Menopause adversely affects the lives of many older women. This change, beginning around age 45, causes decreases in estrogen and progesterone. It also causes memory loss and mood swings. Taking prescription medications and nutritional supplements can help combat these unwanted changes. Yet, such treatments may produce side effects. Natural hormones, called bioidenticals, can provide a more effective approach to hormone replacement therapy. Patients should consult their doctors to explore these options.
Micronized Progesterone
Treatments labeled micronized progesterone contain only the progesterone molecule. Women usually take this type of hormone replacement as a vaginal suppository, although oral and gel forms have become available as well. Micronized progesterone appears to have some advantages over synthetic progesterone.
A paper by C. Campagnoli and associates published in the April 20, 2009 issue of the medical journal "Maturitas" reviewed the impact of progesterone use on breast cancer in postmenopausal women. The authors critically evaluated clinical trials investigating the relationship between hormone intake and cancer risk. Traditional forms of progesterone intake were associated with an enhanced risk of breast cancer. Micronized progesterone, in contrast, did not increase cancer risk.
17-Beta-Estradiol
Hormone replacement therapies including 17 beta-estradiol use only the estradiol molecule. This form of estrogen is identical to that made by the body. Available for administration by several delivery methods, 17 beta-estradiol may provide benefits that synthetic estrogens do not.
A survey by V. Olie and researchers presented in the September 2010 issue of "Current Opinion in Hematology" looked at the effect of transdermal 17 beta-estradiol on blood clotting, a possible complication of hormone replacement. The authors carefully reviewed studies evaluating the potential association of estrogen intake and clot risk. They concluded that for postmenopausal women, estradiol use on the skin greatly reduced the risk of clots relative to oral estrogen use. In fact, taking 17-beta-estradiol conferred no additional risk in some cases.
Estradiol Hemihydrate
Prescription drugs that contain estradiol hemihydrate are considered bioidentical to natural estrogen. This kind of estradiol remains available in different forms. Taking estradiol hemihydrate can produce positive effects not seen with conventional estrogen.
A study by B. Baksu and his team in Istanbul, Turkey tested the hypothesis that estradiol hemihydrate would be superior to conjugated estrogen in surgically menopausal women. Patients were given daily doses of estradiol hemihydrate, conjugated estrogen, or an inert treatment for 12 months. The results, published in the June 2007 issue of "Journal of Obstetrics and Gynaecology Research," indicated that the bioidentical estrogen improved cholesterol scores. In contrast, the synthetic estrogen worsened them.
Estradiol Hemihydrate
Medications containing estradiol acetate include only a natural form of estrogen. Women can use this type of estradiol orally in pill form or vaginally in a suppository ring. Estradiol acetate, a bioidentical product, offers advantages over other forms of estrogen.
An experiment by W. H. Utian and colleagues described in the November 2005 issue of the periodical "Menopause" compared estradiol acetate and equine estrogen. Equine estrogen, a common product, is made from horse urine. Postmenopausal women received one of these treatments nightly for 12 weeks. Relative to baseline, both treatments reduced menopausal symptoms such as negative vaginal and urinary changes. Although the two drugs were equally effective, estradiol acetate had the advantage of being free of animal ingredients. In addition, scientists have raised concerns about the safety of equine estrogen.
References
- "Maturitas"; Progestogen Use in Women Approaching the Menopause and Breast Cancer Risk; C. Campagnoli et al.; April 20, 2009
- "Current Opinion in Hematology"; Risk of Venous Thrombosis with Oral versus Transdermal Estrogen Therapy among Postmenopausal Women; V. Olie et al.; September 2010
- "Journal of Obstetrics and Gynaecology Research"; Do Different Delivery Systems of Estrogen Therapy Influence Serum Lipids Differently in Surgically Menopausal Women?; B. Baksu et al.; June 2007
- "Menopause"; Comparative Controlled Trial of a Novel Oral Estrogen Therapy, Estradiol Acetate, for Relief of Menopause Symptoms; W. H. Utian et al.; November 2005
