Hormone Replacement
What Women Need to Know:
Biologically Identical Hormones—Are They Natural?
By Nancy Aagenes, ND
Dr. Aagenes is experienced and educated in all hormone prescribing for perimenopausal and menopausal women. Her education in this area is from the North American Menopause Society and the Women’s Institute of Health and Integrative Medicine. These two organizations cover the span from the most conventional to the most science based alternative medicine.
More importantly she has more than a decade of experience in prescribing hormones from all sources for hundreds of individual women.
“Natural” is so poorly defined in medicine that it is virtually meaningless. Some say Premarin (a pharmaceutical preparation of estrogen made from the urine of pregnant mares) is natural because it comes from a horse. But is that natural for a human woman?
Are hormones natural because they come from plants? Plant hormones either have no hormonal activity in human metabolism, or have it at about 1/400th to 1/1000th the strength of human hormone. To demonstrate how powerful hormones (and plants for that matter) can be, even at that fraction plant hormones are often enough to help symptoms.
The term “bioidentical” refers not to plant hormone in the raw. Bio-identical hormones are those taken from plants (either soy or one species of wild yam) and acted on with enzymes until they are indistinguishable from human hormone. The result is a “natural” hormone, but the process does not occur in nature.
At one end of the spectrum conventional practitioners think the pharmaceutical hormones are safer because they are more rigidly manufactured. Over 20 years in practice I have learned to regard most information from drug companies as marketing rather than science. While the goal is always science-based medicine, their science is too often suspect.
At the other end of the spectrum is Suzanne Sommers saying all women should use bioidentical hormones to achieve the levels that are necessary to continue menstruating well into aging. Who wants that?! An aging actress as a source of science? Not in my clinic.
I sit in the middle. It makes sense that bioidenticals are safer because they follow normal female metabolism. Still, I study the conventional and alternative literature to carefully assess the risk of any hormone prescribing. Then I make the assumption that any hormone from any source has that risk. Assuming the risk keeps patients safer.
What women need to know:
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Sometimes hormones improve the quality of our lives so greatly that we are wise to use them.
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We can’t trust the drug companies to give us accurate information. For decades they told us hormones prevented heart disease when it had never been studied. When it was, heart attacks increased in aging women.
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If we assume the same risk for bioidenticals that occur in pharmaceutical hormones we will be safer.
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Even the most preeminent medical experts are confusing on these issues. The best we can do now is to use hormones in the safest forms, the lowest doses and for the shortest times to alleviate our symptoms.
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If we use hormones that create risk, we can also use common sense strategies to diminish risk.
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Our habits are far more powerful in our long term wellness than any hormone in any form. A hormone won’t save or promote wellness in the absence of good nutrition, rest and an active life style.
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