The Bio-identical Hormone Solution

By Karen M. Rider, M.A.

“I remember throwing a frying pan at my husband but, to this day, I could not tell you why. What I do remember is how irritability turned into volatile mood swings that would make a werewolf look like a puppy,” Susan Wells* recalls of her initiation into menopause.

The stretch of time just before menses stops completely; peri-menopause is marked by wide ranging symptoms, from mild and harmless to harsh and debilitating. Women can experience changes in skin pigmentation and growth of facial hair. They suffer through cramps and upset stomach, weight gain, insomnia and body aches. And, of course, hot flashes and night sweats. Symptoms can last anywhere from months to years before menstruation ceases. Woman’s initiation into the Wise Crone Years sounds more like a journey into madness. And, for Susan, it nearly was.

“Soon after I turned 41, my symptoms infiltrated all areas of my life. I was too exhausted to spend time with friends or to enjoy a movie with my husband. Even being around people at my sons’ basketball games was tough,” she says. “I was self-conscious about how much I sweat and of how I looked, which was usually haggard. I also had this weirdly heightened sense of smell that just drove me nuts. It changed the way I ate and how I interacted with the world. I felt like I was changing into something un-human.”

Coping with the Change

Despite having consulted with her gynecologist and implementing a variety of holistic practices, Susan’s symptoms wreaked havoc with her life for nearly two years.

“I practiced yoga and took fitness classes a few times a week. I traded coffee for green tea and added soy milk to my diet, which I loathed,” she says.

When she celebrated her 42nd birthday with an extra ten pounds and a migraine, she added herbal supplements, like black cohosh and evening primrose but says “nothing made me feel like me.”

Exhausted from lack of sleep, Susan lost time at her job. She was missing events with her eight-year old twin boys, who just couldn’t fathom what was wrong with Mom.

“I was caught in a vicious cycle where I would avoid activities because I felt so awful. Or, I was afraid I’d overreact to something because I was just so sensitive. It was just easier to keep my distance from everyone else, but try explaining why to your husband and sons.”

Her doctor diagnosed her with depression. “He wanted me to try traditional hormone replacement therapy (HRT) and an antidepressant. I was desperate and my body felt foreign to me,” Susan says. “But I knew I didn’t want that drug cocktail.”

Susan was determined to find another solution to her “menopausal madness.” She learned about Bioidentical Hormone therapy (BIH), a natural alternative to HRT from journal articles she found with the help of a librarian at a medical college near her home in Connecticut.

‘Natural’ Confusion

Respected physician and women’s health specialist, Christiane Northrup, M.D., knows very well the struggle women have when seeking menopausal solutions. Dr. Northrup is the bestselling author of Women’s Bodies, Women’s Wisdom and The Wisdom of Menopause.

“There is a lot of confusion around the definition of ‘natural’ versus ‘bio identical’ versus ‘synthetic’ hormones, Dr. Northrup, says, “Many healthcare providers and researchers don’t appreciate the difference between a progestin, which is a synthetic hormone, and progesterone, which is a bio identical hormone.”

‘Bio identical’ refers to the shape of the molecule itself rather than the source of the hormone. “A bio identical hormone is identical to what is found in the human female body. Progesterone, as opposed to progestin, matches a woman’s body exactly. Supplementing with it may ease mood, sleep and cycle-related issues. Synthetic progestin is actually known to exacerbate peri-menopausal symptoms and post-menopausal symptoms,” Northrup continued. In addition, synthetic progestin can increase the risk of breast cancer, heart disease and stroke.

“Hormones can be marketed as ‘natural’ or ‘plant-based,’ even though they don’t come near to being ‘bioidentical’ to native human female hormones or performing as such in the body,” Dr. Northrup says.

Women also need to be aware that many HRT products are marketed as ‘plant-based’ and ‘natural.’ Just because a product uses molecules that have been derived from a plant does not necessarily mean the molecules match those found in a woman’s body.”

“These other sources are not effectively converted or used in the body and may have actions that are more deleterious than the symptoms the purport to quell or stave off,” Dr. Northrup advises.

Mother Nature Knows Best

So, what makes Bio identical Hormones so special?

“When we take hormonal replacement therapy that doesn’t fit the original design that our cells have evolved to recognize, the end result simply may not feel or act quite right,” explains Dr. Northrup, “Hence, all those side effects, ranging from annoying and uncomfortable to downright dangerous.

“Bioidentical hormones are those whose biochemical structure exactly duplicates those found “naturally” in the human body—that is, the ones whose structure has evolved for millennia. Why mess with a good thing?”

Why Synthetic Hormones Are Prescribed

The molecules naturally produced in the human female body for which we most often seek replacement include the three basic types of estrogen (estrone, estradiol, and estriol); progesterone; testosterone and DHEA, an adrenal precursor to testosterone. These truly “natural” hormones are available by prescription (or, in the case of progesterone and DHEA, over-the-counter in low doses), and can be readily adjusted (titrated) to a woman’s individual needs.

What about research? Most of the mainstream studies have been performed on conventional HRT. In addition, pharmaceutical companies cannot take out a patent on what the majority of human women make effortlessly on a daily basis and, therefore, cannot generate large sums of money by packaging and selling such a product. This may explain why women are commonly offered prescriptions for non-bioidentical forms of HRT, while their efforts to obtain a prescription for bioidentical HRT can be met with varying degrees of skepticism.

“On the other hand,” Northrup points out, “[a company] can patent a unique delivery system for HRT. There are many options for HRT delivered via transdermal skin patches, some of which are bioidentical, including Vivelle, Estraderm, and Climara. These are widely available at your local pharmacy. Often, these are even covered by health insurance.”

For a truly custom BIH formulation, women can seek out a formulary pharmacy. These pharmacies create a compound that’s unique to each individual using bio identical hormones, typically in cream that you rub into your skin. However, this isn’t always covered by insurance. Women can still get great results without a custom formulation, using products like those Dr. Northrup mentions.

“If you are in doubt as to whether a particular product offered to you by prescription is natural, check the label—if it includes “esterified estrogens,” “progestins,” or “progestogens,” the product is essentially not bio identical,” advises Dr. Northrup.

Talk to Your Healthcare Provider

In today’s healthcare climate, it really is the patient’s responsibility to initiate a discussion with her physician about any treatment plan. Susan Wells learned the hard way.

“You can get so stuck in your experience that you can’t even think of options. But you have to if you want any quality of life.”

After Susan learned about BIH, she did a lot of research on her own and relied on the librarians at UConn Medical School to guide her. Then she spoke to her physician and health insurance provider.

Dr. Northrup agrees. “It’s your body, and therefore it’s worth a try to bring questions and any information you discover on your own to your practitioner.”

After The Change

Susan stopped menstruating the year she turned 47. Because she was proactive in dealing with her symptoms, she was able to get her life back on track during the final three years before the The Change was complete.

“I can’t imagine I’d have survived those years without BIH,” she says.

The Change is a part of every woman’s biological, emotional and mental journey into the Wise Crone Years. And, perhaps these years are considered “Wise” because transitioning through this time requires a woman allows herself to know her body differently. It takes time, patience and support to embrace The Change.

Susan’s words of wisdom: “Learn how to be your own best advocate. As hard as it is to talk about what you are experiencing, it is important to confide in your loved ones. Don’t give in to the madness.”

RESOURCES

Many physicians and formulary pharmacists work in partnership with their patients to provide individualized hormone-replacement solutions. Your physician can call a local formulary pharmacy to consult with a knowledgeable pharmacist.

• International Academy of Compounding Pharmacists (IACP) Website has a compounding pharmacy locator feature.

• The Wisdom of Menopause, by Christiane Northrup, M.D.

• Natural Woman Institute. Maintains a database of physicians and health practitioners nationwide that prescribe natural, bio identical hormones.

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FINE PRINT

This information is not intended to treat, diagnose, cure or prevent any disease. All material in this article is provided for educational purposes only. Seek the advice of your physician or other qualified healthcare provider regarding a health condition, and before undertaking any health program.

*Not her real name. Susan Wells is not a patient of, nor has she met Dr. Northrup.

To learn more or to connect with D. Northrup, visit: http://www.drnorthrup.com