As women age, their bodies go through various changes which can cause adverse effects and affect their day to day activity. Specifically, a hormonal imbalance is one area that can be affected as the body matures. When women go through menopause, their hormones begin to fluctuate, often decreasing rapidly, which can cause several side effects such as hot flashes, insomnia, and night sweats, to name a few. Hormone balancing is a delicate process in which a licensed healthcare provider must be proactive in monitoring their patient blood levels and making the correct necessary hormone dosing changes. One method in improving hormone imbalance is to prescribe a compounded hormone or what is commonly known as bio-identical hormone replacement therapy (BHRT).
What is BHRT?
In a nutshell, BHRT is the process of taking hormones that are identical in molecular structure to those found naturally in humans and compounding them into a form that is easily distributed into the body. BHRT eliminates the unwanted side effects seen with synthetic hormones by using these natural occurring hormones. Synthetic hormones are typically made with other additives which can give rise to unwanted side effects whereas BHRT compounds utilize natural hormones.
Where Do Natural Hormones Come From?
Progesterone and estrogen are two commonly prescribed compounded hormones when it comes to BHRT. Both of these products are extracted from soy or wild yams, from which a laboratory processes and refines these natural products into the desired hormones. Our compounds utilize natural based hormones to help alleviate menopause symptoms by restoring the body’s hormone balance.
Is BHRT Really Natural?
One could argue that these “natural” hormones are not natural because they are refined in the lab instead of obtained directly from “nature”. This is a debate that has been, and will be ongoing for many years. The only true way to obtain “natural” hormones is by consuming plant foods that naturally contain compounds that mimic estrogen in the body. These compounds are called phytoestrogens and the three most common phytoestrogens are isoflavones (soybeans), lignans (flaxseeds) and coumestans (alfalfa sprouts). Because we don’t live in an ideal world where we can consume the right amount of phytoestrogens, sometimes the human body needs an extra boost when it comes to hormone replacement and this is where BHRT comes into play.
What are the Benefits of Using BHRT?
As discussed above, BHRT uses hormones that are refined from natural substances such as wild yams or soy. These hormones don’t contain any additional additives that can cause unwanted side effects as seen with traditional synthetic hormone replacement. Some of these more serious side effects are blood clots and heart disease.
What Forms Do BHRT Come In?
When it comes to dosage forms of compounded BHRT medications, a patient has several options to choose from. The most popular form of BHRT is a topical cream which is applied directly to the skin. A vaginal cream is another way a hormone can be absorbed into the body. Our creams utilize site specific cream bases to allow for best absorption. A third form is a sublingual troche or liquid drop. Both of these forms get absorbed through the cheek and is a convenient way to take a medication by mouth. These compounds also come in a traditional capsule formulation for patients who prefer that method.
Is BHRT Right For Me?
Hormone replacement therapy is not for everyone. The most important thing one can do is to find a healthcare provider who is willing to check your hormone levels and utilize BHRT as a treatment option. You can also talk with other women who have been or are on BHRT and ask them if the compounded hormones are working for them. Once you have done your homework and chosen the right provider, then discuss with your provider all your options. From there your provider can write you a compounded prescription to have your compounding pharmacy customize it in a form that is acceptable for you.
Once on the BHRT and a noticeable difference is seen, in which your menopause symptoms are minimized or eliminated, this is a good indication that BHRT is a viable option for you. Not everyone is molded from a cookie cutter shape and that is why BHRT can be customized to any dosage strength and form to best fit the patient and their needs.
John Watt, PharmD
