Why Bioidentical Hormone Replacement Therapy Is Safe & Good For You
One thing I can count on is the look of shock and/or fright when I tell a new client they’ll most likely need bioidentical hormone replacement therapy (BHRT), if not now, then at some point down the road.
Then I let them know to smile at this reveal, because it’s a GOOD THING!
There’s so much stigma that still surrounds any form of hormone replacement therapy (HRT) due to the Women’s Health Initiative (WHI) study that was stopped due to an uptick in breast cancer in the participants.
What people and the media often fail to mention is that:
1. The study used conjugated equine estrogen (i.e. estrogen that is derived from horse’s urine) and progestin, a chemically different form than the progesterone that our body produces.
2. The participants that saw an increase in breast cancer risk were over 60 (most had been in menopause for over 10 years) and had pre-existing conditions.
3. There has been a lot in the way of reviews of the initial findings, back-tracking, and “lessons learned,” since 2002 that unfortunately has not penetrated every primary care physician or OB-GYN’s office. There’s plenty of research showing the benefits of even regular HRT, but we’re finally also seeing more research on BHRT, which have the same chemical makeup as our own hormones.
And because they have the same chemical makeup and aren’t different than our hormones, like the ones used in the WHI study, the comparison is truly apples and oranges.
I wanted to share some of that research, so that if you are needlessly suffering and need to talk to your doctor about the benefits of BHRT, you’ll have some important information to hand over to them.
Benefits of BHRT
The most significant benefit of BHRT is its ability to relieve the symptoms of both peri and menopause, such as anxiety, sleep issues, hot flashes, mood swings, and vaginal dryness. BHRT can help restore hormone levels to a more balanced state, reducing and often eliminating symptoms altogether.
Trust me, I’ve worked with many women in late perimenopause and early menopause, and they can feel like they no longer know who they are. BHRT can help bring them back to themselves. I’ve even heard women say, “I haven’t felt like this since my late 20s!”
Here are the many health benefits of BHRT:
- Helps Prevent Osteoporosis: The drop in hormones at menopause – especially estrogen – can lead to bone loss and an increased risk of osteoporosis. This is one of the biggest risks women and cycling people will face post-menopause.
This is where BHRT can step in to save the day. This review shares that “observational and case-control studies suggest that bioidentical estradiol (particularly oral or patch forms) is comparable to CEE (aka traditional HRT) for slowing bone loss, slightly increasing BMD, and reducing fracture risk.”
According to this study, “Given the need for estrogen in menopausal women and evidence supporting the cost effectiveness, safety, and efficacy of HT, we propose that HT should be considered for the primary prevention and treatment of osteoporosis in appropriate candidates. HT should be individualized and the once ‘lowest dose for shortest period of time’ concept should no longer be used.” (!)
- Improves Cognitive Function: Brain fog and memory loss are some of the big complaints I hear from women as they head into menopause. This can be debiliating when you are at the height of your career, running a company, or overseeing important tasks for your family.
Luckily, the right levels of BHRT can help bring back that sharpened brain function. In this study on bioidentical estrogen and progesterone, “mental symptoms experienced upon presentation improved in 90% of the patients.” 90%! Participants also lost an average of 14.8 pounds, and even cooler, “complications described with traditional HRT did not develop in this group of patients.”
- Reduces Risk of Cardiovascular Disease: One of the biggest issues women will face later in life is heart disease. A large part of this has to do with the drop in hormones we experience at menopause.
This study showed that women who started using hormone replacement therapy within six years of menopause showed “significantly” slower rates of build-up within the arteries.
This review found that “bioidentical progesterone does not have a negative effect on blood lipids or vasculature as do many synthetic progestins, and may carry less risk with respect to breast cancer incidence,” as well as “both bioidentical estrogens and progesterone suggest a reduced risk of blood clots compared to non-bioidentical preparations” (again, showing BHRT is safer AND more protective than traditional HRT).
- Improves Libido: The downward spiral of hormones at menopause can unfortunately lead to quite a nose dive in libido, particularly due to a drop in testosterone.
BHRT showed an improvement in libido in this study, as well as “significantly greater” increases from baseline in sexual desire, as well as in frequency of satisfying sexual activity, in this study. Check out more studies about this area of health here.
- Helps with Weight Management: Weight gain often comes with menopause. While some weight gain is normal and not necessarily a bad thing (there are even studies to show that those who are slightly overweight fair better on health outcomes than those who are thin), if you have basically been the same weight your entire adult life, and suddenly you have an extra 30+ pounds on your body, it’s not going to feel very good.
Along with the study mentioned above under the cognitive function section, this study found that BHRT helped with many different facets of life, including blood sugar regulation, and a literature review showed that “estrogens combined with MP (micronized progesterone) either do not change or reduce body weight in normal weight postmenopausal women.”
- Improves Mood: Hormonal imbalances can also affect mood, leading to anxiety and depression.
A 2011 study published in the Journal of Women’s Health found that BHRT demonstrates that compounded BHRT improves mood symptoms.
This study found that “cardiovascular biomarkers, inflammatory factors, immune signaling factors, and health outcomes were favorably impacted, despite very high life stress, and home and work strain in study subjects” after using BHRT for 8 weeks, specifically BiEst (80%Estriol/20%Estradiol) and natural progesterone.
There are so many additional benefits to using BHRT than what’s even listed above. But what I want you to remember is there is nothing else that will protect you when it comes to your long term bone, heart, and brain health than BHRT.
And those fears about breast cancer risk? That’s another article for another day, but suffice it to say that the research is showing breast cancer protection in many cases with BHRT, not increased risk.
The most important thing to do is work with a knowledgeable BHRT practitioner who will test your hormones, monitor your symptoms, and work with you to figure out the best form and dosing (there are multiple!). If your doctor is uninformed about HRT, I implore you to seek out one that is.
Here are a few Hormonally Speaking podcast episodes to learn more about BHRT: