Synthetic Non-bio-identical Hormones
Bio-identical hormones have been used for hundreds of years but the technology to deliver these natural hormones painlessly to the patient was not developed until the 1980’s. Before then, pharmaceutical companies created synthetic hormones. The first of the non-bio-identical hormones were conjugated equine estrogens (CEEs) and they were very popular until they became associated with endometrial cancers. Pharmaceutical companies then developed progestin, a non-human form of progesterone. Adding progestin therapy to the conjugated equine (typically horse) estrogens alleviated the cancer concerns but also created side effects. Synthetic progestins increase LDL and decrease HDL cholesterol and drastically diminish SHBG (sex hormone-binding globulin) thus potentially increasing androgenicity in patients as it binds to more receptors in the body. It is estimated that less than 20% of women taking synthetic hormones continue on a long-term basis.
Development of Bio-Identical Hormones
By the late 1980s micronized “human” progesterone became available, enabling BHRT to be released slowly and absorbed by various means. Bio-identical hormones are created and derived from diosgenin, a type of plant oil that is chemically altered to exactly match our human bio-identical steroid hormones. There are more than 15 endogenous steroid hormones within our bodies with unique metabolites that allow enzymes to convert them as needed. We categorize hormones into 5 major groups:
- Estrogens (estrodial (E2), estrone (E1), estriol (E3)
- Mineral corticosteroids (aldosterone)
- Glucocorticoids (cortisone, cortisol)
- Androgens (androstenedione, DHEA, testosterone)
Bio-Identical hormones can be produced to replace any of these types of hormones and can be individualized to each patient’s needs. The various delivery methods available for BHRT include
intra-dermal patches, foam, creams, oral, sublingual troches, and implantable pellets. The dosing can be individualized to the patient and can be delivered in a readily absorbable and gradual rate.
There are very few side effects associated with these hormones as compared to pharmaceutical synthetic hormones. They can flow easily through the steroid pathway and interact naturally to create balance in the body.
Integrative medicine is becoming very popular because the “baby boomers” want to age gracefully, feel younger for longer, and be as active as possible. Hormone deficiencies in men and women have direct relationships with a number of chronic conditions, including fatigue, sleep disorders, mood swings, memory, osteoporosis, and sexual dysfunction. Bio-identical hormones have distinct advantages over their synthetic and non-bio-identical counterparts:
- Bio-identical hormones are individualized and well tolerated with few side effects.
- Bio-identical hormones can be incorporated in a number of delivery systems that allow for controlled absorption and they also regulate blood hormone levels at a steady rate.
- Non-bio-identical hormones contain animal hormones and are not controlled as well in the way that they bind to hormone receptors.
- Non-bio-identical hormones have numerous side effects, which result in poor patient compliance.
- Non-bio-identical hormones cannot flow through the steroid pathway like our natural precursor steroids.
- Bio-identical testosterone, estradiol, and progesterone are FDA approved.