Hormones, chemicals produced in one part of the body to affect functions in another part of the body, regulate nearly all metabolic functions. When hormones become unbalanced, such as during menopause---a period in a woman's life when estrogen and progesterone production falls---functions throughout the body become affected, resulting in a variety of symptoms. Patients seek treatments through hormone replacement therapy, or HRT, to help bring their hormone levels back in balance and reduce the occurrence and severity of symptoms. A new form of HRT uses bioidentical hormones, but to understand this new therapy, traditional HRT must be understood.
Relevant Hormones
Although the body produces many types of hormones, including thyroid hormones, male sex hormones, DHEA and melatonin to name a few, HRT typically refers to medications used to treat hormone imbalances involving the female sex hormones estrogen and progesterone. In addition to regulating reproduction, estrogen functions within the blood vessels, heart, brain, bladder, liver, bones and skin. Progesterone functions to reduce anxiety, build and maintain bone, decrease the digestive process, promote appetite, and mature breast tissue to aid in milk production, as described by Project AWARE.
Traditional HRT
Traditional HRT utilizes medications containing synthetic estrogen and progesterone. Scientists produce synthetic hormones in the laboratory from animal substances. Although these compounds resemble the natural hormones produced in the body, the structure and function is not identical. For example, scientists produce synthetic estrogen compounds using the urine from pregnant mares.
Combination vs. Estrogen-Only HRT
Doctors prescribe two main types of HRT: combination therapy, which includes both estrogen and progesterone and estrogen-only therapy. Doctors reserve estrogen-only therapy for patients who no longer have their uterus. Increased levels of estrogen increase the risk for endometrial cancer. Progesterone and its synthetic versions counteract the cancer-promoting effects of estrogen. Therefore, women with an intact uterus should only take combination HRT, but only for short periods of time to reduce other associated risks.
Risks Associated With Synthetic Hormones
Because the structure of synthetic hormones differs from natural hormones, the reactions in the body also differ. Studies conducted by the Women's Health Initiative concluded that taking synthetic hormones for extended periods of time increased the risk for blood clots, cardiovascular disease, stroke and breast cancer, as indicated by MayoClinic.com. So although synthetic HRT can alleviate symptoms associated with menopause, such as hot flashes, the risk-to-benefit ratio leaves patients searching for alternatives.
Bioidentical Hormone Replacement Therapy
Scientists derive bioidentical hormones from plant substances and alter the molecular structure to produce exact replicas of the natural hormones produced by the body, according to the Austin Wellness Clinic. Although these hormones produce fewer side effects and alleviate the risks encountered with traditional HRT, this type of therapy may not be safer, according to MayoClinic.com.
Risks Associated With Bioidentical Hormones
Pharmacists produce bioidentical hormones in a compounding pharmacy to custom fit each patient. Unfortunately, not all compounding pharmacies follow rigorous quality assurance standards, so they may produce substandard medications. These pharmacies produce the hormones by testing the patient's saliva; however, the level of hormones in saliva does not necessary represent the level in blood. Lastly, the U.S. Food and Drug Administration does not approve bioidentical hormones.
