Natural/Bio-Identical Hormone Replacement
Natural hormone replacement therapy is probably better described as bio-identical hormone replacement therapy. This means that the hormones are chemically identical to the hormones that the human body makes. These hormones are plant derived from soy or wild yam and purified out so that even soy or yam allergic patients can tolerate these "clean" forms of hormones. These hormones include progesterone; estrone (E1); estradiol (E2); estriol (E3); dehydroepiandosterone (DHEA); and testosterone. Hormone replacement therapy may be beneficial for men as well as women. Creating the proper hormone balance is important for good health.
Progesterone is an important hormone that is a precursor to other hormones like testosterone, estrogens and also cortisone. Cortisone that your body makes is very important for healthy stress and immune function. Progesterone is vital in maintaining pregnancy. It is supplemented in patients to prevent miscarriage and relieve PMS symptoms.
Dehydroepiandosterone (DHEA) is a precursor to testosterone but its exact role and importance in the hormone balance is somewhat unclear. Some people with low DHEA levels will "feel better" if supplementation is initiated.
Testosterone is a "body building" or anabolic hormone and is responsible for masculine characteristics in men. Women also make (and need) a small amount of testosterone (like men have small amounts of estrogen). Testosterone increases libido, decreases fatigue, improves sense of well-being and can even toughen fragile vaginal tissue.
Estradiol and estrone are the more potent estrogens that the body makes. Estriol is the "good estrogen" if there is a "good" estrogen. It has been shown to have anti-estrogen activity similar to drugs that are used for breast cancer. Estriol is only 25% as potent as the other estrogens, so it important to dose it accordingly.
The combination of the estrogens commonly called "triest" includes all three estrogens in the balance found in young healthy women. As women age, the liver easily and more quickly converts estradiol to estrone. Because of this metabolic difference, often a combination called "biest" (estradiol & estriol) is used for supplementation.
All of these hormones can be compounded in a variety of dosage forms suitable for each patient. These hormones do require a prescription from a licensed healthcare practitioner.
At this time there are no scientific double blind comparisons of these hormones to placebo therapy or other hormone therapies. Natural hormones are at their highest levels in the body during our late teens and early twenties when we are at our peak of health. Our bodies have all the proper breakdown pathways to metabolize and eliminate these hormones so they may be the most suitable for replacement therapy. There is significant data from research articles and case studies supporting the use of natural hormones. They are used extensively in many other countries around the world.
Recent findings about synthetic hormone replacement therapy have raised concerns about ALL hormone replacement therapy. This may or may not be a reasonable conclusion about natural hormones but at this time it is prudent to remain on hormones for no more than 5 years. After this length of time, no benefit has ever been documented from taking any type of hormone. Certainly some patients will still be symptomatic and quality of life may become an issue. Each patient must weigh the risks and benefits and determine with their practitioner when and how long to use hormone replacement therapy.