If you’re miserable from menopause symptoms, give serious thought to hormone replacement therapy (HRT). You may not realize it, but a diabetic using insulin is using hormone replacement therapy, with the hormone is insulin. Taking Synthroid for an underactive thyroid is hormone replacement, too. Is there a problem with replacing your sex hormones, estrogen and progesterone, when you’re suffering because their levels have gone into the free-fall of menopause?
The short answer is “no.” A small but rapidly growing group of physicians, myself included, believes the health problems associated with traditional HRT have everything to do with the source of the sex hormones themselves. Premarin, the top prescribed estrogen, comes from the urine of a pregnant horse. It’s not human estrogen–it’s a mare’s estrogen. Premarin simply is not the same molecule as the estrogen of a human female. If you’re going to restore your hormone levels, you want to use hormones that are identical to your own, hence the term bioidentical hormones.
To the surprise of many women, “Premarin” stands for “pregnant mare urine.” And by the way, there is probably no product manufactured on Earth involving greater cruelty to animals than Premarin. Animal rights activists have petitioned its manufacturer for years to come up with something more humane. But why would they bother? Until the Women’s Health Initiative linked Premarin to breast cancer and caused a plummeting of Premarin sales, profits from Premarin were in the billions.
Here’s why horse estrogen isn’t right for you. Human female estrogen consists of three separate molecules: estrone (10-20%), estradiol (10-20%) and estriol (60-80%). Premarin, on the other hand, is mainly estrone (75%) and equilin (25%), the latter found only in horses. Although Premarin may act like a replacement for your estrogen, the fact that the estrone content is three times that found in women means the match is far from perfect. And equilin is a foreign molecule altogether.
What we know for certain is that bioidentical hormones effectively relieve menopause symptoms. The ultimate goal when using bioidentical HRT is to replicate as closely as possible your hormone status when you were about fifteen years younger. Doctors like myself who prescribe bioidentical hormones usually recommend “Bi-Est” (dropping the weakest one, estrone) and add progesterone. Some doctors use bioidentical estradiol alone. Many physicians suggest you cycle the hormones, taking them three weeks of every month. The amount of hormone per capsule can be adjusted based on your particular symptoms. Doctors sometimes also add a small amount of the male hormone testosterone to each capsule. This enhances the effect of the estrogen (without needing to increase the actual amount of estrogen) while having a beneficial effect on a faltering sex drive.
Bioidentical hormones are available from compounding pharmacies throughout the US, and are mailed to you after receipt of a telephone order or written prescription from your doctor. Because bioidentical hormones are sold by prescription, they are eligible for insurance reimbursement from your health plan. You mail them a paid receipt, though you might have to rattle their cage a bit to receive payment.
We’ve prescribed bioidentical hormones to thousands of women for more than 17 years. Usually a single office visit is all that’s necessary, along with a recent Pap smear and mammogram.
Bioidentical hormones can ease a painful menopause transition, and you won’t need to take them forever. Time to get relief. To contact us please click here or call WholeHealth Chicago at 773.296.6700 today.
David Edelberg, MD