Bio-identical Hormone Replacement Therapy

Bio-identical hormones have been spotlighted by the media in recent years; however, what are these new medications, and do bio-identical hormones truly produce different results than conventional therapies?

Sarah Wymer, M.D., Mayo Clinic Health System family medicine physician explains, “Bio-identical hormones are a chemical match to hormones naturally produced in a woman’s body. Conventional hormone replacement therapies are made by drug companies, are approved by the FDA, and are sold in standard doses. Bio-identical hormones are made at special pharmacies, called compounding pharmacies, and are not approved by the FDA.”

Compounding (creating personalized mixtures of medications) is available for many types of medications; the patient is possibly allergic to a dye or bonding agent, or he or she cannot swallow a pill and needs the medication in another form. When bio-identical hormones are compounded, individual hormonal levels of each woman are determined through a saliva or blood test. The test results are sent to a compounding pharmacy, where two or three bio-identical hormones are mixed and made into a usable form, such as a gel, oral pill or cream.

Conventional hormone replacement therapy to treat the symptoms of menopause has been under scrutiny since 2002 when a study determined long-term use of hormone replacement therapy the risk of developing a blood clot, heart attack, stroke and breast cancer. Since then, research has shown that low doses of hormones, such as estrogen or progesterone, taken for the shortest time are effective in treating symptoms with minimal risk. Dr. Wymer says, “Bio-identical hormones have not been proven to increase or decrease the risk of unwanted side effects from hormone replacement therapy. They are just another option.”

As with all compounded medications, the FDA has not approved compounded bio-identical hormone replacement therapy as a safe option for menopause treatment because prescriptions are based on individual dosages, not federal regulations. In addition, the FDA also does not regulate the environment in which the medication is mixed, nor the quality of each ingredient.

What may sound like an exciting solution to treat menopause may not be the answer for everyone. Dr. Wymer says, “Bio-identical hormone replacement therapy may be an appropriate choice for some women, but there are a number of unknowns surrounding this treatment option. Until research finds it to be more effective, conventional methods of hormone replacement therapy will provide the same benefits, with the same risk factors, but at a potential lower cost. It is truly up to the woman and her doctor to find a treatment that works for her.”

Learn more about hormone replacement therapy options. Make an appointment at Winneshiek Medical Center by calling 563-382-2911.

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