Bio-Identical Hormone Replacement Therapy (BHRT) for Women
What are bio-identical hormones?
Bio-identical hormones have the same chemical structure as hormones that are made by the human body. The key to natural or bio-identical versus synthetic is the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones which were originally naturally produced and present in the human body, the chemical structure must exactly match the original. Researchers have long held that there are significant differences between hormones that are natural to humans (bio-identical) and synthetic (including horse) preparations.
Structural differences that exist between human, synthetic, and animal hormones can be responsible for side effects that are experienced when non-bio-identical hormones are used for replacement therapy. It is the structure of the hormone, not the source, that is key. The term “bio-identical” does not indicate the source of the hormone, but rather indicates that the chemical structure of the replacement hormone is identical to that of the hormone naturally found in the human body. These hormones are able to follow normal metabolic pathways so that essential active metabolites are formed in response to hormone replacement therapy. Synthetic—”patented,” “conventional,” “artificial,” or “horse”—hormones have been chemically altered, and are not identical in structure or activity to the naturally occurring hormones they are intended to replace.
Women today prefer natural hormones. In a survey of a nationally representative sample of 1,009 women aged 40 and older, 83% said they would prefer to use hormones that are similar to their own body’s hormones. Bio-identical hormones include estrone (El), estradiol (E2), estriol (E3), progesterone, testosterone, dehydroepiandrosterone (DHEA), and pregnenolone.
Three Types of Hormones Typically Prescribed for BHRT
The three types of hormones typically prescribed for BHRT are estrogens, progesterone, and androgens. The precise components of each woman’s therapy need to be determined after physical examination, medical history, and laboratory testing are considered. Close monitoring is essential to ensure that appropriate dosage adjustments are made.
Most of the estrogen produced in the body comes from the ovaries but if it weren’t for the brain controlling the pituitary gland, which then controls the ovaries none of it would be produced. This estrogen, in addition to all the sexual and reproductive effects it has, also has a profound effect on brain health and function. Estrogen is required for learning, memory, and mood in addition to nerve development and degeneration processes. Studies have shown that estrogen can prevent or delay memory and cognitive decline from diseases such as Alzheimer’s and Parkinson’s. If estrogen is too low there can be difficulty concentrating, lower libido, and mood swings. If too high, there can be headaches, memory problems, weight gain, hair loss, and altered sleep patterns.
Progesterone is primarily known for its reproductive effects, but is also responsible in the Central Nervous System for non-reproductive functions like regulation of cognition, neurogenesis (nerve formation), mood, and regeneration of nerves. Progesterone is calming to the brain and has a protective effect since it reduces swelling and improves mental clarity after a traumatic brain injury. Low levels of progesterone are also associated with memory loss, mood swings, PMS symptoms, mood swings. If too high, progesterone can also cause mood swings and dizziness.
Testosterone, although frequently thought of as the male hormone, is also produced in women. Women produce the testosterone in the ovaries prior to menopause and lower amounts in other tissues after menopause. We know that when the levels are too low, fatigue, mood swings, depression and loss of mental acuity occur. Excess levels cause acne, more body hair, changes in body shape and menstrual irregularities. Testosterone is known to strengthen muscles, arteries, and nerves including in the brain. In men, a study showed that low levels of testosterone increase the risk of Alzheimer’s Disease and are also associated with other neurodegenerative diseases like Parkinson’s.