Many people wonder about hormone replacement risks and if there is a difference between synthetic hormones and bioidentical ones. It can be even more confusing because you may get conflicting information from different doctors.
Hormone replacement therapy risks remain one of the most controversial subjects in women’s health. This type of hormone replacement became popular in the late 1960s when birth control pills were available and used to treat osteoporosis and help relieve menopausal symptoms. This became controversial after the results of a comprehensive study showed that some synthetic hormones were doing more harm than good.
The study, called the Women’s Health Initiative, was prompted by the U.S. National Institute of Health in 1991. It included three large clinical trials and one observational study with the purpose of addressing major health issues regarding mortality in post-menopausal women. The clinical trials addressed how hormones impacted cardiovascular disease, cancer, and osteoporosis. Over 160,000 women were enrolled for a period of over 15 years. After the study had been going on for some time, it became apparent that hormone replacement risks far outweighed the benefits, and the study was halted.
During the first years, the study focused on SYNTHETIC hormones, which included Premarin, either alone or in combination with various progestogens, or PremPro, another synthetic estrogen, along with medroxyprogesterone acetate (Progestin). The estrogens were manufactured from several estrogens found in the urine of pregnant mares. The progestogens produced were also synthetic, and while they seem similar to the natural progesterone produced by a woman’s body, the molecular structure is completely different.
Risks of Synthetic Hormones
When the results of these particular studies were published, the adverse risks far outweighed any benefit that they might provide, and many doctors stopped prescribing them at all. The findings showed:
- 26% increased risk of breast cancer
- 29% increased risk of heart attack or death from coronary disease
- 41% increased risk of stroke
- 200% increased risk of blood clots
- 50% increased risk of dementia
The only benefits were a 33% decreased risk of hip fractures and a 37% decreased risk of colorectal cancers. Pharmaceutical sales decreased on these drugs by up to 40%.
Conversely, other countries had been using bioidentical hormones for many years. And after the release of the Women’s Health Initiative study, bioidentical hormones started trending more in the United States. Additionally, the WHI shifted its focus to concentrate on researching bioidentical hormone risks. For additional information regarding our Bioidentical Hormone Replacement Therapy Program, click here.
Benefits of Bioidentical Hormones
So, what exactly is a bioidentical hormone? It is molecularly IDENTICAL to what the human body naturally produces. The Women’s Health Initiative study on bioidenticals showed that not only are they safer and have fewer hormone replacement therapy risks, but they can also be beneficial to women’s health. The findings include:
Studies show that bioidentical progesterone can reduce blood pressure in some hypertensive women, as well as ease symptoms of water retention. Progesterone can also improve microcirculation in the body.
Synthetic estrogens are known to increase the risk of blood clots, raise blood pressure, and increase stroke risk. Bioidentical estrogens have not shown any increased risk, nor have they increased cholesterol formation. Bioidentical progesterone helps to block cholesterol formation.
Synthetic progestins increase the extent of atherosclerosis in coronary arteries and suppress the protective effect of estrogen on an arterial injury. Conversely, in two of the studies completed on bioidentical estrogen/progesterone therapy, these combinations protected against coronary hyper-reactivity and subsequent vasospasm. Progesterone and estradiol have also been shown to inhibit cardiac fibroblast growth, which suggests that this combination may help to protect postmenopausal women against cardiovascular disease.
Bioidentical progesterone has also been shown to be safe with regard to lipid metabolism and blood clotting.
Overall, the research to date on bioidentical hormone risks has shown they are the preferred therapy to support cardiovascular health.
The study on synthetic hormone replacement therapy showed a 26% increased risk for breast cancer. Conversely, several reviews of the Women’s Health Initiative study show that bioidentical progesterone may have a protective effect on breast tissue. A review by Desreux et al emphasized that progesterone use helps to oppose the proliferative effects of estrogen on the breast.
A study of women with benign breast disease showed no increased risk of cancer using progesterone and noted that women using a progesterone cream in addition to oral progesterone had a decreased risk of breast cancer.
Another large-scale study, called the E3N Cohort, was completed in France. This 12-year study compared different hormone replacement therapies and breast cancer risk in more than 80,000 women. As with the US study, synthetic estrogen and progestogen hormone risks were significant for breast cancer — a risk so great that the combination of synthetic HRT has been deemed carcinogenic regarding breast cancer.
Bioidentical estrogen-only therapy and cancer of the breast continue to be the source of debate. The Women’s Health Initiative showed a decreased risk, but some observational studies have not confirmed this.
The E3N Cohort in France also performed a longer study which doubled the number of cases analyzed, but did not consider bioidentical estrogen-only therapy. They compared synthetic estrogen/progestin use against bioidentical estrogen/progesterone use and again found that the use of synthetics significantly increased breast cancer risk. A major finding suggested that the use of estrogen and progesterone together was much safer than estrogen therapy alone.
All studies have shown that the use of bioidentical progesterone is associated with a diminished risk for breast cancer. However, the French study is the first ever to provide evidence showing that bioidentical combinations of estrogen and progesterone may be the least harmful hormone replacement therapy regarding breast cancer risk.
Estrogen has long been associated with the treatment of osteoporosis. Now that research has shown that bioidentical estrogen doesn’t carry the same hormone replacement therapy risks as the synthetics of the past, it is used to both treat and prevent osteoporosis in postmenopausal women.
The studies of progesterone therapy to treat osteoporosis have had mixed results, though all have deemed it safe. Several studies have shown that progesterone has a positive effect on bone formation and prevention of bone loss, but double-blind placebo studies have yet to show either with progesterone alone.
Some results suggest that using a combination of estrogen and progesterone is the best treatment since they appear to have complementary roles in the maintenance of bone.
The Women’s Health Initiative study results on synthetic estrogen and progestins showed that the risk of dementia more than doubled! However, studies of the effects of bioidenticals on brain health have been positive, especially regarding progesterone.
Bioidentical hormones have many beneficial effects on both the brain and the nervous system. They play a role in the reduction of ischemia and also help to decrease the inflammatory response after a traumatic brain injury.
Progesterone is also showing promise as a viable treatment for neurodegenerative diseases and the preservation of cognitive function with age.
The studies have also demonstrated that estrogen alone does not affect cognitive function either positively or negatively. However, bioidentical estrogens have known benefits on the brain, including improved blood flow and the stimulation of serotonin and norepinephrine, which can impact nerve cell function and mood.
At the offices of Leigh Ann Scott, M.D., we ONLY prescribe bioidentical hormones. Our goal is to help you reach your optimum health by treating you both safely and individually and minimizing any hormone replacement therapy risks.
Free Phone Consultation with Our New Patient Coordinator
The health and safety of our staff and patients is a top priority for all of us at the office of Leigh Ann Scott, M.D. We offer both virtual appointments and in-clinic appointments, whichever you prefer. If you are coming in to see us in person, keep in mind that we maintain the highest standards when it comes to the safety of our patients. We sanitize rooms between patients and shared surfaces, such as door handles, throughout the day.
Should you choose to have a telemedicine appointment, you will still be able to see your provider, just as if she were standing in front of you in the office. You’ll still get the same “connection” as if your appointment was in the clinic. Additionally, we have mobile phlebotomy services available if you do not want to go to a public lab.
Our providers at Leigh Ann Scott, M.D. are devoted to understanding our patients’ health concerns and symptoms. We use scientific-based protocols to find the root cause of hormonal imbalances, thyroid dysfunction, nutritional deficiencies, and more. We believe that spending quality, personalized time with each patient provides the necessary foundation to help you achieve optimal health and wellness. Our system incorporates provider consultation, comprehensive health assessment, and laboratory testing in a warm and caring environment.
Contact our New Patient Coordinator for a Free Phone Consultation. She can explain our protocols and fees in more detail, answer any questions or concerns you have, and explain how our approach can help with hormonal balance, anti-aging, and disease prevention so that you can enjoy a vibrant and healthy life!
For More Information, call our New Patient Coordinator at 972-960-4800
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