconsin study conducted by naturopaths of 100 women with perimenopausal symptoms, 82 showed improvement when using bioidentical hormones in combination with improved diets and exercise. * A 2003 Univeristy of Southern Florida study showed synthetic progestins were responsible for most side effects of traditional HRT.

Most conventional and alternative medical doctors agree that hormone replacement of any kind should be supervised by knowledgeable professionals. Despite the availability of hormone home-testing kits, patients with hormonal symptoms will always benefit from the guidance of experienced medical professionals. Female patients interested in trying natural HRT might find their regular doctors are willing to prescribe it, but don't know which hormone pharmaceuticals are derived from plant sources. The FDA has approved estrogen and progesterone products under the brand names Estrace, Vivielle-Dot (a patch) and Climara (a patch) for estradiol, and Prometrium for progesterone. All four are formulated from plant materials.