Celebrities like Suzanne Somers and Oprah Winfrey have promoted natural hormone replacement therapy using bioidenticals. These drugs, similar to substances manufactured by the body, can correct hormone deficiencies in some people. Such patients may take bioidentical hormones like dehydroepiandrosterone, testosterone, estradiol, estrone, estriol and progesterone. Advocates of natural hormone therapy often rely on inaccurate tests and make misleading claims. In addition, bioidentical hormones may cause permanent damage.
Questionable Tests
Patients considering bioidentical treatments are encouraged to self-monitor their hormone levels. Such tests, often conducted by mail, remain unreliable and inaccurate. The results vary according to ethnicity, time, diet and other idiosyncrasies. They also may not correlate with physiological processes. A 2005 review published in the medical journal "Menopause" shows how circulating progesterone levels poorly reflect the endometrial impact of bioidentical progesterone use.
Natural replacement therapy strives to reproduce physiological hormone levels. Yet two things remain unclear for each individual: First, what are physiological levels? Second, will such levels be sufficient or overwhelming? Patients need answers to these complex questions from licensed doctors prior to taking bioidentical hormones.
Dubious Claims
Promoters of natural replacement therapy typically work outside of the conventional medical and scientific community. A 2008 paper offered in "Menopause" lists several ethical violations committed by the advocates of the Wiley Protocol. This procedure, described in a 2004 book by T. S. Wiley and co-workers, suggests that hormone deficiencies underlie many medical conditions. Unfortunately, Wiley et al. do not have the educational training necessary to give such advice and many of their claims remain unfounded.
Because of such issues, the Food and Drug Administration issued warning letters to several pharmacies making natural hormone treatments. These letters, sent in 2008, focused on the fact that the FDA has not approved many of the bioidentical drugs available. Therefore, the efficacy and safety of some natural hormone therapies remain unknown. The FDA also noted that the pharmacies made repeated reference to the notion that bioidentical hormones are identical to the body's natural chemicals and that this idea has not yet been scientifically proven. Thus, more research is needed before natural hormone therapies can be safely recommended.
Side Effects
Manufacturers of bioidentical hormones often imply that such drugs are safer than conventional medications. Yet the data do not support this claim. Natural hormone therapies, like all treatment protocols, can produce both immediate and delayed changes in the body. Bioidentical hormones may cause heart dysfunction, increase stroke risk, change breast density and create bowel distress. And a 2008 paper written for the periodical "Oncology Reviews" describes the potential carcinogenic impact of dehydroepiandrosterone and testosterone. Thus men and women considering the intake of bioidentical hormones should proceed with caution.
References
- "Menopause"; Percutaneous Administration of Progesterone: Blood Levels and Endometrial Protection; F.Z. Stanczyk et al.; March 2005
- "Menopause"; The Wiley Protocol: An Analysis of Ethical Issues; M.S. Rosenthal; September 2008
- "Sex, Lies and Menopause"; T.S. Wiley et al.; 2004
- Food and Drug Administration: FDA Takes Action Against Compounded Menopause Hormone Therapy Drugs
- "Oncology Reviews"; Hormones and Breast Cancer: Can We Use Them in Ways that Could Reduce the Risk?; K. Mahmud; 2008
